People Directorate - Coventry

People Directorate

UNCLASSIFIED Strategy and Communities Room 138, Civic Centre 1 Little Park Street Coventry CV1 5RS Telephone 024 7683 1652 Fax 024 7683 3494 [email protected]

Our reference FOI 20122183 3 February 2014

Executive Director - People Brian M Walsh Head of Service Sara Roach Deputy Director Strategy and Communi ies

Dear

Thank you for requesting information about housing adaptations, which the Council received on 23rd December 2013. Your request has been considered under the Freedom of Information Act 2000 (“The Act”). You have requested the following information;

1. The assessment criteria for a stair lift and wet room to be authorised for the disabled through Coventry City Council’s Occupational Therapy Department where the applicant is a tenant of Whitefriars Housing Group.

2. A copy of any policies/documents that are referred to in the assessment criteria

In respect of questions 1 and 2 Please find attached a blank copy of the Occupational Therapy Assessment Form used using the assessment process. Also attached are the Disabled Facilities Hierarchy documents for provision of bathing facilities and access to sleeping facilities, used by practitioners following the specialist assessment to aid decision making about individual cases.

3. Any policies that you have in place for reasonable adjustments to be actioned in respect of waiving what appears to be your normal process of waiting for the applicant to return to hospital

4. Any documents/policies relating to the assessment of the level of/impact of

defined disabilities as part of the assessment process (eg any disability specific procedures/policies or any exclusions that are disability specific)

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5. Ay policies/documents on the health and safety detriment of a person not being awarded a stair lift as a result of severe pain and near blindness leading to an increased risk of falling without it.

In respect of questions 3,4 and 5 It has been established that the Council does not hold the above information. This is because the Occupational Therapy Department does not have any documented process for when people return to hospital. Similarly, the Occupational Therapy Department does not hold any policies or documentation about specific disabilities or exclusions. Thus, we are unable to provide any information relating to the above, and are informing you as required by Section 1(1) (a) of the Act, that states: "Any person making a request for information to a public authority is entitled to be informed in writing by the public authority whether it holds information of the description specified in the request". Individual needs are assessed using the documentation provided. Within the attached documentation, you will see that the health and safety of individuals forms part of the assessment process for adaptations such as stair lift or wet rooms. To advise and assist you regarding the types of information the Council does hold and regularly discloses, you may wish to view the latest Freedom of Information responses issued by the Council on our disclosure log or look at the Council's Publication Scheme and it's published reusable Open Data . For a wider range of information about the Coventry area and to see what other organizations are doing, have a look at Facts about Coventry In respect of question 3 Your original letter makes reference to another individual and their individual circumstances. The Council considers that the requested information is caught by the exemption to disclosure contained in Section 40 (2) of the Freedom of Information Act 2000 and the related first condition of Section 40 (3). Specifically, the Council considers that this meets the definition for personal data set out in Section 1(1) of the Data Protection Act 1998 ("DPA") as: "data which relate to a living individual who can be identified - (a) from those data, or (b) from those data and other information which is in the possession of, or is likely to come into the possession of, the data controller and includes any expression of opinion about the individual and any indication of the intentions of the data controller or any other person in respect of the individual"

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Involved individuals would also have no reasonable expectation that this information would be disclosed to the wider world (which is how any disclosure under the Act must be viewed). The information requested will not therefore be disclosed in this manner. This does not however mean that the person who is the subject of the requested information cannot obtain personal information about themself. Under the subject access provisions of the Data Protection Act 1998, a person has the right to:

• Ask us if we hold personal/sensitive information about them • Ask for incorrect personal/sensitive information to be corrected • Be given details about the purposes for which we use the information and the

details of other organisations we may be sharing it with • Request a copy of that information

The Council holds a vast amount of information in order to deliver its services to the community. Simply requesting 'all information' will result in a delayed response, so we always encourage requesters to provide as much detail as possible on the application form. For information about the application process, this is available on the Council website at the following link: http://www.coventry.gov.uk/info/826/data protection act/828/requesting personal information

