Service planning and delivery outcomes of home adaptations for ageing in the UK

Abstract

In response to the impact of demographic change on the healthcare system, 'ageing in place' was introduced as a national policy to support elderly people living independently in their homes. Housing adaptation is essential for successful independent living and has been given increased political priority. However, adaptation policies and practice vary regionally, reflecting statutory limits, policy choices and local planning. This study investigated the current status of adaptation provision in different regions in the UK and assessed the effectiveness of local service planning and management. A mixedmethods sequential explanatory research strategy was employed. In the first quantitative phase, a questionnaire survey was carried out involving all 378 local authorities in England, Scotland and Wales. This was followed by a second qualitative phase involving individual interviews with five professionals and two clients and a focus group meeting with six key stakeholders. The study found that the current number of adaptations was relatively small compared with potential demands in most local areas, as was funding for adaptations. On the operational side, the adaptation process was fragmented, involving different service groups in many local authorities. There were disconnections between these groups, which often caused inefficiencies and poor effectiveness. Moving forward, local authorities need to have a clear vision of the overall need for adaptations and allocate sufficient resources. Practical guidelines are also needed for better integrated working and performance management.

An Economic Evaluation Framework for Government-Funded Home Adaptation Schemes: A Quantitative Approach

“…Among others, Curtis and Beecham (2018) estimated the cost composition of home adaptation schemes in the United Kingdom and found that DFG schemes spent more than they should due to a high staffing component accounting for 76% of the total cost [ 39 ]. Zhou et al (2019) explored the causes of time delays of housing adaptations and also found that DFG schemes were understaffed and the resources were not enough to process the applications [ 19 ]. We found similar results in our regression results for DFG in comparison to its alternative, PAG.…”

“…Over £40 million has been spent annually by the subnational devolved government in Wales on home adaptation schemes to improve the living standards of disabled people. Among others, the Disabled Facilities Grant (DFG) is the most comprehensive scheme with the widest coverage and largest amount (Zhou et al, 2019) [ 19 ]. In addition, a specialized Physical Adaptations Grant (PAG) is funded through a standalone government budget dedicated to social housing (the Social Housing Grant).…”

Older Clients’ Pathway through the Adaptation System for Independent Living in the UK

“…In practice, adapting the house to help older people remain independent could be beneficial to individuals, families and governments. A number of studies [35][36][37] have reported that housing adaptations have improved health, independence and quality of life in later life. Beyond health and independence, several other studies [38][39][40] have further found that environmental adaptations have reduced older people's need for support from family caregivers and have lessened the strain on family relationships.…”

Adaptations for Aging at Home in the UK: An Evaluation of Current Practice

“…Housing adaptations have been defined in different ways (Sanford, 2012). This study adopts the definition of modifications as permanent physical features in the indoor and immediate outdoor in order to reduce environmental barriers and restore independent living (Zhou, Oyegoke, & Sun, 2019a).…”

“…Since the introduction of home improvement agencies (HIAs) in the Local Government and Housing Act 1989, many local authorities have cooperated with them during the delivery of adaptations. As a result, the adaptation process is administered by different departments and organizations in different local authorities (Heywood, 1994;Zhou et al, 2019a).…”