Respite Care Scotland, 2011-12

4.Background information on the collection of the data

4.1 Data Sources

Audit Scotland (2006/07 to 2008/09)

This data was provided to Audit Scotland by all Local Authorities in Scotland as one of the Statutory Performance Indicators (SPIs). The information was collected and published locally by each council in Scotland. Audit Scotland publishes information about the comparative performance of councils across Scotland in a compendium of all the data. These are available from www.audit-scotland.gov.uk/performance/index.php, but please note that all respite figures have been superseded with those presented in this publication.

Scottish Government (2009/10, 2010/11 & 2011/12)

The Scottish Government is now responsible for the collection of respite data. This follows Audit Scotland’s decision to discontinue the collection of the SPI data for respite care.

4.2 Understanding the Statistics in this Report.

All information in this Statistics Release is based on a year from 1st April to 31st March.

In order to provide an estimate of total respite provision across Scotland, respite nights and respite hours have been converted into respite weeks. In order to calculate this, seven respite nights equal one respite week and 52.5 hours equal one respite week. This standard method was agreed by CoSLA and the Scottish Government.

The figures published in this Statistics Release were last published on 25 October 2011.

As part of the collection of the 2011/12 data Local Authorities were given the opportunity to check their respite figures to ensure that they were correct and any large increases or decreases between years were questioned. This validation work has resulted in the following changes to the figures previously published.

Information is asked separately for different age categories. Note that the age group refers to the person being cared for (not the carer):

• Children aged 0-17
• Adults aged 18-64
• Older People aged 65 and over

Daytime respite

One Local Authority identified an error in the previously published daytime respite data and provided revised figures for the publication. They are:

• Renfrewshire - revised Older Adults (aged 65) for 2010/11 as an error identified in figures originally supplied. Decrease in respite hours of 1,973 hours (38 weeks).

4.2.1 Methodology used by Local Authorities

Local Authorities were asked to provide full details of the methodology they use to identify respite provision based on the Audit Scotland guidance.

The collection of respite data is something that has proved to be very complex for Local Authorities to capture. This means that each Local Authority may use a variety of data collection methods and sources of information to collect the required information as specified in the Audit Commission guidelines. (Refer to Annex 7).

The data is collected from either management/financial information systems, from manual records or direct from private/voluntary respite suppliers and is most commonly a combination of these data sources.

The data will also incorporate a number of different services depending on the services available within a Local Authority, examples of the services included are;

• Day Care
• Home Care
• Short Breaks/Holiday breaks
• Direct payments

Figures are not comparable between Local Authorities due to the different methodologies used. An example of this is the counting of respite as both daytime and overnight support, when the services are received in the same episode of respite care.

The Audit Commission Guide for 2005/06 and 2006/07 stated “Where a single episode of respite care involves both daytime and overnight support, count both the nights and the daytime hours” (p50). This sentence was removed from the guidance for 2007/08 onwards.

There are four Local Authorities that have used this methodology beyond 2007/08:

• Edinburgh (this ceased in 2010/11)
• Fife (from 2008/09 to 2010/11)
• Moray (only for Respite provided in the home, this ceased in 2009/10)
• West Dunbartonshire (only for Respite provided to a small number of Young people (aged 0 to 17))

Overall respite provision in these areas may appear to be higher than other areas for the years affected because they were, in effect, over counting their Care Home and Homecare respite provision. If a client has a week of respite in a Care Home, then most Local Authorities simply count this as 7 nights (=1 respite week). If a Local Authority counts this as 7 nights and 12 hours for each of 7 days then this is equal to 2.6 respite weeks.

To further improve the comparability of the data collected a working group has been established to review the definitions and guidance used.

4.2.2 Methodology changes over time

Local Authorities were asked whether they used exactly the same methodology to measure respite provision each year.

A total of 22 Local Authorities have changed their methodology between 2007/08 and 2011/12 (further details provided in the following pages). In many cases, Local Authorities began counting services which had been running for some time but which had not previously been included in the figures.

In these cases, a comparable figure based on the same methodology as the previous year and a figure based on a revised methodology, which is not comparable to previous years but comparable going forward has been applied depending when the methodology changes happened. This allows us to see any genuine increase in services provision from 2007/08 onwards, whilst allowing for an improved count of respite care data to be provided by the Local Authorities.

