Project lead: Local authorities

• Local authorities
• Civil Society Organisation
• Social or health care provider
• Private sector

How collaboration worked: The Home Refurbishment Programme is a complex one due to the number of agents involved and the interrelations between them and the procedures used in the different phases. For this reason, an operational governance model has been created to manage relations between the different actors and thus identify their needs more closely and improve the design and adaptation of the types of actions to the needs of vulnerable elderly people living at home, or people with disability. This model has helped scale-up interventions to improve accessibility and personal autonomy throughout the municipalities in the Barcelona province, reaching a large number of small and medium-sized municipalities. In this operational governance model, Barcelona Provincial Council is the institution that promotes, coordinates, manages and finances the programme, by contracting a company specialising in functional adaptation of homes, which is responsible for managing the intervention projects. The interventions are executed by building companies contracted by this corporation. For their part, local authorities, as the authorities closest to the public, participate by identifying target beneficiaries and homes for the programme and by co-funding the work. They are also involved in the evaluation of the program through debate workshops. Beneficiaries participate by evaluating the programme, which has helped to adapt and improve the interventions. Third sector social organisations specialising in care for vulnerable elderly people and those with disabilities also work with Barcelona Provincial Council by designing and publicising the programme among their users and referring potential beneficiaries to participating local councils. Results of the evaluation made by the beneficiaries of the work done and the treatment of the workers (On a scale of 1 to 5 – 1 = minimum score; 5 = maximum score -): Evaluation of the work done: • 2009-2010 Edition: 4.80 • 2012-2013 Edition: 4.83 • 2014-2015 Edition: 4.86 Evaluation of the treatment of the workers: • 2009-2010 Edition: 4.91 • 2012-2013 Edition: 4.83 • 2014-2015 Edition: 4.88

Older people’s involvement: Older people were consulted during the planning process

Details on older people’s involvement: Beneficiaries participate by evaluating the programme, which has helped to adapt and improve the interventions.

Has the impact of this age-friendly practice been analysed: Yes

Was the impact positive or negative:
Positive

Please share with us what you found in detail:
According to a study carried out by the University of Barcelona in 2015 on the “Economic impact of the functional adaptation of the home in home help and the prevention of falls” on the Program of functional adaptation of the home for elderly people with dependency in the city of Barcelona: • The level of satisfaction of the beneficiaries with the actions carried out by the Program is very high in all the aspects analyzed. • The actions carried out have a clearly preventive nature, as evidenced for example in the value of the self-perception indicator of dependence (IAPD, acronym in Spanish) • For every euro invested in support products, the annual savings range between 2.74 and 3.71 euros, taking into account the lower need of help from other persons and the prevention of different types of falls. • In the case of works at home it is necessary to analyze the investment taking into account the permanent nature of its effect, that is, the cost of the action is greater but its effect can be maintained over time. Taking a medium term horizon, the yield ranges between 5 and 6.35 euros. • The cost-benefit analysis performed by type of action corroborates the efficiency of preventive policies to deal with future increase of dependency situations. From the data collected through the monitoring of the program during the years 2009 – 2017 and with regard to the effectiveness of the interventions, it can be deduced that: • In 82% of cases beneficiaries are people with a high level of autonomy, a fact that confirms the preventative nature of the programme. • After the interventions, the percentage of people unable to carry out ADLs without help from someone else dropped by 24%. • With regard to accessibility, the number of people who could not access certain spaces in their home without help dropped by 20% after the refurbishment work. • In terms of safety, around 90% of beneficiaries state they feel completely safe in performing daily activities themselves. • The programme also includes users’ assessments of the interventions. These have been highly favourable and have risen each time: from 4.80 out of 5 in 2009 to 4.90 in 2015. The local council assessment of personalised attention, professional competence and administrative simplicity gives an average score of 8.15 out of 10.

Evaluation report: Avaluacio-CVI_BCN_Taller-2018.pdf

Feedback:
All the users participate in the final evaluation of the intervention in their homes, together with the project and sitemanagement facultative direction of the works, the construction building company and the social worker of the city council. The user evaluates both the intervention performed and the treatment received by the operators during the execution of the work.

Expansion plans:
The experience has characteristics that facilitate its generalisation or adaptation to other contexts. The programme is developed using agents present in other geographic contexts, such as local government, municipal social services, second-level local authorities or regional governments, building companies and the third sector. Therefore, the only thing that requires transfer is the knowledge and working method that is systematised and documented by the programme. The fact that 174 local councils (of all sizes) in the Barcelona area have participated or continue to participate in the programme shows the extent to which it has a multiplier effect and is affordable in different territorial and social contexts.

Reflections:
• Expand the type of interventions and technical aids • Improve management circuits • To intervene in the common spaces of the communities of owners

Challenges:
• Work with multiple and very heterogeneous agents: social workers and municipal technical services, architects and construction managers, construction companies, etc. • Complexity of program management. The programme coordinates a model of inter-government cooperation (provincial council and municipalities) and public-private cooperation to offer a home accessibility service to all municipalities in the Barcelona province, including the smallest ones with an older population and few resources. Other government bodies in Spain subsidise beneficiaries to contract the service individually, but have not developed a scalable public service. The programme is innovative in its multidisciplinary approach, with specialists such as physiotherapists, social workers and architects, who, based on a detailed analysis of each situation, propose specific solutions for functional adaptation of the home to the needs of each person (person-centred functional adaptation solutions). This involves a change in paradigm regarding accessibility, focussing more on functional adaptation of the different elements in the home to the person’s characteristics. The MGLC method permits this form of analysis. ICT also plays a key role in the programme, as it is run through a specific online application for managing documentation and actions, interconnecting all participating local councils, building companies, the project management and Barcelona Provincial Council.