Low Level Adaptations and Equipment

Provision of community equipment, and minor adaptations up to a value of £1000, will be funded from the Adaptation and Equipment Budget held within the adult social care budget.

Equipment is provided on a free loan service but remains the property of the Integrated Community Equipment Service. Low level equipment available is:

• Bathing equipment;
• Toileting equipment;
• Adjustable trolleys;
• Perching stools;
• Chair raisers but not chairs;
• Some kitchen equipment.

These items of equipment are specialist and not items that are readily available for use by non-disabled people, for example bathmats. Occasionally readily available equipment may be loaned for the purposes of a Reablement/Rehab programme only.

Where a support package is being considered, consideration may be given to provision of alternative items of equipment that reduce the need for human assistance.

Low level adaptations are categorised as either a mini minor, or a minor adaptation. In Wigan they are assessed for predominantly by the Early Intervention Service within adult social care but can also be assessed for by wider council teams – Reablement and Be Well, who have both received competency training to assess for adaptations. The adaptations are currently arranged by Leigh Building Services (LBS), an in-house contractor.

Mini Minor adaptions are classed as Stair rails, grab rails and floor fixed toilet frames.

Minor adaptations are classed as wall-to-floor/floor-to-floor rails, steps, floor-to-ceiling poles etc.

If an adaptation is expected to cost below £1,000 then it will be considered to be a Minor Adaptation and will be funded by the Council for people living in all tenancies.

Such items are for use in individuals only or main home, however they are not provided for nursing or residential homes. 

Minor adaptations have a target delivery time following assessment and recommendation. For mini minor adaptations (simple fixing such as small grab rails, stair rails, floor fixed toilet equipment, wall fixed showering equipment) the guide time of 7 working days.

To support hospital discharge, where the adaptation is essential for safe discharge, mini minor adaptations have the guide time of 2 working days.

For minor adaptations such as external steps, wall-to-floor or floor-to-floor external rails, the guide time is 28 working days.

In private rented properties the assessor prescribing the minor adaptation will seek permission from the landlord. In Housing Association propertied the assessor will write a letter of recommendation to the Housing Association for the adaptations to be completed. The installation of the adaptations in properties belonging to registered social landlords is the responsibility of the landlord.

Equipment delivery times vary according to the priority level awarded to the request. Bespoke or special equipment timescales are dependent on the company providing them.

The Early Intervention Service are the main assessors of equipment and adaptations. However, a trusted assessor approach is in place for some key teams who have undertaken adaptations competency training. These include:

• Suitably trained NHS Therapy;
• Reablement Service;
• Manual Handling team;
• Be well Service;
• Commissioned external organisations such as Ableworld or suitably trained Adaptations contractors.

Trusted assessors undertake adaptation assessments and pass the recommendations through to the EI service who process via a passported assessment on the mosaic system. The Reablement and Manual Handling service can access minor adaptations via their own mosaic pathway, and forward requests directly to LBS. The Be Well service can also access minor adaptations via the same passported route as NHS assessors.

Accountability for the recommendations lies with the trusted assessor. 

Where necessary, joint assessments with other health and social care colleagues will be undertaken. 

A range of assessment methods may be used including self-assessment, face to face, digital and telephone assessments.

Occasionally, we may commission external organisations to complete assessments on our behalf. Such organisations are used in times of high demand, or while awaiting recruitment. All such contracts are subject to internal audit, commissioning and recruitment rules.

Ableworld are a local retailer who supply low level equipment and adaptations on the high street. Wigan Council have a contract with Ableworld to provide assessment and recommendations, including provision of low-level preventative equipment and adaptations. The majority of the referrals identified as suitable for Ableworld come from the Early Intervention service. The locality social care teams across adult social care can also access Ableworld for service users where they identify the need for some low-level equipment, and this would avoid the need of a referral the EI service.

Locality teams are requested to consider Ableworld in the first instance if the assessor and/or the service users have a good idea of what would resolve their needs. Ableworld can provide simple pieces of equipment and adaptations including the following:

• Bathing and showering equipment;
• Dressing aids;
• Access equipment (minor steps and rails);
• Toilet equipment;
• Furniture and bed raising equipment;
• Kitchen equipment;
• Perching stools;
• Grab rails;
• Stair rails.

Referrals to Ableworld go to the EI service via a next action of EI screening from the Supported self-assessment, urgent or review work step.

The Early Intervention Service arrange minor adaptations via Leigh Building Services, an inhouse contractor that offers a range of building services. Feasibility visits for more complex minor adaptations can be request via minor works. More straightforward requests can be emailed directly to minor works on the adaptations request sheet.

Trusted assessors, as described above arrange minor adaptations via completion of an adaptations request sheet and forwarding this to the EI coordinator. The coordinator will complete a passported EI assessment on mosaic and send this to LBS on behalf of the trusted assessor.

Arranging Urgent mini minor adaptations over Bank Holiday weekends

Mini Minor adaptation request sheets created by health and social care staff need to be forwarded to Central Watch email box at CWS.Supervisors@wigan.gov.uk.

Mini minors that can be treated as urgent for discharge are:

Grab rails and Mop-stick stair rails

When sending the request through to Central Watch, please complete the following:

• Please copy minorworks@wigan.gov.uk into the e-mail to Central Watch so they can be logged on the system by LBS admin;
• Please ring Central Watch to confirm that they have received the advice sheet and to ensure they have the data they need - Tel: 01942 404040;
• Please ensure they have a contact number for the family.

Please send very urgent referrals only to Central Watch as the number of contractors working are reduced on the bank holiday period.

Adaptations are recorded as an optional form (Adaptations Request Sheet) in the Early intervention assessment work step of mosaic.

Once the assessment has been completed:

• Choose EI specialist assessment once within the EI workstep;
• Complete a full holistic assessment;
• Record your recommendations in the non-Reablement outcomes section;
• Record this in person summary - person details section - notes - select note type of current communication needs and choose which facility the service user has access to;
• Choose an optional form of Adaptations request sheet and complete;
• Send this form as a PDF document to Minor works.

The assessing staff member will check that the person is able to use the minor adaptation following the installment. The local requirement is to check one in ten cases where there is no predicted concern about use. However, where a prescriber has any concerns for a specific case, checks should be made, this can be by telephone or face-to-face depending on the reason and level of concern.

When the adaptation has been recommended by a Trusted Assessor from an external organisation, they are responsible for checking the adaptation is suitable.

When equipment is no longer required, contact should be made with the Integrated Community Equipment Stores to arrange collection or advice regarding disposal of small items.