This document discusses the structure and activities of Herefordshire Council's Home Improvement Agency (HIA) and Occupational Therapy (OT) team. It outlines their past restructuring, current team structure, policies, and a housing and technology project to support people with learning disabilities. The project retrofitted 13 properties with adaptations and technologies like sensors, alarms, and assistive devices. This supported 81 people and aimed to increase independence and community participation for those with disabilities. The document discusses case studies and lessons learned around supporting independent living.

1.  Herefordshire Council Home Improvement
Agency
 “You at Home”
 Philippa Winstanley
 Promoting Independent Living Services Manager
 3rd October 2019

2. Adults and Communities Directorate

3. Current HIA Team Structure
Senior Officer
HIA
Kanute Kindamba
1FTE
Senior
Technician
1FTE Neil
Prince
Technicians
1FTE Phillip Ricketts
1FTE Richard Bufton
1FTE William Watling
Surveyors
1FTE Paul
Woollaston
1FTE Andrew Cross
1FTE Matthew
George
0.5FTE Victoria
Gauld
Caseworkers
1FTE Nick Cadwallader
1FTE Eira Levi
1FTE Jane Reid
1FTE Isabel Bright
0.6FTE Lisa Massam
0.4FTE locum Julie Jones
PILS Manager
Philippa Winstanley
1FTE
OT Team TECS Team

4. Past History:
 In-house HIA created within Private Sector Housing 2006
 Restructure approx. 2013- 2014 – Environmental Health – EEC Directorate, PSH
no longer exists. HIA joins Adults and Wellbeing Directorate
 2014 – OT Service created in Adults and Wellbeing Directorate, TUPE of some
staff from NHS
 2015 – Creation of “Operations” and “Prevention & Support” Services within
AWB. OT Service is centralised within Prevention & Support Services. HIA
becomes jointly managed with OT.
 2016 – Telecare service added to OT/HIA Management
 2019 – Restructure into Adults and Communities Directorate
 June 2019 – internal review of Prevention Services started

5. Home Adaptations & Assistance Policy

6. Regulatory Reform (Housing Assistance) England &
Wales Order 2002

7. Housing & Technology
Project
for
People with
Learning Disabilities
January 2017- March 2018 Herefordshire Council

8. “Having a home guarantees a place in the community and is
part of how people are accepted as equal citizens”
(DOH September 2016)
 Half of the population of adults with learning disabilities
in England live with their families, most of the remainder
(33%) live in residential care.
 Only 15% of adults with learning disabilities have a secure
long-term tenancy or their own home.
 This is in comparison with 70% of the general adult
population who own their own home and nearly 30% who
rent.

9. What we did:
 Properties identified by survey sent to existing schemes
 Put in a successful bid to DOH to retrofit 13 properties with adaptations and
technology
 Received £285,000 from DOH and added an additional £85k + from capital
funds
 Delivered a council led project with input and support from housing and care
providers
 Liaison with staff in 2gether NHS Trust LD Team
 Technology providers – Tunstall/ Just Checking/ Brain In Hand – formed part of
project group
 Limited time available – Launched Sept 2016, Application by end October
2016, MOU signed off January 2017, completion of project by March 2018.
Final report to DOH Autumn 2018
 Total of 81 people supported by adaptations/technology installed

10. The type of works included:
 Shower rooms/ Washing & Drying WC/ wheelchair accessible front door/ zero
pressure internal fire doors/ ramped access
 Finger print lock releases/ video door entry systems
 Linked fire control panels to lifeline alarms for automatic contact to call
centre if fire alarm went off
 Proximity sensor to alert staff to whereabouts of an individual in selected
areas to avoid property damage (linked to pager via nurse call system)
 Electronically opening blinds – to allow all to use sensory room without
damage to curtains
 Sensory Baths – to maximise engagement in personal hygiene/ sensory
stimulation & relaxation

11. Type of works cont:
 Provided “Buddi” bracelet trackers for 3 residents to allow them to access the
community independently without a support worker but with emergency
support if needed
 Trialled “Brain in Hand” with several residents to support with anxiety
management and access support in an emergency when accessing community
facilities
 Installed “Just Checking” systems to allow an evaluation of potential for
independent living and plan support delivery.
 Provision of overbed movement / epilepsy sensor

12. Property 1 ( Care Home)
 Shower room upgrade Bathroom: shower walls boarded, WC, wash hand basin
Two people cannot weight bear, so get around on the floor
They both need Zero pressure bedroom doors
This has made such a difference to their lives.

