In response to the impact of demographic change on the healthcare system, ‘ageing in place’ was introduced as national policies to support elderly people living independently in their homes. Housing adaptation is essential for successful independent living and has been given a greater political priority. However, adaptation policies and practice varied regionally, reflecting statutory limits, policy choices and local planning. This study investigated the current status of adaptation provision in different regions in the UK and assessed the effectiveness of local service planning and management. A mixed-methods sequential explanatory research strategy was employed. In the first quantitative phase, a questionnaire survey was carried out, involving all 378 local authorities in England, Scotland and Wales. This was followed by a second qualitative phase involved individual interviews with 5 professionals and 2 clients, and a focus group meeting with 6 key stakeholders. The study found that the current number of adaptations was relatively small compared with potential demands in most local areas, so was funding for adaptations. In the operational side, the adaptation process was fragmented, involving different service groups in many local authorities. There were disconnections between these groups, which often caused inefficiencies and poor effectiveness. Moving forward, local authorities need to have a clear vision on the overall need for adaptations and allocate sufficient resources. Practical guidelines are also needed for better integrated working and performance management.