AWD ppt promotional presentation September 2019
                     Adaptations without 
delay
Presented by……
Adaptations without delay : 
purpose
•Ensure a more responsive service to those needing adaptations
•Reduce demand on occupational therapy services
•Improve efficiency in response to uplifts in funding
•A rationale for key stakeholders on when an occupational therapist is not needed
•Make best use of the expertise of occupational therapists in complex situations 
•Being applicable in all four UK nations
Intended audience
Services concerned with providing advice and information to disabled 
and older people and their families :
- Occupational therapy services in health, social care and housing
- Housing providers and housing associations 
- Home improvement agencies, care and repair 
- Handy persons services 
- Training providers 
- Voluntary organisations 
- Members of the public
Role for different audiences 
• Housing providers 
• Local Authority housing services, home improvement and care and repair 
agencies
• Occupational therapists
• Health and social care commissioners
• Retailers, product suppliers and independent contractors
• Members of the public 
Adaptations without delay : 
contents 
• A fresh approach to  respond to growing demand
• Stakeholder consultation: process and findings 
• Describing adaptations based on complexity rather than type 
and cost 
• A framework to support a proportionate response
• Tools on work force and operational considerations 
• The value of occupational therapy in complex situations
• Demonstrating how other staff can carry out simple 
assessments 
• Innovations in practice from around the UK
• Sources of design guidance
UK Wide Stakeholder consultation : 
methodology
Survey of front line practitioners 
Desktop Review (800 + respondents)
Legislation Policy and Practice • Occupational therapists
• Staff working in Home Improvements Agency
• Staff working Housing Associations
• Technicians
Stakeholder interviews • Trusted Assessors
•Occupational therapy managers
•Home Improvement Agencies Focus Groups 
•Care and Repair  Manchester, London, Cardiff, Belfast, Glasgow 
•Housing providers  and Housing 
Associations Steering Group:  meetings and reviews
•Royal College of Occupational Therapists Foundations, Care @ Repair, RCOT Specialist Section 
representatives Housing, CIH, RCOT 
  
Stakeholder consultation : key questions
Stakeholder consultation : key 
findings
• Common themes in policy and legislation that place an emphasis on prevention
• Waiting  for a social care assessment is contributing to delays 
• That  integrated approach to assessment , design and installation can deliver better 
person centred outcomes
• The most common major adaptations are showers, stair lifts and ramps where the 
situation  is simple and straightforward
• Typically the need has been defined by the type or cost of the adaptation rather than 
the complexity of the situation
• Significant numbers of people who are self-funding need information and advice  
A new way to describe adaptations : based on 
the complexity of the situation 
• Simple or complex (not minor Vs major)
• A person centred approach 
• Provide a proportionate response 
• Prioritise prevention
• Values occupational therapy as a complex 
intervention 
A new way to describe adaptations : 
based on the complexity of the situation 
Dimensions of complexity
•The person, their priorities and needs
•The nature of the activities the person is 
having difficulty performing
•Environmental barriers to independence
•The types of solutions required
Developing the Adaptations without delay 
framework:
Key Learning 
•Providing a more proportionate 
response 
•Establishing the right skill mix
•A guide for the retail market  on 
when a targeted or specialist 
response is needed
•Helping members of the public 
understand the type of service they 
might need 
Work force and operational considerations – and level of  
complexity 
UNIVERSAL
TARGETED
SPECIALIST
Natureof WorkforceSkills Operational
complexity Considerations
Universal
Targeted
Specialist
Service Delivery Examples 
• Training –DLF (England) – Housing Solutions Change programme i(Scotland)
• Agreed levels of responsibility – example from RBG
• Communication Tools – example from Northern Ireland Housing Executive
• One stop shops – example from Borders Care and Repair 
• Integrated teams – example from Lightbulb Project in Leicesteshire 
• Strategic Forums  - HAC (England) , AHG (Scotland) , HASG (Wales) JASG (NI)
Sources of design guidance
• Guidance on space and layout for home adaptations
• Organisations that provide technical expertise 
• Organisations that specialise in the needs of people with 
sensory and cognitive impairments
The final message : How the guide 
can help to reduce delays
• Avoid service design that is  based on type and cost of adaptation
• Avoid misinterpretation of legislation and the role of occupational therapists
• An understanding of the type of situation where an occupational therapist does 
not need to be involved 
• To make more effective use of occupational therapists where the situation is 
complex
• To enable redesign of services that prioritise person-centred and preventative 
outcomes
Thank you!
Royal College of Occupational Therapists Housing LIN 
106-114 Borough High Street, C/o PRP, the Ideas Store, 10 Lindsey 
Street,
London SE1 1LB 
Clerkenwell, London EC1A 9HP 
email: [email protected]  
website: www.rcot.co.uk email: [email protected]  
website: www.housinglin.org.uk   
Twitter: @theRCOT
Twitter: @HousingLIN; @HousingLINews