Meeting documents

Communities Scrutiny Sub-Committee (DCC)
Monday 28 November 2005

            Meeting: Communities Scrutiny Sub-Committee (County Hall, Durham - Committee Room 1a - 28/11/2005 10:00:00 AM)

                  Item: A5 Aids and Adaptations Review


Scrutiny Sub-Committee to Promote Strong, Healthy and Safe Communities

28 November 2005

Aids and Adaptations Service

Report of Head of Overview and Scrutiny

Purpose of Report

1. To explain that a further review meeting with Service Users and Carers has taken place to consider progress in relation to the Aids and Adaptations Service.


2. The Scrutiny members identified the Aids and Adaptations Service as a key element of improving independence for County Durham residents. When this Service was investigated about three years ago, there was a recognised need to improve the Service in a number of areas to make it more responsive to Service User and Carer needs.

3. On a regular basis, Scrutiny members have met with Service Users and Carers to review progress. The latest meeting took place on the 7 th October at Newton Aycliffe. This time, the meeting was held jointly with Darlington Borough Council. This was an opportunity to compare Durham’s service.

4. A copy of the notes of the meeting held on the 7th October is attached. A summary of the main issues raised appears at the end of the report in paragraph 4.

5. Following a number of comments made about the ‘One Stop Shop’ telephone service - 0845 8505010 - County Council members have been asked whether they have any experience of this service which they would like to pass on to the Sub-Committee.

6. A number of County Council members will also be attending the Service Users and Carers Forum on the 22 nd November at the Chester-le-Street Riverside. It may be that some of the issues raised at the Newton Aycliffe meeting will also be raised at this meeting.


7. You are asked to note this report.
Contact: Ian Mackenzie Tel: 0191 383 3506


7 OCTOBER 2005
Joint Chairs:

Councillor Nicholls Councillor Copeland
Durham County Council Darlington Borough Council

Others Present :

Durham County Council
Councillor Armstrong, Bowman, Henderson, Magee and Robinson.

Durham County Council Co-opted Member
Mr M Williams, Mr K Ibbotson and Ms S Stevens

Parent Governor Representative Durham County Council
Mrs A Tallentire

Officers from Durham County Council
Caroline Molloy - Social Care and Health
John Thornberry - Social Care and Health
Linda Vevers - Social Care and Health

Darlington Borough Council
Councillor Flowers

Darlington Borough Council Officers
Jane Breheny
K Guram
C Thomas
N Simpson

Other Organisations/Associations
Jane Hartley - Pioneering Care Partnership
Diane Hancock - Home Independence Service
Pauline Morpett - County Durham Society for the Blind
Linda Curtis - County Durham Society for the Blind
Sean McEneamy - Darlington PCT

Service User and Carers

Michael White
Michael Dalton
Leslie Clarke
Jackie Clarke
Sheila Grant
C A Briggs
K McMillian
D Crosby
J Welch
M Welch
K Keogan
B Hall

Apologies were received from Councillors Carr, Ebbatson, Porter, Vasey and Mrs A Atkinson (Parent Governor representative).

1. Welcome and Introduction

The Joint Chairs welcomed everyone to this joint meeting between Durham and Darlington and service users and carers they explained that the meeting provided the opportunity for comparisons in the way in which services are delivered and feedback from users and carers as to how the service currently meets their requirements.

2. Durham County Council

(a) Presentation and report from Durham’s Social Care and Health Service

John Thornberry, Head of Adult Services, referred members and representatives to the report which had previously been circulated (for copy see file) and then gave a presentation highlighting the following (for copy see file).
  • Cost, quality and quantity
  • Demand, resources, efficiency and outcomes
  • Outcomes
  • Understanding demand
  • Resources
  • Efficiencies to date
  • Hot spots
  • The way forward
It was emphasised that the service assesses more than 6,000 people per annum, many of whom had very complex needs. In addition, the referrals for occupational therapists have currently increased by 10%.

With reference to the way forward for the service it was suggested that the following is needed:-
  • A whole system approach
  • A single community equipment board properly constituted and supported
  • A pooled budget
  • Agreed commissioning and providing arrangements
  • More funding to meet expectations and increased demand
The meeting was informed by a Carer that she had a bathroom extension to her home which involved the fitting of a new bath, unfortunately the wrong bath was delivered but it took months for the appropriate equipment to arrive. It was highlighted that guidance should have been given on how long the process would take.

A user of the Service commented that in relation to the supply of equipment, due to changes in the tendering process, rather than equipment being repaired new equipment had to be ordered which seemed wasteful.

John Thornberry responded that Home Equipment via the main responsibility of the Health Authority who have a decontamination unit which allows for recycling however he agreed that there is a need to bring together an integrated approach and look at the current tendering processes.

With reference to wheelchairs, a user informed the Group that he had received a chair via the voucher scheme. He had now been reassessed for a powerchair, however, the Commissioner had stated that vouchers cannot be used for the purchase of powerchairs. The user would have rather had vouchers to be used towards the maintenance of his existing wheelchair rather than the purchase of a new chair.

John Thornberry commented that more and more people are buying their own equipment but sometimes after the purchase they realise that they often cannot get it into their own homes, as they have not considered the adaptations which need to be made i.e. ramps, etc. therefore the cost to the authority is often increased.