This means that two sets of figures are published for each year as follows:

• 2008/09¹ -This figure is produced using the same methodology as was used in 2007/08 and is therefore only comparable with 2007/08.
• 2008/09² - This figure is produced using the same methodology as was used in 2009/10² and is therefore only comparable with 2009/10².
• 2009/10² - This figure is produced using the same methodology as was used in 2008/09² and is therefore only comparable with 2008/09².
• 2009/10³ - This figure is produced using the same methodology as was used in 2010/11³ and is therefore only comparable with 2010/11³.
• 2010/11³ - This figure is produced using the same methodology as was used in 2009/10³ and is therefore only comparable with 2009/10³.
• 2010/11⁴ - This figure is produced using the same methodology as was used in 2011/12 and is therefore only comparable with 2011/12.

Please note that the Local Authorities were not asked if any methodology changes were made between 2006/07 & 2007/08. Therefore it is not known if these figures are comparable for all Local Authorities.

Further details on the Local Authorities who changed their methodology are given below:

• Aberdeen City - Prior to 2008/09, included Direct Payments, after school clubs and play schemes in the Children daytime respite figure; from 2008/09 these were excluded. In 2010/11 an adult daytime service was reclassified as providing day care services rather than respite and this alone has resulted in a drop in hours provided in a day care centre. It was not possible to re-calculate the 2009/10 figures to adjust for this change in methodology.
• Aberdeenshire - Improved data collection in 2008/09 by identifying a number of additional methods of recording respite that weren’t included in 2007/08. In 2009/10 an exercise was carried out that identified a large number of specifically 18-64 daytime respite packages that where inappropriately recorded. This exercise was not repeated for 2010/11. In 2011/12 changed how day care sessions are accounted for. It has been agreed from 2011/12 that a full session should be counted as 6 hours and a half session counted as 3 hours. Previously these have been counted that a session equals one hour. Provided revised 2010/11 figures to ensure comparability over time.
• Angus - Prior to 2008/09, respite provided in day centres wasn’t included. In 2009/10, improved data collection to ensure that returns from a service provider only included clients who attended specifically to provide respite. In 2010/11 re-classified a day time service for adults (aged 18-64) as non-respite; 2009/10³ figure has been provided to reflect this change.
• Dumfries & Galloway - In 2010/11 improved methodology to include an overnight block contract for older adults (aged 65+); 2009/10³ figure has been provided to reflect this change.
• Dundee City - In 2008/09, Home Care enablement services were included for the first time. In 2010/11 to improve collection methodology now using information management system to provide daytime hours, 2009/10³ figure has been provided to reflect this change.
• East Ayrshire - In 2008/09, started to include adult day care respite not in a day centre.
• Edinburgh - In 2009/10 migrated data held by Children and Families Centres in standalone databases to central system as this provided an opportunity to improve data quality and realign the client categories of children receiving a service from these centres. Unable to provide revised figures for either 2008/09 or 2009/10. Changed methodology in 2011/12 so that no daytime hours related to overnight stays are included, provided revised 2010/11 figures.
• Falkirk - In 2009/10 improved methodology for identifying overnights provided to all clients and daytime hours for young adults. The 2008/09² figure for daytime hours and overnight nights is based on this methodology, to produce a comparable figure to 2009/10².
• Fife - In 2008/09, Adult day care centres were included for the first time. Also began recording daytime hours in conjunction with overnight respite, so overnight respite in a Care Home would count as 1 night and 12 hours. In 2009/10 improved collection methodology to include daytime hours for services not previously recorded, the 2009/10³ figure reflects this change and is comparable with 2010/11³. Changed methodology in 2011/12 so that no daytime hours related to overnight stays are included, provided revised 2010/11 figures.
• Glasgow City - In 2010/11, improved methodology so that the hours of respite provided by purchased services are now included. The 2010/11⁴ reflects this improvement and is comparable with 2011/12. Ongoing modernisation of services makes the capture of all respite activity difficult due to the personalisation of services and a focus on outcomes for service users.
• Highland - In 2009/10 improved methodology for identifying overnights provided to clients aged 65 and over, which had previously been under reported. The 2008/09² figure for overnight nights is based on this methodology, to produce a comparable figure to 2009/10².
• Inverclyde - In 2008/09, began counting respite provided by contracted services and included additional homecare services. In 2009/10 improved methodology further for identifying daytime hours provided to clients aged 65 and over. The 2008/09² figure for daytime hours is based on this methodology, to produce a comparable figure to 2009/10².
• Midlothian - In 2009/10 improved methodology for identifying respite provision to young adults (aged 0 -17). The 2008/09² figures for daytime hours and overnight nights are based on this methodology, to produce a comparable figure to 2009/10². In 2011/12 recording systems improved so that clients attending respite in an adult day centre not owned by Midlothian Council can be counted; provided revised 2010/11 figures.
• Moray - In 2009/10 changed methodology so that no daytime hours were included for overnight stays and are now including direct payments provide to clients for respite care. The 2008/09² figure for daytime hours is based on this methodology, to produce a comparable figure to 2009/10².
• North Lanarkshire - Due to ongoing modernisation of services from building based to community based, it has proved difficult to capture all respite activity. Unable to provide revised figures for either 2008/09 or 2009/10.
• Orkney ISLAnds - In 2008/09, began counting respite provided by Crossroads, through direct payments and Childcare summer play scheme. In 2009/10, improved methodology so that the hours of respite provided are for clients where "respite is an explicit reason for this service recorded in the care plan of the carer or the cared-for person". The 2009/10³ reflects this improvement and is comparable with 2010/11.
• Renfrewshire - In 2009/10, identified that provision was being overestimated; revised methodology for identifying daytime hours for Young Adults (aged 0-17). The 2008/09² figure for daytime hours is based on this methodology, to produce a comparable figure to 2009/10².
• Scottish Borders - In 2009/10 improved methodology for identifying overnights provided to clients. The 2008/09² figure for overnight nights is based on this methodology, to produce a comparable figure to 2009/10².
• Shetland ISLAnds - In 2009/10, improved methodology to include previously unreported day care respite provided by one of their establishments. The 2009/10³ reflects this improvement and is comparable with 2010/11. In 2010/11, improved methodology to include previously unreported daytime respite provided by day care units within the Council's residential establishments. The 2010/11⁴ reflects this improvement and is comparable with 2011/12.
• South Ayrshire - In 2009/10, improved methodology to include the hours of respite provided for clients in a day care centre. The 2009/10³ reflects this improvement and is comparable with 2010/11.
• West Dunbartonshire - In 2008/09, improvements made to how home care respite captured. Unable to provide revised figures for 2008/09.
• West Lothian - In 2009/10, reviewed users receiving day care and identified that an element of the care provided was respite. The 2008/09² figure for daytime hours is based on this methodology, to produce a comparable figure to 2009/10².

