Respite Care Scotland, 2014

6. Background information on the collection of the data

6.1 Data Sources

Audit Scotland (2007/07 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are available from www.audit-scotland.gov.uk/performance/index.php, but please note that all respite figures have been superseded with those presented in this publication.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 to 2013/14)

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.

For 2013/14, Local Authorities were given two options for the method used to submit respite data:

1. Aggregated data, returned through a respite-specific spreadsheet.

2. Individual level data, returned as part of the 2014 Social Care Survey.

For 2013/14, aggregated data has been used for 27 out of 32 Local Authorities. Individual level data has been used for City of Edinburgh, Clackmannanshire and Stirling. Perth & Kinross submitted aggregated data for young people (aged 0-17) and individual level data for adults. Fife submitted aggregated data for adults and a number of young people (aged 0-17) who received grant-funded services and individual level data for the remaining young people (aged 0-17).

6.2 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. 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. In order to convert Direct Payments into respite weeks we have assumed that the cost of one week is £630 and the cost of one hour is £12. This rate is derived from an estimate of residential care weekly costs made by the Respite Task Group.

The figures published in this Statistics Release were last published on 29 October 2013.

6.3 Changes to figures for previous years

As part of the collection of the 2013/14 data Local Authorities were given the opportunity to check their previously published respite figures. There have been no changes to the figures published in previous years.

6.4 Data Completeness

While every effort has been made to ensure that data is recorded as completely as possible, the following issues should be noted for the figures published in this report. Due to issues with data submission, we are unable to publish 2013/14 data for respite provided for the benefit of the carers of young people (aged 0-17) from South Ayrshire. The most recently available figures, those from 2012/13, have been used as an estimate.

6.5 Comparability between 2012/13 and 2013/14 data

Local Authorities were asked to only submit one set of data for 2013/14, as there has been no change to the national guidance since 2012/13. However, it is clear from the explanatory material submitted by many of the Authorities alongside their data submissions that a range of factors other than genuine changes in service provision may also have affected their recorded figures.

It should also be noted that, even were the recording issue described below to be put to aside, direct comparisons between 2012/13 and 2013/14 data should not be drawn for the Orkney Islands, as the published 2012/13 data were estimated on the basis of the 2011/12 figures, which were completed on the basis of different national guidance.

6.5.1 The roll-out of Self-Directed Support

As of 1st April 2014, the Self-Directed Support (SDS) Act came into force across Scotland. However, some Local Authorities have been implementing SDS arrangements over the preceding financial year. For the 2013/14 respite data collection, the following Authorities all mentioned that the recorded changes to the stated types of provision may, at least in part, be related to the roll-out of SDS.

Aberdeenshire: overnight respite for the benefit of carers of adults aged 18-64
East Ayrshire: overnight and daytime respite for the benefit of carers of young people (aged 0-17)
Glasgow City: overnight and daytime respite for the benefit of carers of young people (aged 0-17) and adults aged 18-64
Highland: overnight respite for the benefit of carers of adults
Moray: overnight and daytime respite for the benefit of carers of older people (aged 65+)
Orkney Islands: all overnight and daytime respite
North Ayrshire: all overnight respite and daytime respite for the benefit of carers of young people (aged 0-17) and adults aged 18-64

For Local Authorities that are able to identify respite care that has been provided through Direct Payments (which now forms one option under SDS), the SDS roll-out process would be expected to result in a reduction in the recorded number of overnight / daytime respite weeks and a corresponding increase in the total recorded values of Direct Payments. Of the Authorities listed above, such a situation applies in East Ayrshire, Highland, Moray and the Orkney Islands. For example, Orkney Islands indicated that if the SDS Day Care packages had been included as hours rather than values, then the recorded decrease in overnight / daytime provision between 2012/13 and 2013/14 would have changed to an increase.

Not all Local Authorities are currently able to identify support that has been provided for the purpose of providing respite care through Direct Payments (or other SDS options). As SDS rolls out in these Authorities, apparent decreases in the total amounts of respite recorded must also be expected, without necessarily reflecting any change in the level of service provision. Of the Authorities listed above, such a situation applies to Aberdeenshire, Glasgow City and North Ayrshire.

Looking forwards, the continued roll-out of SDS over the coming years will likely mean that the current focus on recorded overnight / daytime provision will cease to be appropriate. However, when also combined with a situation in which the systems used by some Authorities are not able to record respite-related expenditure information for SDS clients, these changes may pose a fundamental challenge to any publication of national level respite data.

6.5.2 Improvements to local recording systems

Several Local Authorities have described what we have interpreted to be substantial changes to aspects of their specific local recording systems over the course of the past year.

