Aids and adaptations for children with disability

Occupational Therapy Service Offer

Supporting you to live safely, independently and well at home

If you or your child has a physical or neurodiverse disability, long-term health condition or additional need that impacts everyday life, you have the right to request an Occupational Therapy assessment.

Our Occupational Therapy Service works with children, young people, young adults up to the age of 18 years and their families, to identify what matters most to them and explore solutions that promote independence, safety, dignity and participation in everyday occupations. We take a person-centred, strengths-based approach, recognising that every individual and family is unique and that there is no one-size-fits-all solution.

Our aim is to support people to live as independently as possible within a home environment that meets their needs now and in the future.

What we offer

We can provide support through:

• Comprehensive Occupational Therapy assessments, considering functional ability, strengths, goals and environmental barriers
• Recommendations for equipment and minor adaptations that support independence and safety within the home
• Assessment and clinical specification of major adaptations where appropriate
• Advice and intervention relating to mobility, access, personal care, moving and handling, and participation in daily activities
• Consideration of rehousing where a property cannot be reasonably adapted to meet assessed needs
• Professional recommendations to support applications for adaptations and housing-related solutions
• Collaborative working with families, carers and professionals to identify practical and sustainable solutions

Our recommendations focus on achieving the least restrictive, most practical, proportionate and cost-effective way of meeting assessed needs, whilst promoting independence, wellbeing and quality of life.

What happens during an assessment

Following receipt of a referral, an Occupational Therapist will:

Following receipt of your referral and with your consent, we aim to complete a remote triage assessment within five working days. This enables us to gather additional occupational therapy information from you and, where appropriate, your family, carers and other professionals involved in your care, helping us to understand your needs and determine the most appropriate next steps.

• Complete an in-person functional and environmental assessment, usually within the home environment, to identify challenges, barriers and opportunities to improve independence, safety and participation in daily activities
• Discuss your daily routines, challenges and goals, and what is important to you, ensuring that your voice is captured throughout the assessment process
• Identify barriers, risks and opportunities to improve independence and participation
• Explore possible solutions and discuss available options

Following the assessment, recommendations may include:

• Advice and strategies
• Provision of equipment
• Minor adaptations
• Recommendations for major adaptations
•  Consideration of rehousing where appropriate

All recommendations are based on clinical reasoning, assessed need, relevant legislation, local policy and professional standards.

Adaptations and Disabled Facilities Grants (DFGs)

Where major adaptations are identified as necessary, we will provide information about the adaptations process and work closely with Housing Services and other relevant agencies.

We will -

• Explain any proposed works and the likely process involved
• Discuss the potential impact and disruption associated with adaptation work
• Provide information regarding funding routes, including Disabled Facilities Grants (DFGs)
• Ensure recommendations are clinically justified and focused on meeting assessed needs
• Work with partner agencies to identify sustainable long-term solutions

Disabled Facilities Grants are administered by Housing Services and may provide financial assistance towards eligible adaptations. Grants are subject to statutory criteria and, where applicable, a financial assessment. Adaptations should not commence before an Occupational Therapy assessment and recommendation has been completed, as grants cannot usually be awarded retrospectively.

Housing and rehousing

In some circumstances, a property cannot be adapted in a way that is reasonable, practical, safe or cost-effective.

Where this occurs, we may -

• Provide professional recommendations to support with adapted housing applications
• Liaise with housing providers and partner agencies regarding adapted or adaptable properties
• Support individuals and families to access accommodation that is more suitable for their long-term needs
• Provide evidence regarding the impact of the current property on independence, safety and wellbeing
• Any recommendation for rehousing will be based on assessed disability-related and clinical need and the suitability of the property to support long-term outcomes

Equipment and ongoing support

Equipment provision will be based on assessed need and clinical justification. Where equipment is provided -

• Information and training will be given regarding its safe use
• Maintenance, repairs and collection arrangements will be managed through the commissioned equipment provider
• Reviews may be completed were needs change significantly
• Some specialist equipment and interventions may require referral to other services where responsibility sits outside Occupational Therapy

What we do not offer

To ensure fairness, consistency and appropriate use of public resources, there are some areas which do not fall within the remit of the Occupational Therapy Aids, Adaptations and Housing Service.

We do not -

• Generically provide minor supervision or safety adaptations such as window restrictors, window locks, kitchen cupboard locks, stair gates, general door alarms or similar child safety products
• Assess or provide specialist car seats, vehicle harnesses, travel harnesses or transport-related equipment
• Undertake wheelchair assessments or provide wheelchairs. Referrals should be made to the local Wheelchair Service
• Complete sensory assessments or provide sensory integration services, sensory equipment, sensory rooms or sensory programmes
• Fund adaptations directly or make decisions regarding grant approval
• Retrospectively approve adaptations or building works that have already been completed
• Recommend additional bedrooms, extensions or larger properties unless there is clear evidence of a disability-related occupational need that cannot reasonably be met through alternative options
• Provide assessments solely to support housing preference, overcrowding concerns or lifestyle choices where there is no identified disability-related need

Where we are unable to support a request, we will explain the reasons for our decision and, wherever possible, signpost individuals and families to alternative services, agencies or pathways that may be better placed to provide support.

Our professional standards

Our service is delivered in accordance with -

• Care Act 2014
• Children and Families Act 2014
• SEND Code of Practice
• Housing legislation and Disabled Facilities Grant guidance
• Equality Act 2010
• Royal College of Occupational Therapists (RCOT) Professional Standards

This ensures our practice remains -

• Person-centred
• Occupation-focused
• Strengths-based
• Evidence-informed
• Outcome-focused
• Proportionate and least restrictive
• Fair, transparent and accountable

How to access the service

Referrals can be made by -

• Individuals and families
• Health professionals
• Education professionals
• Social care professionals
• Housing professionals and partner agencies

Make a referral via the Early Help and Safeguarding Hub (EHASH)

All referrals are reviewed and prioritised according to risk, safety, urgency and level of need. This helps ensure that those with the greatest need receive support at the earliest opportunity.

Waiting for an assessment

Whilst waiting for an Occupational Therapy assessment, you may find the following resources helpful - Waiting well | NHS inform.

The Waiting Well resource provides practical advice, information and signposting to services that may support you whilst your referral is awaiting assessment.

Home Fire Safety

Your safety at home is important. If you or a family member has a disability, health condition or reduced mobility that may affect safe evacuation in an emergency, you may be eligible for a free Home Fire Safety Visit from the local Fire and Rescue Service. These visits provide personalised fire safety advice, smoke alarm checks and guidance to help keep you and your family safe.

Find out more or request a Home Fire Safety Visit

Our commitment to you

We understand that seeking support can often occur during challenging times for individuals and families. We are committed to working openly, honestly and respectfully with those who access our service.

We will -

• Listen to what matters to you
• Involve you in decision-making
• Explain our recommendations and clinical reasoning clearly
• Treat you with dignity, respect and compassion
• Work collaboratively with you and relevant professionals
• Ensure our recommendations are evidence-based, person-centred and focused on achieving the best possible outcomes

Our goal is to help people live as independently, safely and meaningfully as possible within a home environment that supports their current and future needs.