#FixtheDFG Disabled Facilities Grants Review 2018

#FIXTHEDFG
CONSULTATION MARCH 2018
Ferret Information Systems

#FIXTHEDFG
DFG INDEPENDENT REVIEW
■ This review will:
– (i) provide an assessment of how the DFG is currently
being used, and
– (ii) make evidence-based recommendations on how
the DFG could function in the future.
To report by end of
May 2018

#FIXTHEDFG
DFG INDEPENDENT REVIEW
■ The commission to carry out the review was won by the
University of West of England, working with
– Foundations
– The Building Research Establishment (BRE)
– Ferret Information Systems
– Rachel Russell OT
Ferret Information Systems

#FIXTHEDFG
SCOPE OF REQUIREMENTS
■ How the DFG is being used currently – who gets what and how it’s delivered;
■ How DFG could change in the future – focussing on the means test,
the £30,000 upper limit, the allocation formula and methods of delivery;
■ The link between adaptations and health and social care services, including
timely discharge from hospital;
■ The changing aids and adaptations market – considering new innovations and
technology, market development and
supporting people who are not eligible for a DFG; and
■ The impact of Section 36 of the Equality Act 2010 on adaptations to communal
areas.

#FIXTHEDFG
Purpose of consultation
■ Intentionally early in the review process
■ Testing principles to give direction
■ Not necessarily got all the details – yet!

#FIXTHEDFG
DFG TIMELINE
Local Government and
Housing Act 1989
Housing Grants Construction and
Regeneration Act 1996
Money Well Spent 2001
Good Practice Guide 2004
DFG Review 2005
DFG Reforms 2008
BRE Report 2011
DFG Review 2018

#FIXTHEDFG
The DFG Rules
Housing Grants, Construction and
Regeneration Act 1996
Regulations
General
Consents
Guidance
Orders
RegulatoryReform
Order

#FIXTHEDFG
DFG Funding
District Council
County Council
(Better Care Fund)
1990 - 2014NOW

#FIXTHEDFG
DFG Budget for England
-£100
£0
£100
£200
£300
£400
£500
£600
2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19
MILLIONS
Government Allocation LA Contribution
? ?

LINKING TO HEALTH
AND SOCIAL CARE
The Issues

#FIXTHEDFG
The brief
■ DFG is funded by the Dept. of Health & Social Care
■ Increased DFG funding linked to care home savings
■ Using DFG to support prevention/early intervention
■ Using DFG to support timely discharge from hospital

#FIXTHEDFG
The legislation
■ A person is disabled if…
– sight, hearing or speech is substantially impaired
– mental disorder or impairment of any kind
– physically substantially disabled by illness, injury,
impairment
– registered disabled or could be

#FIXTHEDFG
Primary
Impairment
Physical Disability
89%
Learning Disability
2%
Sensory Impairment
2%
Dementia
3%
Other
4%
Other
11%

#FIXTHEDFG
Prevention?
■ “actively promote wellbeing and independence…not
just…respond when people reach a crisis point”
■ responsibilities for prevention apply to all adults, including:
– people who do not have any current needs for care and
support
– adults with needs for care and support, whether their
needs are eligible and/or met by the local authority or not
– carers

#FIXTHEDFG
Housing & health
1989 – DFG Legislation
2013 – Health &
Wellbeing Boards
2014 – Better Care Fund2002 – Supporting
People

#FIXTHEDFG
Total
Population
Lives in a
Household
Has LLTI or
Disability
Requires
Adaptations
Still Needed
Major Adapts
Wants to
Adapt
Eligible for a
DFG
Agency
Assisted
DIY
Application
Not Eligible for
DFG
HIALocal Builder
Back of Daily
Mail
Wants to Move
Extra Care
Supported
Housing
Sheltered
Housing
Adapted
General Needs
Minor Adapts
ICESHandyperson
Retail
Assistive
Technology
Already Done
Doesn't Need
Adaptations
No LLTI or
Disability
Lives in an
Establishment

#FIXTHEDFG
DFG Legislation
Wellbeing
Create Care
Savings

#FIXTHEDFG
Help to
Move
Home
Repairs
Major
Adapts
Asst
Tech.
Equip-
ment
Re-ablement Care & Support
I need help to stay living
independently in my own home
Outcome
I can continue living independently in
my own home
Property Person
Institutional Care
Secondary Prevention
Primary Prevention
Lifetime
Homes
Decent Homes
Adaptations
Adapts
Register
Planning
Policy
Strategic Oversight?

