Agenda item

The Council’s Head of Housing and Asset Strategy (HH), and Project Manager, Adults’ Care and Support (PMA) delivered a presentation on adaptations to council resident and private ownership properties, to help residents gain an increased level of independence. This included an overview of the assessment process, how funding was spent, issues through the system, the impact of Covid-19, projects underway to increase the supply of adapted homes in the Borough and the utilisation of existing housing stock. The Cabinet Member for Social Care and Health Integration (CM) also emphasised the importance of managing the expectations of residents, by having open conversations with them at the beginning of the adaptations process about their requirements, realistic objectives and the Council’s adaptations budget.

In response to a suggestion from the Chair relating to the Council ‘growing its own’ occupational therapists (OTs) due to a national OT shortage, the CM stated that the Council was exploring the potential to establish its own OT course, along with Coventry University London (CUL). CUL would run the course and the Council would use the apprenticeship levy to enable it to offer a salary to those in training. The CM hoped that this course would be established from Autumn 2021. The Council was also exploring the option of working with North East London NHS Foundation Trust (NELFT) and neighbouring boroughs, to ensure that the course could gather the numbers required to run and more people could benefit from the offer.

In response to further questions from Members, the PMA and the Operational Director for ACS stated that:

• A social care assessment would be the first stage in helping to support someone who had an immediate need for an adaptation. The adaptation would be the next stage to help them to reach their independence.
• The adaptations waiting list, which was based on the level of need, was assessed on a regular basis. The team would try to prioritise those deemed to be in more need; however, this could sometimes prove difficult depending on the adaptation itself. There were various stages within the adaptations process where delays could occur, such as through the planning process, architects or neighbour disputes. The team would facilitate the process and try to ensure that the adaptation was completed as quickly as possible.
• The Dynamic Purchasing System (DPS) was a commissioning tool that sat within the Commissioning service. Details of a job for works could be uploaded to the system and contractors could bid for that job. The team would then review the bids that came through and select the most viable option, and all bidding contractors would already be on the Council’s approved framework. For a long time, the Council had been in a situation whereby it had had to wait for Barking and Dagenham Management Services (BDMS) to take on adaptations works, and this had caused quite a backlog of work. The DPS had helped significantly in reducing this backlog, especially considering the shortage of companies able to undertake such work, and the Council was expecting the backlog to reduce further over the coming months.
• A frequent obstacle to works being completed, was clients cancelling their adaptations. Whilst there was not a main reason for this, the team tried to collect information around the reasons for cancellation, such as the client’s financial assessment requiring them to pay a higher contribution for their adaptation than they may wish to pay.
• The wait time for assessments differed over the year. During timeframes where there was a higher number of hospital discharges, such as the winter period, the service faced increased pressure, resulting in longer wait times. Nevertheless, the wait time always averaged between 4 to 8 weeks. Current pressures on the service were largely attributed to Covid-19, with more residents asking for adaptations. The team’s OT manager was very good at assessing the Council’s waiting list, actively working through it and ensuring that contact with the resident was made wherever a risk had been managed.
• Choice and control were key parts of the adaptations process and the team would talk to the individual about their adaptation preference. It was very often the case that the individual’s preference would exceed the level of support deemed appropriate for their needs. The OT would give their professional view of what was required and explain that the individual could “top up” their adaptation to ensure that it was more to their preference and liking. Furthermore, very often, the provision requested might not be safe. In this situation, OTs ensured that safety was a top priority and would advise the resident accordingly.

In response to a question, the Chair stated that those present were unlikely to be able to account fully for the reasons behind the long delays in BDMS works completion times, and that the Committee may need to look into this. The CM stated that as she sat on the Shareholder Panel, she was aware that BDMS had a large backlog of ordinary repairs to undertake and that this was why the decision was taken to temporarily outsource current adaptations whilst the company dealt with its backlog, as the Council did not want further delays. The Chair requested further information around waiting times before the pandemic, as well as what could be done to improve these going forward.

In response to further questions from Members, it was stated that:

• When the team purchased an adaptation such as a stairlift, it was also purchasing the service that went with it. It usually aimed for the highest specification service, ensuring a faster callout response time if there was a malfunction, for example. It was essential that the team monitored such performance.
• There were regular meetings between Council commissioners, the Adaptations team and BDMS to review the backlog of works. There would also be ongoing conversations around how the DPS service could be used to manage the workload going forward and currently. The team would also report back to the Committee on the numbers of cancellations experienced by the service. A new Chief Executive Officer had joined BDMS and if the Council felt that a better service could be offered by requesting that BDMS continue to outsource its adaptations work, then this could be looked into once the current backlog had been addressed.
• Expectations around the length of time required to complete adaptations works needed to be managed, as works on average could take around six months to complete.
• The 139-week example of the longest wait to start work through BDMS was due to a neighbour dispute.

In response to questions from Members, the HH stated that:

• The new-builds that the Council was receiving from Be First were going to Reside, and the planning policy for the London Plan ensured that ten percent of new schemes were wheelchair-accessible. The team was working closely with ASC to ensure that unit sizes could be better specified, as well as with other housebuilders in the Borough, to ensure greater accessibility.
• More complete data had been gathered as a result of reviewing the adaptations waiting list, which could better inform works going forward.

The CM stated that further conversations would also be had around specialist housing and bringing residents back in Borough, citing the redevelopment of Brocklebank Lodge and the desire to undertake similar developments.

The Chair emphasised the need to plan ahead for sufficient quantities of specialist accommodation and suggested that work be undertaken to look into the properties that the Council could build now, to ensure there would be enough specialist housing and greater cost-effectiveness for the Council. The OD noted that the number of residents waiting for accommodation was not as high as originally thought following a waiting list review, and also that the Council had to be smarter with properties that had been adapted when it came to moving new tenants into these.