Community Care Statistics, Social Services Activity ...... [email protected] Author: Social Care statistics team, Health and Social Care Information Centre Responsible statistician:

Community Care Statistics, Social Services Activity - England, 2011-12, Final release

Published 15 February 2013


2 Copyright © 2013, Health and Social Care Information Centre. All rights reserved.

We are England’s national source of health and social

care information

www.ic.nhs.uk

[email protected]

Author: Social Care statistics team, Health and Social Care Information Centre

Responsible statistician: Katharine Robbins, Programme Manager

Version: V1.0

Date of publication

15 February 2013

http://www.ic.nhs.uk/

mailto:[email protected]


Copyright © 2013, Health and Social Care Information Centre. All rights reserved. 3

Contents

1. 2

2. Executive Summary 5

Main findings 5

List of Tables and Figures 7

3. Chapter 1: Introduction 10

Data Sources 10

Acknowledgement 11

4. Chapter 2: Access to Care 12

Referrals 12

Waiting time to completed assessment 15

Assessments 19

Reviews 26

Total review events 29

Assessments and reviews provided at the expense of the CASSR 30

5. Chapter 3: Packages of Care 32

Introduction 32

Type of services provided to service users 33

6. Chapter 4: Community Based Services 40

Introduction 40

Community Based Services provided by type of service and service user characteristics 40

Home care 45

Intensity of Home Care 48

Self directed support 49

7. Chapter 5: Residential Care 53

Introduction 53

Type of Registered Accommodation 54

Supported Resident by Age Group 56

Supported Residents by primary client type 58

Admissions and Transfers 60

Permanent Admissions 60

Adult Placements/Shared Lives Schemes 63



8. Chapter 6: Carers 65

Introduction 65

Carers assessments and reviews 66

Carers receiving Services 68

9. Annex A - Editorial Notes 71

10. Annex B - Data Quality 75

11. Annex C - How are the statistics used? Users and Uses of the

Report 88

12. Annex D - Glossary 90

13. Annex E - Reference Tables 95

14. Annex F - Flowchart of RAP & ASC-CAR Proformas 96

15. Annex G - Related Publications 97

16. Annex H - Further Information 99



Executive Summary

This is a report on the social care activity of Councils with Adult Social Services Responsibilities (CASSRs) in England. It contains information taken from council administrative systems used to record the process of assessing eligibility to state funded social care and providing services where people are eligible.

It combines data from two sources: the Referrals, Assessments and Packages of Care (RAP) and the Adult Social Care Combined Activity Return (ASC-CAR). Information presented here is final and relates to England for the period 1 April 2011 to 31 March 2012. It supersedes the provisional data published on 12 September 2012.

National level information is provided in this report; data at a Regional and CASSR level is available (together with a wealth of other social care data) via the National Adult Social Care Intelligence Service (NASCIS) online. NASCIS provides a set of analytical, query and reporting options which can be accessed from http://nascis.ic.nhs.uk

Main findings The number of contacts from new clients in 2011-12 was 2.1m (down 3% from 2010-11 and

up 2% from 2006-07). Of these, 1.0m required a further assessment or commissioning of ongoing service (down 4% from 2010-11) while 1.1m were dealt with at the point of contact (down 3% from 2010-11) (section 2).

The number of assessments in 2011-12 was 607,000 - down 8% from 2010-11 and down 7% from 2006-07. Of these, 32 per cent were assessed within the first two days of making contact with the CASSR and 68 per cent went on to receive services as a result of their assessment (section 2).

The number of service users with completed reviews in 2011-12 was 1.0m - down 13% from 2010-11 and down 20% from 2006-07 (section 2).

The number of people receiving services in 2011-12 was 1.5m (down 7% from 2010-11 and down 18% from 2006-07). Of these, 1.2m received community based services (down 8% from 2010-11), 213,000 received residential care (which is less than a 1% change from 2010-11) and 86,000 received nursing care (down 1% from 2010-11). Feedback from councils suggests that the fall this year is due to a number of reasons which include providing services outside of a formal assessment process and data cleaning. This will also help to explain the reduction in the number of reviews (section 3).

The number of people receiving self-directed support was 527,000 (an increase from 377,000 in 2010-11). Of these, 139,000 received a direct payment - up 11% from 2010-11 (section 4). The number of carers receiving self directed support was 78,000 (up 12% from 2010-11)

Of those receiving community based services not in the form of direct payments in 2011-12, 517,000 received home care, 431,000 received equipment, 268,000 received professional support, 159,000 received day care, 70,000 received short term residential care (excluding respite care), 60,000 received meals and 107,000 received other services (section 4).

The number of carers receiving services was 363,000 (down 4% from 2010-11 but up 15 from 2006-07). Of these, 48 per cent of carers received a carer specific service and 52 per cent received information only. This compares to an equal 50 per cent split in 2010-11 (section 6).

http://nascis.ic.nhs.uk/



Summary Table: Main figures from the RAP returns for 2011-12, showing flow of information1.

1. A client may appear on different parts of the RAP proformas during different periods. For example, a client may have appeared as a contact on the R returns during the period 1 April 2010 to 31 March 2011, but then appear as a client with a completed assessment on the A returns in the 2011-12 survey. The same applies to services.

2. Some clients will be recorded more than once on the R returns as they may make more than one contact during the period. In addition, the R proformas include all contacts made during the year, regardless of whether or not the client actually received an assessment or any service during the period.

3. The assessment and review figures relate to clients whereas the referral figures are a count of contact events. It is therefore not expected that the referral and assessment figures will match. There should be no double counting of clients within assessments for new clients on A6 and within reviews for existing clients on A1. If a client has more than one assessment or review event during the period then details are recorded in relation to the most recently completed event. However, it is possible for a client to be recorded on both A1 and A6 if they were both assessed as a new client and received a review during the reporting period.

4. This figure is the number of service users receiving one or more services at some point during the year and excludes double counting.

5. This figure includes service users receiving services provided, or commissioned by the CASSR during the year following a community care assessment. The client's assessment may have taken place in the current reporting period or in an earlier year. It includes new services that have started during the period and those carried forward from a previous period.

Number of screened contacts Number of clients with completed Number of clients receiving

from new clients2 assessment or review3 services during the period

1,003,000 607,000 1,231,000

213,000

1,083,000 1,003,000

86,000

Total 2,086,000 Total 1,610,000 Total4,5 1,462,000

Source: RAP proformas

Contacts for new

clients that resulted in

further assessment of

need or commissioning

of service (R1)

New clients for whom the

first assessment was

completed during the

period (A6)

Clients receiving

community

based services

(P1)

Clients receiving

residential care

services (P1)Contacts for new

clients dealt with at or

near the point of

contact (R2)

Existing clients for whom

a review was completed

during the period (A1) Clients receiving

nursing care

services (P1)



List of Tables and Figures

Figure 2.1: Number of contacts from new clients, 2006-07 to 2011-12 13

Table 2.1: Length of time from first contact to completed assessment for new clients for whom the assessment process was completed during the period1 by age group, England 2011 to 2012 15

Figure 2.3: Percentage distribution of all new clients of the length of time from first contact to completed assessment, 2006-07 to 2011-12 16

Figure 2.4: Percentage distribution of all new clients of the length of time from first contact to completion of assessment by age group and time band, 2010-11 and 2011-12 17

Figure 2.5: Length of time from first contact to completion of assessment for new clients by primary client type and time band, 2011 to 2012 18

Figure 2.6: Number of new clients with completed assessments by age group, 19

2006-07 to 2011-12 19

Figure 2.7: Percentage distribution of all new clients from first contact to completed assessment by age group, 2006-07 to 2011-12 20

Figure 2.8: Percentage distribution of new clients with completed assessments by primary client type, 2011 to 2012 21

Figure 2.9: Percentage of new clients with completed assessments by primary client type and age group, 2011 to 2012 22

Figure 2.10: Percentage distribution of new clients with known or anticipated sequel to assessment, 2006-07 to 2011-12 23

Figure 2.11: Percentage distribution of new clients with a known or anticipated sequel to assessment, by age group, 2011 to 2012 24

Figure 2.12: Percentage distribution of new clients aged 18 and over with a known or anticipated sequel to assessment, by gender, 2010-11 and 2011-12 24

Figure 2.13: Percentage distribution of new service users with completed assessments by ethnic group and anticipated sequel to assessment, 2011 to 2012 25

Figure 2.14 Number of existing service users with completed reviews by age group, 2006-07 to 2011-12 26

Figure 2.15: Percentage distribution of all existing service users with completed reviews, by age group, 2006-07 to 2011-12 27

Figure 2.16: Percentage of existing service users with completed reviews by primary client type, 2011 to 2012 27

Figure 2.17: Percentage distribution of existing service users with completed assessments and reviews by primary client type, 2011 to 2012 28

Table 2.2: Numbers and ratio of existing service users with completed reviews and review events by age group, 2011 to 2012 29

Figure 2.18: Percentage distribution for assessments and reviews provided at the expense of the council by age group for all service users, 2011 to 20121 30

Figure 2.19: Percentage distribution of funding source for assessments and reviews by primary client type, 2011 to 2012¹ 31

Table 3.1: Number of service users receiving services during the year by service type and age group, 2010-11 to 2011-12 33

Figure 3.1: Number of service users receiving services by age group, 2006-07 to 2011-12 34



Figure 3.2: Percentage of service users receiving services during the period by type of service and age group, 2011 to 2012 34

Figure 3.3: Percentage distribution of service users receiving services by age group and primary client type, 2011 to 2012 35

Figure 3.4: Percentage distribution of service users receiving services by service type and gender, 2011 to 2012 36

Figure 3.5: Percentage distribution of service users receiving services by gender, age group and primary client type, 2011 to 2012 37

Figure 3.6a: Ethnic group of service users aged 18 to 64 receiving services, 2011 to 2012 38

Figure 3.6b: Ethnic group of service users aged 65 and over receiving services, 2011 to 2012 38

Figure 3.7: Percentage distribution of ethnic group by primary client type, 2011 to 2012 39

Figure 4.2: Number of service users receiving community based services by age group, 2011 to 2012 41

Figure 4.3: Number of service users receiving direct payments, 2006-07 to 2011-12 42

Table 4.1: Number of service users receiving community-based services by service type and age, at 31 March 2009 to 2012 43

Figure 4.4: Distribution of service users receiving community-based services by primary client type, England as at 31 March 2012 44

Table 4.2: Actual number of contact hours of home care provided during the year, by sector, 2006-07 to 2011-12 45

Figure 4.5: Percentage of contact hours of home care provided during the year, by sector, from 2006-07 to 2011-121 46

Figure 4.6: Average number of contact hours of home care provided during the year, by sector, 2006-07 to 2011-12 47

Figure 4.7: Service intensity: distribution of planned contact hours, 2010-11 and 2011-12 48

Figure 4.8: Distribution of social care service users receiving self directed support and/or direct payments provided or commissioned by the CASSR, by client type and age group, 2011-12 49

Figure 4.9: Distribution of social care service users receiving self directed support and/or direct payments provided or commissioned by the CASSR, by age group, 2010-11 to 2011-12 50

Figure 4.10: Distribution of social care service users by type of self directed support, client group and age, 2011-12 51

Figure 4.11: Distribution of social care service users receiving self directed support and/or direct payments provided or commissioned by the CASSR, by ethnic group, 2011-12 52

Figure 5.1: Number of Supported Residents by type of accommodation1, 2, 3, 4 , 2002 to 2012 54

Figure 5.2: Percentage of Supported Residents by type of accommodation1,2,3,4 , 2002 - 2012 55

Figure 5.3: Percentage of Supported Residents in registered accommodation¹ by age group, as at 31 March 2012 56



Figure 5.4: Percentage of Supported Residents aged 18-64 and 65 and over by type of registered accommodation, 2007 to 2012 57

Figure 5.5: Percentage of Supported Residents aged 18-64 in registered accommodation¹ by primary client group, as at 31 March 2012 58

Figure 5.6: The percentage distribution of accommodation type for Supported Residents aged 18 to 64 by primary client group1, as at 31 March 2012. 59

Figure 5.7: Number of Permanent admissions1 to all Residential and Nursing care, 2006-07 to 2011-12. 60

Figure 5.8: Permanent admissions by client group¹, 2011-12 61

Figure 5.9: Comparison of permanent admissions across client groups¹ for adults aged 18-64, 2007-08 to 2011-12 62

Table 5.2: Number of service users recorded on Adult Placement schemes by client type, 2007 to 2012 63

Table 5.3: Number of permanent admissions to adult placement schemes by client type, 2006-07 to 2011-12. 64

Figure 6.1: Percentage distribution of assessments or reviews offered to carers by assessment type, 2006-07 to 2011-12 65

Table 6.1: Number of carers offered an assessment or review by age group of carer, 2011 to 2012 66

Figure 6.2: Number of carers with a completed assessment or review by primary client type of the person cared for, 2006-07 to 2011-12 66

Figure 6.3: Percentage distribution of carers offered an assessment or review by age group of carer, 2011 to 2012 67

Figure 6.4: The number of carers offered an assessment or review, 2006-07 to 2011-12 67

Table 6.2: Number of carers receiving services by age group of carer, 2011 to 2012 68

Figure 6.5: Number of carers receiving services by type of service received, 2006-07 to 2011-12 68

Figure 6.6:Percentage distribution of service delivered after an assessment or review, 2006-07 to 2011-12 69

Figure 6.7: Number of carers receiving services by primary client type of the person cared for, 2006-07 to 2011-12 70

Table A1: Number of CASSRs providing non-voluntary data, by proforma and level of completion, 2011-12 78

Figure A1: Number of full, partial or empty returns by RAP proformas, England in 2010-11 and 2011-121. 79

Figure A2: Percentage of CASSRs using a whole population count as the basis of return, by RAP proforma, England 2010-11 and 2011-12. 80



Chapter 1: Introduction

The Health and Social Care Information Centre publishes a suite of reports on adult social care which cover:

Activity – number of referrals, assessments, reviews and services received.

Expenditure – amount spent by local authorities carrying out their social care activity including unit costs.

Experience – surveys of service users and carers which include questions on satisfaction with services received and quality of life of the individual.

Workforce – the number and characteristics of staff employed by adult social services departments.

Abuse of vulnerable adults - information on alerts and referrals to adult social care safeguarding teams.

This particular report is on the social care activity of CASSRs in England and does not cover people who pay entirely for their own care. It is estimated that around 170,000 (45%) of the registered care home places in England are occupied by self-funders and 170,000 older people pay for care in their own home. This increases to 270,000 if it is widened to include help with activities such as housework and shopping1. This activity is not included in this report.

Some of the data in this report is used to populate measures from Adult Social Care Outcomes Framework (ASCOF)2. Specifically, data contained within this report will be used to populate the following ASCOF measures:

1C – Proportion of people using social care who receive self directed support, and those receiving direct payments.

2A – Permanent admissions to residential and nursing care homes.

Data Sources

This report combines data from two main data sources, the Referrals, Assessments and Packages of Care (RAP) and the Adult Social Care Combined Activity Return (ASC-CAR). This report was new for 2008-09 and replaces a number of reports based on separate data collections that have been published in the past. There is also a small amount of expenditure data used from the PSSEX1 collection.

Not all figures mentioned in the text are from tables and charts in this report but can be found in the previous years report. 3

RAP

RAP was developed to provide a coherent set of National Statistics on adult community care. Community care is the process by which requests for social care help made to Councils with Adult Social Services Responsibilities (CASSRs) are translated, via assessment and care planning into appropriate services.

Most of the information presented has been collected since 2000-01. Some of the waiting times data was collected for the first time in 2004-05, information around carers in 2005-06 and the age split of service users receiving services by ethnicity in 2006-07. Information on home care (number of hours and visits) was collected for the first time in 2008-09 and more detailed information on self directed support was introduced in 2009-10.

1 See “An Analysis of Self-Funders in the Social Care Market” available from http://ipc.brookes.ac.uk/publications/index.php?absid=646

2 ASCOF definitions can be seen at

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_131059 3 www.ic.nhs.uk/pubs/finalcarestats1011ssa

http://ipc.brookes.ac.uk/publications/index.php?absid=646

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_131059



ASC-CAR

The S tables of the ASC-CAR return collect information on residential and nursing care placements funded by CASSRs. A supported resident is a person receiving care in residential or nursing accommodation whose costs are met wholly or partly by a particular CASSR. Some CASSRs may place a resident in a home located outside of the council; in this report such residents have been assigned to the CASSR responsible for making the placement. Data are collected by type of care, age group, type of accommodation and type of stay (i.e. permanent or temporary). Information is also collected on permanent admissions during the course of the year. These tables provide more detailed information on residential and nursing care than the RAP return. Data from ASC-CAR can be found in chapter 5.

