Agenda item

(To receive a report by Roz Cordy, Interim Assistant Director – Adult Frailty and Long Term Conditions, Gareth Everton, Head of Integration and Transformation and Prashant Agrawal, Partnership Manager, LCES, which invites the Committee to note progress supports the in principle plans for future alignment of occupational therapy, DFG and LCES services through a Good Homes Agency)

During this item, Councillor T A Carter declared a personal interest having previously accessed the service.

Consideration be given to a report by the Assistant Director - Prevention and Early Intervention, which provided an update on the three areas of the Occupational Therapy, Disabled Facilities Grants and the Lincolnshire Community Equipment Service.

Covid-19 had impacted the delivery of services but services had been maintained throughout and improvements had been made in some areas as a result  of the pandemic.

The Committee was advised that the current system for occupational therapy and equipment services was complicated, disjointed and did not provide a service that aimed to help people stay independent and well when coming home from hospital.  There was an ambition within the corporate strategy to make the system simpler in order to improve outcomes and improve timeliness of support and delivery as well as a need to ensure that support was not just isolated to the specialised equipment but a wider vision and longer term aspirations had been considered where appropriate. Members were referred to page 36 which provided further information about the principles that had been tested through the Housing, Health and Care Delivery Group which included a wide range of partner organisations. A project officer had been appointed to oversee the work.

There was also a number of considerations as to what should be included within the Council’s equipment service, prior to the re-commissioning of the service, such as whether stair lifts could be provided.  

The service was moving towards implementing service change. The Head of Integration and Transformation acknowledged the work that been carried out on the project to develop a discretionary housing policy which would sit alongside disabled facilities grants, which were covered by a quite specific guidance. It was noted that Council’s had flexibilities which they could use in relation to their discretionary powers it was reported that at the last Housing, Health and Care delivery group all seven District Councils have signed up to a discretionary housing policy and that means that they were able to act flexibly with the funding that they had allocated to support hospital discharge.. The changes also included proposals in the re-commissioning of the equipment service for the incentivised the return of equipment which represented significant cash value.

Members considered the report and during the discussion the following points were noted:

• A benchmarking exercise had been undertaken with neighbouring authorities to investigate the level of return of equipment and had concluded that a similar incentivised service had been successful in Hull. In the immediate short term, the service would run an equipment amnesty using  collection points at the seven recycling centres in the County where members could deposit small pieces of equipment which were not necessarily financially viable for the Council to collect. Efforts would be made to ensure that the public were aware of the new service as it was beneficial for the council’s green agenda as well as having a positive cost impact. Members welcomed the introduction of the incentivised return of equipment.
• It was confirmed that there was currently an element in the service in which larger pieces of equipment were brought back by providers.
• The Executive Councillor for Adult Care and Public Health thanked the officers for their hard work  carried out on the Community Equipment Service.
• It was suggested that improvements could be made to the occupational therapy service to ensure it was more personalised and consider the wider impact of peoples lives.
• Officers acknowledged that visits from the equipment service and occupational therapy service were sometimes separate as the referral routes were separate. The Committee was assured that where possible, referrals were joined up to minimise visits.
• The Council was leading on work with occupational therapists to implement a more seamless pathway, working with occupational therapy colleagues at the hospitals and in primary care networks to ensure a more joined up and person centred approach.
• Members welcomed the joining up of services.
• It was suggested that more investment into more extra care housing which would already provide many of the adaptions and facilities needed as standard may be more beneficial over the long term and would meet the needs of more people.
• Officers sometimes had issues as they were working under legislation that was  out of date however where possible the Council lobbied for change. The Chairman highlighted the opportunity for the Committee to be involved in lobbying for change on issues which were effecting the Council
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• The Head of Integration and Transformation emphasised the importance of working together with other organisations to address the wider conversation. Officers acknowledged the need for more extra care housing but recognised that the situation was complex, and many people wished to remain in their own homes due to social connections and family support networks. There was a risk in moving people that they would become more dependent on services and perhaps lose those.
• District Council’s had initially been  hesitant to be  flexible with their DFG budgets as they had to deliver their mandatory grants. Gathering robust evidence meant District Council’s now had the confidence that they could have a discretionary policy which they used to fund works without losing the ability  to fulfil their mandatory commitment.
• Funding for the Better Care Fund was typically received around December, which was late in the financial year, meaning that district council’s were usually unable to spend all of the money in the same financial year.
• Council’s were not generally able to obtain funding for assisted housing schemes through Section 106 agreements, however individual District Council’s sometimes worked with developers on new housing developments to build houses with adaptations in the initial stages, if they knew of somebody who was able to apply for a disabled facilities grant. Relationships between local planning authorities and local builders were beneficial to the process.
• The County Council worked with some District Council’s to allocate monies received from section 106 agreements to support extra care contributions.
• It was suggested that it would be useful to have a way of measuring equipment to ensure the Council were providing an efficient equipment and adaption service.

RESOLVED:

1. That the report be received and the comments made be noted;

That support be given to the in principle plans for future alignment of occupational therapy, DFG and LCES services through a Good Homes Agency.