Home Care Services, Scotland, 2012

2. Home Care Services

There was an estimated 712,894 hours of service provided to 62,832 clients in 2012. The number of clients has fluctuated over time from 70,210 in 2000 increasing to a peak of 71,094 in 2005, then decreasing to 62,832 in 2012 (see Annex Table 2 & Chart 1).

The number of client hours has increased by 81 per cent since 2000, from 393,071 to 712,894 hours. In 2000 clients received, on average, 5.6hours of Home Care per week. This has risen steadily to 11.3 hours for 2012 (See Annex Table 2, and Chart 2).

Chart 2: Average Number of Hours Provided per Client, 2000-2012

Source: Home Care Statistical Return (See Annex Table 2)

Of the 62,832 clients who received a Home Care service provided or purchased by a local authority in 2012, 43 per cent received at least part of their Home Care service from a private or voluntary provider - compared to only 10 per cent in 2000 (Table 1 & Annex Table 5).

Chart 3: Proportion of Home Care Clients by Provider, 2000- 2012

Source: Home Care Statistical Return (See Annex Table 5)

Table 1: Number of Home Care Clients and Hours Provided / Purchased by Provider of

Service, 2012

Provider of Service	No. Clients	%	Client Hours	%	Hours per client
Solely from local authority	35,588	57%	299,874	42%	8.4
Solely from private/voluntary sector	22,624	36%	348,657	49%	15.4
Combination of provision from LA and private/voluntary sector	4,620	7%	64,362	9%	13.9
Total	62,832	100%	712,894	100%	11.3

Source: Home Care Statistical Return (See Annex Table 5)

The average number of contact hours per client for those receiving local authority provided services only was 8.4 hours per week, compared to 15.4 hours for those receiving Home Care from a private or voluntary provider only (See Table 1).

348,657 hours were provided to clients receiving Home Care Services solely from the private or voluntary sector. This has increased by 78 per cent since 2006 when 196,297 hours were provided (see Annex Table 5).

Additionally, 64,362 hours (9 per cent) were provided by some combination of local authority, private and voluntary provision as at the last week in March 2012 (See Table 1 & Chart 4).

The proportion of service hours provided solely by local authorities has been decreasing steadily from 82 per cent in 2000 to 42 per cent in 2012. The majority of this decrease is due to the increase in service provided or purchased solely from the voluntary and private sectors (see Annex Table 5 & Chart 4).

Chart 4: Proportion of the Hours of Home Care Service by Provider, 2000 — 2012

Source: Home Care Statistical Return (See Annex Table 5)

Profile of Clients Receiving Home Care Services

Approximately 50 per cent of clients receiving Home Care Services provided or purchased by local authorities were due to 'infirmity due to age'. 28 per cent of clients had physical disabilities. An estimated 66 per cent of clients were female and 34 per cent were male. An estimated 81 per cent of all clients were aged 65 years or over (See Table 2 & Chart 5).

Table 2: Age, Client Group and Gender of Clients Receiving Home Care Services, 2012

Client Group	Age Group				Total Clients	Percentage
	0-64	65-74	75-84	85+
Infirmity due to age	74	4,378	12,776	14,187	31,415	50%
People with Dementia	74	364	1,536	1,310	3,284	5%
People with Mental Health Problems	1,609	524	439	205	2,777	4%
People with Learning Disabilities	3,912	460	178	38	4,588	7%
People with Physical Disabilities	4,470	2,957	5,082	5,017	17,526	28%
People in other vulnerable groups	954	390	400	342	2,086	3%
Not Known	620	97	230	208	1,155	2%
Male	6,004	3,845	6,511	5,146	21,506	34%
Female	5,709	5,325	14,130	16,161	41,325	66%
Total Clients	11,713	9,170	20,641	21,307	62,831	100%
Male - rate per 1,000 population	2.8	17.2	52.2	148.8	56.2
Female - rate per 1,000 population	2.6	20.8	79.3	213.6	81.1

Source: Home Care Statistical Return, Excludes one client with no date of birth provided
*Note: 2011 Mid Year Population Estimates used as 2012 Mid Year Population Estimates are not yet available

Chart 5: Client Group of Clients Receiving Home Care Services by age group, 2012

Source: Home Care Statistical Return

Chart 6 shows that for older people (aged over 65) the rate per 1,000 population has 74 per 1,000 people to 57 per 1,000 people. This means that a smaller proportion of people aged over 65 are receiving a home care service than in 2000. (See Annex Table 2)

Chart 6: Rates per population of Clients aged over 65 receiving Home Care Services, 2012

Source: Home Care Statistical Return
*Note: 2011 Mid Year Population Estimates used as 2012 Mid Year Population Estimates are not yet available

An estimated 57 per cent of clients in receipt of a Home Care Service were living alone (See Table 3). There is a far higher percentage of clients aged over 65 living alone than compared to those under 65. Note that this information was not provided by all Local Authorities.