Aberdeen City: the recorded decrease in daytime respite provided for the benefit of carers of older people (aged 65+) may in part be due to changes in recording systems, following the transferral of service management to a Local Authority Trading Company.
Angus: the recorded increases in overnight respite may in part be due to an operational review of how respite information is collated and recorded.
East Dunbartonshire: the recorded increases in daytime respite provided for the benefit of carers of adults may be in part due to improved recording of Supported Living services.
Fife: the recorded increase in daytime respite provided for the benefit of carers of older people (aged 65+) may be in part due to information becoming available that was not previously provided by external sources, or was unable to be included due to lack of verification.
Highland: the recorded increase in daytime respite provided for the benefit of carers of older people (aged 65+) may be in part due to Day Care Units now reporting directly on carer break attendance.
West Lothian: the recorded increase in daytime respite provided for the benefit of carers of older people (aged 65+) may be in part due to services being asked to improve their reporting arrangements.

6.5.3 The implications of recording changes for national estimates of real terms change in service provision

Both sets of recording changes described above mean that the 2013/14 data from the cited Local Authorities should not be considered directly comparable, in terms of service provision alone, to that from 2012/13. However, in order to produce the Scotland level estimate of a real terms decrease of 1,990 respite weeks, it has been necessary to include the figures from all of these Local Authorities within the national totals. The potential uncertainties associated with the inclusion of this data may be assessed by re-doing the Scotland level estimates on the basis of only the data that is thought to be unaffected by one / both of the sets of recording changes.

If only data thought to be unaffected by the SDS roll-out were to be used in the national totals, then a real terms increase of 1,050 respite weeks would have been estimated. If, however, only the data thought to be unaffected by improvements to local recording systems were to be used, then a real terms decrease of 6,020 respite weeks would have been estimated. If only data thought to be unaffected by both sets of recording changes were to be used, then a real terms decrease of 2,970 respite weeks would have been estimated.

The two sets of recording changes are seen to both represent relatively large sources of uncertainty, but which oppose one another. This is because the SDS-related changes tend to result in the underestimation (decreased reporting) of overnight / daytime respite weeks, whereas the local improvements to recording systems tends to result in the increased reporting of overnight, and especially daytime, respite weeks. At least on the basis of the sensitivity test approach used here, the influence of the local improvements to recording systems is greater in magnitude than that of the SDS-related recording changes. It is, therefore, thought likely that a real terms decrease in overnight and daytime respite provision has indeed occurred over the past year.

The sensitivity test approach applied here is based on respite provision data across all cared-for age groups. It is clear from the information in the preceding sub-sections that the two different sets of recording changes will differentially affect these different cared-for age groups. As such, the likely influence of the combined recording changes may well differ according to cared-for age group.

6.6 Methodology used by Local Authorities

The guidance issued to Local Authorities for completion of the 2013/14 survey may be found here:
http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/RespiteCarenew

Further information on the rationale for this guidance has been provided in a Q & A document:
http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/RespiteCarenew/ShortBreakQA

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 guidance.

The data is collected from 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 and short stays in Care Homes.

6.7 Reasons for large increases/decreases in respite provision

Any large increases or decreases (+/- 10%) in recorded respite provision for overnight and daytime respite weeks were queried with the Local Authorities concerned. Some of the reasons identified within Local Authorities for such changes are detailed below:

Increases in recorded provision:

• Improved reporting systems / under-estimation of figures in previous years (see Section 6.5)
• Day care centres focusing on providing support to older people with higher levels of need
• The introduction of administrative services such as a 'Respite Bed Bureau'

Decreases in recorded provision:

• The roll out of Self-Directed Support / increased use of Direct Payments (see Section 6.5)
• Reductions in residential placements available and / or maximum length of placement stay
• Introduction of charging for Day Care services, leading to reduced demand
• The temporary / permanent closures of care homes / centres
• Reclassification of care home beds from respite to permanent
• Reduction of overnight carers available
• High use service users shifting to supported living arrangements

6.8 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 12 Local Authorities has then been used within the calculation below to calculate that the total cost of responding to this survey is £15,800 (rounded to nearest £100). It is also noted that the time taken to respond also varies widely across Local Authorities, from less than 5 hours to more than 350 hours.

6.9 Other data sources

To calculate percentage changes in population between 2007/08 and 2013/14, the National Records of Scotland mid-year population estimates for mid-2007 to mid-2008 and mid-2013 have been used. This data is reproduced in the table below.

	mid-2007 to mid-2008	mid-2013
Aged 0-17	1,052,278	1,035,394
Aged 18-64	3,227,104	3,345,444
Aged 65+	857,746	946,862
All ages	5,137,128	5,327,700

In order to calculate 2013/14 rates per population, the National Records of Scotland 2013 mid-year population estimates at the Local Authority level have been used. This data is available from the National Records of Scotland website.
http://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/population/population-estimates/

6.10 Further information

Further details and analysis of the data presented in this Statistics Release are available on request from the address given below. This Statistics Release is available on the Internet:
http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/Publications

Information at the Local Authority level is shown in the Annexes to this Statistics Release. Additional care should be taken when interpreting year-to-year changes within this data, especially in the cases of the Authorities who have experienced known recording changes over the past year (as listed in Section 6.5).

This statistics release was published on 28^th October 2014.