PSS Ex1

The activity data sheet within the PSS Ex1 return collects the information on the number of hours of home care provided by councils. This is the actual number of home care hours that have been provided and paid for by the council. This is used in chapter 4.

Many of the national figures presented in this report are estimates as they have been grossed up to allow for non-response. When comparing data with previous years it should be borne in mind that the level of completion and quality varies over time. This, together with changes in the recording procedures used by CASSRs, may in part explain some of the observed trends.

Acknowledgement

Collation of the data for the RAP, ASC-CAR and PSS Ex1 collections involves significant work for staff in Councils at a busy time. The Health and Social Care Information Centre would like to place on record its appreciation to CASSR staff, in the work of collating the data and their efforts to try to ensure that the data reported gave a true picture of services actually delivered. This report is based upon details from all 152 CASSRs in England.



Chapter 2: Access to Care

This chapter provides information on referrals to social services, the time it takes from first contact to completed assessments and the number of assessments and reviews completed by Councils with Adult Social Services Responsibilities (CASSRs). This information is explored by primary client type, age group and gender where appropriate.

All data within this chapter of the report is taken from the Referrals, Assessments and Packages of Care (RAP) return.

Referrals

Introduction When contact is initially made with CASSRs, the clients are screened to determine whether information, advice or a basic service is appropriate, or whether further investigation and assessment are required. A decision is then made as to whether the client should be passed on for further assessment of need or commissioning of ongoing services (and therefore recorded in the R1 table on the RAP proforma) or whether their needs can be met with a basic service at or near the point of contact (and therefore recorded in the R2 table on the RAP proforma).



Figure 2.1 shows that the number of contacts from new clients in 2011-12 was 2.1m (down 3% from 2010-11 and up 2% from 2006-07). Of these, 1.0m required a further assessment or commissioning of ongoing service (down 4% from 2010-11) while 1.1m were dealt with at the point of contact (down 3% from 2010-11).

The rate of contacts from new clients aged 18 and over who required a further assessment or commissioning of ongoing service was around 2,400 contacts per 100,000 population compared to 2,600 per 100,000 population for new clients dealt with at or near the point of contact.

The percentage of contacts which resulted in further assessment or commissioning of ongoing service was 48 per cent and 52 per cent were attended to solely at or near the point of contact.

Figure 2.1: Number of contacts from new clients, 2006-07 to 2011-12

Source: RAP proforma R2 and R3



Source of referral for contacts

From 2003-04, Councils with Adult Social Services Responsibilities (CASSRs) were asked to indicate the main source of referral for all contacts which is now captured in the RAP return. Figure 2.2 and Annex Table R3.1 show the number and percentage distribution of all contacts from new clients during 2011-12 by source of referral. In 2011-12, of the 2.09 million contacts, around 491,000 (24%) were self-referrals, 476,000 (23%) were referred from Secondary Health sources (for example, by hospices or hospital wards), 308,000 (15%) were from Primary/Community Health and 302,000 (14%) were referred by family, friends or neighbours, 80,000 clients (4%) were from an unknown referral source; this has increased by 1 percentage point since 2010-11. Figure 2.2: Number of contacts from new clients by source of referral, 2009-10 to 2011-12

Source: RAP proforma R3



Waiting time to completed assessment

Waiting time information is collected for new clients by age group, primary client type and by referral category and is based on calendar days, not working days. The time taken from first contact to completed assessment is collected on the A7 proforma. A small number of councils were unable to reconcile differences between the data reported on RAP proformas A6 and A7 as they could not provide information on the waiting times for all assessments. Assessments are only included in this section where the waiting time is also known and therefore the definitive number of assessments should be taken from A6.

Table 2.1 shows that where the waiting time was known between first contact and completed assessment, 32 per cent were assessed within two days of the first making contact with the CASSR (compared with 34% in 2010-11), 60per cent of clients were assessed within two weeks of first contact.

A higher proportion of younger clients waited less than 2 days between the first contact and completed assessment (37%) compared to older clients (30%). However a higher proportion of younger clients had to wait more than 3 months (8%) compared to 6 per cent of older clients.

Table 2.1: Length of time from first contact to completed assessment for new clients for whom the assessment process was completed during the period1 by age group, England 2011 to 2012

1. These figures exclude new clients with completed assessments reported on proforma A6 for whom the time from first contact to completed assessment was not known.

2. These figures include estimations based on actual figures from 152 A7 forms

England Thousands and percentages

% % %

Timeband Number Distribution Number Distribution Number Distribution

All clients 607 100 193 100 414 100

Less than or equal to 2 days 196 32 72 37 125 30

More than 2 days and less than or equal to 2 weeks 166 27 45 23 122 29

More than 2 weeks and less than or equal to 4 weeks 107 18 33 17 74 18

More than 4 weeks and less than or equal to 3 months 97 16 29 15 68 16

More than 3 months 41 7 16 8 25 6Source: RAP proforma A7

65 and overAll Ages (18 and over) 18-64



Figure 2.3 shows the percentage distribution of the length of time from first contact to completed assessment for all new clients from 2006-07 to 2011-12. The percentage of new clients that have had an assessment completed within two days of first contact with social services has decreased to 32 per cent in 2011-12, a decrease of 2 percentage points from 2010-11 but an increase of 1 percentage point from 2006-07. The percentage of new clients waiting more than 3 months has declined from 2006-07 but did increase by 1 percentage point from 2010-11.

Figure 2.3: Percentage distribution of all new clients of the length of time from first contact to completed assessment, 2006-07 to 2011-12¹

Source: RAP proforma A7

1. Figures may not add up to 100 due to rounding.



Figure 2.4 shows that since 2010-11, the percentage of all new clients having their assessment completed within two days has decreased by 1 percentage point for adults aged 18-64 and decreased by 2 percentage points for older adults. The number of clients seen within 4 weeks has decreased from 79 per cent to 77 per cent for 18 to 64 year olds and has decreased from 81 per cent to 77 per cent for older adults.

Figure 2.4: Percentage distribution of all new clients of the length of time from first contact to completion of assessment by age group and time band, 2010-11 and 2011-12




Figure 2.5 shows the length of time from first contact to completion of assessment for new clients by primary client type and time band in 2011-12. 45 per cent of new clients with a mental health problem received a completed assessment within 2 days of first contact compared to 29 per cent of those with a physical disability and 28 per cent of those with a learning disability. Of this latter group, 19 per cent had to wait more than 3 months compared to 7 per cent of those with a physical disability and 5 per cent of those with a mental health problem.

Figure 2.5: Length of time from first contact to completion of assessment for new clients by primary client type and time band, 2011 to 2012¹ ²



2. In 2011-12, this part of the A7 table was voluntary with 141 councils providing this information and estimates were not provided for the remainder.



Assessments

Introduction For those new clients with completed assessments, the assessment process may have started prior to, or during, the current reporting period. The client would have been recorded as a contact in form RAP R3 either in this period or a previous collection period. It should also be noted that the assessment and review figures relate to clients rather than events. There should be no double counting of clients within assessments for new clients on RAP A6 and A7 and within reviews for existing service users on RAP A1. If a client has more than one assessment or review event during the reporting period then details are recorded in relation to the most recently completed event. Therefore, each individual is counted as a new client only once. However, if an individual came to the CASSRs as a new client more than once during the period they would be recorded more than once on R3, as the R returns are concerned with contact events, not clients. Proforma A6 records the total number of assessments regardless of waiting time and is the definitive number of assessments carried out by the council. However this table does not include a breakdown by primary client type so analysis by client type is taken from RAP A11.

New clients with completed assessments The number of assessments in 2011-12 was 607,000 (down 8% from 2010-11 and down 7% from 2006-07).

In 2011-12, the number of new clients aged 18-64 with completed first assessments decreased by 6 per cent to 193,000 from 206,000 in 2010-11. There was also a decrease (9%) amongst the number of new clients aged 65 and over with completed first assessments from 454,000 in 2010-11 to 414,000 in 2011-12 as shown in Figure 2.6. Overall the number of new clients for whom a first assessment was completed has decreased by 7 per cent from 650,000 in 2006-07 to 607,000 in 2011-12. Figure 2.6: Number of new clients with completed assessments by age group, 2006-07 to 2011-12




Figure 2.7 illustrates the proportion of new clients for whom a first assessment was completed by age has gradually decreased for those aged 65 and over, a fall of 3 percentage points from 71 per cent in 2006-07 to 68 per cent in 2011-12. For those aged 18-64 the percentage distribution has increased 3 percentage points from 2006-07 to 32 per cent in 2011-12.

Figure 2.7: Percentage distribution of all new clients from first contact to completed assessment by age group, 2006-07 to 2011-12




Figure 2.8 shows that 73 per cent of new clients for whom a completed first assessment was completed had a physical disability, 22 per cent had mental health problems and 2 per cent had a learning disability.

Figure 2.8: Percentage distribution of new clients with completed assessments by primary client type, 2011 to 2012


1. In 2011-12, this data has been taken from the A11 table which includes all 152 councils.



Figure 2.9 shows the percentage of new clients with completed assessments within each primary client type by age group in 2011-12. It can be seen that the 65 and over age group is dominant in the ‘physical disability’ and ‘vulnerable people’ client types, accounting for 81 per cent and 63 per cent respectively. While the other three client types are dominated by the 18-64 age group where clients aged 18 to 64 classified as having a ‘substance misuse’, a ‘learning disability’ or a ‘mental health’ problem account for 95 per cent, 92 per cent and 66 per cent of their respective primary client types.

Figure 2.9: Percentage of new clients with completed assessments by primary client type and age group, 2011 to 2012


1. In 2011-12, this data has been taken from the A11 table which includes all 152 councils.



Anticipated sequel to assessment CASSRs were asked to record the sequel to assessment that was anticipated, or intended, at the time the assessment was completed (most recent event only). The anticipated sequel considers the whole package of care (rather than specific services). Of those new clients with a completed assessment in 2011-12:

68 per cent had some or all new services intended or already started (including those started and finished) at the time the assessment was completed.

Just over a fifth (21%) of clients were not offered or intended to be provided with new services upon completion of assessment.

9 per cent of clients had an anticipated sequel to assessment of ‘other’. These clients may have, for example, gone into hospital, left the area or passed away before the service got underway.

The remaining 2 per cent of clients declined the services offered by their council. The percentage of new clients with completed assessments with an anticipated sequel ‘some or all new services intended or already started’ rose from 69 per cent in 2006-07 to 72 per cent in 2007-08 but has decreased since 2008-09 to 68 per cent in 2011-12. Overall however, this is a decrease of 1 percentage point since 2006-07. The percentage distribution of those who had ‘new services offered but declined’ has decreased from 3 per cent in 2006-07 to 2 per cent in 2011-12.

Figure 2.10: Percentage distribution of new clients with known or anticipated sequel to assessment, 2006-07 to 2011-12




Figure 2.11 illustrates the percentage distribution of outcomes by age group. The younger age group, 18-64, had a higher percentage of outcomes as ‘No new services offered or intended’ (27%) compared to the 65 and over age group (19%).

Figure 2.11: Percentage distribution of new clients with a known or anticipated sequel to assessment, by age group, 2011 to 2012


Figure 2.12 shows the percentage outcome distribution by gender for 2010-11 and 2011-12. It shows that females are slightly more likely than males to have some or all new services intended or already started.

Figure 2.12: Percentage distribution of new clients aged 18 and over with a known or anticipated sequel to assessment, by gender, 2010-11 and 2011-12¹


1, Figures may not add up to 100 due to rounding.



Ethnic group of clients with completed assessment

Of the 607,000 new clients with a completed assessment reported on A6, 680,000 had a known ethnic group. The remaining 4 per cent of clients were allocated to the category ‘Not stated’ which is unchanged in recent years. Although all 152 councils provided information on the ethnicity of their clients, a small number of councils were unable to reconcile differences between the data reported on proforma A7 and the data reported on proforma A6. This is due to these councils being unable to provide information on the waiting times for all completed assessments as assessments are only included in proforma A7 where the waiting time is also known. Therefore the information sourced from the A6 proforma is used as the best indication of the number of completed assessments for new clients.

Of those with a known ethnic group, 88per cent of new clients with completed assessments reported on A6 had the ethnic group ‘White’, 3 per cent of clients were of the ethnic group ‘Asian or Asian British’ and a further 2 per cent were ‘Black or Black British'. This profile has remained similar in recent years.

There was some variation in the anticipated sequel to assessment by ethnic group. The lowest percentage of service users (58%) who had some or all (new) services intended or already started following completion of assessment were in the ‘Chinese and other’ ethnic group, which is comparable to 69 per cent of clients whose ethnic category was ‘Black or Black British’. This is illustrated in Figure 2.13 and more detail can be found in Table A6.1 (Annex1).

Figure 2.13: Percentage distribution of new service users with completed assessments by ethnic group and anticipated sequel to assessment, 2011 to 2012¹

Source: RAP proforma A6 1. Figures may not add up to 100 due to rounding.



Reviews Figure 2.14 shows that the number of service users with completed reviews in 2011-12 was 1.0m (down 13% from 2010-11 and down 20% from 2006-07).

Reviews for those aged 18-64 has decreased by 12 per cent since 2010-11 and reviews for those aged 65 and over decreased by 13 per cent between 2010-11 and 2011-12. It should be noted that this decrease may be linked to the reduction in the number of service users receiving services as discussed in Chapter 3.

Figure 2.14 Number of existing service users with completed reviews by age group, 2006-07 to 2011-12




The age distribution of existing service users with completed reviews was similar to that for new clients with completed assessments (Figure 2.7). The distribution for those aged 65 and over has decreased by 2 percentage points in 2011-12 since 2006-07. Correspondingly the distribution for those aged 18-64 has increased by 3 percentage points in 2011-12 since 2006-07, as illustrated in Figure 2.15.

Figure 2.15: Percentage distribution of all existing service users with completed reviews, by age group, 2006-07 to 2011-12


Figure 2.16 shows that of those service users who had a completed review, 67 per cent of users had a physical disability, 21 per cent had a mental health problem and 9 per cent had a learning disability.

Figure 2.16: Percentage of existing service users with completed reviews by primary client type, 2011 to 2012




Figure 2.17 compares the percentage of new clients with completed assessments with the percentage of existing service users with completed reviews within each primary client type.

Over two thirds (67%) of the 1 million service users with completed reviews were classified as the primary client type ‘physical disability‘ compared to 73 per cent for new clients with assessments. Service users classified as having the primary client type ‘learning disability’ accounted for 9 per cent of all completed reviews for existing service users but only 2 per cent of completed assessments for new clients.

Figure 2.17: Percentage distribution of existing service users with completed assessments and reviews by primary client type, 2011 to 2012

Source: RAP proformas A1 & A11

In 2010-11 this part of the A7 table was voluntary with 147 councils providing this information and estimates were not provided for the remainder. In 2011-12, the A7 data has been replaced with A11 data, in order to provide a complete count of council data, provided by all 152 councils.



Total review events The number of review events is greater than the total number of service users reviewed, suggesting that some service users are reviewed more than once during the year. During 2011-12 the number of review events was 1.65 million which gives the average number of review events per service user as 1.6. The average number of review events per service user increases with age from 1.5 for 18-64 year olds to 1.7 for those aged 75 or over.

Table 2.2: Numbers and ratio of existing service users with completed reviews and review events by age group, 2011 to 2012


England Number

All ages (18

and over)18 - 64 65 - 74 75 and over

1,648 497 201 950

1,003 325 124 553

1.64 1.53 1.62 1.72Average number of reviews events per reviewed client

Total number (thousands) of review events completed during the year

Total number (thousands) of clients for whom a review was completed during the year



Assessments and reviews provided at the expense of the CASSR

In 2009-10, a new voluntary proforma was included to capture the number of section 256 and self-funded service users with completed assessments or reviews provided at the expense of the council. 68 councils entered data into this proforma.

Figure 2.18 illustrates the majority of assessments and reviews provided by the council for self funded service users are for those aged 65 and over; 96 per cent of assessments and 93 per cent of reviews. This is comparable to 68 per cent and 70 per cent of those service users wholly or partially funded by the council.

Less than a tenth (7%) of Self-funded service users reviewed at the expense of the council were aged 18-64, compared to 30 per cent of reviews for service users partially or wholly funded by the council.

