Agenda item

To provide an update on the provision of aids and adaptations following the recommendations made by the Panel in September 2022. Minutes from the September 2022 meeting are available to view at: https://www.minutes.haringey.gov.uk/mgAi.aspx?ID=74001

Vicky Murphy noted that significant additional work had been carried out in the area of Aids & Adaptations/Disabled Facilities Grant (DFG) since the previous scrutiny item on this in September 2022. Janet Bradbury, new interim Head of Service covering aids and adaptations, noted that the issues raised by the Scrutiny Panel had largely concerned delays and communication issues. She then presented slides on the recent work which included the following key points:

• Standard letters had been developed and sent to service users at every stage of the process and the wording of these letters had been checked with Disability Action Haringey and they included information about expected timescales and contact details.
• Everyone on the waiting list as of October 2022 (approximately 800 people) received a personal phone call to check that they understood the process and the progress of their case.
• Delays had been reduced through additional capacity in surveying and assessment and the number of people waiting for an adaptation to be completed had reduced from 812 in August 2022 to 448 in February 2023 and it was expected that this would be reduced further through external contracting. Of the remaining 448 people:

o   66 had seen the work completed but the review stage was still underway;

o   in 125 cases, the work was in the process of taking place;

o   in 184 cases, surveyors were working to draw up specification, arrange for contractors or putting work out to tender;

o   73 cases were being allocated to an external surveyor. 

• In terms of communications, it had been found that officers did not always provide their contact details after a contact with residents and that some residents were unclear about which phone number they should call. This was a particular problem when there were long delays between stages of the work. Residents could now expect to be provided with officer contact details after every visit.
• Residents were also now proactively being provided with a copy of their support plan unless they specifically said that they didn’t want it. The support plans included details of what had been agreed with the resident, actions being taken and a list of conversations that had occurred.
• Residents waiting for an adaptation to be completed would be proactively contacted by phone every 4-6 weeks to check how they were doing and to update them on expected timescales.
• The next steps involved continuing the ongoing journey of culture change by carrying out a series of workshops involving staff and engaging with service users to improve their experience, deep diving into complaints and challenging inefficiencies in the system.
• Recruitment was currently being made to occupational therapy and surveyor vacancies, though this was challenging due to current workforce shortages in these areas, particularly for occupational therapists. 
• The team was moving to a new client record system which should allow better tracking of timescales. It was also necessary to improve prioritisation of new referrals according to government guidance.
• The team was looking at adding more detailed information to the Council website and had sought advice on commissioning formal advocacy services to support residents in their requests for adaptations.
• A slide displaying the 11 stages of the full adaptation process illustrated how complex the system was and that this was generally expected to take around 12 months from beginning to end depending on the complexity of the case.

Janet Bradbury and Vicky Murphy then responded to questions from the Panel:

• Cllr Abela asked whether public money was used for adaptations when a property was owned by a private provider. Janet Bradbury explained that the disabled services grant legislation set out the conditions required for state money to be applied for, such as access to the property or making a property safe, and this could be requested irrespective of the ownership of the property.
• Cllr Mason spoke about complex cases that she was aware of, including a case involving overcrowding, and asked how these could be prioritised where necessary. Janet Bradbury referred back to the point made previously about prioritisation, on which there was government guidance, and that it was important to accurately assess the higher risk levels that some people had. There were also now four additional customer care officers which would help with this process and tracking cases more closely. She also clarified that it was not possible to agree to a grant for overcrowding reasons, except in cases where there were two siblings who would usually have been expected to share a room but could not do so due to a disability.
• Cllr Connor expressed surprise that 12 months was seen as an expected timescale for an adaptation to be carried out as she had previously approximated this to be closer to 6 months in cases where nothing went wrong. Janet Bradbury clarified that the government guidance categorised cases as urgent/non-urgent and simple/complex. The shortest target timescales were 55 working days for urgent and simple cases (such as a stairlift) whereas the non-urgent and complex cases were closer to 12 months. For example, the installation of a through floor lift could have a lead-in time of three months from order, so these kind of issues lengthened the overall completion time. There could also be complexities arising from negotiations with residents who may have not have the same views on the alterations required as the professionals involved.
• Asked by Cllr Connor about the likely timescales for the next steps, including the website changes, advocacy and co-design work, Janet Bradbury said that the workshops were expected to begin in April with work proceeding in May and June. Cllr Connor suggested that it would be useful for the Scrutiny Panel to receive a further update after there had been further progress on the website, advocacy, co-design and workforce items perhaps at the beginning of next year. (ACTION) Vicky Murphy indicated that officers were happy to do this, had found the feedback from the Panel useful and would update the Panel on timescales.
• Asked by Cllr Connor how the views of service users would be considered when measuring improvements to the service, Vicky Murphy said that this would include user/lived experience in a multitude of ways, including complaints, user feedback, one-to-one meetings and co-production around the pathways.