Occupational Therapy News OTnews February 2020 | Page 17

HOUSING FEATURE
Closer working
Perhaps most important, though, is the chance for occupational
therapists to see plans for newbuilds far earlier than in the past.
Tom says: ‘Previously we would go out and do viewings for
people to move, but would have to say “no, this isn’t going to
work, this will need pulling out,” and housing associations were
spending an awful lot of money to have almost partial wheelchair
accessible properties. That was where they were getting
annoyed.’
Properties are now sent to the team through an online portal.
A lettings officer who works closely with the team earmarks a
potential resident as much as 12 months before the move-in date.
The team can then flag what features are not going to work in
the plans. That means that properties are ready to go from day
one for wheelchair users, rather than costing further money in
adaptations.
It also offers a chance to explain to developers why certain
design features would not work for wheelchair users. For
example, many duplexes were being built with the bedroom and
bathroom on separate floors, making it difficult for a resident to
get between the two.
The new system allows the team to catch such flaws and
easily rectify them at the design stage. A small number of units are
also built bespoke, particularly around bariatric cases.
Earlier conversations with developers can also avoid
unnecessary adaptations where they are not needed, such as
dropping height-adjustable kitchens if a resident will not need it,
offering an extra saving.
The result is a more open and ongoing dialogue during
construction. ‘We have planners and developers calling us now and
saying, “give us some guidance on it”, and they’re talking before they
have even submitted the plans for final approval,’ says Tom.
It’s not just developers who now work more closely with the
team; the planning teams have also been engaged more.
Says Tom: ‘We invited the planners to a completed scheme on
the Ocean Estate and see what they have achieved and delivered.
We heard from them that they didn’t realise what a wheelchair
property entailed and the difference for independence that a
through-floor lift and automatic doors brings.
‘It’s good for them to see a finished scheme to know what
works well and how it can be implemented in future schemes.’
And as well as working more closely with developers and
planners, the team is also working earlier with the eventual
residents. Wheelchair users are matched with properties about
a year before handover, so the team has a chance to manage
expectations about what users will be able to have.
Ground floor properties are rare, and parking spaces are even
rarer; expectations around moving to a housing association from
council-provided property also need managing.
Aplin et al (2018) investigated the clinical utility of the
In-Home Occupational Performance Evaluation
(I-HOPE) for major home modification practice in
Australia. The I-HOPE was trialled in one service. Data
were gathered from two focus groups, involving five
occupational therapists in total, and a questionnaire
completed at initial assessment (n=25) and post-
modification (n=14) by people who accessed the
service. Analysis revealed four themes relating to
client experience, training/resources, suitability and
improvements for future use. Findings included
therapists valued the person-centred focus of the
I-HOPE, but there were concerns it was not suited to
all client groups, and some clinical utility issues were
identified. The authors conclude the I-HOPE may not be
suited to major home modification services in Australia,
and they make suggestions for future developments
including an app/online version.
to have two lifts, to ensure that people do not become
housebound if the lift breaks. Fully automated front doors are
also now required to improve accessibility.
Reference
Aplin T, Ainsworth E (2018) Clinical utility of the In-
Home Occupational Performance Evaluation (I-HOPE)
for major home modification practice in Australia.
Australian Occupational Therapy Journal, 65(5), 431-438
Cumulatively, it is a project that has worked with clear rules
from above and with the occupational therapy team being
supported to make changes.
Adds Nerys: ‘We’ve got really supportive management here
and they give us quite a lot of autonomy. They trust us to identify
things that work well and things that don’t; we can go to them
and say ‘we need to go down this path’ and they let us know if
they think that’s something they can take further and discuss with
cabinet members.’
Looking to autism
The team has an annual ambition in its service plan and for the
coming year it is looking at what can be done for the fast-rising
numbers of families with autistic children.
That can include looking at window restrictors for high-rise
properties, and also paying close attention to issues around
overcrowding.
Unlike for wheelchair users, there currently is not a lot of
evidence on what such families need, so the team is closely
following the progress of some properties built on the borough’s
most recent project in the Ocean Estate specifically for families of
children with severe autism.
Kaltun Hirsi, a housing occupational therapist in the team, is
studying a Masters in autism and is also leading on this work.
She says: ‘In Ocean we talked about banister rails and the safety
issues with them, and the sensory toys that are in the communal
garden and the layout.
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