Figure 2.18: Percentage distribution for assessments and reviews provided at the expense of the council by age group for all service users, 2011 to 20121

Source: RAP proforma A10, A1 and A6

1. Figures for Self-funded clients are taken from the 68 councils who provided information on A10 and no estimations have been

made for the other councils who did not provide data.

2. Figures for all assessments and reviews are taken from A6 and A1 respectively for all councils and estimates have been used if a council did not provide all the information on these proformas.

3. Comparable figures for section 256 clients assessed or reviewed ceased to be collected in 2011-12.



The percentage distribution of assessments and reviews by client group provided at the expense of the council is illustrated in Figure 2.19. The majority of assessments and reviews for self funders provided at the expense of the council are for those with a physical disability (81% of assessments and 73% of reviews). By comparison 73 per cent and 67 per cent of those service users wholly or partially funded by the council were for those clients with a physical disability.

Figure 2.19: Percentage distribution of funding source for assessments and reviews by primary client type, 2011 to 2012¹

Source: RAP proforma A10, A11, A1 and A7

1. Figures for Self-funded clients are taken from the 68 councils who provided information on A10 and no estimations have been made for the other councils who did not provide data.

2. Figures for all assessments and reviews are taken from A11 and A1 respectively for all councils and estimates have been used if a council did not provide all the information on these proformas.

3. Comparable figures for section 256 clients assessed or reviewed ceased to be collected in 2011-12.



Chapter 3: Packages of Care

Introduction This chapter contains information on the number of people receiving packages of care. This includes analysis of the characteristics of those receiving services and the type of services received. The different types of services are discussed in more detail in the community-based services and the residential care chapters.

Care should be taken when interpreting tables on services as; for example, some service users may have received more than one type of service if they have moved between residential and community-based service sectors within the year. However, if a service user is receiving concurrent community-based and residential services they should only be recorded under the appropriate residential sector. It is also possible that service users who had been receiving services during the current period were assessed during a previous collection period, and similarly some service users will have been assessed during the current period but did not receive services until the following period. Therefore there is not a direct comparison between assessment and packages of care figures but they will be closely related. In previous years data this chapter also included information on the waiting time between assessment and receipt of all services, but this information is no longer collected following a National Statistics consultation4 which took place in summer 2011.

4 The report on the responses to the consultation as well as the consultation documents can be seen at

http://www.ic.nhs.uk/adultsocialcareconsultation12




Type of services provided to service users Table 3.1 shows that the number of people receiving services in 2011-12 was 1.5m (down 7% from 2010-11 and down 18% from 2006-07). Of these 1.2m received community based services (down 8% from 2010-11), 213,000 received residential care (which is less than a 1% change from 2010-11) and 86,000 received nursing care (down 1% from 2010-11). Feedback from councils suggests that the fall this year is due to a number of reasons which include providing services outside of a formal assessment process and data cleaning. This will also help to explain the reduction in the number of reviews in the previous chapter. Over three quarters (78%) of adults in residential care were aged 65 and over compared to 91 per cent in nursing care.

Table 3.1: Number of service users receiving services during the year by service type and age group, 2009-10 to 2011-12

England Thousands

Source: RAP proformas P1, P2f & SD1

1. The 'Total number of service users receiving services' is the number of service users receiving one or more services at some point

during the year excluding double counting.

2. A service user may have received more than one type of community based service during the year and thus there may be some double counting across service categories.

3. In 2009-10 service users who received a personal budget did not have any services they received within this personal budget recorded. Therefore, the figures for home care, day care, meals, short term residential breaks, professional support, equipment and adaptations and other are not comparable to those for 2010-11 and subsequent years.

Service 2009-10 2010-11 2011-12 2009-10 2010-11 2011-12 2009-10 2010-11 2011-12

Total number of clients receiving services1 1,698 1,575 1,462 550 510 471 1,148 1,064 991

Community-based services2 1,464 1,340 1,231 507 467 429 958 873 802

Existing / new Direct payments and Personal Budgets3 166 377 0 74 124 0 92 253 0

Direct Payments3 107 125 139 62 73 78 45 52 61

Home Care3 557 543 517 104 106 103 453 437 415

Day Care3 195 179 159 89 84 77 106 95 83

Meals3 100 81 60 7 6 4 93 76 56

Short term residential - not respite3 76 72 70 14 14 13 62 58 57

Professional Support3 445 372 268 240 208 166 204 164 102

Equipment and adaptations3 512 466 431 118 109 100 394 357 330

Other3 119 115 107 50 47 45 69 68 62

Residential Care 215 213 213 48 46 46 167 167 167

Nursing care 90 88 86 9 8 8 82 79 78

65 and overAll Ages 18-64



Services provided by age group, gender and primary client type

Figure 3.1 shows a slight increase in the number of service users receiving services from 2006-07 to 2008-09 and a subsequent decrease in the last two years. Overall, the number of service users has dropped by 18 per cent since 2006-07. The decrease for those aged 65 and over has been even more marked at 20 per cent over the same period while the decrease for those aged 18-64 has been smaller at 13 per cent.

Figure 3.1: Number of service users receiving services by age group, 2006-07 to 2011-12

Source: RAP proforma P1

Figure 3.2 shows that 91 per cent of service users aged 18 to 64 receiving services were receiving a community-based service compared to 81 per cent of service users who were aged 65 and over. However, older service users were more likely to be in residential care (17% compared to 10%) and nursing care (8% compared to 2%).

Figure 3.2: Percentage of service users receiving services during the period by type of service and age group, 2011 to 2012




Figure 3.3 shows the majority of service users in the primary client types substance misuse (92%) and learning disability (90%) were aged 18-64, whereas most service users classified with a physical disability (83%) and other vulnerable people (73%) were aged 65 and over. Service users with mental health problems were more evenly distributed between the two age groups with 52 per cent aged 18 to 64 and 48 per cent aged 65 and over.

Figure 3.3: Percentage distribution of service users receiving services by age group and primary client type, 2011 to 2012




Figure 3.4 shows that 62 per cent of all service users receiving services were female. There is some difference by type of service with 61 per cent of female service users receiving community-based services compared to 66 per cent in residential care and 65 per cent in nursing care.

Figure 3.4: Percentage distribution of service users receiving services by service type and gender, 2011 to 2012

Source: RAP proformas P7

1. A service user may have received community-based service during the year and then entered residential accommodation thus there may be some double counting across service categories.

2. Service users may move between residential and nursing care during the year so there may be some double counting across these groups



Figure 3.5 shows the percentage of adults with a physical disability is considerably higher for the older service users, both male and female. For example, 83 per cent of female service users aged 65 and over were classified as having a physical disability compared to 42 per cent aged 18 to 64.

There is a similar distribution by primary client type for males and females for those aged 65 and over, but there is a variation in the 18 to 64 age group. 31 per cent of male 18-64 year olds had a client group of physical disability compared to 42 per cent of females. Conversely 31 per cent of male 18-64 year olds had a learning disability compared to 24 per cent of females.

Figure 3.5: Percentage distribution of service users receiving services by gender, age group and primary client type, 2011 to 2012




Ethnic group of service users receiving services

Of the 1.5 million service users receiving services, 1.4 million (98%) had their ethnic group specified which is similar to 2010-11. In the 18 to 64 age group, for those with a known ethnic group 87 per cent were classified as White; 5 per cent Asian or Asian British and 5 per cent were recorded as Black or Black British. The 65 and over distribution has a higher percentage of service users classified as White (95%) and lower percentages of Asian or Asian British (2%) and Black or Black British (2%).

Figure 3.6a: Ethnic group of service users aged 18 to 64 receiving services, 2011 to 2012


Figure 3.6b: Ethnic group of service users aged 65 and over receiving services, 2011 to 2012




Figure 3.7 shows the percentage distribution of primary client type varies by ethnic group with a higher percentage (68%) of people classified as White having a physical disability compared to the Mixed ethnic group (35%). This group had a much higher percentage of service users in the Mental Health primary client group (38%) compared to the White ethnic group service users (19%)

Figure 3.7: Percentage distribution of ethnic group by primary client type, 2011 to 2012




Chapter 4: Community Based Services

Introduction Community-based services are services provided to people who live in their own homes (this includes supported/sheltered accommodation and extra care housing). This chapter provides information on the different community-based services provided or commissioned by Councils with Adult Social Services Responsibilities (CASSRs) that help people to live independently in their own home for as long as possible. This information is explored by primary client type and age group where appropriate.

Community Based Services provided by type of service and service user characteristics Community-based services (for example, home care, day care and meals) were provided to 1.23 million service users during 2010-11. It is possible that many of these service users received more than one of the components of community-based services

Figure 4.1 shows the number of service users receiving community-based services rose gradually from 1.52 million in 2006-07 to 1.54 million in 2008-09. It then fell to 1.47 million in 2009-10 and has fallen further to 1.23 million in 2011-12 which is 84 per cent of all service users. This is a fall of 8 per cent from last year and an overall fall of 19 per cent since 2006-07. Feedback from councils suggests that the fall this year is due to a number of reasons which include providing services outside of a formal assessment process and data cleaning. This will also help to explain the reduction in the number of reviews in the earlier chapter. Figure 4.1: Number of service users receiving community-based services,

2006-07 to 2011-12

Source: RAP proforma P2f



The age breakdown of service users for the period, 1 April 2011 to 31 March 2012 is shown in Figure 4.2. 517,000 service users received home care of which 80 per cent were aged 65 and over; 431,000 received equipment and adaptations and 268,000 received professional support5 of which, over half (62%) were aged 18-64. 159,000 service users received day care services and 60,000 received meals, of those the majority 93 per cent were aged 65 and over. There were 139,000 service users in receipt of direct payments.

Figure 4.2: Number of service users receiving community based services by age group, 2011 to 2012¹

Source: RAP proforma P2f

1.Figures may not add up to 100 due to rounding.

Professional support includes any professional activity undertaken by the care manager, social worker or other professional staff, such as Occupational Therapists, that is beyond the process of care management.



As shown previously in table 3.2, the number of people receiving self directed support was 527,000 (an increase from 377,000 in 2010-11). Of these, 139,000 received a direct payment (up 11% from 2010-11). The number of service users receiving direct payments has continued to rise steadily since 2006-07 as shown in figure 4.3, where only 49,000 users receiving direct payments in 2006-07, compared to 125,000 in 2010-11 and 139,000 in 2011-12. The number of service users receiving direct payments since 2006-07 has more than doubled.

Figure 4.3: Number of service users receiving direct payments, 2006-07 to 2011-12

Source: RAP proformasP2f and SD1



Service users on the books to receive community-based services as at 31 March 2012 Councils with Adult Social Services Responsibilities were asked to record the number of service users on the books to receive community-based services on the last day of the period (i.e. on 31 March 2012 as opposed to any time during the whole year).

Table 4.1 shows a total of 808,000 service users were recorded as receiving community-based services on 31 March 2012, a decrease of 9 per cent from 2011. Similar to services received during the year, the majority of service users on the books to receive community based services at 31 March 2012 were aged 65 and over (60%), with 40 per cent of all service users aged 18 to 64.

Components of service for people on a Personal Budget were not recorded in 2010 and therefore data is not comparable with other years.

Table 4.1: Number of service users receiving community-based services by service type and age, at 31 March 2010 to 2012

“.” Indicates that data is not available 1. The figures for the number of service users receiving each different component of service do not necessarily sum to the total of

service users receiving community-based services as a client may receive more than one component of service during the year. 2. Data for Direct Payments as at 31 March 2010 is unavailable as this was combined with Personal Budgets in 2010. 3. Data for 31 March 2010 is not comparable with other years as service users who received a personal budget did not have any

services they received within the personal budget recorded.

England, at 31 March

Thousands

All Ages

Service 2010 2011 2012 2010 2011 2012 2010 2011 2012

All community based services11,003 885 808 391 350 325 613 535 483

Direct payments2,3 . 94 107 . 60 65 . 35 42

Home Care3 337 323 298 77 78 74 259 244 224

Day Care3 150 136 117 76 72 64 74 65 53

Meals3 61 48 33 4 3 2 56 45 31

Planned Short breaks3 21 17 15 6 6 5 15 11 10

Professional Support3 301 223 180 185 146 121 115 77 59

Equipment and adaptations3 276 246 220 68 61 55 208 185 165

Other3 81 80 75 37 36 36 45 44 40

Source: RAP proforma P2s

18-64 65 and over



Figure 4.4 shows that nearly two-thirds (64%) of service users had a physical disability while 21 per cent had mental health problems and 13 per cent had a learning disability Of the remainder, other vulnerable people accounted for 2 per cent and 1 per cent had a substance misuse problem.

Figure 4.4: Distribution of service users receiving community-based services by primary client type, England as at 31 March 2012

Source: RAP proforma P2s



Home care Information on the number of hours and the intensity of the home care service provided to households in a survey week was previously collected via the Home Help return (HH1). This information was published separately in the Community Care Statistics: Home Help/Care Services for adults, England6. The report for September 2008 was the last HH1 collection but some parts of the return were moved to other existing collections.

Table H1 has been moved to the RAP return; this provides information on the number of planned visits and hours for service users receiving home care on the 31 March. The hours of home care provided were already collected on the activity spreadsheet of the Personal Social Services Expenditure Return (PSSEX). Information is collected split by hours of home care provided by the independent sector and hours of home care provided directly by the council.

Information from both these sources is explored further in this section of the report.

Contact hours

Councils with Adult Social Services Responsibilities (CASSRs) purchased or provided 188 million contact hours of home care during the 2011-12, an increase of 4 per cent on 2006-07, but a decrease of 6 per cent from 2008-09 as shown in Table 4.2. The number of contact hours provided directly by CASSRs has fallen by 57 per cent since 2006-07 while the number of contact hours provided by the independent sector (private and voluntary sectors) has increased by 25 per cent over the same period.

Table 4.2: Actual number of contact hours of home care provided during the year, by sector,

2006-07 to 2011-12 England Millions

Source: PSS Ex1 Activity

1. The 2009-10 data should be treated with caution as it looks out of line with the trend from previous years. This may be because some councils under recorded those receiving home care via a personal budget to tie in with changes made to the RAP return for tables P2f and P2s and although the definitions for PSSEX were not changed, it is possible that some councils may have recorded home care hours differently on the PSSEX Activity sheet. The change for RAP was reverted back to 2008-09 definitions so the 2010-11 and 2011-12 figures are unaffected.

6 www.ic.nhs.uk/pubs/commcarestats08home

All sectors CASSR Independent

2006-07 180.3 47.1 134.4

2007-08 188.0 41.0 146.8

2008-09 200.2 37.3 162.8

2009-10¹ 183.2 28.9 154.4

2010-11 200.3 25.6 174.6

2011-12 188.2 20.3 167.9



The number of contact hours provided directly by CASSRs has fallen by 2 percentage points in the last year, continuing the downward trend. CASSRs now directly provide 11 per cent of total contact hours, compared with 13 per cent in 2010-11 and 26 per cent in 2006-07 as shown in Figure 4.5. The number of contact hours provided by the independent sector (private and voluntary sectors) increased by 2 percentage points between 2010-11 and 2011-12, and has increased by 15 percentage points from 2006-07. 89 per cent of all contact hours were provided by the independent sector in 2011-12, compared to 87 per cent in 2010-11 and 74 per cent in 2006-07.

Figure 4.5: Percentage of contact hours of home care provided during the year, by sector, from 2006-07 to 2011-121

Source: PSS Ex1 Activity

1. The percentages are calculated using the sum of the two sector totals as this may not always equal the total hours provided due to estimation methods used prior to 2008-09.



Average number of contact hours provided

The average number of contact hours could not be calculated for 2009-10 due to the changes in the recording practices in P2f which related to how councils were asked to record people receiving a personal budget. For 2009-10, these were only included under the heading Existing Direct Payment and/or Personal budget and no longer under the different services that the service user received as part of their care package. This means that the figures for the number of people receiving Home Care was unknown in its entirety as there may be people receiving council commissioned home care via a personal budget. In 2010-11 the recording practices reverted back to be consistent with 2008-09 and earlier years.

Figure 4.6 shows that the average number of contact hours provided increased year on year from 2006-07 to 2008-09 and continued to increase in 2010-11. 2011-12 saw a decrease in the average number of contact hours provided. There has been an 18 per cent increase in the average number of contact hours per service user between 2006-07 and 2011-12.

Figure 4.6: Average number of contact hours of home care provided during the year, by sector, 2006-07 to 2011-12¹

Source: PSS Ex1 Activity, RAP P2f

1. Data for 2009-10 is not available as service users who received home care as part of a personal budget were not recorded in the P2f tables.