Table 3: Living Arrangements of Clients Receiving Home Care Services, 2012

Source: Home Care Statistical Return
Note: 31 Local authorities retuned (partial) data on if their clients lived alone. Of these 31 local authorities, 8 provided complete data on whether their clients lived alone.
¹ - Includes one client with no date of birth provided

Level of Home Care Services Provided

In 2012, 27 per cent of under 65's received 20 hours or more Home Care a week compared with 6 per cent of over 65's. An estimated 70 per cent of clients aged 65 and over receive less than 10 hours of home care per week.

Table 4: Number of Home Care Clients by Level of Service Received, 2012

Level of service	Aged Under 65		Aged 65+		Total number of clients
	No. of clients	%	No. of clients	%
Less than 1 hour	185	2	1,869	4	2,054
1 hour to less than 2 hours	950	8	5,971	12	6,921
2 hours to less than 4 hours	1,951	17	10,169	20	12,120
4 hours to less than 6 hours	1,287	11	5,937	12	7,224
6 hours to less than 8 hours	1,177	10	7,148	14	8,325
8 hours to less than 10 hours	678	6	4,051	8	4,729
10 hours to less than 15 hours	1,526	13	9,475	19	11,001
15 hours to less than 20 hours	776	7	3,681	7	4,457
20 hours or more	3,183	27	2,817	6	6,000
TOTAL CLIENTS	11,713	100	51,118	100	62,831

Source: Home Care Statistical Return
Excludes one client with no date of birth provided

Chart 7: Level of Service, 2000-2012

Source: Home Care Statistical Return (Annex Table 4)

People aged 65 and over account for 90 per cent of people receiving less than 1 hour of Home Care, compared to 18 per cent of all people receiving 50 hours of Home Care or over. Chart 8 also shows that clients aged 65 and over are more likely to receive smaller packages of care than a client aged under 65.

Chart 8: Ratio of clients age groups by level of service, 2012

Source: Home Care Statistical Return

Potential issue with hours data.

More detailed analysis of the hours data has identified a large increasing number of clients being recorded who receiving care packages of 168 hours a week. This equates to a person receiving care 24 hours a day, seven days a week. In 2011, 499 clients received 150+ hours of support per week, this has increased to 574 in 2012.

Further work with local authorities is required to identify the type of care package these clients are receiving as it is suspected that the clients won't be receiving constant care or help but do have support available 24 hours a day. It is more likely that this kind of support should be classed as housing support rather than home care and may be distorting the hours figures presented in this report.

Please refer to annex Table 6 & Chart 12 for more detailed information on the issue.

Home Care clients receiving services in addition to their Home Care service

From 2010 information was collected on Home Care clients who received other services in their own home. These included; Community Alarms, other Telecare and Meals. The 'Background information' (section 4) contains definitions of Community Alarm and 'other Telecare' services.

Diagram 1 — Relationship between home care and other services received by clients

Diagram 1 shows the overlapping relationship of services provided to clients. At March 2012 there were 62,832 clients receiving a home care service, 110,088 clients had a Community Alarm and/or other Telecare services and 9,621 clients received a meals service.

Community Alarm and other Telecare

Table 5 shows that as at March 2012, there were 33,937 (54 per cent) Home Care clients who also had a Community Alarm or another Telecare service. Of the 33,937 Home Care clients who also had a Community Alarm and/or other Telecare services, 79 per cent only had a Community Alarm. Moreover, of the 33,937 Home Care clients who also had a Community Alarm and/or other Telecare services, 89 per cent (30,346 clients) were aged 65 and over.

Table 5: Clients who are receiving Home Care and a Community Alarm and/or another Telecare Service by age group, 2012

Age band	Home care clients	Number of Client
		Community alarm only	Another Telecare service only	Both services	Total
Aged Under 65	11,713	2,527	251	813	3,591
Aged 65+	51,118	24,303	1,118	4,925	30,346
Total	62,831	26,830	1,369	5,738	33,937

Source : Home care statistical return
Excludes one client with no date of birth provided

Chart 9: Percentage of Home Care clients who are receiving Home Care and a Community Alarm and/or another Telecare Service by age group, 2012

Source: Home Care Statistical Return

Table 6: Clients who are receiving Home Care and a Community Alarm and/or another Telecare Service by client group, 2012

Client Group	Home care clients	Number of Client
		Community alarm only	Another Telecare service only	Both services	Total
Infirmity due to age	31,416	15,125	639	2,540	18,304
People with Dementia	3,284	1,116	85	492	1,693
People with Mental Health Problems	2,777	603	85	197	885
People with Learning Disabilities	4,588	617	114	224	955
People with Physical Disabilities	17,526	8,429	397	1,934	10,760
Other 1	2,086	516	36	328	880
Not Known	1,155	424	13	23	460
Total	62,832	26,830	1,369	5,738	33,937

Source : Home care statistical return
¹ Other includes addiction, palliative care and carers

Of the 33,937 clients who received Home Care and had a Community Alarm and/or another Telecare service, 54 per cent were people who had 'infirmity due to age' (18,304), followed by 32 per cent who had physical disabilities (10,760).

