Measuring the benefits of home adaptations

This article was written by Doug Stem, development manager at Foundations, for LocalGov

It’s now 25 years since the Disabled Facilities Grant (DFG) was introduced by the Government to fund adaptations that enable people to continue to live in their own homes. Since then it has had a huge impact on hundreds of thousands of lives, with around £1.4bn being spent across England in the last five years.

DFGs fund a whole range of work from ramps and stairlifts to wet floor rooms and extensions, reducing the risk of people being admitted into care or hospital as well as enhancing their wellbeing by increasing their independence. Adaptations also allow informal carers to cope better and reduce the risk of breakdowns in support.

Our research has revealed that people who do need to move into residential care having previously adapted their home with the help of a DFG have delayed the move by four years on average compared with those who haven’t had a DFG. At around £29,000 per year for a residential care placement, this can be a significant saving.

It’s common sense that a well-adapted home will allow someone with a disability to stay living there longer but in the current financial climate, all public spending is under review and DFGs are no different. It is therefore essential that all parties involved in delivery look at measuring performance and in particular the outcomes achieved for the person in receipt of the grant. Whether or not the grant is around for another quarter of a century will be down to all concerned ensuring the benefits it brings are recognised far and wide.

Local authorities and home improvement agencies are at the forefront of the challenge to measure the efficacy of DFGs carried out in their areas. However, local health services benefit greatly from the increased wellbeing experienced by recipients being able to live in a well-adapted property.

DFG delivery usually involves a number of organisations and departments and this complicates how data is collected. It’s vital this information is recorded in order to build the case for continuing funding. The evidence we do have demonstrates how adaptations funded by the grant improve quality of life as well as reducing care costs, accidents and falls.

In many ways DFG was ahead of its time and the preventative ethos that lies at its heart is more relevant today than ever before. Local authorities are working hard with partners in the NHS and third sector to integrate health and social care, bring early intervention and prevention to the fore and reduce demand on frontline services.

Housing support is a vital part of the equation, which is why the Care Act places a responsibility on councils to ensure people have suitable living accommodation that supports their wellbeing. Home improvement agencies are a key part of meeting this challenge as the only service that can help people living in any tenure or type of housing in most areas.

Funding for DFG has been transferred to the pooled Better Care Fund, which brings new opportunities. It’s a chance to ensure it is part of an integrated package of support provided to vulnerable people along with other preventative services such as reablement and assistive technology. It is a condition of the Better Care Fund that health and social care recording systems are joined up through the use of the NHS Number – we are recommending that the NHS Number is recorded for all preventative services, including the DFG, to allow the impact of those interventions to be measured as part of a person centred approach to delivery.

This transition also fits with the general direction of travel towards local authorities becoming commissioners rather than providers of services, highlighting the importance of performance and outcome monitoring. Our research can help to build the evidence base that is so important as part of the insight required for good commissioning. Foundations is here to help. We have been tasked by Government to help improve service delivery for customers and are keen to meet with local commissioners interested in innovation and change. We offer free DFG audits as well as more intensive system reviews, and can share good practice and advise on reporting models.