Intensity of Home Care Information on the number and duration of home care visits is collected on table H1. It should be noted that these are planned hours for those service users “on the books” to receive home care in their own homes on 31 March. It should be noted however that this may not be the actual number of hours delivered to the service user. Figure 4.7 shows that although there has been a drop in the number of service users receiving home care, the number receiving more than 10 hours or overnight/live-in/24hr services has increased slightly to 122,000. It now represents 41 per cent of all service users receiving home care compared to 38 per cent in 2010-11. Figure 4.7: Service intensity: distribution of planned contact hours, 2010-11 and 2011-12

Source: RAP proforma H1



Self directed support In 2009-10 three new proformas were introduced to the Referrals, Assessments and Packages (RAP) return to capture information on service users and carers receiving services via the self-directed support process. Specifically the number of social care users and carers who are receiving self directed support and direct payments is broken down by:

o Existing or new direct payment but not via a self directed support process.

o Only a directed payment but through a self directed support process.

o Only other services (ie. not a direct payment) arranged or paid for by the CASSR via a self directed support process.

o Both a direct payment and services arranged or paid for by the CASSR via a self directed support process.

The remaining tables in this chapter are restricted to just those service users and carers who are receiving an existing or new direct payment and/or services through a self directed support process. The percentage distribution of client types receiving direct payments or self directed support is shown in Figure 4.8. Of those service users aged 65 or over receiving self directed support or a direct payment, 97 per cent received self directed support with the remaining 3 per cent receiving a direct payment outside of the self directed support process. In comparison, 13 per cent of service users aged 18 to 64 and 43 per cent of carers received a direct payment outside the self directed support process. The overall proportion for all service users was 6 per cent. 17 per cent of mental health service users aged 18 to 64 received a direct payment but not through a self directed support process compared to 6 per cent of services users classified as having a substance misuse problem. Figure 4.8: Distribution of social care service users receiving self directed support and/or

direct payments provided or commissioned by the CASSR, by client type and age group, 2011-12

Source: RAP proformas SD1 and SD3



Figure 4.9 shows that the proportion of service users receiving a direct payment outside of a self directed support process has fallen from 17 per cent in 2010-11 to 6 per cent in 2011-12. There was also a decrease for carers from 53 per cent to 43 per cent.

Figure 4.9: Distribution of social care service users receiving self directed support and/or direct payments provided or commissioned by the CASSR, by age group, 2010-11 to 2011-12

Source: RAP proforma SD1 and SD3



Figure 4.10 is restricted to those service users receiving self directed support only and therefore does not include those receiving an existing or new direct payment outside of a self directed support process. It shows that 88 per cent of service users aged 65 and over receiving self directed support, received services arranged or paid for by the CASSR only, compared to 62 per cent of services users aged 18-64 and 39 per cent of carers.

In contrast, nearly half of carers receiving self directed support (46%) received a direct payment only compared to 8 per cent of services users aged 65 or over and 26 per cent of those aged 18-64.

Of those service users with a substance misuse problem receiving self directed support, 85 per cent received services arranged or paid for by the CASSR only, compared to 58 per cent of service users with a physical disability.

Figure 4.10: Distribution of social care service users by type of self directed support, client group and age, 2011-12

Source: RAP proforma SD1 and SD3



Figure 4.11 compares how the proportion of service users receiving a direct payment outside a self directed support process compares with those receiving either a direct payment or council commissioned services through a self directed support process. The table shows how this varies by ethnicity. The ethnic classification of service users receiving a direct payment and/or self directed support show that 11 per cent of service users from the Asian, Black , Mixed and Chinese or Other ethnic groups are receiving direct payments outside of a self directed support process compared to 6 per cent of those from the White ethnic group.

Figure 4.11: Distribution of social care service users receiving self directed support and/or direct payments provided or commissioned by the CASSR, by ethnic group, 2011-12

Source: RAP proforma SD2



Chapter 5: Residential Care

Introduction This chapter presents information on supported residents; this is a person receiving care in residential and nursing accommodation funded by Councils with Adult Social Services Responsibilities (CASSRs). Information was also collected on the number of permanent admissions during the year.

The information within this chapter was collected on the S tables of the Adult Social Care – Combined Activity Return (ASC-CAR). In 2011-12 this was submitted by all 152 Councils with Adult Social Services Responsibilities (CASSRs) in England. In 2011-12 there was a recording change which has impacted on the number of permanent admissions. The Valuing People Now (VPN) initiative7 changed the responsibility for, and funding of, some learning disability services which became commissioned by local authorities. These service users were counted as new clients as their care became the responsibility of a council and they were not in receipt of council funded care This approach is consistent with the treatment of other people whose funding source has changed from zero council contribution to care costs, for example self funders who become funded by the council. Therefore these service users were classed as new permanent admissions and recorded in table S3 of the ASC-CAR return. They also appeared as residents in table S1. As a result, an additional row was added to the ASC-CAR S3 permanent admissions table in the learning disability section. This row captured for each type of accommodation (ie. each column) the following information:

“Of those ‘new admissions’ in the learning disability rows, how many people were already resident in a residential care, nursing care or adult placement setting which was previously the responsibility of the NHS and transferred to the local authority under Valuing People Now?”

This information was captured to allow users of the data to understand the effect of the VPN funding transfer and to maintain a time series of new admissions to care homes. This additional data requirement was only needed for one year (2011-12) and will be removed from ASC-CAR S3 for 2012-13. The tables and charts in the section on permanent admissions have been adjusted for the impact of this change where possible. The number of new admissions as a result of the change of funding was only collected for those aged 18 or over. It has been apportioned to the 18-64 and 65 and over age groups using data taken from the three previous years 2008-09, 2009-10 and 2010-11 for each type of accommodation separately. The tables and charts on the number of residents has not been adjusted as the impact will be small and the recording change has been noted as footnotes on the relevant tables and figures. Not all figures mentioned in the text are from tables and charts in this report, but can be found in previous reports.² S5 data which is the ‘number of LA supported permanent residents transferring between residential and nursing care during 1 April 2011 to 31 March 2012 (excluding admissions to group homes), by age group, will not be collected in future years.

7http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_087149.pdf

² www.ic.nhs.uk/pubs/finalcarestats1011ssa

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_087149.pdf



Type of Registered Accommodation

Data are collected by type of registered accommodation; council staffed homes, independent residential care homes, nursing homes and adult placements.

Adult Placements were no longer classed as registered residential care from 2006-07; prior to 2006-07 this information was collected as part of ‘Other registered accommodation’. It is now collected separately in columns introduced to several tables. Adult placements are analysed separately in the Adult placements section of this chapter.

Figure 5.1 shows that the number of supported residents has risen slightly from 219,600 as at 31 March 2011 to 219,700 in 2012. Over a longer time period, there has been a fall of 21 per cent since 2003. Numbers of supported residents in CASSR staffed homes have continued to decline in 2012 with a fall of 17 per cent to 13,300 between 2011 and 2012. The number of supported residents in independent residential care has increased by 2 per cent, from 146,300 in 2011 to 149,300 in 2012 while independent nursing provision remained the same in 2012 as in 2011 at 57,200.

Figure 5.1: Number of Supported Residents by type of accommodation1, 2, 3, 4 , 2002 to 2012

Source: ASC-CAR proforma S1

1. Excludes adult placements, un-staffed and other homes. 2. Dotted line indicates that from 2003, former preserved rights residents are included making the data incomparable with previous

years. 3. From 2004 onwards data includes Boyd loophole residents. 4. From 2008 Other registered accommodation was redistributed across the existing categories and is not included for previous years. 5. In 2012, 1,840 LD service users were recorded as being permanent admissions to care homes as a result of their funding transferring

from the NHS to councils. These service users would not have been recorded in S1 in previous years.



Figure 5.2 shows the percentage distribution by type of accommodation since 2002. The percentage of supported residents in independent residential care has increased by 6 percentage points from 62 per cent in 2007 to 68 per cent in 2012; with the proportion of residents in council staffed homes decreasing by 4 percentage points from 2007 to 2012. The percentage of supported residents in independent nursing care has fallen by 2 percentage points from 28 per cent to 26 per cent over the same period. Figure 5.2: Percentage of Supported Residents by type of accommodation1,2,3,4 , 2002 - 2012


1. Excludes adult placements, un-staffed and other homes. 2. Voluntary and private residential care homes. 3. General and mental nursing homes only. 4. Data includes Boyd loophole residents. 5. Dotted line indicates that from 2003, former preserved rights residents are included making the data incomparable with previous

years. 6. Other registered accommodation was excluded from 2008 and redistributed across the existing categories. 7. In 2012, 1,840 LD service users were recorded as being permanent admissions to care homes as a result of their funding transferring




Supported Resident by Age Group

Of the 219,700 supported residents in registered accommodation, 77 per cent of all supported residents were aged 65 and over. The number of residents aged 65 or over in residential and nursing care homes has increased slightly from 169,700 in 2011 to 169,900 in 2012.

Figure 5.3 shows that in 2012, 43 per cent of supported residents in registered accommodation were 85 and over. The age distribution of supported residents has remained the same as last year. The age breakdown is not available historically prior to 2008 as this data includes service users in the other homes category which can not be separated from adult placements. Figure 5.3: Percentage of Supported Residents in registered accommodation¹ by age

group, as at 31 March 2012

Source: ASC-CAR proformas S1 & S2

1. Excludes adult placements, un-staffed and other homes. 2. In 2012, 1,840 LD service users were recorded as being permanent admissions to care homes as a result of their funding transferring




There were 49,800 supported residents in registered accommodation aged between 18 and 64, a very small decrease from 49,900 in 2011. Figure 5.4 shows that for residents aged between 18 and 64 over three quarters (82%) were in independent residential care homes, 13 per cent were in independent nursing care and 5 per cent were in CASSR staffed homes in 2012. 64 per cent of the supported residents in registered accommodation aged 65 and over were in independent residential care homes in 2012, which is a rise of 7 percentage points from 2007. 30 per cent were in independent nursing care, with 6 per cent in CASSR staffed homes.

Figure 5.4: Percentage of Supported Residents aged 18-64 and 65 and over by type of registered accommodation1,2,3, 2007 to 2012






Supported Residents by primary client type

Figure 5.5 shows the 49,800 supported residents aged 18-64 in registered accommodation by primary client group, 61 per cent were people with learning disabilities, 20 per cent of these were people with mental health problems, 17 per cent being adults with a physical disability and the remaining 2 per cent were in the substance misuse and other vulnerable people category. Figure 5.5: Percentage of Supported Residents aged 18-64 in registered accommodation¹

by primary client group, as at 31 March 2012


1. Excludes adult placements, un-staffed and other homes. 2. In 2012, 1840 LD service users were recorded as being permanent admissions to care homes as a result of their funding

transferring from the NHS to councils. These service users would not have been recorded in S1 in previous years.

There has been no change in supported residents with physical disabilities aged 18-64 in registered accommodation (excluding adult placements), from 2011 to 2012, but there has been a 16 per cent decrease since 2007. The number of supported residents with mental health problems aged 18-64 decreased by 2 per cent, 220 fewer residents from 2011 to 2012 and overall there has been a 10 per cent decrease since 2007.

The number of residents with a learning disability aged 18-64 has fallen by 12 per cent in council staffed homes, decreased by 14 per cent in independent nursing homes and has increased by 2 per cent in independent residential care homes since 2011.

The number of residents with mental health problems aged 18-64 rose by 1 per cent in council staffed homes (although from a very small base) from 2011 to 2012, and the number of residents with mental health problems decreased by 2 per cent in independent residential care homes and 1 per cent in independent nursing homes since 2011.



Figure 5.6 provides the percentage distribution of accommodation type by primary client group in England as at 31 March 2012. It shows that the majority of people are supported in independent residential care for all client groups but there are some interesting differences between the groups. For example, the physically disabled group has the highest percentage in independent nursing homes at 38 per cent; whist the learning disabled group has the highest percentage of people resident in council staffed homes at 7 per cent. The distribution of accommodation type by primary client group has remained similar to that in 2011. Figure 5.6: The percentage distribution of accommodation type for Supported Residents

aged 18 to 64 by primary client group1, as at 31 March 2012.






Admissions and Transfers From 2006-07 transfers from residential to nursing care and vice versa were not classed as permanent admissions but transfers from temporary to permanent care were (see Editorial notes – definitions).

Permanent Admissions Figure 5.7 shows that there were a total of 67,100 permanent admissions to registered accommodation in 2011-12 which is an increase of 5 per cent from 64,000 in 2010-11, although the increase drops to 2 per cent when the figures are adjusted to take account of the impact of the VPN transfer. 4 per cent of all permanent admissions were to CASSR staffed residential homes, 64 per cent to independent residential homes and 31 per cent to nursing care homes. There has been a decrease of 4 per cent in permanent admissions (excluding Adult Placements) since 2006-07 from 69600 to 67100 (6% when the adjusted figures are used). Permanent admissions to council staffed residential care homes have decreased by 41 per cent from 5,000 in 2006-07 to 2,900 in 2011-12. Admissions to independent residential care homes have increased 7% since 2006-07 from 40,300 to 43,000 in 2011-12. Permanent nursing home admissions have decreased by 13 per cent from 24,300 in 2006-07 to 21,100 in 2011-12. Figure 5.7: Number of Permanent admissions1 to all Residential and Nursing care, 2006-07

to 2011-12.


1. Excludes admissions to adult placements, un-staffed and other homes. 2. In 2012, 1,840 LD service users were recorded as being permanent admissions to care homes as a result of their funding transferring

from the NHS to councils 3. Adjusted 2011-12 data has those admissions as a result of the VPN removed.



Figure 5.8 shows that in 2011-12, 91 per cent of the 67,100 permanent admissions were for people aged 65 and over, an increase of 3 per cent from 2010-11. The remaining 9 per cent were for people aged 18 to 64. The total number of permanent admissions for people aged 18 to 64 has risen by 24 per cent from 4,800 in 2007-08, but this is only a decrease of 3 per cent when adjusted for the VPN transfer. In comparison, the total number of permanent admissions for people aged 65 and over has risen by 1 per cent from in 2007-08 and this decreases to less than 1 per cent when adjusted for the VPN transfer.

Figure 5.8: Permanent admissions by client group¹, 2011-12

Source: ASC-CAR proforma S3 1. Excludes admissions to adult placements, un-staffed and other homes. 2. Figures may not add up to 100 due to rounding. 3. The chart above illustrates the Permanent Admissions by client group, un-adjusted data. 4. In 2012, 1,840 LD service users were recorded as being permanent admissions to care homes as a result of their funding transferring

from the NHS to councils.



Figure 5.9 looks at the number of permanent admissions for people aged 18-64 by primary client group. It shows that there has been a large increase in the number of permanent admissions in 2011-12 for the Learning Disabled group of 65 per cent but when this is adjusted for the VPN transfer, it is a decrease of 23 per cent from 2010-11. There were also increases for all the other groups.

Figure 5.9: Comparison of permanent admissions across client groups¹ for adults aged 18-64, 2006-07 to 2011-12


1. Excludes admissions to adult placements, un-staffed and other homes. 2. In 2012, 1,840 LD service users were recorded as being permanent admissions to care homes as a result of their funding transferring

from the NHS to councils.

Table 5.1 shows for residents aged 18-64 there were 19 permanent admissions per 100,000 population in 2011-12 compared to 696 permanent admissions per 100,000 population for residents aged 65 and over. When adjusted for the VPN transfer however, the number of permanent admissions per 100,000 population for residents aged 18-64, drops to 14 in 2011-12.

The number of permanent admissions aged 18-64 per 100,000 population remained constant from 2007-08 to 2010-11 at 15, but increased to 19 admissions per 100,000 of the population in 2011-12.

Permanent admissions for residents aged 65 and over has declined from 738 per 100,000 population in 2007-08 to 696 in 2011-12. When adjusted for the VPN transfer, the number of permanent admissions per 100,000 population for residents aged 65 and over, drops to 694

Table 5.1: The number of permanent admissions1 per 100,000 population2 by age group,

2006-07 to 2011-12.


1. Excludes admissions to adult placements, un-staffed and other homes. 2. Uses mid year population estimates. 3. In 2012, 1,840 LD service users were recorded as being permanent admissions to care homes as a result of their funding

transferring from the NHS to councils. 4. Adjusted figures illustrate the data after the VPN transfer amendments.