#FIXTHEDFG
STRATEGIC OVERSIGHT
■ “Our predecessor Committee considered the operation of
the Disabled Facilities Grant in its inquiry on adult social
care and found that its administration and operation was
hampered by the split in responsibility between district
and county councils. This tier split may also hamper
closer working between health, social care and housing.”
House of Commons Communities and Local Government Committee

STRATEGIC
OVERSIGHT
The Options

#FIXTHEDFG
OPTION 1 -
NO IDENTIFIED LEAD
■ Continue as we are with no oversight of DFG and related
services

#FIXTHEDFG
OPTION 2 -
HOUSING AUTHORITY
■ The Housing Authority oversees all home modification
programmes
■ Statutory duty for DFG
■ Links to care, equipment, minor adaptations?
■ Does not receive direct benefit of investment?

#FIXTHEDFG
Option 3
HEALTH/SOCIAL CARE
■ Health/Social Care oversee all home modification
programmes
■ Statutory Care Act responsibilities
■ Links to housing options, planning policy, etc.?
■ Directly benefits from investment in adaptations

#FIXTHEDFG
Option 4 –
“goldilocks” option
■ Formal strategic partnership between housing, health
and social care
■ Recognises the knowledge and expertise
that each contributes – “just right”
■ Oversight and co-ordination of adaptations,
equipment and housing options

#FIXTHEDFG
The brief
■ How DFGs are processed by local authorities and Home
Improvement Agencies (HIAs)
■ Streamlining administration, inc. RRO and Trusted
Assessors
■ What good looks like

#FIXTHEDFG
The legislation
■ DFG Process
– Grant can’t be approved if works have already started
– Need to consult social services authority
– Decision notice within 6 months of application

#FIXTHEDFG
#1 MINIMUM
Person gets
application
form
Person
compiles
application
Housing
Authority
consults
Social
Services
Local
Authority
approves
grant
Contractor
carries out
works

#FIXTHEDFG
#2 DIY
Person
contacts
Social
Services
Occupational
Therapist
makes
assessment
Person
compiles
application
Local
Authority
approves
grant
Contractor
carries out
works

#FIXTHEDFG
#3 traditional
Person
contacts
Social
Services
Occupational
Therapist
makes
assessment
Agency
helps with
application
Local
Authority
approves
Grant
Contractor
carries out
works

#FIXTHEDFG
#4 INTEGRATED
Person
contacts
Home Mods
Team
Triage and
Assessment
Outcome
based
package of
assistance
DFG and
other
funding
approved
Contractor
carries out
works

#FIXTHEDFG
CASE STUDY:
INTEGRATED TEAM
■ County area with 5 Districts
■ Multiple teams, managers, offices, access points, waiting
lists
■ Competing priorities, no overall ownership
■ 220 step customer journey
■ 35% drop out rate

#FIXTHEDFG
INTEGRATED TEAM
STRUCTURE
Management
Board
Service
Manager
Team Manager
(OT)
Senior Housing
Assessment
Officer
Housing
Assessment
Team
Senior Housing
OT
Housing OT
Team
Housing
Manager
Senior
Surveyor
Technical
Team
Staff seconded from
Districts and County
Professional OT
Lead

#FIXTHEDFG
End to end times
enquiry to completion
0
100
200
300
400
500
600
700
CALENDARDAYS

#FIXTHEDFG
INTEGRATED TEAM
RESULTS
■ Shared vision, goals and strategic direction
■ Single access point and one contact throughout the
customer journey – multi-skilled workers
■ 22 step customer journey (down from 220)
■ Drop out rate falls from 35% to 3%

#FIXTHEDFG
Option 1 - MINIMUM
Person gets
application
form
Person
compiles
application
Housing
Authority
consults
Social
Services
Local
Authority
approves
grant
Contractor
carries out
works

#FIXTHEDFG
Option 2 - DIY
Person
contacts
Social
Services
Occupational
Therapist
makes
assessment
Person
compiles
application
Local
Authority
approves
grant
Contractor
carries out
works

#FIXTHEDFG
Option 3 - traditional
Person
contacts
Social
Services
Occupational
Therapist
makes
assessment
Agency
helps with
application
Local
Authority
approves
Grant
Contractor
carries out
works

#FIXTHEDFG
Option 4 - INTEGRATED
Person
contacts
Home Mods
Team
Triage and
Assessment
Outcome
based
package of
assistance
DFG and
other
funding
approved
Contractor
carries out
works

SUPPORTING PEOPLE
OUTSIDE DFG
The Issues

#FIXTHEDFG
The brief
■ The wider adaptations context beyond the DFG
■ How to support those who do not qualify
■ How to approach adaptations outside the scope
■ The provision of information and advice

#FIXTHEDFG
The legislation
■ Getting in and out of the
property
■ Making the property safe(r)
for everyone living there
■ Access to the living room
■ Access to a bedroom
■ Access to a toilet
■ Access to a bath or shower
■ Access to a wash basin
■ Preparing and cooking food
■ Improving or providing
heating
■ Controlling power, lights and
heating
■ Access around the property
to care for someone else