Chart 10: Percentage of Home Care clients who are receiving Home Care and a Community Alarm and/or another Telecare Service by client group, 2012

Source: Home Care Statistical Return
¹ Other includes addictions, palliative care and carers

Table 7: Clients who are receiving Home Care and a Community Alarm and/or another Telecare Service by hours of Home Care, 2012

Hours provided	Home care clients	Number of Client
		Community alarm only	Another Telecare service only	Both services	Total
Less than 1 hour	2,054	908	12	114	1,034
1 hour to less than 2 hours	6,921	3,055	88	536	3,679
2 hours to less than 4 hours	12,120	4,894	217	861	5,972
4 hours to less than 6 hours	7,224	3,067	158	633	3,858
6 hours to less than 8 hours	8,326	3,613	168	741	4,522
8 hours to less than 10 hours	4,729	2,137	125	506	2,768
10 hours to less than 15 hours	11,001	5,131	299	1,219	6,649
15 hours to less than 20 hours	4,457	2,174	112	617	2,903
20 hours or more	6,000	1,851	190	511	2,552
Total	62,832	26,830	1,369	5,738	33,937

Source: Home Care Statistical Return

Of the 33,937 clients who receive Home Care and a Community Alarm and/or another Telecare service, 31 per cent of clients receive less than 4 hours of Home Care and 64 per cent of clients receive less than 10 hours of Home Care a week.

Chart 11: Percentage of Home Care clients who are receiving Home Care and a Community Alarm and/or another Telecare Service by level of service, 2012

Source: Home Care Statistical Return

Other services

The following tables and charts contain information about Meal Services which Home Care clients can receive in their own home.

Table 8: Home Care clients receiving other services by age group, 2012

Age Group	Home care clients 1	Number of Clients		% of Home Care Clients
		Hot Meals	Frozen Meals	Hot Meals	Frozen Meals
Aged Under 65	11,713	186	213	2%	2%
Aged 65+	51,118	3,321	2,740	6%	5%
Total	62,831	3,507	2,953	6%	5%

Source: Home Care Statistical Return
Note 21 clients receive both hot and frozen meals
¹ - Excludes one client with no date of birth provided

Overall, 6,439 Home Care clients also received a Meals Service. 3,507 (6 per cent) of Home Care clients received a Hot Meals Service and 2,953 (5 per cent) received a frozen meals service. 21 clients received both a hot and frozen meal service.

Of the 6,439 Home Care clients who also received a Meals Service, 61 per cent had 'infirmity due to age' and 69 per cent receive 10 hours or less home care. (Refer to table 9 & 10)

Table 9: Home Care clients receiving other services by client group, 2012

Client Group	Total Home care clients	Number of clients		% of home care clients
		Hot Meals	Frozen Meals	Hot Meals	Frozen Meals
Infirmity due to age	31,416	2,130	1,808	7%	6%
People with Dementia	3,284	212	232	6%	7%
People with Mental Health Problems	2,777	146	89	5%	3%
People with Learning Disabilities	4,588	57	49	1%	1%
People with Physical Disabilities	17,526	784	658	4%	4%
Other	2,086	94	108	5%	5%
Not Known	1,155	84	9	7%	1%
Total	62,832	3,507	2,953	6%	5%

Source: Home Care Statistical Return
Note 21 clients receive both hot and frozen meals

Table 10: Home Care clients receiving other services by level of service, 2012

Client Group	Total Home care clients	Number of clients		% of home care clients
		Hot Meals	Frozen Meals	Hot Meals	Frozen Meals
Less than 1 hour	2,054	145	76	7%	4%
1 hour to less than 2 hours	6,921	513	236	7%	3%
2 hours to less than 4 hours	12,120	616	438	5%	4%
4 hours to less than 6 hours	7,224	477	343	7%	5%
6 hours to less than 8 hours	8,326	472	452	6%	5%
8 hours to less than 10 hours	4,729	365	309	8%	7%
10 hours to less than 15 hours	11,001	578	738	5%	7%
15 hours to less than 20 hours	4,457	198	219	4%	5%
20 hours or more	6,000	143	142	2%	2%
Totals	62,832	3,507	2,953	6%	5%

Source: Home Care Statistical Return
Note 21 clients receive both hot and frozen meals