Year Adults aged 18-64 Adults aged 65 and over

2006-07 17 794

2007-08 15 738

2008-09 15 753

2009-10 15 710

2010-11 15 687

2011-12 19 696

2011-12 (Adjusted Figures) ⁴ 14 694



Adult Placements/Shared Lives Schemes

Adult placement schemes are similar to fostering schemes for children. A full definition is given in the Editorial notes in the definitions section. They are sometimes known as shared lives schemes.

Prior to 2005-06 Adult Placements were recorded as part of ‘Other Registered Accommodation’. Data on service users receiving care on an Adult Placement scheme were collected separately where possible for 2005-06 and from 2006-07 all adult placements were recorded separately as these schemes were no longer registered and therefore have not been included in other parts of this chapter.

As at 31 March 2012, table 5.2 shows that 4,730 service users were receiving care through an Adult Placement scheme, an increase of 10 per cent from 2011 and an increase of 62 per cent since 2007. Over three quarters (76%) of these service users were aged 18-64 with a learning disability.

Table 5.2: Number of service users recorded on Adult Placement schemes by client type, 2007 to 2012¹

England, as at 31 March Rounded numbers1



Age Group Service User Group 2007 2008 2009 2010 2011 2012

18-64 2,570 2,550 3,490 3,630 3,730 4,070

Of which Physical disability 80 90 120 130 140 150

Learning disability 2,230 2,260 3,060 3,200 3,270 3,600

Mental health 240 190 290 280 290 290

Substance misuse

and other vulnerable

people

20 10 20 30 30 40

65 and over 360 380 510 580 580 660

All Ages 2,930 2,930 4,000 4,210 4,310 4,730



Table 5.3 shows that during 2011-12 there were 680 permanent admissions for service users entering an adult placement an increase of 240 admissions since 2006-07. In 2011-12, 91 per cent of service users permanently admitted to an adult placement were aged 18-64 with and the majority were for service users with a learning disability Admissions to adult placement schemes represent 1 per cent of all permanent admissions which has remained unchanged since 2007-08.

Table 5.3: Number of permanent admissions to adult placement schemes by client type, 2006-07 to 2011-12¹.

England Rounded numbers1



Age Group Service User Group 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12

18-64 390 340 560 540 570 610

Of which Physical disability 20 20 30 20 40 30

Learning disability 320 290 470 430 480 510

Mental health 50 30 50 80 50 60

Substance misuse and 10 0 10 10 10 10

other vulnerable people

65 and over 40 30 70 80 80 60

All Ages 440 380 630 630 650 680



Chapter 6: Carers

Introduction This chapter concentrates on carers of adults aged 18 and over. This information has been collected since 2004-05, and is used in the performance assessment for Councils with Adult Social Services Responsibilities (CASSRs). The current Government has identified four priority areas for carers8. They are:

o Supporting those with caring responsibilities to identify themselves as carers at an early stage, recognising the value of their contribution and involving them from the outset both in designing local care provision and in planning individual care packages.

o Enabling those with caring responsibilities to fulfil their educational and employment potential.

o Personalised support both for carers and those they support, enabling them to have a family and community life.

o Supporting carers to remain mentally and physically well. Data on carers is collected by the age group of the carer, the primary client type of the person cared for and age group of the person cared for. As shown in Figure 6.1, 53 per cent of carers were assessed or reviewed jointly in 2011-12; this has decreased by 9 percentage points since 2006-07. Over the same period carers assessed or reviewed separately has increased by 10 percentage points to 38 per cent in 2011-12.

Figure 6.1: Percentage distribution of assessments or reviews offered to carers by assessment type, 2006-07 to 2011-12

Source: RAP proformas C1

8 http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_122077

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_122077



Carers assessments and reviews

In 2011-12 429,000 carers were offered an assessment or review, as shown in Table 6.1 of which 391,000 (91%) were taken up and 38,000 were declined.

53 per cent of all carers who were offered an assessment or review were aged between 18 and 64; with 19 per cent aged 65 to 74 and 27 per cent aged 75 or more. Carers who were under 18 years of age accounted for 1 per cent of all carers assessed or reviewed.

Table 6.1: Number of carers offered an assessment or review by age group of carer, 2011 to 2012

England Thousands and Percentages

Source: RAP Proforma C1

Figure 6.2 shows that 268,000 (69%) assessments and reviews completed are for carers caring for an adult with a physical disability in 2011-12, although this is a 3 per cent decrease from 277,000 in 2010-11 and a 6 per cent increase from 252,000 in 2006-07. 73,000 carers caring for adults with mental health needs received an assessment or review in 2011-12 which is a decrease of 2 per cent from 75,000 in 2010-11.

Figure 6.2: Number of carers with a completed assessment or review by primary client type of the person cared for, 2006-07 to 2011-12


Age group of carer

All ages Under 18 18 to 64 65 to 74 75 and over Unknown

Number of carers offered an assessment or review 429 3 228 82 116 0

Percentage of carers offered an assessment or review 100 1 53 19 27 0

Carers assessed or reviewed separately 162 2 90 31 39 0

Carers assessed or reviewed jointly 229 1 122 44 62 0

Carers declining an assessment during the period 38 0 17 6 15 0



Figure 6.3 shows that 39 per cent of carers aged 18 to 64 received a separate assessment or review compared to 34 per cent in the 75 and over age group. The proportion of carers receiving a joint assessment or review showed little difference by age, but there were differences for those declining an assessment or review with 13% of carers aged 75 and over doing so compared to only 7 per cent of those aged 18-64.

Figure 6.3: Percentage distribution of carers offered an assessment or review by age group of carer, 2011 to 2012

Source: RAP Proforma C1 1. The under 18 group is based on relatively small number of carers (3,000)

Figure 6.4 shows there has been a decrease of 6 per cent since 2010-11 in the number of carers being assessed or reviewed jointly which is a 7 per cent decrease since 2006-07. However, the number of carers receiving a separate assessment or review increased by 1 per cent from 160,000 in 2010-11 to 162,000 in 2011-12 which was a 50 per cent increase since 2006-07. The number of carers declining an assessment or review has decreased by 9 per cent from 42,000 in 2010-11 to 38,000 in 2011-12 and has decreased by 6 per cent from 2006-07.

Figure 6.4: The number of carers offered an assessment or review, 2006-07 to 2011-12




Carers receiving Services Table 6.2 shows that the number of carers receiving services was 363,000 (down 4% from 2010-11 but up 15% from 2006-07). This represents just over 93% of the carers assessed or reviewed which has decreased from 94 per cent in 2010-11. 55 per cent of all carers who received services (including Information) were aged between 18 and 64; with 19 per cent aged 65 to 74 and 26 per cent aged 75 or more. Carers who were under 18 years of age accounted for less than 1 per cent of all carers receiving services. This distribution is similar for those receiving ‘carer specific’ services and those receiving information only.

Table 6.2: Number of carers receiving services by age group of carer, 2011 to 2012


1. Age groups may not sum to totals as some CASSRs reported offering assessments to carers whose age was not known.

Figure 6.5 shows a decrease of 2 per cent from 2010-11 in the number of carers receiving information with numbers falling from from 191,000 in 2010-11 to 187,000 in 2011-12. The numbers receiving ‘carer specific’ services in 2011-12 was 176,000 which has decreased from 188,000 (7%) in 2010-11, and has decreased by 1 per cent since 2006-07. Figure 6.5: Number of carers receiving services by type of service received, 2006-07 to

2011-12


England Thousands and Percentages

Age group of carer

All ages Under 18 18 to 64 65 to 74 75 and over Unknown

Number of carers receiving services 363 2 198 70 93 0

Percentages of carers receiving services 100 1 55 19 26 0

Carers receiving 'carer specific' services 176 1 94 35 45 1

Carers receiving information only 187 1 103 36 47 0



Figure 6.6 shows that 48 per cent of carers received a carer specific service and 52 per cent received information only. This compares to an equal 50 per cent split in 2010-11.

Figure 6.6: Percentage distribution of service delivered after an assessment or review, 2006-07 to 2011-12




Figure 6.7 shows there has been a decrease of 4 per cent in the number of carers receiving services who care for a person with a physical disability from 261,000 in 2010-11 to 249,000 in 2011-12. This follows a previous decrease from 270,000 in 2009-10 and prior to that, a period of steady increase from 229,000 in 2006-07. However, the number of carers receiving services who care for a person with mental health problems has decreased 3 per cent from 71,000 in 2010-11 to 69,000 in 2011-12. Prior to 2010-11 the figures had risen year on year from 42,000 in 2006-07. Figure 6.7: Number of carers receiving services by primary client type of the person cared

for, 2006-07 to 2011-12




Annex A - Editorial Notes

Background Notes

Sources of Data

This report is based on an analysis of information relating to the year 1 April 2011 to 31 March 2012 sourced from the Referrals, Assessments and Packages of Care Return (RAP), sections of the Adult Social Care Combined Activity Return (ASC-CAR) and the activity data on home care from the Personal Social Services Expenditure Return (PSSEX).

The RAP, ASC-CAR and PSSEX returns are concerned with adults, defined as those aged 18 or over, and relate to adult social services. Children’s social services are not covered in these returns, and nor are services provided to adults on behalf of children (e.g. Section 17 payments). Some CASSRs are known to continue with children's services for a few service users aged 18 or over which should be included within the adult returns. Community care is the process by which requests for social care help (made to Councils with Adult Social Services Responsibilities) are translated, via assessment and care planning into appropriate services.

Content of the returns for 2011-12

RAP Forms

Most of the RAP forms seek data for a period of time, usually a full year, but a few forms relate to a snapshot on the last day of the period (i.e. as at 31 March 2012). The returns are concerned with adults aged 18 and over and relate to adult personal social services. The C1 and C2 returns relate to carers of adults, some of whom may be aged under 18 but are caring for an adult aged 18 or over. Some information is collected by gender, ethnicity and age group. The RAP proformas:

referrals (R proformas) – for events;

assessments and reviews (A proformas) - relating to numbers of service users (and events in the number of review events);

packages of care (P proformas) – relating to numbers of service users. In 2006-07 and 2007-08 the P2s proforma was extended to collect data on service users planned to receive services by or on behalf of social services via an Individual Budget as part of the Individual Budget Pilot9. For 2008-09 data relating to Personal Budgets was collected from all CASSRs. From 2009-10 however information on the number of service users receiving personal budgets was collected from the main pages of the P2s and P2f forms with more detailed information on service users receiving self-directed support collected from the new SD1 and SD2 forms. An additional proforma (SD3) was also added to collect information on carers receiving self-directed support.;

Carers (C proformas) were added to the 2004-05 collection to show information relating to carers;

Proforma H1 was added to the return in 2008-09, following the Review of Social Care Collections, to collect further information on home help in place of the discontinued Home Help (HH1) return.

Self Directed Support (SD1, SD2 and SD3) were new proformas added to the return in 2009-10 to capture information on service users and carers receiving services via the self-directed support process and direct payments.

9 More information on the Individual budgets pilot is available at

http://www.dh.gov.uk/en/SocialCare/Socialcarereform/Personalisation/Individualbudgets/index.htm

http://www.dh.gov.uk/en/SocialCare/Socialcarereform/Personalisation/Individualbudgets/index.htm



There are documents providing detailed guidance for each proforma (a protocol), along with a glossary of the terms used. A summary of the proformas is given below with further information and copies of the proformas available in the data collection documents supplied to Councils for 2010-1110.

R2 Number of contacts for new clients during the period concerning services from the CASSR whose needs were attended to solely at or near the point of contact.

R3 Source of referral for all contact events covered in R2 and for those passed on for further assessment.

A1 Number of existing service users for whom a review was completed during the period, by primary client type and age group.

A6 Page 1 Number of new clients aged 18-64 for whom an assessment was completed in the period by age group, ethnicity, and known or anticipated sequel to assessment.

A6 Page 2 Number of new clients aged 65 and over for whom an assessment was completed in the period by age group, ethnicity and known or anticipated sequel to assessment.

A7 Page 1 Length of time from first contact to completed assessment for new clients for whom an assessment was completed during the period by time bands by age group,

A7 Page 2 Length of time from first contact to completed assessment for new clients for whom an assessment was completed during the period by time bands by age group and, primary client type

A10 Number of Section 256 and self-funded service users with completed assessments or reviews, provided at the expense of the CASSR during the period, by age group and primary client type. This proforma was voluntary for 2010-11

A11 Page 1 Number of new clients for whom an assessment was completed during the period, by gender and age group, cross tabulated with known or anticipated sequel to assessment

A11 Page 2 Number of new clients for whom an assessment was completed during the period, by gender and age group, cross tabulated with primary client type

P1 Page 1 Number of service users aged 18-64 receiving services during the period, provided or commissioned by the CASSR, by age group primary client type and service type.

P1 Page 2 Number of service users aged 65 and over receiving services during the period, provided or commissioned by the CASSR, by age group primary client type and service type.

P7 Page 1 Number of clients receiving services provided or commissioned by the CASSR during the period by gender and age group, cross tabulated with service type

P7 Page 1 Number of clients receiving services provided or commissioned by the CASSR during the period by gender and age group, cross tabulated with primary client type

P2f Number of service users receiving community-based services during the period, provided or commissioned by the CASSR, by components of service, primary client type and age group.

P2s Number of service users on the books to receive community-based services on the last day of the period (31 March), provided or commissioned by the CASSR, by components of service, primary client type and age group.

H1 Number of planned hours per week provided or commissioned for those service users on the books to receive homecare as of 31 March.

P4 Page 1 Number of service users aged 18-64 receiving services during the period, provided or commissioned by the CASSR, by age group and ethnicity, cross tabulated with service type.

P4 Page 2 Number of service users aged 65 and over receiving services during the period, provided or commissioned by the CASSR, by age group and ethnicity, cross tabulated with service type

P4 Page 3 Number of service users aged 18-64 receiving services during the period, provided or commissioned by the CASSR, by age group and ethnicity, cross tabulated with primary client type

P4 Page 4 Number of service users aged 65 and over receiving services during the period, provided or commissioned by the CASSR, by age group and ethnicity, cross tabulated with primary client type

10

A full set of proformas and the guidance is available at http://www.ic.nhs.uk/services/social-care/social-care-collections/collections-2011

http://www.ic.nhs.uk/services/social-care/social-care-collections/collections-2011

http://www.ic.nhs.uk/services/social-care/social-care-collections/collections-2011



SD1 Number of service users receiving self directed support and/or direct payments provided or commissioned by the CASSR during the period, by primary client type and extended age group.

SD2 Number of service users receiving self directed support and/or direct payments provided or commissioned by the CASSR during the period, by ethnicity.

SD3 Number of carers receiving self directed support and/or direct payments provided or commissioned by the CASSR during the period, by extended age group.

C1 Page 1 Number of carers for whom assessments or reviews were completed or declined during the period, by age group of carer.

C1 Page 2 Number of carers for whom assessments or reviews were completed or declined during the period, by client group and age group of person cared for by the carer.

C2 Page 1 Number of carers receiving different types of services provided or commissioned as an outcome of an assessment or review, by age group of carer.

C2 Page 2 Number of carers receiving different types of services provided or commissioned as an outcome of an assessment or review by client group and age group of person cared for by the carer.

As a result of a review of Social Care Collections carried out by the Health and Social Care Information Centre in 2011, some data items were removed from the RAP collection (table A8 was deleted in entirety, A10 (while remaining voluntary), no longer collects s256 data and H1 only collects data on planned hours, data on planned visits is no longer required).

ASC-CAR Forms

After the Community Care reforms from 1 April 1993 there were large rises in the number of supported residents. Following the reforms, CASSRs took over responsibility from DSS for funding placements in independent sector nursing homes and residential homes. The S proformas relate to the numbers of supported residents in residential care, nursing care and adult placements. Prior to 2008-09 this information was collected on the Supported Residents (SR1) return. The data from 2002-03 onwards includes residents that transferred to CASSR support on 8 April 2002 who were formerly in receipt of higher rates of income support under the Department for Work and Pensions (DWP) preserved rights scheme. These residents were counted as new admissions during 2002-03 and it was assumed that they were all permanent admissions. Residents who received CASSR support on top of higher rates of income support were previously included in the supported residents data and therefore were not considered as new admissions relating to preserved rights in 2002-03. The latter point relates mainly to residents aged 18-64. From 2003-04 onwards, the data also includes former Boyd Loophole residents, namely those people who have funded their own care through receipt of a range of social security benefits, sometimes topped up by relatives. The abolition of the residential allowance from 6 October 2003 effectively closed the Boyd loophole. The residents affected are likely to have sought CASSR support from 6 October 2003.

