Social Care Services, Scotland, 2014

6. Background information on the collection of the data

6.1 Social Care Survey

All the new data presented in this release was collected through the 2014 Social Care Survey. This is the second year of the Social Care Survey, which replaced the previously separate Home Care and Direct Payments data collections.

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 receives or uses:

During the Census Week (any week including 31 March 2014):

• Home Care services, including re-ablement services
• Self-Directed Support to purchase services;
• Meals services (provided or purchased by the local authority);
• Community Alarms;
• Other Telecare services;
• Housing Support services;
• OPTIONAL - other services e.g. Shopping, Laundry.

During the financial year 1 April 2013 to 31 March 2014:

• A Direct Payment to purchase services;
• Respite Care (Respite Care is reported on in a separate publication. See http://www.scotland.gov.uk63052f06-8681-45ad-8418-66a1471b7c73 for details);

6.2 Data collection prior to 2013

The 'Home Care Census' 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. It should be noted that this collection was focused solely on Direct Payments, and not Self-Directed Support as it is now defined (see section on Self-Directed Support below). 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.

6.3 Why combine Home Care and Direct Payments?

The Home Care and Direct Payments 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. The SDS review group therefore 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.

6.4 Self-Directed Support Act

The Self-Directed Support Act was introduced in Scotland in April 2014 (see http://www.selfdirectedsupportscotland.org.uk for details). Self-Directed Support (SDS) 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. It is expected that an increasing proportion of Social Care services will be provided via SDS, thus impacting on the way they can be reported on.

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

With increasing numbers of Social Care clients receiving SDS rather than services provided directly for them, it is expected that this publication will become more focused on SDS in future years.

More information on Self-Directed Support is available at: http://www.scotland.gov.uk/Topics/Health/Support-Social-Care/Support/Self-Directed-Support

6.5 Revisions to previous years' figures

Both the number of Home Care hours and Home Care clients in Scotland for 2013 have been revised downwards slightly in this years' publication. This is because the recording guidance stated that Home Care should not include 24/7 care (168 hours per week), which is classed as Housing Support. Upon further analysis it emerged that some authorities had included clients with 24/7 care as Home Care clients in 2013.

A more substantial revision in Home Care figures has been made for Renfrewshire council, which was due to a recording error. In 2013 their Home Care figures were published as 1,647 clients and 12,739 hours - these have been revised to 1,901 clients and 29,073 hours.

The effect of these changes has resulted in the Scotland Home Care figures being revised from 60,950 clients and 638,000 hours to 61,070 clients and 631,000 hours respectively.

6.6 Data Quality Issues

Duplicate Client IDs

Three Local Authorities were identified as having duplicates in their data submission for 2014, and were unable to resubmit their data within the required timescale.

• East Renfrewshire (74 duplicates)
• Fife (9 duplicates)
• South Ayrshire (295 duplicates)

The duplicate client IDs were taken out of the published data set. It may be therefore that the figures presented in this report for these local authorities will fall a few people short of the actual figure. The number of records affected is small in comparison to the size of the data sets, and is unlikely to have any significant effect on the totals, however it may impact on the smaller numbers presented when broken down by client group, age, etc.

Large changes in Home Care hours

The number of Home Care hours reported by Angus in 2014 has quadrupled from just over 6,000 in previous years, to over 20,000. This is because several Home Care services that had previously not been captured in the data have now been included. It should not be taken to be a four-fold increase in Home Care provision between 2013 and 2014, but an undercounting in previous years.

The large increase in Home Care hours for City of Edinburgh from 49,100 in 2013 to 74,500 in 2014 can be partly attributed to a number of block contracts, mainly for adults with learning disabilities and mental health problems, having been transferred to spot contracts. This has meant that data that was previously not recorded has now been included in the figure for Home Care hours. However, there has also been a genuine increase in the volume of service delivered to people aged 65+ in Edinburgh over the last two years, due to extra investment aimed at helping prevent hospital admissions and reducing delayed discharges.

The extra hours of Home Care recorded via the change of recording methodologies in Angus and Edinburgh did not account for all of the increase in Home Care hours at Scotland level. We estimate that there has been a real-terms increase in Home Care provision in the last year, however the increase is likely to be less than reported in this publication.

6.7 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 known to be under-recorded in social care management information systems.

6.8 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.

Standalone 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.

6.9 Meals services

Three local authorities did not supply data on Meals services (Edinburgh City, East Renfrewshire and Eilean Siar). Data on Meals services has proved difficult for Local Authorities to capture and so the charts presented in this report have been provided for information on the data collection, rather than an exact number of the people in Scotland receiving Meals services.

6.10 Housing Support services

Data on Housing Support was not published in detail in this report, due to several issues reported by Local Authorities regarding the quality of the data. The figure presented in Section 2 of this report is for information on the data collection. Three Local Authorities (Eilean Siar, North Lanarkshire and Scottish Borders) did not submit any data on Housing Support.

6.11 Other data sources

In order to calculate rates per population, the National Records of Scotland mid-year population estimates have been used. For 2014 rates, the 2013 mid-year population estimates have been used as these are the latest available. http://www.gro-scotland.gov.uk/statistics/theme/population/index.html

For the analysis by deprivation, the special area estimates of June 2013 population by SIMD 2012 decile (aggregated to quintile) are used. http://www.gro-scotland.gov.uk/statistics/theme/population/estimates/special-area/simd.html

6.12 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 11 Local Authorities has then been used within the calculation below to calculate that the total cost of responding to this survey is £51,000.