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Deborah Hale, from Westcountry Case Management talks about her experience and passion for housing adaptations; working with clients, housing associations, architects and grants officers to provide solutions for disabled people in the place where it really matters… home.

As an Occupational Therapy (OT) student, Deborah was taught how to measure for minor adaptations such as handrails and stair-rails and the angles and technical specifications needed to maximise efficacy for clients ergonomically and to enhance safety. She was also taught sessions from an architect technician about how to read plans and use a scale rule. Consideration had to be given to client’s diagnoses and possible prognoses in order to “future-proof” their homes and this is as true today as it always has been.

An OT’s medical training allows them to make clinically-based decisions that are person-centred, holistic, realistic and sensible. As case managers they also need to ensure that advocacy skills are reflected in developing goals and outcomes that are meaningful to clients and their families. It is essential that a collaborative approach is pursued and that communication with all parties is clearly understood and conveyed in a way that allows full participation for all.

Home adaptations for disabled people

Adaptations on the grounds of a disability need not themselves look “disabled” – there is a preconceived view that specifically adapted homes will have a clinical look to them that for many is deeply offensive and unattractive.

Case managers are adept at looking past that and providing solutions that are both aesthetically pleasing whilst solving an issue – making shower rooms look like spa or hotel wet rooms, using different building materials for a high-end look, utilising the many manufacturers that are on board with this movement to de-institutionalise the homes of our disabled clients.

Disabled Facilities Grant

Naturally it is important that case managers liaise and cooperate with statutory services if, for example, a client is receiving a Disabled Facilities Grant through a local authority. This client will have an Adult or Children’s Social Care OT assigned to them and it will be important to establish an effective and productive working relationship with this professional and all others working on behalf of the local authority.

Clients may be able to top up their grant in order to exercise more choice over floor coverings, equipment and materials but ultimately the local authority must be satisfied that the objectives and outcomes of the adaptations are met.

This is where the effectiveness of this collaborative partnership between client, case manager and local authority personnel is demonstrated so that navigation through these somewhat complex processes can be made seamlessly and economically.

The experienced case manager is able to advocate on behalf of the client to ensure the adaptations meet their needs, are appropriate, practicable and reasonable to meet the legislative requirements of the Disabled Facilities Grant and most importantly are delivered to an aesthetic which is acceptable.

Adapting someone’s home is a very sensitive issue – it requires tact and diplomacy, particularly if it is a family home or one where someone has lived for a number of years pre- injury. Occasionally people may want to move property to something more suitable and case managers are very experienced at supporting people in making decisions of the head and heart, identifying and sourcing appropriate properties and helping draw up lists of “must- haves” and “desirables”.

This same level of communication is essential when planning any home adaptations – some clients will demonstrate a high level of commitment and opinion in designing their environment and some will be indifferent – both require ongoing support in making decisions about their living space.

Case managers are very experienced at working holistically with clients, recognising emotional barriers and psychological issues around home adaptations and balancing these with the practical elements of future-proofing their properties and making their homes work for them again once more.

About Westcountry Case Management

Westcountry Case Management is a specialist case management service for adults and children with complex needs. Their expertise has been built up since 1991. They cover the South West of England up to Gloucestershire, Warwickshire and Wales. See more about Westcountry Case Management.

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