S1 Number of residents supported by the local authority in residential and nursing placements as at 31 March 2011, by type of residence, primary client type and age group (previously tab.1 in SR1 return)

S2 Number of residents aged 65 and over supported by the local authority in residential and nursing placements as at 31 March 2011, by type of residence and age group (previously tab.2 in SR1 return)

S3 Number of LA supported PERMANENT admissions to residential and nursing care during 1 April 2010 to 31 March 2011 (excluding admissions to group homes), by type of residence, primary client type and age group. (previously tab. 5a in SR1 return)



S5 Number of LA supported PERMANENT residents transferring between residential and nursing care during 1 April 2010 – 31 March 2011 (excluding admissions to group homes) by age group. (previously tab. 5c in SR1 return)

Table S4 has been deleted from the ASC-CAR return from 2011-12 onwards. An additional row has been added to S3 to identify service users having their care funded by the ‘Valuing People Now’ (VPN) initiative. ASC-CAR also collects data for four Adult Social Care Outcomes Framework measures

1. 1E: Adults with learning disabilities in paid employment 2. 1G: Adults with learning disabilities in settled accommodation and 3. 2A: Permanent Admissions to residential and nursing care homes per 100,00 population 4. 2B: Older people still at home 91 days after discharge from hospital into rehabilitation/reablement

services

These outcomes are reported on in - Measures from the Adult Social Care Outcomes Framework, England - 2011-12 - Final Release11 PSS Ex1 Activity Data

In addition to capturing data on the expenditure of CASSRs on social care, the PSS Ex1 return collects additional activity information to complement the RAP and ASC-CAR returns and provides additional data items for the calculation of council level unit costs for services Information on the number of hours of home care has been used within this report to provide a consistent time series for data on the intensity of home care services.

11

www.ic.nhs.uk/pubs/socialcareof1112final

http://www.ic.nhs.uk/pubs/socialcareof1112final



Annex B - Data Quality

In this section we discuss the steps taken to improve the quality of the response to the RAP and ASC-CAR returns in 2011-12 and summarise the implications for the results already published for earlier years.

Relevance, the degree to which the statistical product meets the user needs in both Coverage and Content.

The information is provided at Council level for all Councils with Adult Social Services Responsibilities (CASSRs) in England. The data is used by Central Government and the Care Quality Commission to monitor the impact of social care policy and by local Government to assess performance in relation to their peers. This is also available for use by researchers looking at Council performance and by service users and the public to hold councils and government to account. The Social Care Collections are developed by the Adult Review Group (ARG) and the Social Services User Survey Group which is attended by Health and Social Care Information Centre (HSCIC), Department of Health (DH), Care Quality Commission (CQC), independent representatives with an active interest in the subject and CASSR performance and information. The 2010-11 collections were approved by the Strategic Improving Information Programme board (SIIP). This group is jointly co-chaired by DH and the Association of Directors of Adult Social Services (ADASS) and contains representatives from HSCIC, CQC and Local Government Association (LGA). Since signing off the 2010-11 collections SIIP has now become the Outcomes and Information Development Board (OIDB).

Accuracy

The information published here has been reported by councils as final data for 2011-12 and supersedes that published as provisional in September 2012. Changes are small at national level between the provisional and final figures. RAP data is collected via the Omnibus collection tool which is an online tool and includes a set of key validation checks that are applied to the data, enabling it to be validated at source before submission to the HSCIC. Councils are able to provide explanations for overriding any validation checks and also explain any other discrepancies in data for which there is not a validation check. This reduces the level of error in returns and the subsequent need for follow up with CASSRs when the data undergo further validation checks within the HSCIC. The RAP data was previously (until 2009-10) collected via the HSCIC’s Internet Data Collection tool (IDC). Due to the size and complexity of the RAP return it was not possible to include all the “at source” validations within the Omnibus system and instead these were carried out by the HSCIC after the data had been submitted. Specifically, year on year checks previously carried out on the IDC were not included in the Omnibus system. The ASC-CAR return was collected in its current format via the Omnibus collection tool as in previous years. From 2011-12 only one round of validation checks are carried out on data submissions from the RAP and ASC-CAR returns. During this round, councils have an opportunity to change their data, Prior to this, two validation rounds were performed, the drop to one was agreed through the Adult Review Group (ARG) and Outcomes and Information Development Board (OIDB). Analysis of the level of changes has shown that changes resulting from the 2nd round of checks is minimal12.

12

See paper 33/06 for the ARG meeting on 10 November 2011 available from: http://www.ic.nhs.uk/services/social-care/review-approval-and-development/adult-review-group

http://www.ic.nhs.uk/services/social-care/review-approval-and-development/adult-review-group



Not all the RAP and ASC-CAR data items were provided so estimates have been derived from the raw data provided by councils. In addition, some council figures were overwritten and replaced with an estimate as their responses to validation queries showed they had not followed the definitions in the guidance for completing the return. The steps to safeguard data quality in 2011-12 follow.

2011-12: action taken to safeguard data quality The HSCIC actions included a number of validation checks:

Examining internal consistency within a form and between forms (e.g. ensuring that components added to totals).

For key variables, comparing information with that already given, for example, looking at the total number of people receiving at least one service each year.

Examining data for plausibility – e.g. looking to see if the number of service users receiving services during the year is higher than those receiving services at 31 March; examining the percentage of people receiving services where the service was for example equipment and adaptations, or professional support against the total number of service users receiving services.

For the information on waiting times, examining cases where a very high or very low percentage of service users have been assessed or received all their services within a very short time.

Comparing the number of new service users to the number of service users receiving services and to the rate per population.

Blank and zero data items were also followed up with CASSRs. There were follow-ups with the majority of councils about some aspect of their data.

Estimation procedures in 2011-12 Data provided by some CASSRs was incomplete in a number of ways: 1. Entire sections were completely blank – contributions for these sections were assumed to be in line with

the profile for councils responding to these sections; 2. Parts of sections were missing - in these cases, the blank cells were assumed to be zero where there

was a very clear presumption, from evidence within the other RAP proformas from the council, or in the explanation provided by the council that the blank cell(s) represented zeros. In other cases, an estimate was inserted. This was estimated either in terms of the known total for the activity from another proforma where there was one, or in terms of the national profile for that cell for other councils who did provide the data.

3. Councils providing data for all or part of the primary client analysis but none of the client subset analysis in some of the proformas - where the primary client data are present but the subset data are not provided, subset data is estimated using the England profile (derived from councils that provided this information).

4. As mentioned earlier, some council figures were overwritten and replaced with estimates as it was clear from their responses to validation queries that they had not followed the definitions in the guidance documents.

Timeliness of the RAP and ASC-CAR returns

The number of councils submitting a completed RAP return by the deadline were 151 out of 152 - this compares to 150 out of 152 councils in 2010-11. The number of councils submitting a completed ASC-CAR return by the deadline were 151 out of 152 – the same as the previous year.

Completeness of the proformas

All 152 councils were able to provide full information for all of the S Tables in the ASC-CAR Return, and no estimation was required for these tables in 2010-11.



Some parts of the RAP forms were better completed than others. For example, the primary client group of a person (e.g. physical disability) was generally known, but the subgroup (visual impairment, dual sensory loss etc.) information may have been missing. This may be because some CASSRs do not have computer systems which record the subgroup information, or because the information was received from an external source (e.g. from an agency) who did not know the subgroup.

For some returns, data in individual cells of a few sections have been left blank with no explanation from the council as to whether the blanks are true zeros, or missing data. Where this is the case, the blank has been filled by estimation. In a few instances where there is compelling evidence (e.g. from other proformas) that the true value of the data should be zero the missing data is assumed to be a zero. The data quality section contains further information on estimations Table A1 shows the level of completion for each of the 18 RAP and 8 ASC-CAR proformas in 2011-12. For most tables, completion was fairly high with only a few councils not providing a full return. However, tables A1, P1, P2f and P2s were not as fully completed which reflects the fact that these were the tables where councils struggled to fully comply with the guidance and had their data overwritten as a result. The most common reason for this was due to problems obtaining data from service users with a mental health problem where the service was provided by a mental health partner but funded by the local authority. Some councils were unable to obtain any data from their mental health partner and others did include data, but could not identify the subset of service users who were funded by the local authority. In addition, these are the only tables which ask for a secondary client group and some local authorities struggle to include this information.



Table A1: Number of CASSRs providing non-voluntary data, by proforma and level of completion, 2011-12

Proforma Table Full Partial Empty

RAP R2 152 0 0

R3 152 0 0

A1 146 6 0

A6 151 1 0

A7 151 1 0

A10 64 4 84

A11 151 1 0

P1 147 5 0

P2f 144 8 0

P2s 143 9 0

P4 152 0 0

P7 152 0 0

H1 151 0 1

C1 151 1 0

C2 152 0 0

SD1 151 1 0

SD2 151 1 0

SD3 151 1 0

ASC_CAR S1 152 0 0

S2 151 1 0

S3 142 10 0

S5 151 1 0

L1 150 2 0

Source: RAP and ASC-CAR proformas

1. A7 page 2 and the A10 proforma were voluntary for the 2011-12 collection. 2. As mentioned earlier in this section, some councils values were overwritten with estimates as their responses to

validation queries showed they had not followed the definitions in the guidance for completing the return. These tables are classed as “Empty”.



Annex I13 gives a breakdown of the level of completion (‘full’, ‘partial’ or ‘empty’) for the non-voluntary data items (and proforma A10) by RAP and ASC-CAR proforma and council. Figure A1 shows the level of completion for each of the 18 RAP proformas used to source data for this report in 2010-11 and 2011-12. It shows that more councils submitted a full return for proformas A1, A6, A8, A11, P1, P2f, P2s, P4, H1, SD1, SD2, C1 and C2. A7 and SD3 were the only proformas where a smaller proportion of councils provided a full return this year compared to the last.

Figure A1: Percentage of full, partial or empty returns by RAP proformas, England in 2010-11 and 2011-121.

Source: RAP proformas

1 Both the content and mandatory elements of tables can change across years. With the exception of A10 all completion rates are based on only the mandatory elements of each table.

2 As mentioned earlier in this section, some councils were overwritten with estimates as their responses to validation queries showed they had not followed the definitions in the guidance for completing the return. These tables are classed as “Empty”.

13

Provided in excel table “Annex J and I - Completion and basis of response.xls www.ic.nhs.uk/pubs/communitycaressa1112final

0

10

20

30

40

50

60

70

80

90

100

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

20

10-1

1

20

11-1

2

R2 R3 A1 A6 A7¹ A10² A11 P1 P2f P2s P4 P7¹ H1 SD1 SD2 SD3 C1 C2

Co

mp

lete

ne

ss p

erc

en

tag

e

Full Partial Empty

http://www.ic.nhs.uk/pubs/communitycaressa1112final



Status of the CASSR RAP data Where CASSRs were unable to provide data on the basis of a full population count they were asked to provide information based on a sample of records grossed up to produce estimates. Annex J14 provides details on the basis of return for each proforma by council. The basis of return gives some indication of whether councils were using IT systems to produce RAP figures (i.e. some of those councils providing information on the basis of a sample or estimate were doing so from manual client records) and of the quality of the response. Figure 7.2 illustrates that the proportion of councils using a whole population count as the basis for RAP returns has increased for 15 proformas since last year and decreased for 3 proformas. All ASC-CAR data used in this report was based on full population data.

Figure A2: Percentage of CASSRs using a whole population count as the basis of return, by RAP proforma, England 2010-11 and 2011-12.

Source: RAP proformas 1 A7 page 2 and A10 in full were voluntary in 2011-12 2 As mentioned earlier in this section, some councils were overwritten with estimates as their responses to validation queries showed they

had not followed the definitions in the guidance for completing the return. However, whether their submission was based on a sample or whole population count has been included in the chart.

6 Provided in excel table “Annex C and D - Completion and basis of response.xls ” which can be found at www.ic.nhs.uk/pubs/finalcarestats1011ssa

0

10

20

30

40

50

60

70

80

90

100

A1 A10 A11 A6 A7 C1 C2 H1 P1 P2f P2s P4 P7 R2 R3 SD1 SD2 SD3

Pe

rce

nta

ge

Proforma

2010-11 2011-12

http://www.ic.nhs.uk/pubs/finalcarestats1011ssa



Coherence and Comparability

The data collection is signed off by ARG and OIDB as explained earlier which contains representatives from most of the users outlined in annex C.

Changes to the data collections over time causing Inconsistency in time series data RAP In 2003-04 several changes were made to the referrals and assessments proformas (see following details). Data from 2003-04 onwards is therefore not directly comparable with data from previous years. In 2004-05 the RAP guidance relating to service users receiving services was restated to only include service users who are assessed by social services and have a care plan. The 2004-05 data is therefore not comparable to previous years. Section 6 of the 2001-02 national report gave a detailed discussion of the implications of the 2001-02 results for the results published for earlier years. These issues are summarised below and should be taken into consideration when comparing historical data.

1999-00 With the publication of the 2001-02 RAP data it became clear that some of the detailed data for the second RAP dress rehearsal (1999-2000) were no longer plausible in relation to the data reported for the following two years. In 1999-00, there were problems with the size and representativeness of the sample used to derive the sample estimates. The councils in the sample may have had more activity in certain services than councils which did not respond that year. These concerns cast doubt on the P2f analysis for 1999-00, and the whole of this section was therefore withdrawn from January 2003. This means that there are no figures for 1999-00 for meals on wheels, home care/home help, professional support, transport and equipment. Time trends which use data for these items from previously published RAP reports are not valid.

2000-01 In a number of instances the raw data supplied by councils for 2001-02 exceeded the grossed up estimate of the data reported in 2000-01. In the vast majority of these cases there seems to be compelling evidence that the 2000-01 data are too low, most probably because large groups of service users were missed in CASSR IT systems.

2001-02 and 2002-03 (i) The figures for visually impaired clients receiving a completed assessment fell by nearly a third to

33,000 in 2001-02, although the figure of 36,000 in 2002-03 is more in line with the 2001-02 figure. This seems to be a data collation issue for Local Authorities.

(ii) The figures on the number of completed assessments for asylum seeking clients appeared to show a marked fall during 2001-02 followed by a further drop during 2002-03. Councils reporting large numbers in 2000-01 were asked to explain the apparent fall, but were not able to come up with a satisfactory explanation.

(iii) No guidance was given with RAP on what constitutes 'frailty' as opposed to 'physical disability'. The result is that the two categories have not been consistently reported across the years. In 2001-02, for the subset ‘frailty’ there was a 23 per cent increase in 2001-02 from the year before whilst the figures in ‘physical disability’ dropped by 10 per cent during 2001-02. The data for these categories in 2002-03 are similar to those reported in 2001-02. However the trend in the total numbers of both categories taken together for 2000-01 to 2002-03 appears plausible. In 2004-05 these two subsets have been combined to form the subset ‘physical disability, frailty and/ or temporary illness’.

2003-04 In 2003-04 several changes were made to the referrals and assessments proformas as follows; (i) The referral forms were redefined to only include contacts from new clients, i.e. clients not on the

books of the Councils with Adult Social Services Responsibilities (CASSR) at the time the contact was made.

(ii) An assessment was redefined as the first assessment for a new client.



(iii) A review was redefined as an examination of an existing client’s needs which must include a formal reassessment.

2004-05 In 2004-05 several changes were made to the RAP proformas as follows; (i) Two new carers’ returns were introduced to collect the number of carers’ assessments and carers’

services provided. (ii) Guidance was re-issued to clarify a number of issues regarding the coverage of RAP and the

recording practices that councils should adhere to, particularly for the P forms. The most significant issue was confirmation that only service users who have had a community care assessment carried out by the CASSR (or legally delegated NHS partner) and whose services form part of a care plan should be included in the RAP return. Therefore the 2004-05 data from the P tables is not comparable to previous years.

2005-06 In 2005-06 several changes were made to the RAP proformas as follows; (i) The new carers’ returns (C1 and C2) captured information on the age and client group of the cared

for person and relate to activity over the full 12 months. (ii) Information on ‘referral category’ was no longer collected in forms A8 and A9. (iii) Information on HIV was no longer collected in the 2006-07 reporting period. The category ‘of which

HIV’ was deleted from the A1 and P1 returns. (iv) Information on Preserved rights was no longer collected in the P1 return. (v) The length of waiting time captured on the A9 return was changed to ‘first contact with social

services to first contact with client’ rather than ‘time to start of assessment’. (vi) ‘Transport’ as one of the components of community based services was no longer captured

separately. (vii) Councils only recorded the outcome of assessments for new clients only on proformas A5 and A6. (viii) Total assessment events’ deleted from proforma A1.

