Assessing for Housing Adaptations under a Disabled Facilities Grant (DFG)

Published on 5 April 2024 at 17:41

Disabled Facilities Grant DFG OT Occupational Therapy

What is the Disabled Facilities Grant (DFG)?

The DFG is a UK government grant. It is awarded for the purpose of adapting homes to be safer and easier to be lived in by the disabled occupant/s. This may be due to a physical, mental or sensory health impairment that makes current living conditions difficult. The impact of inappropriate housing can have a significant impact on occupants health and wellbeing, and the provision of suitable adaptations can be lifechanging.

How much is the grant?

In England the grant is up to £30,000, in Wales £36,000, and Northern Ireland £25,000. The DFG isn’t available in Scotland.

Is it means tested?

A financial assessment will be completed by the local council. The applicant may be asked to contribute towards the costs depending on their income.

For children under 18, the grant is awarded without consideration of their parents income or savings.

The applicant needs to have the intention to remain living in the property for the next five years. This doesn’t prevent applicants with a palliative diagnosis from applying.

How do I complete an assessment?

Occupational Therapists completing an assessment for a DFG need to ensure that any recommendations are necessary and appropriate for the clients needs. This needs to be based on a strong understanding of their functional abilities, medical conditions and personal situation. Recommendations are based upon need instead of want, which can sometimes require tactful conversations with clients about the purpose of the DFG.

The assessment should be holistic, to gain insight into all aspects of the person, their occupations and environment. A model such as the CMOP-E can be a useful guide for this. Specific assessment criteria should include:

An assessment of mobility and transfers (bed, toilet, chair, bathing facilities, steps).
An upper limb assessment- do they have sufficient range of movement and grip strength needed for all activities?
Do they have falls?
What is their continence and personal care routine?
Do they live alone? What support do others give? What support do they give others? Are there children in the property, pets, or other adults with physical or cognitive impairment?
What OT equipment do they currently have- is this working, will they benefit from anything else?
Height, weight, leg measurements needed for seating/toilet heights.
Do they have any sensory or cognitive impairment? How might this affect safety with any adaptations?
What are their medical conditions, how does this impact on their physical and mental health? Can this be variable- what does a bad day look like?
Do they have a progressive condition- what is the prognosis? (You may need to gain consent to contact their GP or consultant).
What is their mood like, do they have social support, will they benefit from further referrals or signposting for this?
What is difficult for the client in the home, what are their goals?
If needed, take measurements- clear opening door widths, heights of steps, external space to accommodate a ramp, room measurements, heights of toilets and chairs.
With consent, take photographs- these can be invaluable to refer back to later.

How do I complete a recommendation?

It is useful to briefly outline the applicants functional abilities, and what in particular they are unable to do within the home.

Recommendations can then be made based on the above.

It is important to give minimum/maximum requirements- e.g. door widths, step heights, ramp width, space needed (e.g. for wheelchair turning circles, or to allow a carer to assist). If there are any rails, stipulate the position and height. If a toilet is likely to be changed, stipulate the height needed.

What types of adaptation can be completed?

The DFG can be used to fulfil the following purposes:

Access to the home and garden
Making the premises safe
Access to the principal family room
Access to a room useable for sleeping
Access to a toilet
Access to a bath or shower
Access to a wash hand basin
Preparation and cooking of food
Better heating
Control of light, power and heat
Caring for others

Common adaptations include ramps, stairlifts, level access showers, raising toilet heights, provision of wash/dry toilets, widening and rehanging doors. Larger scale works such as building an extension for downstairs living can also be funded through the DFG. Other examples include altering the heights of light switches, soundproofing, and creating a new door.

When do I recommend adaptations, and when is equipment enough?

There may be situations when it is unclear whether to recommend an adaptation or to provide equipment.

One example is whether to raise the height of a toilet, or provide a raised toilet seat. Judgment needs to be used to weigh up the pros and cons. For example, a raised toilet seat is: cheaper; quicker; less disruptive (in terms of noise and workmen coming into the property); it can be removed (if children need to use the toilet, or if a wheeled commode is likely to be pushed over it in the future). On the other hand, a raised toilet seat: is more difficult to clean; can shift position if the client transfers heavily or from an angle.

Another example is ramps. Some people prefer to use a temporary ramp that another person can put down before use and take up again afterwards. There can be a variety of reasons for this, including: insufficient space to build a permanent ramp, especially if the area extends onto shared use land; visual preference; not wanting to alter the property. Discussions with the client need to weigh up all options together, balancing functionality, abilities of client and carer, and safety.

What types of properties can be adapted?

Grant applications can be made for privately owned, privately rented, and social housing. All types of dwellings will be considered, including houses, flats, caravans and houseboats.

Can the applicant arrange the works themselves?

Usually the occupant can arrange the works themselves, and the council will pay the grant to the applicant or directly to the contractor, once the works have been completed and signed off. This usually includes Occupational Therapist or Trusted Assessor input to approve that the works meet the applicants needs. Some councils will arrange the works themselves through their own contractors.

What if adaptations won’t meet the clients needs?

Unfortunately, there are times when it isn’t possible to adapt an existing property. In these cases, the client may need to consider the benefits of moving. Occupational Therapists can assist with moves to social housing by completing a Housing Needs Report to the local council, outlining why the current property is unsuitable, and what the requirements are in an alternative property. It is important to consider reasonable future needs in this.

How do I learn more?

As in any OT job, it is important to keep learning so that we maintain our skills, curiosity and knowledge, give the best possible service to our clients, and fulfil HCPC CPD requirements. Some suggestions are:

Attend a course about the DFG, for example through Foundations.
Attend courses around specific aspects of housing assessment and design.
Familiarise yourself with companies and products that supply disability bathrooms and kitchens, wash/dry toilets, ramps, stairlifts etc. This may include visiting showrooms, talking with reps and looking at websites or brochures.
Link in with your local wheelchair services team to learn about their criteria for wheelchair provision and how this fits in with housing.
Network with other OTs in similar roles.