The Highland Council
Fast-Track Self-Referral Process
for
Medical Adaptations
Session Objective
• Introducing the Highlands
• Why Fast-Track
• What is Fast-Track
• Handyperson Service / Care & Repair Service
• Challenges along the way
Introducing the Highlands
• The Highland covers an area the size of Belgium
• The terrain in parts is isolated, rural and difficult
to access
• Clusters of urbanisation
• Strong and supportive communities
Population
• The Highlands has a population of 222,370
• Higher than average, aging population
• Projections for the future are:
• Number of retired people will almost
double
• The number of people aged 75+ will more
than double
Resources
• Finite number of trained Occupational Therapists
• Close working links with Community Health
Teams & NHS partners
Policy
Adaptations Policy
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Eligibility
Type of adaptation
Timescale
Maintenance
Specification
Installation
Why Fast-Track
• Occupational Therapist assessment of adaptation
need
• Adaptations graded based on their urgency
• A-F Grading
• Desktop Assessments for priority
What is Fast-Track
A model which allows clients to submit a selfassessment application for a range of adaptations
that can be installed in the home without the need
for a full medical or Occupational Therapist’s
assessment.
Adaptations Process
Two main stages
The assessment – of need and priority for an
adaptation
The provision – of the adaptation (the responsibility
determined by tenure)
Adaptations Process
Two stages of assessment
Expert Assessment – Usually by an Occupational
Therapist
• Considers the clients wider community care
needs
• Long term needs and ability to remain in their
home
Adaptations Process
Assessment
Self Assessment
• Self Assessment applies where the client does not
have more complex needs
• Most carried out without referral to OT for
assessment
• Pre-determined criteria
• More efficient and speedy service
Fast-Track Model
Self Assessment for
 Small / Minor Adaptations & Equipment
 Level Access Showers
 Medical Heating Changes
Fast–Track Criteria
Level Access Shower
Applicants must meet one of the following criteria;
 Aged 70 or over
 Already been assessed for mobility aids
 Receive Disability Living Allowance
 Receive Attendance Allowance
Fast–Track Criteria
Heating Changes
Applicants must meet one of the following criteria;
 Aged 70 or over
 Lives alone, under 65 and receives either;
o High Rate of the mobility component of
Disability Living Allowance
o Receives Middle or High rate Care
Component of Disability Living Allowance
 Lives alone, aged 65+ and receives Attendance
Allowance
Fast-Track Priority
Self referral cases fall into a priority category C
Priority
A
B
C
D
Example
• Client unable to be discharged from hospital
• Client unable to carry out essential activities
• To prevent imminent hospital admission
• To prevent serious breakdown in health / home
situation
• To meet the needs of a disabled child
• Adaptation would be a significant benefit
• Adaptation would promote client’s safety or
independence
• Adaptation would prevent future crisis in the
home
• Adaptation is not of sufficient priority to be
funded – clients are offered advice
Timescale
Critical
Substantial
Within
48
hours
Within
15 days
Within
4 weeks
Moderate
N/A
N/A
Adaptations Provision
Who has responsibility for
adaptation decision / provision?
Council
Housing
Housing
Association
Private Sector
Housing
Council
Housing
Association
Council
Who funds adaptation?
Council - HRA
Housing Assoc. Council – through
Grant
private sector
grant
Who is responsible for recording /
monitoring adaptations?
Council – H&P
Service
Housing
Association
Council - H&P
Service
Who guides / supports person
through installation?
Council staff –
H&P Services
Housing Assoc.
staff
Care & Repair
How are minor adaptations
provided?
Council or
Handyperson
Housing Assoc.
or
Handyperson
Handyperson
Service
Who assesses for adaptations (not
fast-track)
Occupational Therapist
What priority categories are used?
Priority Categories A - C
Fast-Track Safeguards
Safeguards in the Fast-Track system include;
• Clients not accepted for Fast-Track if they are
already in the system and awaiting assessment
• Clients with dementia or related illnesses must
always be assessed
• All Maintenance Officers (HC), Handypersons and
Care & Repair Agents undergo training with OT’s
Handyperson & Care & Repair Service
Handyperson Service and Care and Repair Service
are integral to the Fast-Track scheme being a
success.
Often the same organisation delivers both the
services
Fast-Track would not work without these agents
Highland agents provide an exemplar model
One agent has been one of the first organisations to
recently achieve Care & Repair Accreditation
Handyperson & Care & Repair Service
Our leaflets are available to download at:
http://www.highland.gov.uk/NR/rdonlyres/2EC867E1-1DB045A6-8F94-9CF88907357F/0/handypersonserviceleaflet.pdf
http://www.highland.gov.uk/NR/rdonlyres/95DC80B2-C1EA-488C-940DF657554836CE/0/schemeofassistanceadaptations.p
Challenges
Scottish Governments strategy for the next decade
‘Homes Fit for the 21st Century’ – commitment to
simplify arrangements for the public and housing
providers to access funding for adaptations.
Greater integration
Reduce waiting lists and manage client expectation
We don’t always get it right!!
Staff Guidance
Contact Details
Gail.ward@highland.gov.uk
Emma.micklethwaite@highland.gov.uk