2006-07 In 2006-07 several changes were made to the RAP proformas as follows; (i) A new table was introduced to P2s to collect data on service users planned to receive services by or

on behalf of social services via an Individual Budget. (ii) P4 was split into two age groups, 18-64 and 65 and over. (iii) Titles for the C returns were reworded to avoid confusion caused in the previous year’s collection.

2007-08 In 2007-08 several changes were made to the RAP proformas as follows; (i) New table introduced to R2 entitled: Number of contacts for new clients receiving services covered

by definitions relating to RAP P forms at the point of contact outside a formal assessment. This table collected data by CSSRs on a voluntary basis for the period 1 October 2007 – 31 March 2008.

(ii) Due to new legislation, Section 31 arrangements (of the Health Act 1999) were referred to as Section 75 arrangements (of the NHS Act 2006). http://www.opsi.gov.uk/acts/acts2006/ukpga_20060041_en_6#pt3-l1g75

(iii) New guidance for CASSRs on recording service users receiving services via “In Control” projects (for implementation in 2007/08).

(iv) Revised guidance was issued on: a) The definition of the subset ‘Dementia’ b) Double counting of service users on pages 1, 2 and 3 of the A1 proforma c) Definitions on recording of equipment on P2s – one-off pieces of equipment. d) The recording of ‘Telecare’ e) Definitions of ‘respite care’ and ‘Short term residential - not respite’ f) The removal of ‘overnight – respite care’ from ‘P’ forms. This became a service provided

to carers on the ‘C’ forms g) Carer assessments carried out by other organisations, For implementation wherever

possible from 2008-09

2008-09

http://www.opsi.gov.uk/acts/acts2006/ukpga_20060041_en_6#pt3-l1g75



In 2008-09 a number of changes were made to the RAP proformas following the review of social care collections that took place in 2008. These changes were as follows; (i) A number of proformas were deleted: R1, A1 page 1, A1 page 3, A5 and A9. (ii) The table detailing services received at point of contact on R2 page 1 was deleted. (iii) The A6 and P4 proformas were split by gender. (iv) New tables were added to proforma A8 to capture waiting times data for service users aged 18-64.

Completion of these two additional tables was on a voluntary basis in 2008-09. (v) The 2 separate columns entitled ‘CASSR Residential care’ and ‘Independent sector residential care’

were amalgamated into one column headed ‘residential care’ on each of the P1 and P4 proformas. (vi) To support NI 130, 3 extra boxes were added to P2f page 5 to collect the number of service users

aged ‘65-74’, ‘75-84’ and ‘85 and over’ receiving direct payments during the year. (vii) A new proforma (H1) was introduced to collect number of planned hours and visits per week for

those service users on the books to receive homecare as at 31 March. (viii) Revised guidance was issued on:

a) Professional Support b) Information and Advice for carers c) Self assessments

2009-10 In 2009-10 several changes were made to the RAP proformas as agreed by Strategic Information Group on Adult Social Care (SIGASC). The changes are as follows: (i) A voluntary new proforma A10 was added to the RAP return in 2009-10, which captures data on the

number of section 256 (formerly s28) and self-funding service users with completed assessments and reviews provided at the expense of the CASSR.

(ii) The inconsistent ordering or primary client groups across the RAP tables has been brought in line to adhere to the following single order:

a) Physical disability b) Mental health c) Learning disability d) Substance misuse e) Vulnerable people

(iii) Four new additional ethnicity categories were added to A6 and P4 as “Traveller of Irish Heritage” and “Gypsy/Roma” (under the broader heading of ‘White’), and “Refused” and “Information not yet obtained”, (recorded under the broader heading of ‘Not Stated’).

(v) Following the voluntary introduction in 2008-09 of new tables to the RAP proforma A8 to capture the waiting times to receiving services for those aged 18 to 64, these tables became mandatory.

(vi) New proformas on Self Directed Support for service users and carers (SD1, SD2 and SD3) were

added to record information for local and central policy monitoring on Self Directed Support for service users by ethnicity and carers. The table on P2s which recorded information in the number of service users receiving personal budgets was removed.

(vii) The columns on the RAP P2f and P2s labelled ‘direct payments’ were expanded to include ‘Existing/new Direct Payments and Personal Budgets’. Service users who were receiving council commissioned services via a personal budget or direct payment were only included under this heading and not under the specific service received.

2010-11 There were a large number of changes to the RAP proformas in 2010-11 following a review of the collection: (i) A6 - The two A6 female and two A6 male tables gathering data on sequel to assessment by ethnicity

were replaced by two tables, A6 page 1 and A6 page 2, capturing the same data, except not divided by gender.

(ii) A7 - Page 1 was amalgamated into a single table and a ‘total clients’ row was added. A7 page 2 was retained, but return of this page was voluntary for 2010-11. The previous A7 page 3, ‘time to completion of assessment by referral category’ was deleted.

(iii) A8 - Page 1 was amalgamated into a single table and a ‘total clients’ row was added. The previous A8 page 2, ‘timeliness of services by primary client type’, was deleted.



(iv) A11 - Following changes to A6 mentioned above, two small tables, labelled A11, were introduced to ensure necessary equalities monitoring information was still captured. The A11 tables collected information for clients for whom an assessment was completed during the period, by gender, age, primary client type and sequel to assessment. The tables have an identical cohort to A6 and can be considered as a different cross-tabulation of the A6 data.

(v) P2f - The data lines on P2f page 5 were deleted but the ‘basis of return’ section was retained. The ‘Existing/new direct payments and personal budgets’ columns in P2f were changed to record direct payments only, whether delivered through a personal budget or not. All other P2f components of service columns were altered to count clients receiving the given service as a council commissioned service, whether or not this was through a personal budget.

(vi) P2s - The data lines on P2s page 7 were deleted; the ‘basis of return’ section was retained. vii) P2s - Pages 3, 4, 5 and 6, capturing data on clients aged 65 to 74 and clients aged 75 and over

separately, were merged into two pages capturing the 65 and over age group. (viii) P2s - The ‘Existing/new direct payments and personal budgets’ columns in P2s were changed to

record direct payments only, whether delivered through a personal budget or not. All other P2s components of service columns were altered to count clients receiving the given service as a council commissioned service, whether or not this was through a personal budget.

(ix) P4 - The four P4f female and four P4m male tables gathering data on clients receiving services by ethnicity were replaced by four P4 tables, capturing the same data but not divided by gender.

(ix) P7 - The changes to P4 remove all data by gender on services to adults, this led to two small tables, labelled P7, being introduced to ensure necessary equalities monitoring information is still available. The P7 tables capture clients receiving services provided or commissioned by the CASSR during the period, by gender and age group, cross-tabulated with service type. The tables have an identical cohort to P1 and can be considered as a different cross-tabulation of the P1 or P4 data.

2011-12 Changes to the proformas in 2011-12 were minimal from the previous year. They were:

(i) A8 – Deletion of this table

(ii) A10 – was been retained as a voluntary submission, data was no longer be captured on s256 clients within the table. However, data on self-funders was still required.

(iii) H1 – only collected data relating to planned hours. The requirement for data related to the number of planned visits is no longer required.

ASC-CAR Collection The SR1 return, introduced for the 1993-94 collection year, collected information on CASSR supported residents in staffed homes or other accommodation although the return was drastically revised for the 1997-98 collection year. Data was historically collected by type of care (residential or nursing), age group, type of accommodation (CASSR, voluntary, private, homes and other accommodation), type of stay (long or short) and location (within or outside CASSR). Data on short and long stay admissions of supported residents was also collected. It should be noted that no information is collected on supported residents that are in private hospitals and clinics. From 2008-09 the tables within the SR1 return were transferred into the ASC-CAR return. Table number references in the following sections which show changes to the collection refer to the current table numbers in ASC-CAR.

1997-98 (i) For supported residents, the client group prior to 1997-98 was based on the primary purpose of the

homes rather than on the individuals within each home. However, with effect from the collection for the year ended 31 March 1998, councils were encouraged to base the classification on the conditions of the individual and the primary reason for the provision of care.

2002-03 (i) On 8 April 2002, responsibility for funding residential care moved to CASSRs. Residents who were

formerly in receipt of a preserved rights income up to 8th April 2002 but were not supported by the council before that date were recorded as being a new permanent admission in 2002-03. Service users



that were in receipt of preserved rights but who were already being supported by councils before April 2002 were not treated as new admissions in 2002-03 but were included in the count of supported residents.

2003-04 (i) Boyd loophole cases who were already resident in care homes prior to the abolition of the residential

allowance on 6 October 2003 but were not supported by the council before that date were included as being permanent new admissions in 2003-04. Boyd loophole cases are defined as those people who funded their own care through receipt of a range of social security benefits, sometimes topped up by relatives. The abolition of the residential allowance effectively closed the Boyd loophole and meant that these service users needed to approach CASSRs for support, thus making them new service users to the CASSRs.

2005-06 (i) Tables S4 and S5 (5b and 5c in the SR1 return) were introduced to detail the number of people

transferring between permanent and temporary care and also those transferring between residential and nursing care respectively.

(ii) The recording of unstaffed homes was removed as these homes no longer existed. (iii) Where possible the recording of Adult Placements was separated out for the first time from ‘Other

registered accommodation’ as Adult Placements were no longer registered.

2006-07 (i) Table S3 (Table 5a in the SR1 return) was redefined to include transfers from temporary to

permanent residential and nursing care during the year 1 April 2006 to 31 March 2007 as new permanent admissions. Transfers of permanent residents between residential and nursing care were excluded from this table. Tables S4 and S5 (5b and 5c in the SR1 return) remained unchanged from the 2005-06 collection; therefore comparisons can still be made with historical data.

(ii) All Adult Placements were recorded separately.

2007-08 (i) The Other Registered Accommodation column was removed from all tables.

Residents previously recorded in this section were recorded as below: a) Homes owned by health - included as 'Local Authority Staffed' b) Registered Social Landlord Residential (RSLRE) and Resettlement Care (RESETCAR) -

included in 'Voluntary Residential' c) Residential Colleges/Schools - if some part of the residential costs were being met by the

council from social services budgets then they were included in one of the appropriate remaining columns.

d) Supported Living Placements - As these placements in themselves were not registered, then they were excluded from the return.

e) Residents placed outside the council area - if supported by the council from social services budgets then they were included in one of the appropriate remaining columns, as well as Table 3.

f) Those where the type of accommodation was 'Unknown/Unspecified/Unclear/Other' – the homes were contacted directly for clarification regarding the full status of the home.

g) Those recorded as 'Other' by CSCI - the homes were also contacted directly for clarification regarding the full status of the home.

2008-09 Tables 1, 2, 5a, 5b and 5c were retained and included within the new ASC-CAR return (tables 3, 6 and 7 were discontinued). Details of the ASC-CAR returns are as follows;

(i) Table S1: Previously SR1 table 1 – the categories under the headings ‘voluntary’ and ‘private’ were consolidated into one column entitled ‘Independent Residential Care’. ‘Adult Placement’ column was separated from the ‘registered homes’ columns into a separate page.

(ii) Table S2: Previously SR1 table 2 – this table was split into two pages. (iii) Table S3: Previously SR1 table 5a – the categories under the headings ‘voluntary’ and ‘private’

were consolidated into one column entitled ‘Independent Residential Care’. ‘Adult Placement’ column was separated from the ‘registered homes’ columns into a separate page.



(iv) Table S4: Previously SR1 table 5b – the categories under the headings ‘voluntary’ and ‘private’ were consolidated into one column entitled ‘Independent Residential Care’. ‘Adult Placement’ column was separated from the ‘registered homes’ columns into a separate page.

(v) Table S5: Unchanged from the previous SR1 table 5c.

2009-10 and 2010-11

There were no changes to the S Tables in the proforma.

2011-12 (i) Table S4 has been deleted (Number of transfers between LA supported temporary to permanent

residential and nursing care during 1 April to 31 March (excluding admissions to group homes) by type of residence and age group).

(ii) An additional row has been added to table S3 (Number of transfers between LA supported permanent admissions to residential and nursing care during 1 April to 31March (excluding admissions to group homes) by type of residence, primary client group and age group). This is to identify service users who are now having their care commissioned by local authorities following the “The Valuing People Now (VPN) initiative”1 which has changed the responsibility for, and funding of, some learning disability services.

(iii) The addition to I1 of those discharged from hospital and provided with a rehabilitation service following an assessment from social care services only, resulting in an individual support plan that involved active therapy, treatment or opportunity for recovery. Previously only those where a joint health and social care assessment had taken place could be included.

(iv) The restriction to capture employment and accommodation status for learning disabled service users for tables L1 and L2 at assessment or review has been removed. Instead this information should include those in employment or settled accommodation irrespective of whether they have had a review during the year, but the information does need to have been captured or confirmed within the reporting period1 April 2011 to 31 March 2012.

(v) The definition for “known to the council” for L1 and L2 has not been changed but has been clarified to refer to those who qualify for inclusion on the A or P tables in RAP.

(vi) Clarification that only those aged 18-64 with a primary client group of learning disability should be included in L1 and L2. Those clients who have a learning disability but this is not their primary client group should not be included.

(vii) The definition for the follow up period for assessing whether someone is still at home three months after hospital discharge has not changed but has been clarified.



Timeliness and Punctuality

The data relate to the financial year 2011-12 and therefore the lag from the end of the collection period is approximately 10½ months. The ZBR group are currently developing new activity collections which may replace the RAP and ASC-CAR collections for the 2014-15 collection cycle. This may be announced in a letter to councils at the end of March 2013. More information about the review including the consultation documents, full report and all the responses can be seen at:

www.ic.nhs.uk/adultsocialcareconsultation12

and the latest information on the new collection is at:

http://www.ic.nhs.uk/article/2458/Collections-development The HSCIC is assessing the feasibility of and options for the earlier publication of data collected through the RAP and ASC-CAR collections for 2012-13.

The HSCIC currently plans to provide an update on its plans in a letter to councils at the end of March 2013.

Any comments or queries should be addressed to: [email protected]

Accessibility and Clarity

There are no restrictions to access to the published data. The numbers are rounded to the nearest 5.

Assessment of User Needs and Perceptions

User feedback on the format and content of the Social Services Activity Publication is invited; a web form is available to submit comments at the bottom of the publication web page: www.ic.nhs.uk/pubs/communitycaressa1112final

HSCIC social care returns are currently subject to a Zero Based Review, where the data requirements and needs of our stakeholders and customers are sought to shape future data collections. More information about the review can be seen at:

http://www.ic.nhs.uk/services/social-care/the-zero-based-review

Confidentiality, Transparency and Security

The data contained in this publication are Official Statistics. The code of practice for official statistics is adhered to from collecting the data to publishing.

http://www.statisticsauthority.gov.uk/national-statistician/guidance/index.html

Please see links below to the HSCIC relevant policies.

Statistical Governance Policy http://www.ic.nhs.uk/webfiles/publications/Statistical%20Governance%20Policy.pdf

Freedom of Information Process http://www.ic.nhs.uk/data-protection/freedom-of-information-foi/guide-to-information/our-policies-and-procedures


http://www.ic.nhs.uk/article/2458/Collections-development

mailto:[email protected]


http://www.ic.nhs.uk/services/social-care/the-zero-based-review

http://www.statisticsauthority.gov.uk/national-statistician/guidance/index.html

http://www.ic.nhs.uk/webfiles/publications/Statistical%20Governance%20Policy.pdf

http://www.ic.nhs.uk/data-protection/freedom-of-information-foi/guide-to-information/our-policies-and-procedures

http://www.ic.nhs.uk/data-protection/freedom-of-information-foi/guide-to-information/our-policies-and-procedures



Annex C - How are the statistics used? Users and Uses of the Report

Uses of Statistics by Known Users

This section contains comments based on responses from the users listed. All these users have found the information in the report useful for the purposes set out.

Department of Health

Inform policy monitoring.

Speeches and briefings for Ministers and senior officials.

PQs and Prime Minister’s Questions.

Media Enquiries and other correspondence.

Councils with Adult Social Services Responsibilities

Different councils will use the survey in different ways but there will be some commonality between them. Ways in which councils may use the report will include:

Benchmarking against other councils.

Measuring/monitoring local performance.

Policy development.

Service development, planning and improvement.

Management information, local reporting, accountability.

Informing business cases.

Identifying any immediate priorities/areas for concern.