Please note, under the Re-Use of Public Sector Information 2005 Regulations you are free to use this information for your own use or for the purposes of news reporting. However, any other type of re-use under the Regulations, for example; publication of the information or circulation to the public, will require permission of the copyright owner and may be subject to terms and conditions. For documents where the copyright does not belong to Coventry City Council you will need to apply separately to the copyright holder. If you wish to apply to reuse the information you have requested or have any other issues relating to this request please do not hesitate to contact me. You have a right to make representations about the outcome or handling of your request – in the first instance this must be made in writing within 40 working days of the date of this letter, to the Council's Information Governance Team at: Council House, Room 21a Lower Ground Floor Earl Street, Coventry. CV1 5RR [email protected]

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If you have done this and are still dissatisfied, the Information Commissioner can be contacted at: Information Commissioner’s Office Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF

Yours sincerely

Simon Brake Assistant Director, Communities and Health

Client Name: Client ID:

OT assessment blank Page 2 of 6

Are you having any difficulties that have an impact on you health & well being? Do you have any health concerns you would like support with? 2. Having Choice and Control Are there any activities or daily tasks you are having difficulties managing? Are there any parts of your daily living / everyday tasks you would like more control over?

Yes No

3. Economic and Educational Participation Are there any educational or employment (paid or voluntary) activities you would like support with managing / achieving?

Yes No

4. Your Social and Family Life and Being involved in Your Community Do you have any difficulties with accessing your local community and leisure facilities? Do you have any difficulties managing/ maintaining contact with friends or family?

Yes No

Evaluation of the Context Temporal Person's Age Development Stage Life Role/Cycle Health/Disability Status - Please tell us about your health (physical and mental) Use of Drugs/Alcohol Serious Abuse or Neglect

Environment Physical: Building, Furniture, Devices. Social: Availability & Expectations, Significant Others Current support provided? Specify who, when, what type of support and duration Cultural: Beliefs, Standards & Expectations

Evaluation of the Person's Variables



Sensorimotor The ability to receive input, process information and produce output (sensory, neuromusculoskeletal, & motor)

Cognitive Attend to task, reason & problem solve

Psychosocial Ability to interact and process emotions

Analysing Tasks - Evaluationg Performance Abilities Typical Requirements of Tasks Performance difficulties experienced

by Service User Mobility Sensorimotor skills Cognitive skills Psychosocial skills • Planning & programming of movement patterns. • Sensory processing - tactile, proprioceptive, perceptual, visual & vestibular (balance) • Neuromusculoskeletal - range of movement, muscle tone, bulk, strength, & postural control • Motor - gross coordination, motor control, bilateral integration Cardiovascular & Respiratory efficiency Structurally sound bones & joints Environment

Stairs Mobility Includes all requirements of mobility. Stair climbing also requires: Greater range of movement & muscle strength in the legs to carry body upwards on an extending knees & controlling descent of flexed knee Greater reliance on sensory visual cues - depth perception Environment

Detail any FALLS HISTORY Continence Sensorimotor skills Cognitive skills Psychosocial



skills Urine: • Awareness of need • Muscle control to prevent stress incontinence • Ability to empty bladder completely to prevent overflow incontinence Bowel: • Awareness of need • Muscle control • Constipation? • Access to suitable toileting facilities Toileting Sensorimotor skills Cognitive skills Psychosocial skills Access to facility • Transfers-consider: o Planning & programming of movement patterns o Adequate range of movement and postural control to: Manage transfers, Complete the task, Maintain hygiene, and Adjust clothing. Personal Hygiene Sensorimotor skills Cognitive skills Psychosocial skills Full Body washing Sensorimotor skills Cognitive skills Psychosocial skills • Planning & programming of movement patterns • Sensory processing & Neuro musculoskeletal • Adequate range of movement and postural control to: - Complete task, - Manage transfers, - Maintain stable standing / sitting position, - Complete a full body wash.

