In your home

Home adaptations are changes made to the fabric and fixtures of a home to make it safer and easier to get around and to use for everyday tasks, such as bathing. Adapting a home environment can help increase independence, reduce care needs, improve safety, and enable confidence and dignity for individuals and their families. Minor adaptations could include alterations such as the installation of grab rails, modifications to steps, and changes to switches and lights. Major adaptations could include alterations such as level access showers, ramps, lifts, or extensions.

Your occupational therapist may recommend trialling specialist equipment before an adaptation assessment is carried out. This equipment may enable your child’s needs to be met at home without the need for adaptations. Alternatively, it may be used as an interim measure until adaptations can be carried out, for example, using a mobile hoist until ceiling track hoisting can be installed.

The children’s therapy service includes occupational therapists who specialise in adaptations to the home environment. The occupational therapists within the social care team can support with minor adaptations, and the occupational therapists within the children’s home adaptation team (CHAT) can support with major adaptations.

Please see attached leaflet for further information on the children's home adaptations team (CHAT), their role and how they can support you. 

Once your occupational therapist has referred you to the appropriate agency for adaptations, the responsibility to progress the adaptation will then sit with that agency. In some circumstances, you may choose to project manage your own adaptations, in which case it will be your responsibility to oversee the adaptations. Your occupational therapist will be involved with providing advice on the specifications for the works and may need to check the completed works to make sure they meet your child’s needs.

How are adaptations funded?

Some equipment and smaller adaptations may need to be funded by yourself. This could include things such as key safes and window restrictors.

For adaptations that are eligible for support with funding, how this is funded will vary, depending on who owns your home and the cost of the adaptations.

For minor adaptations:

• If you live in a council property, eligible adaptations will likely be funded through your local council.
• If you live in a housing association property, eligible adaptations may be funded by your housing association, or they may only provide permission for the adaptations to go ahead.
• If you own your own property or are privately renting, then your occupational therapist would seek funding through the social care team at Hertfordshire County Council.

For major adaptations:

• If you live in a council property, eligible adaptations will likely be funded through your council.
• If you live in a housing association property, eligible adaptations may be funded by your housing association. Alternatively, they may only offer part funding or only provide permission for the adaptations to go ahead. In these circumstances your occupational therapist would seek funding through a Disabled Facilities Grant (DFG). Depending on where you live, the DFG funding is available through your local council or Hertfordshire Home Improvement Agency. For further information on DFGs, see information sheet below.
• If you own your own property or are privately renting, your occupational therapist would seek funding through a DFG.

 

• DFG Information sheet

 

Is there criteria for adaptations and a limit to the funding available?

The criteria for adaptations is set out within the DFG framework. See DFG information sheet for further information.

Council’s and housing associations may set their own limit as to the funding they will contribute towards adaptations. The DFG is up to a maximum of £30,000 in England and is not means tested for children.

Discretionary funding may be available but will vary depending on where you live, availability, and could be subject to a means test. Your occupational therapist will explain this further as part of their assessment.

If you privately rent your property, you will need permission from your landlord for the adaptation to go ahead. If permission is not granted, you may need to consider moving home.

Provisions not covered by a disabled facilities grant (DFG).

Sensory rooms, rooms for providing therapy and driveways to give access to electric vehicles, are the type of provision that is not covered by the purposes of the disabled facilities grant and such requests will be declined at triage.

Who is responsible for the ongoing upkeep of any specialist fixed equipment installed as part of my adaptation?

Fixed equipment can include items such as ceiling track hoists, through floor lifts and changing tables. Who is responsible for the ongoing maintenance for these will depend on who owns your property:

• If you live in a council or housing association property, then they should have their own agreements set up for any ongoing service and maintenance. You should contact them should your equipment need servicing or if you have any issues with your equipment.
• If you own your own property or are privately renting, then you are responsible for the ongoing service and maintenance fees. It is advisable that you set up a service and maintenance agreement for the equipment. 

Some fixed equipment items, such as hoists, fall under legislation that requires it to be inspected every 6 months and serviced every year. If you employ carers in your home, you will need to adhere to this legislation. For further information see links below

• https://www.hse.gov.uk/work-equipment-machinery/loler.htm
• https://www.hse.gov.uk/work-equipment-machinery/puwer.htm

 

What would happen if adaptations were not possible?

It may be possible that the adaptations required to meet your child’s needs at home are not able to be carried out. This could be because they are practically not feasible, or it could be because there is not the funding available for them to be completed. In these circumstances then moving to a more suitable property may need to be considered. For further information see the Moving home section on this page.

Useful links

Hertfordshire Home Improvement Agency: 

• https://www.hertfordshire.gov.uk/microsites/herts-home-improvement-agency/home.aspx Tel: 01438 843467

District and Borough Councils within Hertfordshire

• North Herts:   https://www.north-herts.gov.uk/ Tel: 01462 474000
• Stevenage: https://www.stevenage.gov.uk/   Tel: 01438 242242
• East Herts: https://www.eastherts.gov.uk/  Tel:  01279 655261
• Broxbourne: https://www.broxbourne.gov.uk/   Tel: 01992 785555
• Welwyn and Hatfield: https://www.welhat.gov.uk/  Tel: 01707 357000
• St Albans: https://www.stalbans.gov.uk/  Tel: 01727 866100
• Hertsmere: https://www.hertsmere.gov.uk/Home.aspx Tel: 0208 2072277
• Dacorum: https://www.dacorum.gov.uk/  Tel: 01442 228000
• Three Rivers: www.threerivers.gov.uk  Tel: 01923 776611
• Watford: https://www.watford.gov.uk/   Tel: 01923 226400 

 

Gypsy and traveller support

• GATE Herts: www.gateherts.org.uk   Tel: 01707 247084  Email: advocate@gateherts.co.uk
• https://www.hertfordshire.gov.uk/services/adult-social-services/money-and-benefits-advice/hertfordshire-gypsy-service.aspx#contact
• https://www.gypsy-traveller.org/

In some cases, moving to another property which can provide more suitable accommodation is the best option to be able to meet a child’s long term housing needs and wellbeing.

