Social Care Services, Scotland, 2015

3. Older People - Clients aged 65+

This section provides more detail on those people receiving Social Care services who are aged 65 and over, and who account for more than two-thirds (74%) of all Social Care clients reported on in this publication.

3.1 Home Care for clients aged 65+

There were 50,160 Home Care clients aged 65+ in March 2015. The rate per population of clients aged 65+ receiving Home Care has decreased slightly in the last year to just over 50 per 1,000 population (Figure 14). The decrease in rates per population since 2006 is partly due to an increase in the elderly population and care being focused on clients with high levels of need.

Figure 14: Home Care clients per 1,000 population aged 65+, 2006 to 2015

Source: Scottish Government Social Care Survey 2013-2015, Home Care Census 2006-2012
Population data: National Records for Scotland mid-year population estimates up to 2014 (latest available).

The number of people aged 65+ receiving Home Care has remained relatively stable over the past three years, following decreases in preceding years (Figure 15). The number of Home Care hours provided has also remained stable in the last year, following increases in previous years.

Figure 15: Home Care clients aged 65+ and hours provided, 2011 to 2015

Source: Scottish Government Social Care Survey 2013-2015, Home Care Census 2011-2012

The majority of Home Care clients tend to receive smaller amounts of care per week: nearly two thirds (65%) of those aged 65+ received less than 10 hours of care per week (Figure 16). 7% of Home Care clients aged 65+ received more than 20 hours of care per week in March 2015.

Figure 16: Home Care clients aged 65+ by level of service, 2015

Source: Scottish Government Social Care Survey 2015

Table 2 shows that 53% of Home Care clients aged 65+ in March 2015 received their care solely from Local Authorities – this has decreased from 60% in 2013 and 55% in 2014. The table also provides two measures of the average hours of care provided per week to clients aged 65+, by service provider; the mean (total hours divided by the number of clients) and the median (the “middle” value: half of values are greater than it and half less, which reduces the impact of extremely large values). Both measures show that those clients receiving care solely from Local Authorities tend to have smaller amounts of care per week.

Table 2: Home Care for clients aged 65+, by service provider, 2015

Service Provider	Number of clients		Client hours		Average (mean) hours per week	Average (median) hours per week
Local Authority only	26,800	53%	200,700	44%	7	6
Private sector only	17,340	35%	172,100	37%	10	8
Voluntary sector only	1,450	3%	25,000	5%	17	8
LA plus private	3,150	6%	50,600	11%	16	14
LA plus voluntary	530	1%	7,500	2%	14	11
All other combinations	240	0%	4,300	1%	18	14
Total	50,160	100%	460,200	100%	9	7

Source: Scottish Government Social Care Survey 2015

Figure 17 shows the distribution of March 2015 Home Care clients aged 65+, by the principal reason they are receiving care (their 'client group'). There are a large number who receive care either as a result of frailty due to old age, or due to a physical disability. Note that Dementia is known to be under-recorded by Local Authorities, and so it is likely there are clients in other client groups (e.g. "Frail Older people") who have Dementia.

Figure 17: Home Care Clients aged 65+ by Client group and age group, 2015

Based on 50,160 home care clients aged 65+.
* Dementia is known to be under recorded by Local Authorities in their social care information systems.
Source: Scottish Government Social Care Survey 2015

Figure 18 shows that of the Home Care clients aged 65+ for whom living arrangements are known, 62% lived alone. As would be expected this is higher than the figure for 18-64 year olds (47%),

Figure 18: Living arrangement of clients aged 65+ receiving Home Care services, 2015

Based on 38,820 clients for whom Living Arrangements were known. Information was unavailable for 11,340 clients.
Source: Scottish Government Social Care Survey 2015

3.2 Community Alarm / Telecare Services for clients aged 65+

From 2015, Local Authorities were asked to provide data on Community Alarm/Telecare services provided at any time during the financial year 2014-15 - previously only those receiving the service during the March census week were recorded). This has contributed to a jump in the number of Community Alarm/Telecare clients recorded in the latest year.

In the year 2014-15, 106,030 people aged 65+ made use of a Community Alarm and/or another Telecare Service. 77% of these had only a Community Alarm (Figure 19).

Figure 19: Distribution of clients aged 65+ receiving Community Alarm and/or another Telecare service, by client group, 2015

* From 2015 Local Authorities were asked to record all clients receiving Community Alarms/Telecare at any time during the financial year. Previously only clients receiving these services during the March census week were recorded.
Source: Scottish Government Social Care Survey 2013-2015, Home Care Census 2011-2012

3.3 Direct Payments for clients aged 65+

In 2014-15, an estimated 2,420 people aged 65+ received Direct Payments. The total amount spent by Local Authorities on Direct Payments to this age group in 2014-15 was an estimated £22.8 million. This saw the continuation of the trend of increasing numbers of people receiving Direct Payments; while the increase between 2013-14 and 2014-15 was smaller than previous years, it followed a particularly large increase between 2012-13 and 2013-14. Figure 20 shows the increase in Direct Payment clients aged 65+ over the last ten years.

Figure 20: Number of people aged 65+ receiving Direct Payments, 2005-06 to 2014-15*

* Direct Payments totals include an estimate for East Renfrewshire council - see 5.5 (background notes).
Source: Scottish Government Social Care Survey from 2013, Self-Directed Support/Direct Payments Survey up to 2012.

Table 3 shows the breakdown of 2014-15 clients aged 65+ receiving Direct Payments by client group. Frailty due to old age is the primary reason for clients in this age group receiving Direct Payments, followed by Physical Disabilities and Dementia.

Table 3: Direct Payments for clients aged 65+, by client group, 2014-15

Client Group	Number of clients**	Expenditure (£ millions)	Mean1 value of direct payments	Median2 value of direct payments
Frail older people	1,130	£10.2	£9,000	£6,000
Physical disability	530	£5.3	£10,000	£7,000
Dementia***	330	£3.1	£10,000	£7,000
Mental Health	100	£0.7	£8,000	£6,000
Learning disability****	20	£0.4	£17,000	£7,000
Other	70	£0.7	£10,000	£7,000
Not known	190	£1.6	£8,000	£6,000
All*	2,420	£22.8	£9,000	£6,000

* The figures presented for "All" clients aged 65+ receiving Direct Payments have been adjusted to account for missing data from East Renfrewshire, so are slightly higher than the sum of individual client groups
** Some clients receive more than one direct payment
*** Dementia is known to be under recorded by Local Authorities in their social care information systems.
**** "Learning Disability" includes clients with both a Learning Disability and Physical Disability.

¹ The Mean denotes the "average" value of direct payments, i.e. the sum of all payments divided by the number of payments (rounded to nearest £1,000)
² The Median denotes 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)

Source: Scottish Government Social Care Survey 2015