Bathing/Showering Sensorimotor skills Cognitive skills Psychosocial skills • Planning & programming of movement patterns • Sensory processing & Neuro musculoskeletal • Adequate range of movement and postural control to: - Complete task, - Manage transfers, - Maintain stable standing / sitting position, - Complete task of washing.

Dressing Sensorimotor skills Cognitive skills Psychosocial skills • Planning & programming of movement patterns • Sensory processing & Neuro musculoskeletal • Postural control, strength to maintain sitting position • Postural control, strength and range of movement to complete task of dressing top/bottom

Sleeping Facilities/Bed Transfers Sensorimotor skills Cognitive skills Psychosocial skills • Access to bed/sleeping area Bed Transfers • Planning & programming of movement patterns • Sensory processing & Neuro musculoskeletal • Postural control and strength to process through movement of transfer and maintain stable position in sitting and standing

Chair Transfers Sensorimotor skills Cognitive skills Psychosocial



skills • Planning & programming of movement patterns • Sensory processing & Neuro musculoskeletal • Postural control and strength to process through movement of transfer and maintain stable position in sitting and standing Nutritional Sensorimotor skills Cognitive skills Psychosocial skills • Access to food preparation area transportation • Planning & programming of movement patterns • Sensory processing & Neuromusculoskeletal • Adequate postural control, strength and range of movement to carry out task

Access to Property Includes all requirements of mobility, and also includes: • Environmental layout of access, steps etc • Greater range of movement, muscle strength in legs to negotiate access • Greater reliance on sensory visual cues – depth perception & sensory processing

Medication Sensorimotor skills Cognitive skills Psychosocial skills • Planning & programming of movement patterns • Sensory processing & Neuro musculoskeletal

Domestics Sensorimotor skills Cognitive skills Psychosocial skills • Planning & programming of movement patterns • Sensory processing & Neuro musculoskeletal

Shopping Sensorimotor skills Cognitive skills Psychosocial skills • Planning & programming of movement patterns • Sensory processing & Neuro musculoskeletal

Property Details Ground Floor Facilities

First Floor Facilities

Front Access

Back Access Bathroom Layout

Stairs Layout

Additional comments You would like to include in your assessment

Summary of difficulties & & risks identified & conclusions



Occupational Therapy Intervention Planed Goals: Agreed Outcomes: For each planned Action - indicate which EHP outcome area this covers

EHP Outcome Areas Adapt/Modify (eg. grab rails), Alter(eg. routines), Create (eg. refer for support), Prevention (eg. manual handling techniques) Restore/Establish (eg. practise of task)

Planned Action 1. Planned Action 2. Planned Action 3. Planned Action 4. Planned Action 5. Planned Action 6. Planned Action 7. Planned Action 8. Planned Action 9. Planned Action 10.

AGREEMENT: Coventry City Council encourages service users and carers to sign Assessments to indicate that they have been properly involved in the Assessment process and that they are in agreement with what is written. Your Signature Date

Carer's Signature

Date

OT Signature

Date

OT Name

OT Team

OT Team Address

OT Team E-mail Address OT Team Phone No

Comments, Compliments or Complaints: If there is any aspect of services that you would like to tell us about, please discuss with any of the people named on the front of this Assessment or use the Council's “SPEAK UP WE’RE LISTENING” forms.

ASSESSMENT IN RELATION TO RISK AND HIERARCHY OF PROVISION PERTAINING TO BATHING FACILITIES Start with the first level of service provision and then continue through the levels if the assessed status indicates that there is a Critical/Substantial (C/S) risk to the Service User or the carer(s). Level Service user's assessed status Resulting

criteria risk level 1 2 3 4 N

Clinical Reasoning Ax date

1. Would be able to continue with present method of maintaining personal hygiene-no critical/substantial (C/S) risks identified

2. Would be able to meet personal hygiene needs by strip washing without equipment or rehab. Cognitively able to accept methods advised-no C/S risks to service user/carer.

3. Would be able to meet personal hygiene needs with rehab and/or minor piece of equipment (perching stool, bathboard/seat, swivel bather, grab rails starting with most cost effective option). Cognitively able to accept methods advised-no C/S risks to service user/carer.

