Agenda item

The purpose of the report is to inform the Executive of developments in the allocation of the Better Care Fund for home adaptations and suggests proposals for making best use of the funding.

Recommendation

It is recommended to the Council that:-

1.            the Better Care Fund be used to pay for works under the Safe and Warm Grant scheme;

2.            the current delegation 36 be amended to now read as follows “Private Sector Housing Manager to exercise authority to approve payments of up to £5,000 for urgent or minor adaptations and fees associated with disabled adaptations using the Better Care Fund or equivalent funding” and the Scheme of Delegation be amended accordingly;

3.            the current delegation 35 be amended so that the last sentence now reads as follows “any recommendation for a grant exceeding £30,000 to be referred to the Director of Operations for a decision” and the Scheme of Delegation be amended accordingly; and

96.1    From 2015/16, the government funding to local authorities towards the cost of Disabled Facilities Grants (DFGs) and home adaptations has come from the Department of Health (DH) and is paid through the Better Care Fund (BCF). There was a slight increase in the amount of funding received by Waverley Borough Council in 2015/16 (£323,000) and a much more substantial increase was made in 2016/17 (£585,000). The funding was received in full in June 2016. The Spending & Autumn Statement 2015 announced that funding towards DFGs would rise by more than 100% by 2019/20.

96.2    The view of the DH is that the increased funding provides an ideal opportunity to review and improve current systems of working between the NHS, Social Care and Housing, to work towards achieving a shared aim of enabling healthy, safe, independent living at home for disabled and older people. It has highlighted the need for areas to think strategically about the use of home aids, adaptations and use of technologies to support people in their own homes. One area of concern is the varying levels of waiting times for adaptations around the country and the need to minimise this. Further guidance in the Integration Briefing from Public Health England and Foundations suggests a range of  measures that can be taken to achieve the health and social care outcomes and emphasises that the BCF allocation can be used flexibly to deliver related services to ensure people’s housing is suitable for their needs.

96.3    The ring fencing for use of DFG funding was relaxed in 2008 to include any local authority expenditure incurred under the Regulatory Reform (Housing Assistance) Order 2002 and it was later removed altogether. Delegated authority has been provided to the Private Sector Housing Manager to approve payments of up to £5,000 for urgent adaptations and fees associated with disabled adaptations without the need for formal grant approval.

96.4    The provision of Disabled Facilities Grants remains a mandatory function of the local housing authority. Prior to 2015/16 the DFG allocation was insufficient to meet demand in the Borough and so the Council provided additional funding from its capital budget. However in 2015/16 when the Better Care Fund allocation increased to £323,000, the DFG spend was only £304,000. Prior to the announcement of the increase in BCF for 2016/17, the Council reserved a fund of £28,000 to meet any shortfall in the DFG budget.  Based on current demand the final DFG spend for 2016/17 is likely to be similar to last year.

96.5    In addition the Council provides a discretionary grant, known as the Safe and Warm grant, under its home improvement policy. In 2016/17 the budget for this is £10,000 together with any grant repayments accrued during the year. This grant allows us to provide heating and insulation and remove housing hazards in homes occupied by vulnerable people.

96.6    The main question is how does the Council maximise use of this additional funding to achieve better outcomes for our residents and reduce the impact on health and social care services from hospital/care home admissions, bed-blocking and care packages.

96.7    A further issue of concern is that Surrey County Council has advised they are reviewing their budgets and may reduce or cancel their funding for the Guildford and Waverley Home Improvement Agency (HIA). They requested that we use the Better Care Fund to maintain the funding for the Agency. However the DCLG has stipulated that the BCF can only be used for capital expenses. The HIA is a vital component of the grant process at Waverley and they administer approximately 90% of the grant spend; without their assistance the process would be slower and less productive. The National Body for Home Improvement Agencies, Foundations, has been commissioned by the Surrey local authorities to carry out a review to identify service delivery models for HIA and Handyperson services and we expect their proposals in the new year.

96.8    There are some measures that can be introduced immediately without the need for change in the home improvement policy:

a)    An agreement has been made with the Social Care Team in Social Services to use the BCF to pay for simple adaptation requests to be sent to private Occupational Therapists for assessment rather than being sent to an external agency. This will help provide much more rapid assessments and should lead to a greater throughput of grants; the current procedure can lead to delays of several months. The use of private OTs also allows better communication through the grant process as they will be local, unlike the external agency. Requests for extensions and major conversions will remain with the Social Care Team.

b)    Use the Better Care Fund to pay for works carried out under the Safe and Warm grant. The works covered by this grant fall entirely within the aims of the Care Act to reduce illness and injuries in the home, thereby reducing hospital and care home admissions and the level of care packages. While the demand for DFGs is currently static, the demand for Safe and Warm grants has already far exceeded the Council’s own budget. An expenditure of £50,000 is quite possible.

c)    Process a greater range of disabled adaptations below £5,000 under the delegated authority mentioned above. This will enable simple adaptations such as ramps and stairlifts to be carried out quickly without going through the cumbersome DFG application process. It will also allow us to install minor equipment (e.g. key clamp rails) more quickly than the Social Care Team is currently able to. This would only be used where it is clear from the means test that the client has a nil contribution.

d)    Top-up funding to major adaptations. The maximum DFG is £30,000 but this level is exceeded where the necessary works involve an extension. Currently the Social Care Team applies to Surrey County Council for top-up funding for the extra cost but it is not clear whether this will continue. Since the increase in BCF comes partly from the removal of the Social Care Capital Grant, it would be reasonable to take over this element of funding. This may also facilitate continued funding of the HIA by Surrey County Council. However the process for approval of top-up funding via committee approval creates unreasonable delays to an already lengthy process. By providing delegated authority to the Director of Operations for decisions on top-up funding using the Better Care Fund, a decision can be made which would match the current process.

96.9    Other possible measures would require changes to the home improvement policy or specific approval. These include:

·        Increase the scope of the Safe and Warm grant to expand on the works covered and/or the eligibility criteria. This could include the discretionary adaptations 9.mentioned under point 3 above, which would make it easier to monitor expenditure and commitment. It could also include help with decluttering hoarded properties.

·        Remove the means test requirement for works costing less than £5,000. This will enable us to fast-track all simple adaptations and installation of equipment and is specifically mentioned in the PHE Integration Briefing.

·        Provide a relocation grant to pay for removal expenses for people where adaptation of their home is not reasonably practicable and they are unable to afford the cost of moving to another property.

·        Hospital discharge project. The aims of the project are to carry out a range of measures (including installation of grab rails, keysafes and extreme temperature monitors) for clients waiting to be discharged from hospital. This will reduce bed-blocking and care packages at home. This project will be managed by the Home Improvement Agency.

·        Fuel poverty project. The aims of the project are to identify properties with low energy efficiency, carry out energy efficiency audits and facilitate completion of recommended works using a combination of government funding and Safe and Warm grants. This project will be managed by Action Surrey.     

96.10  The Executive

RECOMMENDS that

88.       the Better Care Fund be used to pay for works under the Safe and Warm Grant scheme;

89.       the current delegation 36 be amended to now read as follows “Private Sector Housing Manager to exercise authority to approve payments of up to £5,000 for urgent or minor adaptations and fees associated with disabled adaptations using the Better Care Fund or equivalent funding” and the Scheme of Delegation be amended accordingly; and

90.       the current delegation 35 be amended so that the last sentence now reads as follows “any recommendation for a grant exceeding £30,000 to be referred to the Director of Operations for a decision” and the Scheme of Delegation be amended accordingly.

[Reason: to inform the Executive of developments in the allocation of the funding and agree proposals for making best use of the fund]