One Local Authority changed their methodology in 2011/12 but were unable to change the 2010/11 data based on this new methodology therefore they have provided 2011/12 figures based on the methodology used in 2010/11. The details are as follows;

• Angus - In 2011/12, introduced a new charging policy for Social Work and Health which has improved the data recording which now allows for additional daytime respite to be identified which was previously being under-recorded/reported. To ensure that the 2011/12 figure would be comparable with 2010/11 Angus council provided an estimated figure based on the old methodology, of 104,000 hours respite provision in a day care centre for people aged 65+. If the new methodology had been used this figure would have been 120,954 hours.

4.2.3 Reasons for large increases/decreases in respite provision

Any large increases or decreases (+/- 20%) in respite provision for each of the six categories below were queried with the Local Authorities concerned:

• Older Adults (aged 65+), overnight respite
• Older Adults (aged 65+), daytime respite
• Adults (aged 18 to 64), overnight respite
• Adults (aged 18 to 64), daytime respite
• Young people (aged 0 to 17), overnight respite
• Young people (aged 0 to 17), daytime respite.

Some of the reasons identified for the increase or decreases within Local Authorities are detailed below:

Increases in provision

• Due to additional places, beds and funding being made available from existing services
• As a result of new units/services being made available
• Due to the shift in the balance of care making more flexible/alternative respite available.

Decreases in provision

• Due to budget and staffing pressures within the Councils.
• Due to a drop in demand or clients preferring to opt for non-respite services.
• Due to the shift to alternative more flexible services that are not counted as respite.

4.3 Cost of respondent burden

To calculate the cost of respondent burden to this survey each Local Authority was asked to provide an estimate of the time taken in hours to extract the requested information and complete the survey form. The average time from 13 Local Authorities has then been used within the calculation below to calculate that the total cost of responding to this survey is £25,565.

4.4 Further information

Further details and analysis of the data presented in this Statistics Release are available on request from the address given below. The Statistics Release is available on the Internet by accessing the Scottish Governments web site: -

http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/Publications

Information at local authority level is shown in the annex to this Statistics Release.

Health Analytical Services Division
DG Health & Social Care: The Quality Unit

Contact: Steven Gillespie
Tel: 0131 244 3777
E-mail: SWStat@scotland.gov.uk

This statistics release was published on 30^th October 2012.