Home Care Review 25 th March 2009

Care of Older People

The Purpose

Background Scotland’s 65+ population projected to rise by 21% between By 2031 it will have risen by 62% For the 85+ age group specifically, a 38% rise is projected for 2016 And, for 2031, the increase is 144%

HEAT

9% 24% 41% 61% 84% Calendar year ’07 estimate P Knight Scottish Government

General Practice

Contact rates in general practice FEMALE GP Practice nurse

Longer term care of older people by Health and in Social Care Services

Current service provision by service type

Current service provision by age group % 88% 60%

Preparing for the growing older population Ministerial Strategic Group for Health and Community Care Chaired by Minister for Public Health and Sport Members - 4 NHS Board Chairs and 4 Local Authority Councillors Support provided by Scottish Govt, COSLA, Tim Davison (NHS Lanarkshire) and Sue Brace (ADSW) Delivery Group for Health and Community Care Chaired by Tim Davison Membership covers NHS, ADSW, COSLA, local government, Scottish Government, Care Commission

1.H1 Home Care Survey – overview 2.Uses of survey – Scotland Performs, SOAs 3.The way forward

History 1976 – First home care survey? Current survey began reviewed (added FPNC, supporting people and person level data for SNS) Survey takes place last week March each year Provides information on all services provided during survey week Home Care services provided or purchased by LAs Published around November each year

Chart 1: Home care clients and hours provided,

Chart 4: Proportion of Home Care Clients by Provider,

Chart 7: Ratio of people aged 65 and over to people aged under 65 by level of service, 2008

Chart : Clients receiving home care / personal care services

What currently goes well? All 32 LAs return completed survey Comparability within LAs – time series data is good Survey largely unchanged for 10 years – so good time series Comparisons with Audit Scotland SPI

Are there any issues with current data collection? Not all LAs can provide data on purchased services (data is estimated) ‘Planned’ hours vs ‘actual’ hours Morning/afternoon/evening/weekend services – difficult to complete Comparability between LAs Limited analysis

Outcomes & Indicators

Overview National Performance Framework Scotland Performs Concordat Single Outcome Agreements Resources for SOAs

National Performance Framework (1) The 2007 Spending Review introduced a new National Performance Framework with an overarching national purpose, five strategic objectives, fifteen national outcomes, and forty-five national indicators. Moving to an outcomes-focused approach to performance. Delivery partners - including local government

National Performance Framework (2) Our Purpose To focus government and public services on creating a more successful country, with opportunities for all of Scotland to flourish, through increasing economic sustainable growth

Scotland Performs Scotland Performs tell us how Scotland is doing in our pursuit of our aims. It describes the outcomes we want to achieve and how well Scotland is progressing in key areas: health and wellbeing; justice and communities; the environment; the economy; and education and skills. Scotland Performs follows the National Performance Framework

National Indicator Increase the percentage of people aged 65 and over with high levels of care needs who are cared for at home Clients receiving 10 hours+ home care / (Clients receiving 10 hours+ home care + LA supported long stay care home residents + geriatric long stay hospital patients)

Concordat Spending Review agreement Partnership working with Local Government Statistical collections will remain pdfhttp:// pdf

Single Outcome Agreements (SOAs) Single Outcome Agreement (SOA) for every LA (Community Planning Partnership 2009-) SOAs set out local priorities/outcomes, aligned to the fifteen national outcomes. The SOA sets out how the Community Planning Partnership intend to measure progress towards their local outcomes.

Resources for SOAs (1) In developing SOAs a range of indicator were used from a range of sources: –the 45 indicators contained in the National Performance Framework –Menu of local outcome indicators –Statutory Performance Indicators –Community Care Outcomes Framework –Indicators taken from existing local Community Planning Partnership plans and local authority strategic documents –council developed local indicators

Resources for SOAs (2) Data Sources and Suitability Websections on the SG website ScotStat Network of Analysts from LG and Public Bodies  local workshops and short-lived working groups  work work work 

Current data collections Home Care Services Care Homes Day Care Housing Support Free Personal Care Self- directed Support Registered Blind & Partially Sighted FPNC

Meals / Shopping Equipment & adaptations Telecare What don’t we collect? Intermediate Care Alarms Day opportunities Respite Others? Needs (IoRN) Rehab / Enablement

Future Home Care Services Meals / Shopping Telecare Day Care Housing Support Equipment & adaptations Care Homes Self- directed Support Alarms Needs (IoRN) Respite

Priorities Better overview of number of people getting services at home and their needs 10+ hours – not good proxy – what should replace this? Only collecting information on home helps at the moment – lots of other services that ‘make a difference’ Analysis is limited to the tables we currently collect. Don’t know overall number of people known to Social Work, etc The world is changing – data collection needs to adapt.

How can we do this? 1.Move to person-based data collection. –Would allow for more flexible analysis –Would allow us to look at needs as well as variety of services –Could provide us with longitudinal data –Start small and build up each year 2.Set up working group to take forward –Small group –Representation from variety of stakeholders –Make use of IT expertise (Scottish Government and IT suppliers to LAs) –Volunteers?

Contact Details Julie Rintoul – Ellen Lynch – Address: Health Analytical Services Division, Basement Rear, St Andrews House Edinburgh EH1 3DG