Self-directed support, Scotland, 2015-16

3. Client Analysis

The analysis presented throughout Section 3 focuses on the 28 local authorities identified in Section 2.2 as having full Self-directed Support option recording. This means that aggregate-level figures are not skewed by data recording issues and will therefore more accurately reflect the Scotland-level picture. It is expected that continued improvements to local authority recording systems will occur in the following years and this will lead to full data being returned for all local authorities.

3.1 Client Group, Assessed Needs and Support Mechanism

Figure 2 shows the breakdown of clients by client group - the main reason for the client needing a social care service. This shows that the largest groups are 'Frail Older People' (33%) and 'Physical Disability' (28%), which is in line with the Social Care Survey as a whole. The 'Other' group includes addictions, palliative care and carers.

Figure 2: breakdown of client group, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

Figure 3 shows the breakdown of clients by need - the type of assessed support needs that are provided for. Note that clients can be identified as having more than one support need and so the sum of percentages will exceed 100%. This shows that the largest need is 'Personal Care', identified for 38% of clients. Over a third of clients (36%), however, were classed as having 'Unknown' needs, suggesting that there are additional recording issues to those identified in Section 2.2.

Figure 3: breakdown of support needs, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

Figure 4 shows the breakdown of clients by what mechanisms of support were provided. Note that clients can be identified as having more than one support mechanism and so the sum of percentages will exceed 100%. It shows that the largest support mechanism is the 'Local Authority' (49%) - that is, the local authority is who the client purchases services from, or has the service provided by. This option is generally expected to be selected for care packages involving a Self-directed Support Option 3 component. Over a third of clients (28%), however, were classed as having an 'Unknown' support mechanism, suggesting that there are additional recording issues to those identified in Section 2.2.

Figure 4: breakdown of support mechanism, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

3.2 Age Breakdown by Local Authority

Of the social care clients who made a choice regarding their services and support in 2015-16, 3% were aged under-18, 29% were aged 18-64 and 68% were aged 65+. This age distribution is younger than that observed in the Social Care Survey as a whole, where 75% of clients were aged 65+.

The estimated Self-directed Support implementation rate for social care clients aged 65+ is 25%, for those aged 18-64 it is 35% and for clients aged under-18 it is 48%. Implementation, therefore, has been more rapid for younger social care clients than for older clients.

Figure 5 shows the age breakdown of clients by local authority. It shows that North Lanarkshire, Glasgow City and East Renfrewshire have the youngest age distributions, whilst Inverclyde, East Dunbartonshire and Stirling have the oldest age breakdowns. The variation across local authorities is not readily explained by the different demographics in each and so more research is required in order to understand these differences better.

Figure 5: breakdown of age by local authority, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

3.3 Age and Self-directed Support Option Breakdown

Of the social care clients who made a choice regarding their services and support in 2015-16, 11% chose Self-directed Support Option 1, 9% chose Option 2, 75% chose Option 3 and 5% chose Option 4. The majority of clients, therefore, opted to retain council arranged services (Option 3) when assessed under Self-directed Support.

Figure 6 shows that the breakdown of Self-directed Support options chosen varies according to client age group. Older people (aged 65+), who constitute the majority of social care clients, are much more likely to choose council arranged services (Option 3). Younger adults (aged under 18-64) are relatively more likely to choose a Direct Payment (Option 1) or an Individual Service Fund (Option 2) compared with older people, though Option 3 remained the most common choice. Parents of young people (aged under-18), who only account for a small proportion of the total, are more likely to choose a Direct Payment (Option 1).

Figure 6: breakdown of Self-directed Support option choices by age of client, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

3.4 Self-directed Support Option Breakdown by Local Authority

Figure 7 shows that the breakdown of Self-directed Support options chosen varies across local authorities. This suggests that variations in implementation or data recording may play a significant role in the breakdown of options chosen.

In 26 out of 28 of the local authorities considered here, Option 3 was the most popular choice. However, in Glasgow City and North Lanarkshire, Option 2 was the most popular choice. Together, Glasgow City and North Lanarkshire clients accounted for 70% of all recorded Option 2 clients of the local authorities considered here. In addition, Glasgow City and North Lanarkshire are the two local authorities with the youngest age distribution (see Section 3.2), which corresponds to the observation that younger clients are more likely to choose Option 1 and Option 2 (see Section 3.3).

Figure 7: breakdown of Self-directed Support option choices by local authority, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

3.5 Gender Breakdown

Of the social care clients who made a choice regarding their services and support in 2015-16, 41% were male and 59% were female. This gender breakdown compares with 38% male and 62% female from the Social Care Survey as a whole.

The gender split is broadly similar across the local authorities considered here, however in Glasgow City and North Lanarkshire the majority of clients were male (56% in both). East Renfrewshire also stood out as having a higher proportion of male clients (48%) compared to the average. It is notable that these three authorities have the youngest age distribution (see Section 3.2), demonstrating the link between age and gender. Indeed, figure 8 compares the gender breakdown for clients aged under 65 and those aged 65+. It shows that clients aged under 65 are more likely to be male whilst clients aged 65+ are more likely to be female. Women live longer than men on average, and thus the observed correlation of age and gender is not surprising.

Figure 8: comparison of gender breakdown by age, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

3.6 Deprivation and Age Breakdown

In the main social care survey, those in the most deprived quintiles represent a bigger proportion of clients than those in the least deprived. However, the proportion of all social care survey clients making a Self-directed Support choice is lowest in the most deprived quintiles, figure 9.

Figure 9: deprivation breakdown of social care clients making Self-directed Support choice, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

The trend is similar for the 65+ age group, where those in the most deprived areas are least likely to make a choice. The choice made by this group tends to be option 3 and this is consistent across all the deprivation quintiles, figure 10.

Figure 10: proportion of social care clients who chose a Self-directed Support option, 65+, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).

The trend for those under 65 making a choice does not appear to vary greatly between deprivation quintiles. However, there are some notable differences in regards to the choices made. Those in the least deprived quintiles are more likely to choose option 1 than those in the most deprived. However, those in the most deprived quintiles are more likely to choose option 2 than those in the least deprived. Further research to examine why there are differences across deprivation groups is required.

Figure 11: proportion of social care clients who chose a Self-directed Support option, <65, 2015-16

Information refers to the 28 local authorities with full Self-directed Support option recording (see Section 2.2).