Herefordshire HIA Foundations Presentation 03Oct2
                     Herefordshire Council Home Improvement 
Agency
“You at Home”
 Philippa Winstanley
 Promoting Independent Living Services Manager
 3rd October 2019
Adults and Communities Directorate
Current HIA Team Structure
PILS Manager
Philippa Winstanley
1FTE
Senior Officer OT Team TECS Team
HIA 
Kanute Kindamba
1FTE
Senior 
Technicia
n 
 1FTE Neil 
Prince
Surveyors Caseworkers
1FTE Nick Cadwallader
1FTE Paul 1FTE Eira Levi
Technicians Woollaston 1FTE Jane Reid
1FTE Andrew Cross
1FTE Phillip Ricketts 1FTE Isabel Bright
1FTE Matthew 0.6FTE Lisa Massam
1FTE Richard Bufton George 0.4FTE locum Julie Jones
1FTE William  Watling 0.5FTE Victoria 
Gauld
Past History:
 In-house HIA created within Private Sector Housing 2006
 Restructure approx. 2013- 2014 – Environmental Health – EEC Directorate, PSH 
no longer exists. HIA joins Adults and Wellbeing Directorate
 2014 – OT Service created in Adults and Wellbeing Directorate, TUPE of some 
staff from NHS
 2015 – Creation of “Operations” and “Prevention & Support” Services within 
AWB. OT Service is centralised within Prevention & Support Services. HIA 
becomes jointly managed with OT.
 2016 – Telecare service added to OT/HIA Management
 2019 – Restructure into Adults and Communities Directorate
 June 2019 – internal review of Prevention Services started
Home Adaptations & Assistance Policy
Regulatory Reform (Housing Assistance) England & 
Wales Order 2002
Housing & Technology 
Project
for 
People with 
Learning Disabilities
January 2017- March 2018                                       Herefordshire Council 
“Having a home guarantees a place in the community and is part of how 
people are accepted as equal citizens”
(DOH September 2016)
 Half of the population of adults with learning disabilities 
in England live with their families, most of the remainder 
(33%) live in residential care. 
 Only 15% of adults with learning disabilities have a secure 
long-term tenancy or their own home. 
 This is in comparison with 70% of the general adult 
population who own their own home and nearly 30% who 
rent.
What we did:
 Properties identified by survey sent to existing schemes
 Put in a successful bid to DOH to retrofit 13 properties with adaptations and 
technology 
 Received £285,000 from DOH and added an additional £85k + from capital funds
 Delivered a council led project with input and support from housing and care 
providers  
 Liaison with staff in 2gether NHS Trust LD Team
 Technology providers – Tunstall/ Just Checking/ Brain In Hand – formed part of 
project group
 Limited time available – Launched Sept 2016, Application by end October 2016, 
MOU signed off January 2017, completion of project by March 2018. Final report 
to DOH Autumn 2018
 Total of 81 people supported by adaptations/technology installed
The type of works included:
 Shower rooms/ Washing & Drying WC/ wheelchair accessible front door/ zero 
pressure internal fire doors/ ramped access
 Finger print lock releases/ video door entry systems
 Linked fire control panels to lifeline alarms for automatic contact to call 
centre if fire alarm went off
 Proximity sensor to alert staff to whereabouts of an individual in selected 
areas to avoid property damage (linked to pager via nurse call system)
 Electronically opening blinds – to allow all to use sensory room without 
damage to curtains
 Sensory Baths – to maximise engagement in personal hygiene/ sensory 
stimulation & relaxation
Type of works cont:
 Provided “Buddi” bracelet trackers for 3 residents to allow them to access 
the community independently without a support worker but with emergency 
support if needed
 Trialled “Brain in Hand” with several residents to support with anxiety 
management and access support in an emergency when accessing community 
facilities
 Installed “Just Checking” systems to allow an evaluation of potential for 
independent living and plan support delivery.
 Provision of overbed movement / epilepsy sensor 
Property 1 ( Care Home)
 Shower room upgrade        Bathroom: shower walls boarded, WC, wash hand basin 
                                         
                                          Two people can  n  o  t   w   e i g  h  t   b ear, so get around on the floor       
                                                They both need Zero pressure bedroom doors                                         
                
                                                        This has made such a difference to their lives.  
Property 1 cont.
Automated front door & audio door entry             Care Assist – linked to radio pull cords                              
                
                                                       Fire control panel linked to lifeline                                          
Property 2
2x level access showers                                  3x Electronic blinds in sensory room
Property 2 cont.
                    2x Sensory Baths  Bubbles, Coloured Lights, Music … & relax
#
Property 4
Flat 1 is separated now has level access shower in annex 
                                                                                                   
