Social Care Services, Scotland, 2014

4. Working Age Adults - Clients aged 18 to 64

This section of the report provides more detail on the 27,690 Social Care clients aged 18 to 64.

4.1 Home Care for adults aged 18 to 64

There were 10,860 Home Care clients aged 18 to 64 in March 2014. Figure 19 shows that the number of Home Care clients aged 18 to 64 per 1,000 population increased from March 2013 to March 2014, following a general decrease between 2009 and 2013.

Figure 19: Rates per population of Home Care clients aged 18 to 64, 2005 to 2014

Source: Social Care Survey 2013 and 2014, Home Care Census (pre 2013)
Population data: National Records for Scotland mid-year population estimates up to 2013 (latest available).

Figure 20 shows that the number of people aged 18 to 64 receiving Home Care has increased slightly in the last year, following decreases in each of the preceding three years. The number of Home Care hours provided has increased every year since 2011.

Figure 20: Home Care clients aged 18-64 and hours provided, 2010 to 2014

Source: Social Care Survey 2013 and 2014, Home Care Census (pre 2013)

Figure 21 shows that the majority of March 2014 Home Care clients aged 18 to 64 received less than 20 hours of care per week. However, comparison of Figure 21 and Figure 13 shows that a much larger proportion of clients aged 18 to 64, as opposed to those aged 65+, received more than 50 hours of care per week.

Figure 21: Distribution of Home Care hours, clients aged 18 to 64, 2014

Source: Social Care Survey 2014

Table 4 shows that for clients aged 18 to 64, Home Care provided by Local Authorities makes up a smaller proportion of total provision in March 2014 than was the case for clients aged 65+ (Table 2). 31% of clients aged 18 to 64 received their care solely from Local Authorities, compared with 55% for clients aged 65+. Only 15% of 2014 Home Care hours for clients aged 18 to 64 were provided solely by Local Authorities, compared with 46% for those aged 65+.

There is also a greater discrepancy between the mean and median numbers of hours for clients aged 18 to 64 than was seen for clients aged 65+ (Table 2). This is due to the significant numbers of younger adults with relatively large care packages.

Table 4: Home Care by Service Provider for clients aged 18 to 64, 2014

Service Provider	Number of clients	%	Client hours	%	Average (mean) hours per week	Average (median) hours per week
Local Authority only	3,360	31%	33,800	15%	10	5
Private sector only	3,860	36%	79,100	35%	20	10
Voluntary sector only	3,040	28%	98,800	44%	32	16
LA plus private	330	3%	6,900	3%	21	15
LA plus voluntary	100	1%	2,400	1%	24	15
All other combinations	150	1%	4,700	2%	31	22
Total	10,860	100%	225,700	100%	21	9

Source: Social Care Survey 2014

Figure 22 shows that the majority of March 2014 Home Care clients aged 18 to 64 have a Physical Disability.

Figure 22: Home Care Clients aged 18 to 64, by client group, 2014

Note: "Dementia" is under recorded in the social care management information system.
Source: Social Care Survey 2014

Figure 23 shows that of the March 2014 Home Care clients aged 18 to 64 for whom living arrangements are known, 50% live alone. This may be compared to the 65% of clients aged 65+ who live alone (Figure 15). Unlike for older people, a higher percentage of male clients aged 18-64 (55%) live alone than is the case for female clients (45%).

Figure 23: Living arrangement of clients* aged 18 to 64 receiving Home Care services, 2014

Living arrangements information was unavailable for 3,540 clients.
Source: Social Care Survey 2014

4.2 Community Alarm / Telecare Services for clients aged 18 to 64

In March 2014, 15,570 clients aged 18 to 64 made use of a Community Alarm and/or another Telecare Service. These figures represent a slight decrease from March 2013, after increases in previous years. This follows the same trend as that seen for clients aged 65+ (Figure 16).

Figure 24: Clients aged 18 to 64 receiving Community Alarm and/or another Telecare service, 2011 to 2014

Source: Social Care Survey 2013 and 2014, Home Care Census (pre 2013)

4.3 Meals Services for clients aged 18 to 64

In March 2014, around 580 clients aged 18 to 64 in Scotland received meals services at home. Of this total, 270 clients received hot meals and 310 received frozen meals.

4.4 Direct Payments for clients aged 18 to 64

In 2013-14, 3,080 clients aged 18 to 64 received Direct Payments. The total amount spent by Local Authorities on Direct Payments for this age group in 2013-14 was £51.7 million. As with clients aged 65+, the 2013-14 data for clients aged 18 to 64 saw the continuation of the trend of increasing numbers of people receiving Direct Payments, which has been the case each year since 2009-10 (data for the 18 to 64 age group has only been available from 2009-10). Figure 25 shows the increase in Direct Payment clients aged 18-64 over the last five years.

Figure 25: Number of clients aged 18 to 64 who received Direct Payments, 2009-10 to 2013-14

Source: Social Care Survey 2013 and 2014, Self-directed Support (Direct Payments) Survey (pre 2013)

Table 5 shows the breakdown of clients aged 18 to 64 receiving Direct Payments by client group. Physical Disabilities and Learning Disabilities are the primary reason for clients in this age group receiving Direct Payments.

Table 5: Direct Payments for clients aged 18 to 64, by client group, 2013-14

Client Group	Number of clients*	Expenditure (£ millions)	Mean1 value of direct payments	Median2 value of direct payments
Physical disability	1,400	£23.8	£17,000	£11,000
Learning disability	1,060	£18.3	£17,000	£10,000
Mental Health	230	£3.9	£17,000	£7,000
Learning and Physical disability	130	£1.7	£13,000	£7,000
Other	120	£1.7	£14,000	£9,000
Frail older people	50	£0.6	£13,000	£9,000
Not known	50	£0.8	£16,000	£5,000
Dementia	40	£0.9	£21,000	£11,000
All	3,080	£51.7	£17,000	£10,000

* Some clients receive more than one Direct Payment
¹ The mean is the sum of all payments divided by the number of payments (rounded to nearest £1,000)
² The median is the "middle" value of direct payments, i.e. the value at which half of the payments are less and half are more (rounded to nearest £1,000).
Note: "Dementia" is known to be under recorded in the social care management information system.
Source: Social Care Survey 2014