If you live in a council or housing association property, your landlord may have their own policies in regard to looking for alternative housing before adaptations are carried out. This could include policies around not completing adaptions if the property is under occupied, or not completing extensive adaptations such as extensions.

 

Who will support me with moving?

If it is determined that a house move is required, your occupational therapist will assess what the housing needs are for your child. They will provide you with a report, known as a rehousing report or housing needs report, which will specify what the minimum requirements are for a suitable property.

If you need to apply for a council or housing association property, then you will need to complete an application to join your local housing register. You may need to complete a medical form along with your application to outline your child’s needs. You should also send a copy of your rehousing report from your occupational therapist. If you require support with completing this application, then you should contact your local council.

If you own your own property or are privately renting and your property can’t be adapted, you may be able to apply for a council or housing association property, but this will be subject to certain criteria. You will need to contact your local council to discuss this.

Alternatively, if your property can’t be adapted and you are looking to move to another private property, you may be eligible for a relocation grant, up to a maximum of £5,000, to support your move. This is subject to certain criteria and would be explored with your occupational therapist and local council or Home Improvement Agency.

Your occupational therapist will support with viewing potential properties to assess whether they currently meet, or could be adapted to meet, your child’s needs.

Your child may need help to move at home. This can be moving from a wheelchair/ buggy to the floor or helping your child move from the bed to bath.  As parents looking after a child with moving and handling needs, it is important to learn safer moving and handling techniques to look after your own back, by attending an appropriate course.

If your child needs assistance to move from one place to another within the home, an occupational therapist can carry out an assessment to review each of the moves the child makes throughout the day. The occupational therapist will then provide advice or recommendations for appropriate manual handling equipment. This might range from a manual handling belt for minimal assistance, to a ceiling track hoist for maximum assistance. Appropriate demonstration on how to use the equipment will be given to parents.

If you as parents employ carers privately, you are responsible for finding and paying for moving and handling training for those who work for you.

If you would like some general advice regarding your child’s moving and handling needs at home parents can call the advice line 01923 47-680, option 1, then leave a message.

To request an assessment at home from an occupational therapist, as a parent you can self-refer by completing the CYP referral form.

There are lots of different ways you can make your home safer for your child. Below are some ideas that may help increase safety at home:

• Fix furniture to the floor or walls.
• Install screens in front of breakable items such as televisions.
• Purchase toughened furniture – see link below.
• Fill in staircases with panels rather than spindles to prevent leaning through and climbing. This can also be done at the top of the stairs above the banister on landings.
• Install locks or window restrictors to prevent climbing out of the windows.
• Keep the front door locked to prevent escaping. You could install an internal keysafe by the front door to keep keys out of reach but still accessible for other members of the household.
• Install locks on cupboards and keep hazardous items out of reach.
• Use oven or hob guards.
• Install thermostatically controlled taps and showers to prevent scalding.
• Install alarms or self-closing taps to prevent water overflowing.
• Install bathroom locks that can be opened on both sides to prevent a child locking themselves in.
• Ensure blind cords are out of reach.
• Install integral blinds within double glazing to prevent blinds/curtains being pulled down.
• Install radiator covers to prevent scalding.
• Install fencing and gates with horizontal rails on the outside to prevent climbing.

 

Further information on adaptations for improving safety at home

• Information sheet from the Challenging Behaviour Foundation on specialist equipment and safety adaptations: 017-Specialist-equipment-and-safety-adaptations.pdf (challengingbehaviour.org.uk)
• Guide from Foundations, the national body for home improvement agencies, on adaptations for behaviours that challenge: https://booklets.foundations.uk.com/adaptationsforbehavioursthatchallenge#page=1

 

Useful links to companies/charities that can provide support and/or equipment on safety at home

• Tough Furniture: https://www.toughfurniture.com/ - Tough furniture design and manufacture durable furniture for people with behaviours that challenge.
• Fledglings: https://www.fledglings.org.uk/ - Fledglings is a national charity that helps children and adults with additional needs by supplying products and equipment that help with everyday challenges.
• DEMAND: www.demand.org.uk - A national charity dedicated to making new products to suit individuals’ needs. They also refurbish old equipment and have a second-hand section on their website.
• REMAP: www.remap.org.uk - A national charity that makes or modifies equipment to suit an individual’s needs when nothing is suitable through mainstream sources.
• Add-vance: http://www.add-vance.org/ - A registered charity run by a dedicated group of professionals, who also happen to be parents of children affected by attention deficit hyperactivity disorder (ADHD) and/or autism. They aim to support the families of children affected by these conditions.
• In Car Saferty Centre: https://incarsafetycentre.co.uk/car-seats/additional-needs - In Car Safety Centre can assess and advise on car seats, harnesses and buckle covers for children with additional needs. They have showrooms in Milton Keynes and Essex.