13. Property 1 cont.
Automated front door & audio door entry Care Assist – linked to radio pull cords
Fire control panel linked to lifeline

14. Property 2
2x level access showers 3x Electronic blinds in sensory room

15. Property 2 cont.
2x Sensory Baths Bubbles, Coloured Lights, Music … & relax
#

16. Property 4
Flat 1 is separated now has level access shower in annex
Fire control panel linked to lifeline
Property exit sensor

17. Property 6
Finger print Front door entry system – no need for keys Also video access system
Security cameras are linked to staff office
Each person has finger print
access to their own
bedroom as well
Fire control panel linked to lifeline as well

18. The Buddi wristband:
senses motion and communicates wirelessly with the Buddi Connect app
or the Buddi Clip. In the case of a fall, or if the alert buttons are
pressed, the wristband raises an alert. This alert is either communicated
to the wearer’s responder either through the Buddi Connect app or the
Buddi Clip via the 24/7 Monitoring Centre. The app will show the users
last known location, and safe/unsafe zones can be set up.

19. Property 10
Lifelines to seven bungalows,
then linked to Sleep In Room.
Considered linking with Property 11 to reduce
sleep in and facilitate peripatetic support…

20. Property 11
Property with 4 houses & central office and communal area.
Up to 14 residents with varying needs
 Finger print access system
 Lifelines, telecare overlay with call points
 Over bed sensor
 Brain in Hand
 Just Checking

21. Personalised support from your mobile phone
Reduce Anxiety – Feel Safe – Increase Independence

22. Just Checking
Just Checking is an activity monitoring system that helps people live in
their own homes for longer by showing family and professionals their
day-to-day capabilities — or where support is needed.
 Assessment tool, sensors to see how space is used

23. Over bed sensor

24. Outcomes expected from the Project
 The improvements are expected to:
 increase satisfaction with the housing offer 
 enhance the ability of residents to participate more easily and with more
confidence in the local community. 
 Improve the quality of the care and support provided by greater personalisation to
maximise independence 
 People with emergency housing needs will have more options that are more
appropriate to their needs? ?
 the cost of emergency provision will reduce over time? ?
 …as will the cost of some care packages as people’s abilities and strengths are
more readily recognised 
 there will be a reduction in the cost of care and support packages and that support
that is provided will be more personalised and appropriate for the individual. 

25. What we also learnt …..
1. Need more detailed skills assessments & appropriate skills development
programmes to identify & provide proactive support in “supported living”.
2. Clearer measurements of behaviours and mood to evidence needs, changes
and improvements
3. Sleep in issues – assessment details- what is the need and why?
4. Joint working – council/NHS/commissioners/providers
5. Apply the learning to inform and plan future supported living arrangements
6. Links with current/future Home Adaptations & Assistance policy
7. Inspire the providers – eg subsequent meeting with one provider to look at
technology to help change night time support model.
8. Communications & culture change within other provider staff – how to
promote this?

26. Wider outcomes for practice:
What have we done since then…….

27.  PILS Manager involvement with Accommodation Group with Operations &
Housing Commissioning. Reviewing “supported living”.
 Ongoing joint working between Operations/OT/HIA/TECs around supported
living options for individuals
 2 new supported living properties identified and adapted for individuals
 Review of development of 10 Supported Living Flats – lessons learnt
 Option of combining Supported Living & Accessible Homes Register under
consideration
 Ongoing use of technology installations with DFGS by OT/HIA staff
 Business Case for Assessment & Demonstration Centre
 3 new Technology Projects currently being launched

28. Case Studies
 DFG - Access to and from owner occupied property for young woman with
birth defect involving upper limbs

29.  Two young people with learning disabilities in a relationship moved in
together into new property, having lived separately in supported living and
shared lives arrangements.
 Various adaptations provided by DFG including wheelchair accessible kitchen
facilities including work surfaces & high-low sink, also LAS, CT hoists, closomat WC
 Home life going really well – including new kitten!
New “Supported Living” arrangement - two young people with learning
disabilities leaving home.
 Closomat WCs, LAS, finger print door opening system

30.  Technology advice facilitated for father of autistic child around barn
conversion development for integrated technology safety features without
restricting movement and access – private and DFG works – “making the
property safe for the disabled occupant”.
 Plan to install of air conditioning for 50yr old man with LD and autism, plus
adaption to provide additional living space – “making the property safe for
the disabled occupant”. Discussions ongoing with Housing Commissioners and
RP about future tenancy and use of the property.

31. Current Technology Projects
 3 new pilots including:
 Trail of new room sensing systems to detect falls, changes in usual activity or
unhealthy room conditions
 Use of digital technology to support reablement and evidenced based assessment
with a view to facilitating discharge & support, maximising independence and
safety at home
 Technology to help identify those at risk of frailty and prevent the onset of frailty.
This will have the effect of reducing falls by supporting people to maintain their
muscle mass (the key indicator of frailty) and their hydration levels.

32. Thank you for listening!
Any questions?