SOCIAL CARE CURRENT DATA AND GAPS RAPHAEL WITTENBERG PERSONAL SOCIAL SERVICES RESEARCH UNIT ROYAL STATISTICAL SOCIETY CONFERENCE 29 JANUARY 2013

OUTLINE Challenges Data on needs Activity data Expenditure and unit costs Providers and markets Workforce and pay Outcomes and quality Gaps in data

CHALLENGES Mixed economy of provision, including informal carers, and multitude of private, voluntary and public sector providers Mixed economy of finance, with considerable proportion of care purchased privately Personalisation, including Direct Payments and Personal Budgets Mixture of episodic interventions, such as an assessment, and on-going care such as home care Interactions with other services, including health, housing and social security

SOME KEY SOURCES IC: Local authority data available from the Information Centre HSE: Health Survey for England, new module of questions ELSA: English Longitudinal Survey of Ageing NMDS-SC: National Minimum Data Set - Social Care data on workforce PSSRU surveys: Personal Social Services Research Unit surveys

NEED FOR CARE Data on limiting long-standing illness and general health are available from the Census and surveys but not suitable for care needs Data on Activities of Daily Living (ADLs) available in HSE, ELSA, PSSRU surveys but not in administrative data Findings on ADLs sensitive to the wording and context of the questions Data on cognitive impairment more restricted

INFORMAL CARE 2011 Census found increase in numbers of carers since 2001 Census GHS provided detailed data on carers every 5 years to 2000 and on older care recipients every few years to 2001 Survey of Carers in Households commissioned by IC in 2009 New data on carers and older care recipients in HSE from 2011

COMMUNITY CARE SERVICES IC data on referrals, assessments and care packages covers number of LA funded users by age band, gender, ethnicity, user group, type of service Data on privately funded community care, details of care packages, and economic circumstances of users available only from surveys New module of questions to older people about their needs, receipt of services and payment for care in the HSE from 2011 Lack of much data on sheltered housing, extra care housing and Supporting People schemes

RESIDENTIAL CARE Census provides data on numbers of care home residents (and staff) by age, gender, type of home, but not by source of funding IC data covers numbers of supported residents – flow and stock – by age band and user group Laing & Buisson provide estimates of numbers of privately funded and NHS funded residents PSSRU surveys provide detailed information on characteristics of older admissions

USES OF ACTIVITY DATA Cost-weighted activity index for the National Accounts Benchmarking variations between councils, for example in use of residential care Monitoring equality in adult social care Projections of future demand for social care

EXPENDITURE AND UNIT COST DATA IC data on gross and net expenditure by user group and service IC data on unit costs of social services Laing & Buisson data on care home fees PSSRU annual unit cost reports

USES OF EXPENDITURE DATA ONS estimates of the productivity of adult social care Benchmarking efficiency of social services, in terms of unit costs or balance of spend on residential and community services Estimating the impact of policy changes Projections of future public expenditure on social care

PROVIDERS AND MARKETS Care Quality Commission data on numbers of registered care homes (and places) and numbers of home care agencies Laing & Buisson data on care home fees and characteristics, such as single rooms

WORKFORCE AND PAY Skills for Care National Minimum Data Set – Social Care, covers numbers of staff, pay and qualifications Annual Survey of Hours and Earnings (ASHE) data on earnings of staff by occupation

USES OF DATA ON PAY Social services inflation index Resource allocation formulae area cost adjustment for variation in local wages

OUTCOMES and QUALITY Adult Social Care Survey (ASC), replacing earlier user experience surveys of home care and equipment ASC covers data on user satisfaction and on outcomes using the ASCOT tool Carers surveys covering user experience CQC data on quality of care

SOME MAJOR GAPS IN DATA Care packages Use of Direct Payments Quality of care Care pathways, transitions and durations Payments for care Interactions with other services Care providers and care markets

CHALLENGES There is a lack of micro data at national level for social care on the lines of the Hospital Episode Statistics for hospital care Such data are required for detailed analyses of the impacts of reforms to social care policy Mixed economy of provision and mixed economy of finance complicate the collection of micro data

CONCLUSIONS There is a range of administrative data and survey data on social care There are substantial gaps in data which impede analyses necessary to inform policy There are some welcome developments which the next sessions will cover The School for Social Care Research has commissioned PSSRU to conduct a scoping study on social care data