Social Care Services, Scotland, 2013

Background information on the collection of the data

Social Care Census

All the data presented in this release is collected through the Social Care Census. This is the first year of the new Social Care Census which replaces the Home Care and Self-Directed Support (Direct Payments) surveys.

The data is supplied by all 32 Local Authorities in Scotland who collect this information as part of their Social Care Management Information system and is submitted to Scottish Government via a secure web-based system called ProcXed. The ProcXed system reduces administrative burdens and increases the speed, ease and accuracy (via inbuilt validation checks) of information exchange.

Information is returned for every person who has had a Social Care assessment and who receives or uses:

• Home Care services, including reablement services (provided or purchased by the local authority) during the census WEEK;
• Self-Directed Support to purchase services during the census WEEK;
• A Direct Payment to purchase services during the census YEAR;
• Meals services (provided or purchased by the local authority) during the census WEEK;
• Community Alarms which are operational during census WEEK;
• Other Telecare services which are operational during census WEEK;
• Housing Support services during the census WEEK;
• OPTIONAL - other services e.g. Shopping, Laundry - during the census week.

The 2013 collection YEAR is for the financial year from 1st April 2012 to 31st March 2013 and the census WEEK is the week including 20th March 2013. Normally the census would be the last week in March, however in 2013 this clashed with Easter, and so the week including 20^th March was agreed with Local Authorities to provide a more 'typical' week.

One substantial change to the census this year was the introduction of Housing Support services. Housing Support services help people manage in different ways. These include assistance to claim welfare benefits, fill in forms, manage a household budget, keep safe and secure, get help from other specialist services, obtain furniture and furnishings and help with shopping and housework. They also include community alarm services in sheltered housing. The type of support that is provided will aim to meet the specific needs of the individual.

Some Housing Support services may provide 24/7 care with live-in carers. Analysis of the 2010-2012 Home Care census files, identified that some Local authorities were recording these Housing Support services as hours of Home Care where the client received 168 hours of care each week. In order to improve comparability between local authorities, the new Social Care census asks that these clients be recorded as Housing Support clients and not Home Care clients. This has resulted in a reduction in the number of Home Care hours provided in 2013 but a consistent time series has also been shown for 2010-2013 excluding clients with 168 hours of Home Care for previous years.

When asking about Home Care hours, Local Authorities can either provide 'scheduled' hours or 'actual' hours for the census week. This will usually depend on their local Management Information System. In 2013, 20 Local Authorities provided 'scheduled' hours, 4 Local Authorities provided 'actual' hours and 8 provided both.

Another change for 2013 was the introduction of a new question asking about Self-Directed Support for each person. Analysis of this question is not included in this release but will be considered in a discussion paper and published as 'data under development' over the coming months.

The data specification and guidance issued to Local Authorities when completing the Social Care Census can be found at: http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/SocialCarecensus

Prior to 2013:

The 'Home Care Survey' collected annual statistics on the number of people receiving a home help or Home Care service at the end of March each year. From March 2010, the statistics were collected at the individual level, having previously been collected through an aggregate data return. See

http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/HomeCareCensus for more detail on the survey design and collection.

The Self-Directed Support (Direct Payments) Survey collected annual statistics on the number of people who receive direct payments to purchase the care that they need. These statistics relate to everyone who received a Direct Payment during the relevant financial year and from 2010 onwards have been collected at the individual level, having previously been collected through an aggregate data return. See

http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/SelfDirectedSupportcensus for more detail on the survey design and collection.

Why combine Home Care and Self-Directed Support ?

The Home Care and Self-Directed Support surveys were brought together following recommendation by the SDS review group and extensive consultation with all Local Authorities. See

http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/DataSupplier/HSCSCCResults for full results of the consultation.

Previously, the Scottish Government published two separate National Statistics publications, one presenting data on Home Care clients and one presenting data on Direct Payments clients. All of these people are living in their own homes and receiving Social Care services and some people appeared in both surveys, leading to potential double counting when trying to combine the results from the two surveys.

In recent years, many Local Authorities have seen a decrease in Home Care clients while at the same time there has been an increase in clients opting for Direct Payments. In some cases there is a direct link between the decrease in Home Care clients and the increase in Direct Payment clients. This may happen when (for example) a council retenders services and the contract goes to a new supplier. Many clients may opt to take direct payments to stay with their existing supplier and this will show in the statistics as a decrease in Home Care provision but an increase in Direct Payments.