In relation to partner agencies they often do not have the funding available to provide the necessary adaptations for the equipment purchased privately.

Councillor Henderson commented that in many cases if houses which have been modified with adaptations become vacant, the equipment is quite often taken out. He asked why could the property not be given to a person requiring those aids and adaptations.

Sheila Grant (a service user and carer) highlighted that one of the major problems is that the individual is not kept informed as to what is happening when they have requested aids or adaptations. She emphasised that carers are under a great deal of pressure, therefore increased anxiety due to lack of information should be avoided.

She explained that she had experienced particular problems regarding the delivering of a wheelchair for her husband. This mainly concerned lack of
co-ordination and provision of information.

John Thornberry responded that the provision of wheelchairs is the responsibility of the Health Authority. He was sorry about the problems Sheila had experienced, however he highlighted that a good service is being given to a large number of people.

Councillor Bowman commented that a lady in her area who she had helped wanted to stay in her house rather than move to a bungalow and with the help of various agencies, the appropriate adaptations were made including a ramp (which was quite steep due to the design of the garden). However she had received a phone call from the lady requesting that the ramp be removed. She emphasised how good the agencies had been, taking a coordinated approach to meet her individual needs.

Concern was expressed by one user and carer that as her husband and herself did not use the service on a regular basis, their records had been lost from the system. In addition, a social worker had commented that this could happen again which had concerned her.

The group was informed that records should not go missing as the system is computerised and whilst the file may be inactive it would be within the system.

With reference to equipment the group was informed that a significant amount of equipment is not returned. John Thornberry commented that a lot of equipment is now returned and in the last 3 years the systems for the returning of equipment had improved significantly.

The issue of equity in referral times, across the County was raised. John Thornberry responded that there are backlogs in some areas, however, the delays are caused when occupational therapists for whatever reason are not available. He continued that each occupational therapist deals with approximately 300 referrals per month so holidays, sickness, etc. immediately produce a backlog. He suggested that one answer to this problem would be a Peripatetic Team that moved around the County providing cover where it was needed, however, there is a resource issue.

3. Darlington Borough Council

(a) Presentation from Darlington Adult Services

Councillor Copeland (Darlington Borough Council) informed the Group that the service had changed significantly in the last 2 years to meet the increasing demand.

Jane Breheny, Commissioning Manager, informed the group that since January 2005 there have been several major changes at The Home Equipment Loans Service. These changes have had considerable impact on both Darlington Social Services and Darlington Primary Care Trust, these include:-

(1) The introduction of a new catalogue with more items classed as ‘standard’.

(2) The Home Equipment Loans has installed a new computer system, which is designed to provide more detailed information around targets, costs and performance.

(3) The introduction of ‘electronic ordering’ with Darlington Social Services Occupational Therapists being chosen as one of the test sites going on line in July.

(4) The introduction of a new charging system where charges are incurred for each individual piece of equipment.

The group was then referred to the paragraph in the report which gave an update on any outstanding recommendations from the original report in April 2003.

The recommendations were as follows:-
  • That support be given to widening the remit of the self-assessment process and the introduction of trusted assessors.
  • A detailed single assessment process training programme has been delivered to health and social care staff with implementation having commenced on a phased basis. Further work is planned in relation to self-assessment processes.
  • That the joint working relationship between occupational therapists in health and social services continue in developing a fully integrated service. Joint working continues to be promoted at all levels.
  • That the development of a community equipment shop be integrated into plans for the new PCT development.
Darlington Social Services are leading the development of a community equipment shop with the new jointly developed site at Hundens Rehabilitation Centre at Hundens Lane. The development includes a purpose built community equipment shop and assessment area.

Councillor Armstrong commented that he was interested in how Darlington worked with the PCT - was it a pooled budget.

The group was informed that it is not currently a pooled budget although the authority is working towards this.

In relation to coordinated service provision the group was informed that Staffordshire and Harringey had looked at the merits of having a virtual team whereby all those involved with a particular client would come together to discuss potential issues.

In addition, Harringey had a disabled housing register which allowed for accommodation with adaptations to be reused.

John Thornberry continued that the authority is constantly looking at good practice both nationally and internationally.

A representative from County Durham Society for the Blind informed the group that they now have a resource centre in Durham which has a high level of demand.

She emphasised that there is no Home Loan Service for the visually impaired as a lot of the equipment available is not funded therefore individuals have to purchase them privately.

John Thornberry suggested that a future meeting should perhaps focus more on the sensory impaired.

4. Summary of Main Issues
  • Further consideration of the performance of the Social Care Direct ‘One Stop’ Telephone Service. There was a feeling from some Service Users that it was not ‘direct’ and that a ring back service might be more appropriate sometimes.
  • A need to engender a feeling of confidence in the caring services particularly for those Service Users and Carers who have significant needs.
  • A need to reinforce the importance of informing Service Users and Carers where there will be a delay in the delivery of services.
  • A need to assist Service Users and Carers to choose the appropriate contact for their service needs which might be a direct approach to a provider such as the Home Independence Centre.
  • A need to reduce waste and inefficiency.
  • A need to consider the equity of services across the County and, in particular, the disparity of waiting times for occupational therapy assessments.


 Aids and Adaptations Service - 28 Nov..pdf