SUPPORTING PEOPLE
OUTSIDE DFG
The Options

#FIXTHEDFG
Option 1 –
DUTY on COUNCILS
■ DFG duty should be extended to provide information,
advice and support to anyone with a substantial disability

#FIXTHEDFG
OPTION 2 –
leave it to the market
■ If there is sufficient demand the market will respond to
provide appropriate services

#FIXTHEDFG
Option 3 –
national advice
■ Advice and information is available from a national
advice centre (web/call centre)

#FIXTHEDFG
Option 4 –
personal responsibility
■ We should leave people to do what they want in their
own homes

#FIXTHEDFG
The BRIEF
■ The maximum DFG is currently £30k
■ Some adaptations cost more than £30k
■ Councils can use discretion to pay extra costs
■ Is £30k the correct level to
– Deliver Value for Money to the public sector?
– Support as many people as possible?
– Maintain financial viability of the grant?

#FIXTHEDFG
The legislation
■ The Secretary of State may, if he thinks fit, by order
specify a maximum amount or a formula for calculating a
maximum amount of grant which a local housing
authority may pay in respect of an application for a grant.
■ An authority may not pay an amount of grant in excess of
a specified maximum amount.

#FIXTHEDFG
THE REGULATIONS
1989 – No Limit
1993 – £50,000
1994 – £20,000 2008 – £30,000
2002 – £25,000
£95,000
£37,400
£38,000
£38,100

#FIXTHEDFG
The data
0
1
2
3
4
5
6
7
8
2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17
Average number of £30k grants per year per LA

#FIXTHEDFG
EXTENSION COSTS
£0 £10,000 £20,000 £30,000 £40,000 £50,000 £60,000
East Midlands
East of England
London
North East
North West
South East
South West
West Midlands
Yorkshire and The Humber
ENGLAND

#FIXTHEDFG
CLOSED ENQUIRIES
Approved
Contribution
Cost over £30k
Not Reasonable/Practicable
Insufficient Info
Moved
Died
Other
On average, 0.5 applications per LA are
closed due to costs over £30k pa

#FIXTHEDFG
Value for money
0
20
40
60
80
100
120
NHS Social Services DFG
BILLION£
DEPARTMENT OF HEATH AND SOCIAL CARE
BUDGETS 2018/19

#FIXTHEDFG
SOCIAL CARE UNIT COSTS
Provision Type Annual Cost
Private sector nursing homes for older people £41,912
Private sector residential care for older people £32,864
Residential care homes for adults requiring learning disability support £69,524
Private sector residential care homes for adults requiring
physical support
£46,488
Care home for children — local authority own-provision £210,444
Voluntary and private sector care homes for children £171,496
Foster care for children £33,592

#FIXTHEDFG
COST EFFECTIVENESS
UNIVERSITY OF LEEDS REPORT
■ “Some of the student researchers considered it extraordinary that
a grant of £60,000 might be refused even though the consequence
was a five-fold (or more) cost impact to the public purse – but this
in organisational terms is not extraordinary at all.
■ In a time when local authority and health care finances are
experiencing an unprecedented squeeze, managers are under
enormous pressure to ‘stay within budget’.
■ Where a payment from one budget makes a saving in another
budget then, in the absence of integrated decision making, the
manager has little or no power to act outside her or his mandate:
namely to ‘stay within budget’.”

#FIXTHEDFG
Knock on effects
■ If amount increases, do we need to pool some funding at
local, regional or national level for exceptional cases?
■ Any repayment conditions for additional funding?
– Or do savings in care costs need to apply?

#FIXTHEDFG
OPTION 1 -
NO CHANGE
■ There are relatively few £30k grants
■ Hardly any fail to proceed
■ Rely upon discretion of Councils?
■ Value for money?

#FIXTHEDFG
OPTION 2 -
INCREASE THE LIMIT
■ There’s relatively few £30k grants
■ Where should the limit be? £45,000?
■ What about London?
■ What about exceptional applications in excess of the new
limit?

#FIXTHEDFG
OPTION 3 -
REMOVE THE LIMIT
■ There’s relatively few £30k grants
■ Speed up delivery
■ Viability of grant?

#FIXTHEDFG
OPTION 4 -
use a formula
■ Based on alternative cost – residential care
■ Include regional weighting
■ Simple to understand and operate
■ Who pays and who benefits? Districts/Counties?

