Mapping National Adult Social Care and Care Home Data Sources in Scotland: Baseline understanding & future potential: September 2022

Adult Social Care Data Sources

National Data Collections

This section presents information on the range of national adult social care collections.

Collections included here are mainly based on formal social care services. That is, care that is provided by paid adult social care providers. Formal care can be provided by local authority funded providers, voluntary organisations or by private firms. Formal care services include care at home (i.e. personal care, help with tidying, shopping and laundry, and reablement services), self-directed-support (SDS) and housing support services.

It is important to note that informal or unpaid carers contribute significantly to the overall provision of adult social care. However, by its very nature, unpaid care is virtually absent from routine data sources. SOURCE (and the historic Social Care Survey (SCS)) does contain a question on whether or not the care recipient is receiving unpaid care, however it was an optional and poorly completed data item until April 2018 (when it became mandatory) and is currently 50% complete. Instead, the census, the Health and Care Experience Survey, Scottish Health Survey (SHeS) and other longitudinal surveys like the Scottish Longitudinal Study (SLS) are the primary sources for this type of information and are only briefly covered in this document (See a 2015 report on Scotland's carers using Census and SHeS).

SOURCE Social Care Data

• Public Health Scotland (PHS) data collection.
• Published on the Insights in social care: statistics for Scotland page on the PHS website. Most recent publication 26^th April 2022 covering data for financial years 2017/18 up to 2020/21 (most up-to-date data at 31/03/2021).
• Based on data submitted by Health and Social Care Partnerships (HSCPs) on all individuals receiving services and support up to 2020/21. Summary statistics are detailed in the 'People Supported' section, while care services are split into the following four sections:
  • Self-Directed Support,
  • Home care (or its broadly equivalent term 'Care at Home'; Quarterly),
  • Technology enabled care (Annually; this includes community alarms/ telecare),
  • Care home residents (Quarterly) (see later for more information on this aspect).
• Misses those not known to HSCPs (likely to be small number due to Free Personal and Nursing Care and centralised telecare/alarm services).
• For backwards comparison with Social Care Survey (SCS; see below) reports home care figures for a "census week" at the end of March.
• Publications to date are incomplete with various HSCPs unable to complete part or all data fields affecting all reported figures. Glasgow City HSCP only returned aggregate (not individual level) data in 2017/18.
• SOURCE is an individual level dataset. An individual's demographic information can be linked to the CHI database to obtain a CHI number (a unique identifier in NHS data sources) to enable data linkage. The most recent return (for 2020/21 data) had an average 99.5% match rate to CHI for those receiving home care and those in care homes.
• Frequency is to be established, and varies on data items:
  • Demographics – can be quarterly or annually
  • Clients – quarterly pre and post the COVID-19 pandemic, but was changed to annually during the pandemic
  • SDS, IoRN, technology enabled care and LDSS – annually
  • Care at home and care homes - quarterly
• Potential for linkage to other national data sources.

Social Care Survey

• Precursor of SOURCE.
• The Social Care Survey was collected by Scottish Government (2010 to 2016) and includes individual-level data.
• Similar reporting to above.
• Data reported on variable time periods as collection matured. Main point is data initially collected for all individuals receiving care during a "census week" at the end of March. Over time, this developed to include people receiving telecare and alarms at any time in the financial year. Also includes Self-directed Support data for the full financial year.
• Linked to CHI for a PhD project^[1] but variable match rates across LAs (76%-99%) meant meaningful cross-authority comparison problematic although national analysis was possible^[2].

Learning Disability Statistics Scotland (LDSS)

• Scottish Commission for People with Learning Disabilities (SCLD) data collection (2008 to 2019).
• SCLD reports statistics about adults with learning disabilities and/ or autism who are known to local authorities (not just people who are using services) in Scotland.
• Published annually in multiple formats.
• SCLD have been working with Public Health Scotland since 2018, to merge LDSS into the Source Social Care data collection to recognise the changing policy context and meet the needs of data suppliers and data users. However, this process has been challenging and SCLD has made the decision, supported by the Office For Statistics Regulation, to temporarily suspend the National Statistics badging for the 2021 collection.

Free Personal & Nursing Care

• Client and expenditure figures for Free Personal and Nursing Care.
• Aggregate data only. Some figures available at Local Authority level, some are reported annually and some quarterly.
• Published data from Financial Year 2010/11 to 2020/21 for clients aged 65 and over, and 2018/19 to 2020/21 for clients aged 18 to 64 after the extension of personal care to all adults in April 2019 (Available here: Free Personal & Nursing Care).

Eligibility Criteria & Waiting times

• Aggregate statistics broken down at Local Authority level, with Quarter 4, representing the financial year.
• Tables of: new clients receiving care assessment, new personal care clients, time between a) first contact and assessment and b) between assessment and service delivery.
• Substantial missing data.
• Most recent eligibility criteria and waiting times report to March 2021.

Carers Census

• Aggregate statistics of carers who receive local authority support, broken down by age, gender, ability and willingness to care, impact of care, hours of care provided, support plans, support needs and support provided.
• Aggregate statistics of the Cared for People, broken down by age, gender and client type.
• Many data providers were in the midst of implementing new systems to collect and record the required data during the latest collection period. As a result, there are a number of data quality issues that have been identified, including substantial missing data.
• Most recent Carers Census report to March 2021.

Care Inspectorate Register

• There is a legal requirement for all services providing care to be registered with the Care Inspectorate (CI), and for the CI to hold a public register of these.
• The CI register includes details of individual services which each have a unique ID – the Care Service (CS) number. The register also holds details of the people/organisations that provide these services – "the Provider" which also has a unique ID – the SP number. Each provider can provide multiple services.
• The register includes details of addresses, contact details, registered capacity, service managers, date registered, date cancelled (if cancelled).
• The register is dynamic, and is updated on an ongoing basis, and is available and searchable on the CI website.

