Social Care Services, Scotland, 2016

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 (75%) of all Social Care clients reported on in this publication.

3.1 Home Care for clients aged 65+

There were 48,920 Home Care clients aged 65+ in March 2016. The rate per population of clients aged 65+ receiving Home Care continues to decrease to 50 per 1,000 population this year (Figure 14). The decrease in rates per population since 2007 is partly due to an increase in the elderly population and care being focused on clients with highest levels of need.

Figure 14: Home Care clients per 1,000 population aged 65+, 2007 to 2016

Source: Scottish Government Social Care Survey 2013-2016, Home Care Census 2006-2012
Population data: National Records for Scotland mid-year population estimates up to 2015 (latest available).

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

Figure 15: Home Care clients aged 65+ and hours provided, 2010 to 2016

From 2013, Local Authorities were asked to class 24-7 care as Housing Support, not Home Care.
Source: Scottish Government Social Care Survey 2013-2016, Home Care Census 2010-2012

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 2016.

Source: Scottish Government Social Care Survey 2016

Table 2 shows that 53% of Home Care clients aged 65+ in March 2016 received their care solely from Local Authorities - the same as in 2015. 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 the 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, 2016

Service Provider	Number of clients		Client hours		Average (mean) hours per week	Average (median) hours per week
Local Authority only	25,940	53%	191,700	43%	7	6
Private sector only	17,950	37%	180,200	40%	10	8
Voluntary sector only	1,590	3%	25,400	6%	16	7
LA plus private	2,530	5%	35,800	8%	14	12
LA plus voluntary	550	1%	6,500	1%	12	10
All other combinations	350	1%	6,400	1%	18	14
Total	48,920	100%	445,900	100%	9	7

Source: Scottish Government Social Care Survey 2016

Figure 17 shows the distribution of March 2016 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, 2016

Based on 48,920 home care clients aged 65+.
¹ Dementia is known to be under recorded in the social care management information system.
² Other includes addictions, palliative care and carers.
Source: Scottish Government Social Care Survey 2016

Figure 18 shows that of the Home Care clients aged 65+ for whom living arrangements are known, 53% lived alone. As would be expected this is higher than the figure for 18-64 year olds (38%).

Figure 18: Living arrangement of clients aged 65+ receiving Home Care services, 2016

Based on 33,730 clients for whom Living Arrangements were known. Information was unavailable for 15,190 clients.
Source: Scottish Government Social Care Survey 2016

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 - 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 last two years.

In the year 2015-16, 109,310 people aged 65+ made use of a Community Alarm and/or another Telecare Service, with 73% of these having only a Community Alarm (Figure 19).

Figure 19: Distribution of clients aged 65+ receiving Community Alarm and/or another Telecare service, by client group, 2016

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 2013-2016, Home Care Census 2011-2012

3.3 Direct Payments for clients aged 65+

In 2015-16, 2,860 people aged 65+ received Direct Payments. The total amount spent by Local Authorities on Direct Payments to this age group in 2015-16 was an estimated £26.6 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, the increase this year is similar to that observed in most other years. 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 Payments¹, 2006-07 to 2015-16

¹ Direct Payments total includes an estimate for East Renfrewshire council in 2014-15 - 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 2015-16 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, 2015-16

Client Group	Number of clients**	Expenditure (£ millions)	Mean 1 value of direct payments	Median 2 value of direct payments
Frail older people	1,550	£13.0	£8,000	£6,000
Physical disability	610	£6.2	£10,000	£7,000
Dementia***	360	£3.4	£10,000	£6,000
Mental Health	60	£0.5	£9,000	£6,000
Learning disability****	30	£0.6	£21,000	£7,000
Other	140	£1.6	£11,000	£7,000
Not known	110	£0.7	£6,000	£4,000
All*	2,860	£26.6	£9,000	£6,000

* The expenditure figure presented for "All" clients aged 65+ receiving Direct Payments have been adjusted to account for missing financial data from Angus council, 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 in the social care management information system
**** 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 2016