#FIXTHEDFG
The brief
■ Some of the people that do not qualify do NOT then go
on to self-fund the adaptation.
■ How the means test operates
■ Level of eligibility
■ How many more eligible if changed
■ Cost impact of changing

#FIXTHEDFG
The legislation
■ “If … the financial resources of any person … exceed the
applicable amount, the amount of any grant … shall …
be reduced”.
■ Regulations set out:
– How to calculate the financial resources
– The applicable amount
– When it’s assumed resources do not exceed the applicable
amount

#FIXTHEDFG
The legislation
■ Regulations to make provision for:
– Income
– Assets
– Needs
– Outgoings
■ Regulations may apply … any other statutory means-
testing regime

#FIXTHEDFG
The regulations
■ Target grant aid on the most “needy” households
■ Largely mirrors the system of calculating entitlement to
Housing Benefit
■ Passporting for certain specified benefits
■ A "loan generation factor" is applied to excess income to
arrive at a notional "affordable loan“
■ Does not take into account cost of works

#FIXTHEDFG
Means Testing
Made
Contributi
on
No
Contributi
on
■ Only 14% of approved DFGs
required a contribution by the
applicant in 2016/17
■ Average contribution was £1,500
(worth £9.2m)
■ How much does means testing act
as a deterrent?

#FIXTHEDFG
DFG ELIGIBILITY
FROM MEANS TEST
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Not Eligible Make a Contribution Full Grant

#FIXTHEDFG
Closed Enquiries
by reason
Approved
66%
Contribution
8%
Cost over £30k
0%
Not Reasonable/Practicable
1%
Insufficient Info
Moved
3%
Died
3%
Other
14%
Other

#FIXTHEDFG
CARE ACT FINANCIAL
ASSESSMENT - principLEs
1. Ensure that people aren’t charged more than it’s reasonably practicable for them to pay
2. Reduce variation in the way people are assessed and charged
3. Be clear and transparent
4. Promote wellbeing, social inclusion, and support the vision of personalisation, independence,
choice and control
5. Support carers
6. Be person-focused
7. Apply the charging rules consistently
8. Encourage & enable those who wish to stay in/take up employment, education or training
9. Be sustainable for local authorities in the long-term

#FIXTHEDFG
CARE ACT ASSESSMENT
■ In a financial assessment, both capital and income must be assessed, which will be
either disregarded, partially disregarded or included
■ Some capital and income must be disregarded and local authorities have discretion to
disregard assets in some other circumstances
■ The value of a person’s main or only home must be disregarded where they are receiving
care in a setting that is not a care home or where a qualifying relative occupies the
property as their main or only home
■ To help encourage people to remain in or take up employment earnings from current
employment must be disregarded
■ Notional capital and income can be taken into account

#FIXTHEDFG
Upper capital limit
£23,250
Lower capital limit
£14,250
Where a person’s
resources are below the
lower capital limit they will
contribute what they can
afford from their income
Below the upper capital
limit, a person is
entitled to access
means-tested local
authority support
Capital limits
A person assessed as having capital above the upper capital
limit is responsible for funding their own care and support

#FIXTHEDFG
CARE CAP?
■ Encourage adaptation to reduce care costs
■ Any contribution could count towards the proposed “care
cap”
■ Could encourage nil-grant applications with light touch
assessment
– Less likely to reach cap living in safe home
■ Person spends less / Government spends less

#FIXTHEDFG
Justify the existing
■ All means testing systems are inherently complicated.
■ What’s the justification for retaining a 30 year old test
based on a benefit that’s disappearing
■ And totally separate/different to care means test?

#FIXTHEDFG
OPTION 1 -
update existing
■ Retain existing regulations but keep updated
■ Tried and trusted (?) / Minimal change
■ Doesn’t factor in actual living costs
■ In most cases you either get a full grant or nothing

#FIXTHEDFG
OPTION 2 -
REMOVE MEANS TESTING
■ Very simple to operate
■ Preventative for the NHS
■ Unlock latent demand?
■ What would it cost?

#FIXTHEDFG
Option 3
passporting benefits
■ Simple to operate
■ How would it work with Universal Credit?
■ People on low incomes who don’t claim benefits?

#FIXTHEDFG
Option 4 –
adopt care act test
■ An “off the shelf” option that does take into account
outgoings
– What about people with minimal living costs?
– Takes into account care benefits
■ Direct link to care costs
■ Improves integration with social care

#FixtheDFG Disabled Facilities Grants Review 2018

Recommended

Recommended

More Related Content

Similar to #FixtheDFG Disabled Facilities Grants Review 2018

Similar to #FixtheDFG Disabled Facilities Grants Review 2018 (20)

More from Foundations HIA

More from Foundations HIA (20)

Recently uploaded

Recently uploaded (20)

#FixtheDFG Disabled Facilities Grants Review 2018

Editor's Notes