4. Would be able to meet personal hygiene needs with rehab and/or a bath lift (if no over bath shower already in situ) or other bathing equipment not exceeding £500. Cognitively able to accept methods advised-no C/S risks to service user/carer.

5. Would be able to meet personal hygiene needs with rehab and/or over bath shower and minor equipment, or with bathing equipment over £500. Cognitively able to accept methods advised-no C/S risks to service user/carer.

6. Would be able to meet personal hygiene needs with removal of bath & replacement with shower tray and use of minor equipment. Cognitively able to accept methods advised-no C/S risks to service user/carer.

7. Would be able to meet personal hygiene needs with removal of bath and replacement with shower tray and use of major equipment & door widening. Cognitively able to accept methods advised-no C/S risks to service user/carer.

8. Would be able to meet personal hygiene needs with removal of bath and replacement with shower tray and repositioning of toilet. Possible use of minor equipment and/or door widening. Cognitively able to accept methods advised-no C/S risks to service user/carer.

9. Would be able to meet personal hygiene needs with removal of bath and replacement with shower tray and repositioning of toilet. Use of major equipment & door widening. Cognitively able to accept methods advised-no C/S risks to service user/carer.

10. Would be able to meet personal hygiene needs with shower/toileting cubicle using existing space and provision of minor equipment. Cognitively able to accept methods advised-no C/S risks to service user/carer.

11. Would be able to meet personal hygiene needs with shower/toileting cubicle using existing space and provision of major equipment. Cognitively able to accept methods advised-no C/S risks to service user/carer.

12. Would be able to meet personal hygiene needs with use of level access shower using new build and minor equipment. Cognitively able to accept methods advised-no C/S risks to service user/carer.

13. Would be able to meet personal hygiene needs with use of level access shower using new build and major equipment. Cognitively able to accept methods advised-no C/S risks to service user/carer.

Therapist:…………………………………………………………………………… Signed:………………………………………………………………………………

Supervisor:…………………………………………………………………………. Signed:……………………………………………………………………………… Date:………………………………

ASSESSMENT IN RELATION TO RISK AND HIERARCHY OF PROVISION PERTAINIG TO ACCESSING SLEEPING FACILITIES Start with the first level of service provision and then continue through the levels if the assessed status indicates that there is a Critical/Substantial (C/S) risk to the Service User or the carer(s). Level Service user's assessed status Resulting

criteria risk level 1 2 3 4 N

Clinical Reasoning Ax date

1. Would be able to continue with present method of accessing sleeping facilities no risks identified

2. Would be able to access existing sleeping facilities with equipment/minor adaptations and/or rehab. Cognitively able to accept methods advised-no C/S risks to service user/carer.

3. Would be able to access another room that could be used as sleeping facilities, which does not C/S disadvantage others living in the property. Cognitively able to accept methods advised-no C/S risks to service user/carer.

Please note consideration must now be given as to the most cost effective option i.e. partition of a room as opposed to a provision of a lift. 4a. Would be able to access other sleeping

facilities by partitioning of a room, which will not result in critically or substantially disadvantage others living in the property. Cognitively able to accept methods advised-no C/S risks to service user/carer.

4b. Would be able to access existing sleeping facilities by provision of a stair lift. Cognitively able to accept methods advised-no C/S risks to service user/carer.

5. Would be able to access existing sleeping facilities by provision of a through floor lift. Cognitively able to accept methods advised-no C/S risks to service user/carer.

6. Would be able to access new build single bedroom-sleeping facilities. Cognitively able to accept methods advised-no C/S risks to service user/carer.

Please note – Double bedroom will only be provided in exceptional circumstances and can only be approved by head of therapy services

7. Would be able to access new build double bed room sleeping facilities. Cognitively able to accept methods advised-no C/S risks to service user/carer.

Therapist:…………………………………………………………………… Signed:………………………………..…………………………………………

Supervisor:…………………………………………………………………. Signed:………………………………………………………………………… Date:…………………………….

Documents

People Directorate - Coventry