                                                                                                 
                                                                                             Fire control panel linked to lifeline                
            
                                                                                                       Property exit sensor
Property 6
Finger print Front door entry system – no need for keys                               Also video access system
                                                                                             
                                                                                                 Security cameras are linked to staff office        
  Each person has finger print 
            access to their own 
                   bedroom as well             
                                                                                            
                                                                                                                                                                                     
                                                                                              Fire control panel linked to lifeline as well
The Buddi wristband: 
senses motion and communicates wirelessly with the Buddi Connect app or the 
Buddi Clip. In the case of a fall, or if the alert buttons are pressed, the wristband 
raises an alert. This alert is either communicated to the wearer’s responder either 
through the Buddi Connect app or the Buddi Clip via the 24/7 Monitoring Centre. 
The app will show the users last known location, and safe/unsafe zones can be set 
up.
Property 10
Lifelines to seven bungalows, 
then linked to Sleep In Room.
Considered linking with Property 11 to reduce 
sleep in and facilitate peripatetic support… 
Property 11
Property with 4 houses & central office and communal area. 
Up to 14 residents with varying needs
 Finger print access system
 Lifelines, telecare overlay with call points
 Over bed sensor
 Brain in Hand
 Just Checking
Personalised support from your mobile phone
Reduce Anxiety – Feel Safe – Increase Independence
Just Checking  
Just Checking is an activity monitoring system that helps people live in 
their own homes for longer by showing family and professionals their 
day-to-day capabilities — or where support is needed.
 Assessment tool, sensors to see how space is used
Over bed sensor
Outcomes expected from the Project
 The improvements are expected to: 
 increase satisfaction with the housing offer  
 enhance the ability of residents to participate more easily and with more 
confidence in the local community. 
 Improve the quality of the care and support provided by greater personalisation to 
maximise independence   
 People with emergency housing needs will have more options that are more 
appropriate to their needs?  ?
  the cost of emergency provision will reduce over time? ?
  …as will the cost of some care packages as people’s abilities and strengths are 
more readily recognised   
 there will be a reduction in the cost of care and support packages and that support 
that is provided will be more personalised and appropriate for the individual. 
What we also learnt …..
1. Need more detailed skills assessments & appropriate skills development 
programmes to identify & provide proactive support in “supported living”. 
2. Clearer measurements of behaviours and mood to evidence needs, changes 
and improvements
3. Sleep in issues – assessment details- what is the need and why? 
4. Joint working – council/NHS/commissioners/providers
5. Apply the learning to inform and plan future supported living arrangements 
6. Links with current/future Home Adaptations & Assistance policy 
7. Inspire the providers – eg subsequent meeting with one provider to look at 
technology to help change night time support model.
8. Communications & culture change within other provider staff – how to 
promote this?
Wider outcomes for practice:
What have we done since then…….
 PILS Manager involvement with Accommodation Group with Operations & 
Housing Commissioning.  Reviewing “supported living”.
 Ongoing joint working between Operations/OT/HIA/TECs around supported living 
options for individuals
 2 new supported living properties identified and adapted for individuals
 Review of development of 10 Supported Living Flats – lessons learnt
 Option of combining Supported Living & Accessible Homes Register under 
consideration
 Ongoing use of technology installations with DFGS by OT/HIA staff
 Business Case for Assessment & Demonstration Centre
 3 new Technology Projects currently being launched
Case Studies
 DFG -  Access to and from owner occupied property for young woman with 
birth defect involving upper limbs
 Two young people with learning disabilities in a relationship moved in together 
into new property, having lived separately in supported living and shared lives 
arrangements. 
 Various adaptations provided by DFG including wheelchair accessible kitchen facilities 
including work surfaces & high-low sink, also LAS, CT hoists, closomat WC
 Home life going really well – including new kitten!
New “Supported Living” arrangement - two young people with learning disabilities 
leaving home. 
 Closomat WCs, LAS, finger print door opening system
 Technology advice facilitated for father of autistic child around barn 
conversion development for integrated technology safety features without 
restricting movement and access – private and DFG works – “making the 
property safe for the disabled occupant”.
 Plan to install of air conditioning for 50yr old man with LD and autism, plus 
adaption to provide additional living space – “making the property safe for 
the disabled occupant”. Discussions ongoing with Housing Commissioners and 
RP about future tenancy and use of the property.
Current Technology Projects
 3 new pilots including: 
 Trail of new room sensing systems to detect falls, changes in usual activity or 
unhealthy room conditions
 Use of digital technology to support reablement and evidenced based assessment 
with a view to facilitating discharge & support, maximising independence and 
safety at home
 Technology to help identify those at risk of frailty and prevent the onset of frailty.  
This will have the effect of reducing falls by supporting people to maintain their 
muscle mass (the key indicator of frailty) and their hydration levels.
Thank you for listening! 
Any questions?