Community Equipment and adaptations for the patient who has been discharged home
Where a person is to be discharged home, it may be necessary for adaptations to be done to their home. Such equipment may be essential to their successful rehabilitation at home and the maintenance of their independence.
This article describes community equipment services. A subsequent article will address the more substantial adaptations provision available via Disabled Facilities Grants and the Chronically Sick and Disabled Person Act 1970.
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HSC 2001/008 ( also referenced as LAC (2001)13) states that:-
Community equipment is equipment for home nursing usually provided by the NHS, such as pressure relief mattresses and commodes, and equipment for daily living such as shower chairs and raised toilet seats, usually provided by local authorities. It also includes, but is not limited to:
- Minor adaptations, such as grab rails, lever taps and improved domestic lighting.
- Ancillary equipment for people with sensory impairments, such as liquid level indicators, hearing loops, assistive listening devices and flashing doorbells.
- Communication aids for people with speech impairments.
- Wheelchairs for short term loan, but not those for permanent wheelchair users, as these are prescribed and funded by different NHS services.
- Telecare equipment such as fall alarms, gas escape alarms and health state monitoring for people who are vulnerable.
Access to Community Equipment
Access to community equipment should now be from a single local source. Between 2001 and 2003, local health and social services were required to develop integrated equipment supply services.
“community equipment (aids and minor adaptations) service” means a qualifying service which consists of the provision of an aid, or a minor adaptation to property, for the purposes of assisting with nursing at home or aiding daily living; and, for the purposes of this paragraph, an adaptation is “minor” if the cost of making the adaptation is £1000 or less;”
By virtue of section 4(1) of these regulations, community equipment services are to be provided free. Thus any individual item of community equipment or a minor adaptation that an individual is assessed as needing must be provided free. There is no upper limit to the total amount that can be spent.
How to apply for assistance
An application to a community equipment store is usually made by a GP, district nurse or professional therapist such as an occupational therapist or physiotherapist. The need for this equipment is just one aspect of the wider assessment of the individuals health and social care needs. The equipment is usually loaned out and once no longer needed is returned to the store and refurbished.
In recent years the “retail model” for community equipment services has been trialled and is now available for local implementation. The intention has been to increase the market capacity for simple aids for daily living given the anticipated increase in demand due to an ageing population. It forms part of the general move towards personalisation and more market orientated service provision.
The retail model applies to equipment needed for activities for daily living only and not to house adaptations. The individual is given a prescription which is effectively a voucher for the relevant piece of equipment. They then use an accredited private provider who may offer a piece of equipment in exchange for the voucher. However the individual can top up the value of the voucher to buy a better piece of equipment. In this respect it is similar to the manner in which NHS prescriptions for optician services operate. The equipment becomes the property of the user.
Accreditation is mandatory for the dispensing of prescribed items but not for other privately purchased items.
According to Community Care Magazine (online version 5th March 2010) a London pilot was a success, delivering efficiencies for the authorities involved. This success led to the role out of the retail model across the city.
Concerns have been expressed that there are no required minimum standards for community equipment. In March 2011, the Welsh Assembly published minimum standards for community equipment intended to be good practice guidance for two years and to become mandatory in 2014. There are no plans to set such standards in England.
A catalogue of specifications for simple aids for daily living is available here:-
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