Care Quality Commission (CQC)

In previous years, when CQC was still conducting the Annual Performance Assessment (APA) of councils, they extensively used a wide selection of the Adult social care (ASC) returns captured by the HSCIC until the APA was cancelled by the government in 2010. CQC are planning on using some of the ASC information captured in the returns to help measure the contextual risk of care homes. Contextual risk is an independent suite of circumstances that describe or contextualise the ‘environment’ within which health or social care is provided.

PI Benchmark

"At Pi Benchmark our Care and HealthTrak product utilises HSCIC social care data, integrated with nationally available health data, national information such as ONS and POPPI/PANSI, along with the local data held by the specific organisation in order to allow our clients to make informed decisions in regards to spend, activity and resource allocation. Using all of these datasets, we create an interactive visualisation that allows users to better understand the large amount of data available to them. Our clients can then quickly identify areas of good practice, areas where opportunities exist and understand any relationships between these and other factors. Doing this in real time allows our clients to intelligently scrutinize both social care and health data and allows decisions to be made that benefit the local area"

Unknown Users

The survey report is free to access via the HSCIC website and therefore the majority of users will access the report without being known to the HSCIC. Therefore it is important to put mechanisms in place to try to understand how these additional users are using the statistics and also to gain feedback on how we can make the data more useful to them. On the webpage where the report is surfaced there is a link to a feedback webform which the HSCIC uses for all its reports. The specific questions asked on the form are:

How useful did you find the content in this publication?



How did you find out about this publication?

What type of organisation do you work for?

What did you use the report for? What information was the most useful? Were you happy with the data quality?

To help us improve our publications, what changes would you like to see (for instance content or timing)?

Would you like to take part in future consultations on our publications? Any responses via this webform are passed to the team responsible for the report to consider.



Annex D - Glossary

Admissions

An admission is a separate event of a person entering residential or nursing care (and being supported by the Local Authority).

Adult Placement

Adult Placement schemes are similar to fostering schemes for children. These are locally run and place between one to three adults with care or support needs with an adult placement carer and are no longer classed as registered accommodation. They ensure that these adults are able to enjoy an ordinary and independent life in the community and share in the family life of the carer.

Assessment

The process of gathering data for the purpose of determining a client’s need and eligibility for services. The Community Care Act specifies that all services offered to a client should be the outcome of an assessment of needs. There are no restrictions as to who carries out the assessment or part of it. An “assessment” is defined as the first assessment for a new client. All subsequent assessments which include a reassessment are defined as a review. Screening also qualifies as an assessment under the terms of the NHS and Community Care Act 1990 (see ‘Screening’). In some CASSRs partial self-assessment (by the client) is possible.

Assessment or review terminated

Some clients are passed through for an assessment or review of need, but for a variety of reasons the assessment or review is not completed, but rather is brought to an end before completion.

Boyd Loophole Cases

Residents who have funded their own care through receipt of social security benefits, sometimes topped up by relatives. Although these residents were all admitted to before April 2002, these residents will, by definition be new to local authority support from 6 October 2003.

Basic services

These are services where there is an initial but no ongoing financial or other resource commitment on the part of the CASSR. This term is used to describe the issue of blue badges, bus passes or administration of other comparable provisions, such as keys to public toilets for disabled people. CASSR blind / deaf registrations are also included. Many CASSRs do not distribute or fund the distribution of these provisions, whereas others do.

Care plan

A ‘care plan’ is a description of the client’s needs and how these will be met that is developed and agreed as a result of an assessment or review.

Carer

The definition of a carer is taken from the Carers & Disabled Children Act 2000 which states the act affects 'Carers (aged 16 and over) who provide or intend to provide a substantial amount of care on a regular basis



for another individual aged 18 or over’. It is possible for a client to have more than one carer, and for a carer to additionally be a client in his or her own right.

Clients/Service Users

Customers of the CASSR who are ‘on the books’ for an assessment, or review, or the receipt of services. A client can be an individual, family or group or can contain several clients. Individuals being considered as a service provider, for example, as a carer or foster parent in adult fostering scheme, should not be counted as clients.

Community-based services

These are services provided to support service users living in the community.

Completed assessment

A completed assessment for RAP purposes is one where all the components of the assessment of an individual’s needs and eligibility for services have been undertaken, and either a care plan has been agreed with the client or a decision taken that there should be no (further) services as a result of the assessment.

Contacts

A ‘contact’, often called an enquiry, is a person visiting, writing, phoning or making a request of the CASSR in some other way. In the broadest sense a ‘contact’ is anyone who has made a request of the CASSR, at any of its access points (including those shared with others, such as in health settings).

Day care

Attendance at a day care centre for day care and/ or meals and includes the attendance at training centres and luncheon clubs.

Deferred Payments

From October 2001 deferred payments, under section 55 of the Health and Social Care Act 2001, were introduced. (Where residents whose property is taken into account by the financial assessment for residential accommodation, and who would ordinarily have to sell their homes to cover care fees, may keep their homes on admission to residential care contribute assessed income to care home fees, and the council makes up the difference between the residents contribution and its standard rate. Residents or their estates pay back the contribution made by the council when the property is eventually sold).

Direct payments

Direct payments are defined as monetary payments made by local CASSRs directly to adult service users aged 18 and over in lieu of social service provisions, who have been assessed as needing certain services.

Equipment and Adaptations

Equipment and adaptations are defined as one off pieces of equipment such as a ferrule, walking stick or bath rail (including fitting) as well as items of equipment or adaptations that incur an ongoing financial commitment or ongoing regular contractual maintenance’, e.g. stair lifts or hoists, if these are maintained by the CASSR or where the CASSR funds the maintenance. This also includes expenditure on Telecare and other monitoring systems which are not classed as an aid or adaptation.



Former Preserved Rights Service users

People who became supported residents as a result of the end of the preserved rights scheme on 7 April 2002 should be included in ASC-CAR; there is no need to separately identify them on the ASC-CAR in 2009-10.

Home Care

The definition of home care follows (as closely as possible), that which was used in the central data collection HH1 return on home help/home care. The categories home help/home care (meaning all care that is not a short term break in the client’s own home) and overnight short term break (for the benefit of the client) that is provided in the client’s own home have been combined.

Local Authority Staffed Care Home

Residential accommodation provided by local authorities under the terms of Part III, Section 21 of the National Assistance Act 1948

Nursing Homes

Nursing and other medical care provided in the premises defined in Sections 21 to 22 of the Registered Homes Act 1984, and in subsequent amendments as set out in The Care Standards Act 2000. Nursing care homes includes general and mental nursing homes only.

Package of care (care package)

A service or set of services agreed as part of the care plan arising from the first assessment or subsequent reviews. These services can be residential and / or community-based.

Personal and / or domestic care

Synonyms for home care.

Personal budget

A personal budget is a notional amount of social care funding for an individual’s support, some or all of which maybe taken as a direct payment.

Primary client type (group)

The categories of ‘primary client type’ are: physical disability, those with mental health needs, those with

substance misuse problems and other vulnerable people.

Professional support

Typically this occurs when a professional is involved as part of the care package to provide therapy / support / professional input.

Registered Homes

Homes registered under the Care Standards Act 2000.

Rehabilitation services

Rehabilitation services are generally classified as temporary residential places.



Residential Care

Accommodation with both board and personal care for persons requiring personal care by reasons of disablement, past or present dependence on alcohol or drugs, or past or present mental disorder. Residential care homes include local authority staffed and independent residential care homes and exclude adult placements, un-staffed and other homes.

Respite care

Overnight respite care is defined as following an assessment or review where the carer’s needs have been taken into account, planned overnight breaks(s) are arranged for the client either at home or in an alternative setting to allow a break primarily for the carer.

Screening

This is the initial phase with a contact, when basic ‘card index’ type data is gathered (name, address, etc.) along with a sufficient indication as to the purpose of the contact. This enables staff to determine whether information / advice only or a one off basic service is appropriate, or whether further investigation and assessment are warranted. It is also the stage at which callers who have come inappropriately to the

CASSR will be filtered out and / or redirected.

Section 256 client

Many CASSRs receive revenue from a local health authority partner through arrangements under Section 256 of the NHS Act 2006 (formerly Section 28a of the NHS Act 1977 as amended by Section 29 of the NHS Act 1999) to provide social care services to those who were resident in long stay institutions and Care in the Community homes.

Self directed support

Services which are delivered by social services or on behalf of social services via a direct payment or personal budget

Self-funded

A self-funded client is one who pays entirely the direct cost of the services they receive, but whose care is managed (e.g. reviewed) at the expense of the CASSR.

Short-term residential care – not respite

This refers to the provision of short term residential care for the client for any purpose other than respite care of a carer. It includes the provision of rehabilitation services. (see glossary definition for ‘Components of service’ for clarification).

Supported Resident

A Supported Resident is a person in residential or nursing care who is receiving financial support from the local authority towards the cost of that care.

Type of Stay: Permanent

Residential or nursing care which is of a permanent nature and where the intention is that the spell of care should not be ended by a set date. For people classified as permanent residents, the care home would be regarded as their normal place of residence.



Type of Stay: Temporary

A spell of residential or nursing care which is intended to be of a temporary nature and of limited duration (although in some cases this may be as long as 12 to 18 months). This will include respite care, rehabilitation, short breaks and other care which is intended to be of a temporary nature, whatever the actual duration.

Unstaffed Group Home

This is a home catering for a small group of people sharing a common household which is not permanently staffed. The home has communal areas and residents share basic amenities like bathrooms and kitchens. Board and personal care are not provided in such homes.



Annex E - Reference Tables

Table Conventions

Layout

The first 2 digits of the table number indicate the name of the RAP proforma from which the data comes, e.g. Table A1.1a is based on RAP form A1. The source is also given again at the foot of each table.

The title describes what the table contains and gives details of how the information is broken down.

All of the tables present information for adults aged 18 or over except for the ‘C’ tables.

Symbols

The following conventions are used throughout:

Italics percentage

0 zero

. not applicable

.. not available (i.e. information was not provided).

R revised data

Rounding

All figures presented in the Annex Tables are rounded to the nearest five and figures may not add to totals because of rounding.

Estimation

Where councils have not provided complete information on a RAP proforma, estimates have been made by calculating proportions based on data reported by CASSRs who have provided a complete return. These estimates have been used to provide grossed up national figures for England, but are not published at CASSR level. National and Regional totals should be considered as estimates.

It should be noted that the estimation for missing values has been done separately for each individual proforma. This means that there may be marginal differences between the totals in some tables. These differences are shown in the tables as a reconciliation item.



Annex F - Flowchart of RAP & ASC-CAR Proformas

Review (existing clients)

A6, A10, C1, L1, L2

Care plan produced/revised

A7 Length of time

from first contact to completed

assessment for new clients

R3 Source of referral for all

contacts

R2

Client's needs met

Contacts/Enquiries (from new clients)

Client passed on for further assessment of need or

commissioning of ongoing service(s)

I1 Hospital discharge where the intention

is rehabilitation

Assessment 'Multi aspect'

A6, A10, C1, L1, L2

No further services required

Information/ advice or a basic service

provided

P1, P2, P4, C2, S1-5 Provision of services


Change of client circumstances


Review

SD1, SD2, SD3 Self directed support

R1 (= R3-R2)



Annex G - Related Publications

This publication can be downloaded from the HSCIC website at:

www.ic.nhs.uk/pubs/communitycaressa1112final

Further information on the previously collected in the Supported Residents (SR1) return, is available from the IC website.

The following publications are available from the Adult social care information page of The HSCIC website:

Publications relating to social care activity, finance, staffing and user experience surveys can be found at www.ic.nhs.uk/statistics-and-data-collections/social-care/adult-social-care-information.

Data from this report and some of our other social care reports can be accessed directly via our National Adult Social Care Intelligence Service (NASCIS). NASCIS is an online portal which contains standard reports for each council as well as the capacity to carry out further analysis of social care data. The online analytical tool can be found at http://nascis.ic.nhs.uk/

Last years publication can be found here: “Community Care Statistics: Social Services Activity, England – Councils with Adult Social Services Responsibilities tables, provisional, 2010-11” which is available at www.ic.nhs.uk/pubs/finalcarestats1011ssa Other Social Care Reports

“Personal Social Services: Expenditure and Unit Cost, England, 2010-11 I Final Council Data [NS]” which is available at www.ic.nhs.uk/pubs/pssexpcosts1011 “Survey of Carers in Households – 2009-10 England” which is available at www.ic.nhs.uk/pubs/carersurvey0910 “Personal Social Services Survey of Adult Carers in England – 2011-12” which is available at www.ic.nhs.uk/pubs/adultsocialcaresurvey1112 “Personal Social Services Staff of Social Services Departments at 30 September 2010, England. [NS]” which is available at www.ic.nhs.uk/pubs/pssstaffsept11 “Personal Social Services Survey of Adults Receiving Community Equipment and/or Minor Adaptations England, 2009-10” which is available at www.ic.nhs.uk/pubs/pssadultsequip0910 “Abuse of Vulnerable Adults in England 2011-12: Experimental Statistics, Provisional Report” which is available at www.ic.nhs.uk/pubs/abuseva1112

“Community Care Statistics 2009-10: Grant Funded Services (GFS1) Report - England” which is available at http://www.ic.nhs.uk/pubs/carestats0910gfs

“Registered Blind and Partially Sighted People - Year ending 31 March 2011, in England” is available at www.ic.nhs.uk/pubs/blindpartiallysighted11


http://www.ic.nhs.uk/statistics-and-data-collections/social-care/adult-social-care-information

http://nascis.ic.nhs.uk/

http://www.ic.nhs.uk/pubs/finalcarestats1011ssa

http://www.ic.nhs.uk/pubs/pssexpcosts1011

http://www.ic.nhs.uk/pubs/carersurvey0910

http://www.ic.nhs.uk/pubs/adultsocialcaresurvey1112

http://www.ic.nhs.uk/pubs/pssstaffsept11

http://www.ic.nhs.uk/pubs/pssadultsequip0910

http://www.ic.nhs.uk/pubs/abuseva1112

http://www.ic.nhs.uk/pubs/carestats0910gfs

http://www.ic.nhs.uk/pubs/blindpartiallysighted11



Adult Social Care Outcomes Framework

In 2011-12 the National Indicator Set (NIS) was superseded by the Adult Social Care Outcomes Framework (ASCOF). A number of measures from the NIS have been retained within the ASCOF but there are also a number of new measures. The 2011/12 final report is available at; www.ic.nhs.uk/pubs/socialcareof1112final

Historical performance assessment data was published by the Care Quality Commission (CQC) formerly the Commission for Social Care Inspection (CSCI). Associated council data are available via the Care Quality Commission website at

http://www.cqc.org.uk/guidanceforprofessionals/councils/annualassessments.cfm

Data for Child Social Services

Information on social care for children is available at

http://www.education.gov.uk/childrenandyoungpeople

Data for the UK

Information within this report relates to England data, similar publications for Wales, Scotland and Northern Ireland can be found via the following links:

The Welsh Assembly Government

http://wales.gov.uk/topics/health/publications/socialcare/reports/?lang=en

The Scottish Government

http://search1.scotland.gov.uk/Scotland?n=All&$rcexpanded=false&action=search&q=Social+Care

Department of Health, Social Services and Public Safety

http://www.dhsspsni.gov.uk/index/stats_research/stats-cib-3/statistics_and_research-cib-pub/adult_statistics-1.htm

http://www.ic.nhs.uk/pubs/socialcareof1112final

http://www.cqc.org.uk/guidanceforprofessionals/councils/annualassessments.cfm

http://www.education.gov.uk/childrenandyoungpeople

http://wales.gov.uk/topics/health/publications/socialcare/reports/?lang=en

http://search1.scotland.gov.uk/Scotland?n=All&$rcexpanded=false&action=search&q=Social+Care





Annex H - Further Information

Comments

If you have any comments on this publication, they would be welcomed. Please complete the online feedback form which can be found at www.ic.nhs.uk/pubs/communitycaressa1112final

Published by the Health and Social Care Information Centre

Part of the Government Statistical Service

Responsible Statistician

Katharine Robbins, Programme Manager, Social Care.

ISBN 978-1-84636-833-2

This publication may be requested in large print or other formats.

For further information:

www.ic.nhs.uk

0845 300 6016

[email protected]

Copyright © 2013 Health and Social Care Information Centre. All rights reserved.

This work remains the sole and exclusive property of the Health and Social Care Information Centre and may only be reproduced where there is explicit reference to the owner.


Community Care Statistics, Social Services Activity ...... [email protected] Author: Social Care statistics team, Health and Social Care Information Centre Responsible statistician:

Documents