Health investment urged in ‘life changing’ home adaptations for disabled people

Home adaptations are successful in improving the health and safety of disabled people and have, in many cases, transformed their lives, according to research for the Joseph Rowntree Foundation. Their positive effects, which include reducing the need for hospital and residential care, suggest they are a highly effective use of public money and deserve increased investment, particularly from health budgets, because of their demonstrable preventative effect.

The study of adaptations made in the homes of more than 260 disabled people was carried out by a team including environmental health, housing, and occupational therapy professionals and two disabled researchers. It found that:

• Minor adaptations, such as grab rails and handrails, almost always produced lasting, positive results. Some 62 per cent of recipients said they felt safer from the risk of accident and 77 per cent said their health had improved following the provision of the adaptation. Often, more than one person benefited, and there were no harmful side effects.
• Major adaptations, such as walk-in showers, building extensions and lifts, had literally transformed lives. Disabled people who described themselves as ‘prisoners’, ‘degraded’ and ‘afraid’ before the work was carried out, frequently used terms like ‘independent’, ‘useful’ and ‘confident’ afterwards.

Frances Heywood, a Research Fellow at the University of Bristol and author of the study, said: “All the evidence suggests that successful home adaptations deliver many of the Government’s key social care objectives. They keep people out of hospital, reduce the strain on carers, improve the dignity of disabled people and enable them to lead fuller, more socially included lives. For disabled children and their siblings, they improve educational and life chances.”

She added: “Annual spending on permanent or fixed alterations to the homes of disabled people is running at more than £220 million, with demand increasing every year. Almost all these capital costs are met from housing resources, via disabled facilities grants or housing revenue accounts. Our findings indicate that an increase in public funding for adaptations would be money well spent. But it may be that additional capital should come from non-housing sources, since many of the benefits of adaptations are felt by social services and the NHS.”

In contrast with the positive response to most of the adaptations, there were some cases where thousands of pounds had been spent on adaptations that were either unusable or harmful. The study found that where major adaptations failed, it was usually because of attempts to save money. For example, economies on heating provision led to a £14,000 extension being abandoned because it was too cold to use. Through-floor lifts, which had sometimes been fitted as a cheaper alternative to an extension, also caused difficulties for families who were left with even less room to manoeuvre in their homes.

Further problems were linked to staff shortages and overspent capital budgets. Delays had, in some cases, led to accidents and hospitalisation while disabled people were waiting for their homes to be adapted. There was also evidence that the £20,000 limit on mandatory disabled facilities grant in England was leading to poor quality or inadequate work. Some extensions were so small that there was no room for a parent to sleep if their disabled child became sick.

Frances Heywood said: “The waste caused by under-investment in this minority of cases contrasts with the benefits shown from the many adaptations we saw that had been properly funded and well designed and executed. This reinforces the case for more investment to prevent the waste of both public money and human lives.”