Agenda item

To receive an update report on progress towards previous recommendations of the Panel on aids & adaptations.

The recommendations were originally made by the Panel at a meeting in Sep 2022: https://www.minutes.haringey.gov.uk/mgAi.aspx?ID=74001

Previous progress reports on the recommendations were received in:

·         Mar 2023: https://www.minutes.haringey.gov.uk/mgAi.aspx?ID=75471

·         Feb 2024: https://www.minutes.haringey.gov.uk/mgAi.aspx?ID=78855

Cllr Connor introduced this item, noting that this was the fourth report to the Panel on this issue. The Panel had been tracking this closely following a series of recommendations made in 2022 after concerns were expressed by residents about delays and communication issues.

Alexandra Domingue, Commissioning Project Manager, explained that a project board had been established to support implementation of the Panel’s recommendations and that her role had included support and development for the Board. Developments since the most recent update to the Panel in February 2024 included:

• Undertaking benchmarking work with neighbouring local authorities on the Disabled Facilities Grant (DFG) and have incorporated that learning into the team’s work.
• Expanding the Occupational Therapist (OT) adaptations function by appointing an OT Duty Team to triage cases and reduce the number of inappropriate referrals to the main OT Team.
• Improving communications with residents through a 4-6 week contact pathway to update them about the status of their case.
• Reducing waiting lists by commissioning an external team to provide additional support on assessments and support planning processes.
• Use of resident feedback, complaints and Members’ inquiries to improve monitoring of service satisfaction.
• Changing how equipment and adaptations are procured by using the Dynamic Purchasing System.
• Streamlining the commissioning process with a smaller group of suppliers.

Alexandra Domingue then responded to questions from the Panel:

• Asked by Cllr Connor about the current data on cases with delays, Alexandra Domingue explained that the case management system displayed how long individuals had been waiting and that reports were produced and reviewed regularly using this data with cases reallocated according to priority where appropriate. The overall waiting list had been reduced from over 1,000 in September 2024 to a current figure of 388. Over the same time period, the average number of days on the waiting list had been reduced from close to 200 days down to 122 days. The number of assessments completed in a month had increased from 50 to 210. In addition, the number of under-18s on the waiting list had been reduced from 33 to one.
• Cllr Mason reported that, in her experience as a ward Councillor, the number of people contacting her about OT cases and assessments had greatly reduced recently. She noted that the calls still coming through tended to be more complex cases, particularly relating to mental health, and requested further detail on how these cases were dealt with, including liaison with Housing services. Alexandra Domingue highlighted the work on the Older People’s Housing Strategy which had enabled conversations on supporting Council, Housing Association and private tenants by ensuring seamlessness in services. This work was ongoing, but she felt that there were improvements so far in terms of the communications and working together between different teams. Jo Baty, Service Director for Adult Social Services, acknowledged that there was a long way to go in relation to cases where there were multiple layers of complexity. In some cases, there could be several different professionals working with someone and so the Council had made a commitment that there would be a lead professional on aids and adaptation cases so that there would be someone taking ownership for coordination. This would help to improve the tracking of cases and avoid unnecessary delays.
• Cllr Connor requested clarification on the progress towards the improved information sharing highlighted in paragraph 4.6.2 of the report. Alexandra Domingue explained that this was an ongoing piece of work including improvements to internal communications, the sharing of information with residents and working with communications colleagues on the format of communications, including easy read format. Cllr Connor suggested that there should be a future update to the Panel on how the improvements to communications were working in practice. (ACTION)
• Asked by Helena Kania about the timetable for the development of the new case management system referred to in paragraph 4.8.1 of the report, Alexandra Domingue said that a written response would be provided on this. (ACTION) She added that, regardless of the system, it was essential that there was the right management and proactive culture on dealing with complexity and casework.
• Asked by Helena Kania about contact with residents from the named person responsible for their case, Alexandra Domingue explained that management meetings included looking at information such as the number of people on the waiting list and how regularly they had been contacted. This could vary according to resources available which could fluctuate due to the national OT shortage.
• Cllr Peacock asked about equipment used through the Connected Care service as an emergency alert after a fall. Jo Baty agreed to look into the specific case referred to outside of the meeting. Sara Sutton, Corporate Director for Adults, Housing & Health, noted that a review on the Connected Care service was expected to be carried out in 6-12 months’ time.
• Cllr O’Donovan requested further details about the next steps for the implementation of the recommendations set out in section 4 of the report. Alexandra Domingue noted that, on the pilot project for more regular contact with residents, she was directly involved in this programme, meeting fortnightly with the team and could provide a written update with further details. (ACTION) Improvements on advocacy were being considered through the Commissioning Co-production group and the team had worked closely with Disability Action Haringey to ensure that they had sufficient capacity. Cllr Connor suggested that it would be useful for the Panel to receive further details about the work of the project board and the Commissioning Co-production group. (ACTION)
• Cllr Iyngkaran queried the inaccuracies in notes from meetings between officers and residents and suggested the use of AI tools to assist with the accuracy of transcriptions. Jo Baty noted that part of the efficiencies work included the use of tools such as AI to reduce the administrative burden on staff and free them up to use their core skills, so she agreed with the potential benefits of being creative in the area. It may therefore be possible to bring a further update on this area of work to the Panel in future. (ACTION) Sara Sutton noted that they had recently launched a translation and interpreting service with embedded assistance which was another example of utilising new technology. 
• Asked by Cllr Iyngkaran about the triaging of cases, Alexandra Domingue explained that triaging was based on priority so there was an urgent waiting list and a longer-term waiting list.

Nazarella Scianguetta, a member of the Haringey Wheelchair User Group, then spoke about the difficulties experienced by residents on housing and OT issues. She felt that OTs did not always listen to the residents about their requirements which risked resources being wasted on unsuitable adaptations. She also commented that it could be difficult for residents to make contact with the right person when they needed to and that the notes of the meetings involving residents were sometimes inaccurate.

Alexandra Domingue responded that this was not the standard that the department held itself to and committed to looking at the individual circumstances of the cases described. She added that details of assessments or support plans should be shared and agreed upon with the resident and their advocate/carer and that the implementation of practices such as this should be overseen by a team manager. Once agreement had been reached then this would be transferred to a surveyor who would agree with a construction organisation on how the works would be undertaken. At the end of the process, the OT then checked that the works had been carried out to the agreed specification.

Sara Sutton, as the new Corporate Director for Adults, Housing & Health from 1^st April 2025, commented that she was aware of Nazarella Scianguetta’s case and that it was important to have an understanding of cases such as this as an opportunity for learning and reflection, noting that access to suitable accommodation was a critical issue for the Council.

With regards to communications, Jo Baty spoke about improvements to the culture of the service, including the tone and engagement with residents being consistently good and anything written about a resident’s case being signed off by them.

Cllr Connor summarised key points highlighted by the Panel to be included in any future updates:

• Further details about the work of the project board and the Commissioning Co-production group and progress against the Panel’s previous recommendations.
• Progress on innovative approaches using new technologies including AI.
• Accurately capturing the voice of residents in the discussions on their case.
• Improvements on contracts and commissioning, including through the Dynamic Purchasing System.
• Monitoring and tracking of case progress, the use of the support plan as progress is made and how the resident is included in that process.

Cllr Lucia das Neves, Cabinet Member for Health, Social Care and Wellbeing suggested that, given the relevance of the discussion on aids and adaptations to the bespoke housing programme, the Panel could consider some joint scrutiny work with the Housing, Planning and Development Scrutiny Panel. (ACTION)