Agenda item

The Panel received a report which set out how the Occupational Therapy (OT) Aids and Adaptions service operated and how it interfaced with Housing. The report provided an overview and service offer across Adults and Children’s services, with a focus on council housing stock, and the impact on council tenants. The report was introduced by Jahedur Rahman, Director of Housing, Christian Carlisle, AD for Asset Management, and Alexandra Domingue, Commissioning Programme Manager. Also present for this item were Cllr Williams, Cabinet Member for Housing Planning,  and Cllr Das Neves, Cabinet Member for Health, Social Care and Wellbeing. The following arose during the discussion of this item:

a.    The Chair sought clarification about the £1k threshold for minor versus major works and whether this was across all tenures, and whether it was means tested. In response, officers advised that all works below £1k were not means tested. The organisation was reviewing means testing for works over £1k. Officers clarified that the threshold was £1k in total, so this would include a package of smaller jobs that added up to that amount. Cllr Das Neves advised that nationally the threshold for when means testing might be used tended to be around £30k.

b.    In response to a question about a drop in the number of cases in 2023/24 compared to the previous year, officers advised that it was possible this drop reflected a higher percentage of non-Council properties being fitted for aids and adaptions that year. Officers also set out that there were some resourcing issues around that time, which have subsequently been rectified, including the recruitment of additional surveyors.

c.    In response to a question, officers advised that the Housing Aids and Adaptions Policy was in draft and was being reviewed by Housing colleagues. It was anticipated this would be ready in a few months.

d.    In response to a question, officers advised that the CQC did an inspection of Adult Social Care and in general they had positive comments about OT, but were concerned about things like waiting lists. The Adults Health Scrutiny Panel had also asked officers to evidence how they were incorporating the voice of the residents in this. The Director of Housing advised that any policy that went to Cabinet for Approval would also go to the Resident Voice Board first for their feedback and consultation.

e.    The Panel queried whether aids and adaptions were carried out on to housing association properties. In response, officers advised that the aids and adaptions were carried out for the residents rather than the provider, so yes work was done on housing association properties, but their permission was needed.

f.     In response to a question about caseloads, officers advised that the number of cases was down to around 350 and that this was specific to the OT Sensory team. Those people on the waiting list were very likely to have already been seen by the OT Duty team and offered minor adjustments.

g.    In reference to recruitment of Occupational Therapists, officers acknowledged that this was a national issue and that work was being done to look at this. Officers confirmed that they did have an apprenticeship currently in place in that team.

h.    The Panel sought clarification about reason that the volumes for the OT Duty Team were much lower that the OT Sensory team in 2024/25 and whether this was a result of the Duty team being able to discharge cases. In response, officers advised that it was a combination of the fact that the data only came in at the end of 2024 and that the OT Duty team was able to see people more quickly. They’re timescales were to see someone within two weeks and for the assessment to be made two weeks after that. The OT Duty team were able to make determinations about short term equipment and would refer more complex cases to the OT Sensory team. Officers advised that the OT Duty team were fully functioning by October 2024 and that this had had a big impact on being able to clear the backlog. The service had also been able to deploy some external resources to clear the backlog.

i.      The Panel queried the fact that costs had increased significantly in 2023/24 despite the number of cases going down and questioned whether this was down to the complexity of the cases. In response, officers advised that this was during the cost of living crisis and that construction costs went up dramatically. Officers also advised that with the backlog in cases it was likely that people’s needs had become more complex if they had been waiting without any intermediary intervention taking place.

j.      The Panel sought clarification about whether aids and adaptations works were only carried out in a person’s home or whether it was possible to carry out works in front gardens or to the pavement outside their homes. In response, officers advised that the works could be external to the property, provided they owned the land. The works undertaken would be based on their assessed eligible need under the Care Act. Works to the pavement would require the consent of the highways authority.

k.    In response to a question, officers advised that they were not clear about when they would be re-inspected by the CQC, but would expect this to be around 12 months later. It was cautioned that the CQC had well publicised capacity issues which may affect the timescales for re-inspection. Officers advised that there was a three year improvement plan in place.

l.      The Panel sought clarification about the areas of improvement that officers felt the service needed to focus on. In response, officers advised that there was a huge opportunity for strengthening integration with health colleagues in areas like hospital avoidance. Officers also identified the need to work with residents and to  offer clear information and advice. It was also commented that the service would like to see even more local people recruited into social care in Haringey.

m.  The Panel queried about the burden of funding and how the equity question could be resolved around funding. In response, Cllr Das Neves advised that equity was an important part of everything the organisation did. The locality model split the borough into three areas – central, east and west. The CQC welcomed this approach as part of their inspection and the fact that it allowed the Council to put more resources in greater areas of need. The Cabinet Member advised that if there was a magic money tree she would like to see greater investment in more preventative work at an earlier stage, as well as more work to address health inequalities. The Cabinet Member advised that NHS colleagues had set out that Haringey had around 20% more people living with two or more conditions than some other London boroughs.

n.    In response to a question, officers recognised that there had been problems historically around updating the asset management register when adaptations had been carried out. Officers advised that a piece of work had been undertaken over the past nine months to ensure that records were updated when an adaptation was carried out.  Officers commented that their preference would be that an adapted property was allocated to someone who needed that adaptation when it became that property became empty, rather than the adaptation being removed and the property allocated to general needs housing.

RESOLVED

That the report was noted.