With the introduction of the Self-Directed Support bill, there will be new options that clients can select and potentially we may see increasing numbers of clients opting to take a 'direct payment' or 'direct the available resource'. The SDS review group agreed that it no longer made sense to collect Home Care and Direct Payments through separate surveys and these should instead be combined into a new 'Social Care' survey.

Further information on the work of the SDS review group can be found at:

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

What is Self-Directed Support?

Self-Directed Support gives people control over an individual budget and allows them to choose how that money is spent on the support and services they need to meet their agreed health and social care outcomes.

Self-Directed Support allows people to choose a number of different options for getting support. The person's individual budget can be:

• Taken as a Direct Payment (a cash payment)
• Allocated to a provider that the person chooses. The council holds the budget but the person is in charge of how it is spent (this is sometimes called an individual service fund); or
• the person can choose a council arranged service; or
• the person can choose a mix of these options for different types of support

More information on Self-Directed Support is available at:

http://www.scotland.gov.uk/Topics/Health/Support-Social-Care/Support/Self-Directed-Support

Client groupings

Since 2010, Local Authorities have been able to provide multiple client groups for each person.

In this publication, where a local authority returned multiple client groups, in order to avoid double counting clients have been allocated to one client group as follows:

1. Dementia

2. Mental Health Problems

3. Learning Disability

4. Learning Disability and Physical Disability

5. Physical Disability

6. Frail older people

7. Other vulnerable groups (including Addiction, Palliative Care and Carer's)

8. Not known

For example, if a client has dementia and has a physical disability, then they will appear in the dementia client group (as this appears higher in the list) for the purpose of analysis.

It should be noted that Local Authorities vary in how they record people whose reason for receiving a service is frailty due to old age. Some record this as 'physical disability' while others record as 'frail older people'. Therefore when looking at the older age groups these two client groups are best considered together when comparing statistics for different local authorities.

It is also important to note that "Dementia" is under recorded in the social care management information system.

Community Alarm and other Telecare services

Telecare is the remote or enhanced delivery of care services to people in their own home by means of telecommunications and computerised services. Telecare usually refers to sensors or alerts which provide continuous, automatic and remote monitoring of care needs emergencies and lifestyle changes, using information and communication technology (ICT) to trigger human responses, or shut down equipment to prevent hazards (Source: National Telecare Development Programme, Scottish Government). Community Alarms are considered to be the basic, introductory level of telecare.

Community Alarm is defined as: A person in receipt of a technology package which consists of a communication hub (either individual home hub unit or part of a communal system e.g. the alarm system within sheltered housing), plus a button/pull chords/pendant which transfers an alert/alarm/data to a monitoring centre or individual responder.

Telecare is defined as; A person in receipt of a technology package which goes over and above the basic community alarm package identified above, and includes any other sensors or monitoring equipment e.g. (not an exhaustive list);

• linked pill dispensers,
• linked smoke detectors,
• linked key safes,
• bogus caller buttons and door entry systems,
• property exit sensors, extreme temperature, flood, falls, movement detectors.

Stand alone devices and pieces of equipment are not be considered 'Telecare' for the purpose of this return i.e. they should be capable of alerting/providing information to a monitoring centre or individual responder and should generally be 'linked' to the home hub or communal alarm system.

Housing Support services

The following Local Authorities were unable to provide information on Housing Support Services:

East Renfrewshire, Eilean Siar, Scottish Borders, Stirling.

Meals services

The following Local Authorities were unable to provide information on Meals Services:

Dundee, East Renfrewshire, Eilean Siar.

Other data sources

In order to calculate rates per population, the General Register Office (GRO) for Scotland (NRS) mid-year population estimates have been used. For 2013 rates, the 2012 mid-year population estimates have been used as these are the latest available.

http://www.gro-scotland.gov.uk/statistics/theme/population/index.html

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 10 Local Authorities has then been used within the calculation below to calculate that the total cost of responding to this survey is £28,000.

Further information

A spreadsheet can be downloaded to accompany this publication. The spreadsheet provides analysis for each local authority in Scotland. The Statistics Release is available on the Internet by accessing the Scottish Government web site:

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

Contact details

Community Care Statistics
Basement Rear
St Andrews House
Edinburgh
EH1 3DG

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

This statistics release was published on 26^th November 2013.