Care Inspectorate Datastore

• Snapshot of ALL current registered care and support services in Scotland, updated monthly.
• Services are identified by CS number based on service registration.
• The CI Datastore is publicly available online, and includes address data, service information and quality ratings based on inspection outcomes, whether there have been any complaints or enforcements about the service, and details of any recent requirements or recommendations: CI Datastore.

Care Inspectorate Annual Returns

• Each registered care service must complete an annual return capturing data for the previous calendar year. This includes care home (see more below), housing support services and support services (including care at home and adult day care), nurse agencies, offender accommodation, adult placement.
• Some housing support and care at home services must have separate registrations but operate as a single service – these are referred to as combined services. There is a separate annual returns for combined services so that only one must be submitted, and these are usually submitted under the housing support registration.
• Annual returns vary by service type, but include some core elements such as staffing, service usage, and types of clients.
• The staffing section in each annual return includes details of each staff member as well as a range of summary data. Data includes all staff, covering those registered with Scottish Social Services Council (SSSC), Nursing and Midwifery Council (NMC) etc., and ancillary staff such as kitchen and cleaning staff. Data about individual staff members is structured around the SSSC's core minimum dataset (CMDS). This data is shared with SSSC and forms the basis of their workforce intelligence reports about registered services.
• More information is available on the CI annual returns website.

Scottish Social Services Council Data

• Two main sources of data: Workforce Data and SSSC Register
  • o Workforce data via two sources
    • Local Authority Social Work Services (LASWS) Census
      • Snapshot taken in December. Covers all staff in Local Authority social work. Individual-level.
      • Collects information on social care service staff including demographic information, their role, area of service provision, type of contract, job dates, working hours etc.
    • CI annual returns (shared with SSSC via Data Sharing Agreement and Data Processing Agreement)
      • Includes all those working in a registered care service, including nurses. Individual-level data also available. Most recent report on 2021 Workforce Data combines these two sources. The report includes information on the number of people working in the social service sector, broken down by sub sector (including housing support and care at home) and across employer types (private, public, voluntary).
    • The LASWS Census and the relevant workforce extract from the Care Inspectorate annual returns, combine to form the SSSC Scottish Social Service Workforce Core Minimum Dataset.
  • SSSC Register
    • Collected as part of SSSC regulatory role (mandatory registration).
    • A registry of most social service workers, social workers and social work students in Scotland. Individuals register according to the job they are doing e.g. working for a care at home service.
    • Now 160,000+ registrants.
    • Updated daily by registrants.
    • The SSSC register doesn't include ancillary/auxiliary staff or those registered with another body, for example nurses employed in social care services. The register doesn't include staff in some service or post types (e.g. non-managerial staff in adult day care, staff in adoption, fostering, offender accommodation services, childminders, social work assistants in local authority social work services etc.), and has other gaps including: a) personal assistants (PAs) employed directly by recipients of self-directed support as an alternative to receiving their care from an existing registered care service, b) staff employed by providers commissioned by a local authority to discharge parts of the authority's social work functions, and c) staff located in "headquarters" of private and voluntary sector care providers (i.e. not those employed within a registered care service).

Flags in National Data Sources

This section presents information on the flags in data of national adult social care collections.

There are no flags in national healthcare data sources (e.g. inpatient episodes (SMR01)) for identifying those in receipt of care at home or other domiciliary social care services. A flag for social care does exist in Primary Care systems, but is poorly completed.

Priority Development Areas in Adult Social Care Data Capture

This section presents information on the priority development areas in national adult social care collections. As collated by members of the 2021 Scottish Government Data, Analysis and Research Steering Group for Care Homes and Social Care in 2021.

• Reliable indicator of social care receipt. Any development in the intelligence that can be garnered from social care data will be hindered until we are able to count accurately.
• Good measures of social care client need – current measures (such as hours of care at home received) reflect supply of, rather than need for, social care. The Indicator of Relative Need (IoRN) score is very poorly completed in SOURCE. An accurate electronic Frailty Index score could also fill this gap but would require linkage to Primary Care data and this is an evolving area in Scottish Primary Care systems.
• Eligibility criteria and assessment. Data pertaining to needs assessments carried out by local authorities when checking the eligibility of individuals and the outcomes of these assessments could be linked to outcomes to explore what does and doesn't work.
• Linkage to disability benefits data. Could also help to understand how needs are changing over time and to ensure needs are being met.
• Unpaid care provision. The most recent report on unpaid care in Scotland relies on information from the 2001 & 2011 census as well as 2019 SHeS. Apart from the few questions and the carers census (detailed below), other data collections either do not collect information on carers or contain data fields that are poorly completed. This is an important part of the social care sector of which very little is currently known. Other surveys and publications that include further information on unpaid care:
  • The 2020/21 Health and Care Experience survey (HACE) includes a small number of questions relating to care received or caring responsibilities. In 2020/21, 46% of those that responded identified unpaid care as their main source of funding.
  • The 2020 Scottish Health Survey also asks some questions about caring responsibilities. In 2020, 19% adults reported that they provided regular unpaid care.
  • The 2019/20 and 2020/21 Carers Census is the second carers census published, covering unpaid carers being supported by local services across Scotland. Around 31,760 individual carers were supported by local services in 2020/21.

Additional development areas have been identified in the 2020 OSR report, and will also be identified through the 2022 care home data review, and subsequent wider social care data review. These projects will focus on the development of data sources which will improve the evidence base, supporting the inception of the National Care Service and meeting the future needs of data users.