Care Comment




    Social care has been in the headlines again, with additional funding allocated in The Budget, and new reports about the importance for appropriate housing for our ageing and disabled population.


    The majority- more than 75%- of specialist and supported housing is in the social rented sector. Regardless of tenure, the home may need to be adapted so that it continues to address their needs, and enables them to live independently without reliance on social care.


    It is consistently proven that it makes better use of available resources- financial and human- to provide a piece of equipment that enables independent living than to fund a care package. It is not just the £ of care budget.


    To paraphrase a section of the Equality & Human Rights Commission’s recent report Housing & Disabled People, provision of an adaptation enabled a severely disabled client to manage without a package of care, and gave the recipient the confidence to go out and get a job. It goes on to say “the financial, emotional and human cost of inaccessible housing includes increased need for social care, increased reliance on carers, accidents, and avoidable hospital admissions and stays in hospital.


    Similarly, the Centre for Ageing Better’s report Adapting for Ageing: Good Practice & Innovation in Home Adaptations found that even small changes, such as provision of grab rails, are a cost-effective intervention, reducing falls and injuries.


    How many care visits could be made for the cost of a grab rail? Extrapolate that out: how many visits for the cost of something like a shower toilet that eliminates the need for a carer to visit just to help someone ‘go’?


    An adaptation has a place in the overall social care strategy. It needs however to be done with care. It can compliment the overall strategy, making better use of the funds available by eliminating the need for a carer to visit one home to help with certain ADLs, and allowing that carer the time to visit someone where the human element cannot be replaced by equipment.


    But, especially if developing supported or sheltered housing, why do we not design it to be accessible, inclusive from the outset? Many have emergency cords. How many have the key features of level access, a ground floor WC, wider doorways? The Equality & Human Right Commission report alleges that adapting a home costs up to five times more that making it adaptable at the design stage. That in itself highlights better use of resources.


    And more often than not, when talking about adaptations, there is reference to enabling people to take a bath or shower unaided, instead of having a carer help them in, out, strip wash them.


    But let’s bear in mind, we shower or bath in reality once a day. We go to the toilet on average eight times a day. So which ADL should be a priority to deliver better value in care resources: a single visit for bathing, or several visits per day, every day, to help with toileting…..?


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