Home care is one of the largest expenditures in Social Work and plays a significant
part in supporting people to remain in their own home for as long as possible. The
costs include in-house and externally purchased home care and relate to the volume
and complexity of care required. However, it is important to note that the home care hours used to calculate
these costs are based on a single snapshot week, whereas the weekly hours fluctuate
from week to week. In addition, the total costs included in the calculation of this
indicator are not assigned consistently across all councils, as reflected in the implausible
range of costs published (from £12.79 per hour to £31.18, even excluding the Islands
councils) so comparison across councils is not reliable.
Self directed support is a new policy which allows people needing support to choose
how their support needs will be met, including through direct payments. However,
the policy is still in the early stages of implementation, and so demand and expenditure
is still highly variable across the 32 councils, ranging from 0.8% to 32.3%.
The balance of care indicator, measures the percentage of people receiving intensive
care at home as a proportion of those placed at home, in care homes or in long stay
hospitals. It measures the extent to which the council and NHS Boards are jointly
maintaining people with intensive needs in the community, rather than in care homes
or in continuing care beds in hospitals. So people receiving 10 or more hours of
home care per week is one of three variables used to calculate this result. However,
the indicator is limited because of the data source used - the number of people receiving
10 or more home care hours in the snapshot reporting week – as this is a very crude
measure. As noted above, the number receiving 10 or more hours of home care per
week fluctuates from week to week, affecting the percentage calculation. Across
Scotland, the range of data reported is implausible, ranging from 21.6 to 51.4% across the
32 councils. Finally, other community based care services also help to support people
to stay in their own homes for longer (eg OT equipment, community alarms, adaptations,
respite care etc) and none of these are included in the indicator.
The Scottish Household Survey is carried out every second year and reports on a
range of social issues, including how satisfied adults are with social care or social
work services. It is worth noting that this data source is based on a limited sample
of cases and there is no evidence as to whether those people who report their satisfaction
levels have actual experience of social care services or not. So some care is required
in interpreting this information.
As most older people prefer to stay at home for as long as possible, with appropriate
community care support, care home placements are generally required as infirmity
increases with age. But all placements are made based on the assessment of each
person's needs which are always complex if a care home placement is required. The
cost of care home placements for people aged over 65 is a major cost to local councils.
This indicator should be looked at in the context of the balance of care indicator
above, and caution should be taken when making comparisons.
Five indicators are reported on Adult Social Care Services. We performed well on indicators 1, 4 and 5, whilst our performance has improved marginally on indicators 2 and declined on indicator 3. However, it is important to bear in mind the limitations noted above relating to comparability of this data which is reported by the Improvement Service.
- SW 1: Older Persons (Over65) Home Care Costs per Hour was reported as £15.57 for 2014-15. This represents a significant reduction on the figure reported in 2013/14 and is predominantly due to the costs being allocated according to the total hours provided to older people rather than simply the number of service users.
- SW 2: Self Directed Support (Direct Payments) spend on adults 18+ as a % of total social work spend on adults 18+ was 1.09% of the total spend on adults aged 18+ in 2014-15, a marginal increase from the previous year for this newly developing policy area.
- SW 3: Percentage of people aged 65+ with intensive needs (plus 10 hours) receiving care at home was 28.8% in 2014-15, a fall of 2.9% from the previous year associated with a fall in the numbers receiving 10 or more hours home care in the reporting week.
- SW 4: Percentage of Adults Satisfied with Social Care or Social Work Services showed 69% were satisfied. However, although this is a reduction of 7% from the previous year, we nevertheless rank in the top quartile of local authorities in Scotland.
- SW5: The Net Cost of Residential Care Services per Older Adult (+65) per Week was £324.60 per resident week in 2014-15. Whilst this represents a 7% increase in cost per resident week from the previous year, Falkirk is still in the top quartile, ranked 6th of the Scottish Councils.
What the Council is doing to improve services
A key issue has to be the need for the Improvement Service which produces this dataset to improve the reliability of both the data and the guidance provided to monitor the performance of adult social care services. Much of the data presents an implausible range of results from the 32 councils which undermines the credibility of the data sources as a source of comparable data on councils. The councils have started to work with the Scottish Community Care Benchmarking Group to look at these data sources and guidance provided, and this result in improvement over time in data reliability/comparability.
There is also scope for the council to improve the ways in which costs are assigned and recorded in Local Financial Returns made to the Scottish Government to help to improve the level of comparability of data in these areas of service. This applies to the costing basis for indicators 1 and 5.
The responsibility for managing the balance of care between people receiving home care services in community placements and those placed in care homes or continuing care beds in hospital is shared between the NHS and social care services. The establishment of Joint Integration Boards over the next year representing Forth Valley NHS and Falkirk Council should result in more coordinated actions to improve economy, efficiency and effectiveness in the area of adult social care.
Direct payments made under the self directed support policy are just one option among four possible options to provide people with more choice about how their support needs will be met. The implementation of this policy is underway, but the Scottish Government acknowledge that this will occur in a phased way across the councils over the next two years.
The Council carries out consultation with citizens, service users and partners in a variety of ways currently, in order to obtain views about council services and policies. This includes a Citizens' Panel, as well as service user surveys. We will continue to undertake these to improve the information we can use to find out what our stakeholders think about our services.
How can the public get involved?
The Citizens Panel helps us listen and respond to your views. We are always looking
for more people to join the Citizens Panel, so that we can be sure that the survey
responses are representative of the whole population. If you want to make your voice
heard, join the Citizens Panel today. You have the option to complete surveys online
or on paper.
You can also give us your feedback on services: