Adult Social Care comes under the remit of the Falkirk Health and Social Care Partnership. Social Work Adult Service's purpose is to provide and commission support, care and protection services for the adults in the communities of the Falkirk area. We do this by assessing need and providing individuals and families with services that, as far as possible, meet their unique circumstances, whilst promoting their independence.
Six Local Government Benchmarking Framework indicators are reported on Adult Social Care Services for 2016-17. These are:
- SW1 Home care costs per hour for people aged 65 or over
- SW2 SDS spend on adults 18+ as a % of total social work spend on adults 18+
- SW3 % of people aged 65 or over with intensive needs receiving care at home
- SW4a % of adults receiving any care or support who rate it as excellent or good.
- SW4b % of adults supported at home who agree that their services and support had an impact in improving or maintaining their quality of life
- SW5 Residential costs per week per resident for people aged 65 or over
Health and Social Care Partnership Performance
SW1 Home care costs per hour for people aged 65 or over
There has been an increase of 1.7% in spending per hour on home care for people of 65 across Scotland. In contrast, Falkirk's Home Care costs per hour for people aged 65 has gone down from £23.73 in 2011/12 to £16.24 in 2016/17, with a rank of 6th lowest cost in Scotland.
SW2 SDS spend on adults 18+ as a % of total social work spend on adults 18+
Since 1 April 2014, self-directed support has introduced a new approach that provides people who require social care support more choice and control over how their support is delivered. Falkirk’s SDS spend on adults 18+ as a % of total social work spend on adults 18+ in 2016/17 has grown from 2.74 in 2015/16, to 3.73 in 2016-17 improving our rank from 20 to 18th highest ratio of spend in Scotland. However, the national data needs to be treated with caution, as it reports only expenditure on SDS options 1 – Direct payments and SDS Option 2 – Directing the available resource. The data specifically excludes data on the choices made of SDS Options 3 - Local authority arranged service; and SDS Option 4 where people have chosen a Mix of SDS Options 1, 2, or 3. This means the national data is not comparable as different local authorities have different policies on in-house provision and outsourcing of services to external providers. This is a particular issue in high expenditure service areas such as home care services. So this would directly affect the balance of expenditure assigned to the different SDS Options in different local authorities shown in the report. However, Falkirk’s expenditure on SDS Options 1 and 2 has increased significantly in 2016-17 - from £2.35 million in 2015-16 to £3.59 million in 2016-17 - an increase of 53%. This reflects the fact that we are catching up from a previously delayed position in comparison with the rest of the country.
SW3 The percentage of adults over 65 with intensive care needs receiving care at home
This is an area of increasing significance in an effort to care for more people in their own home rather than institutional settings such as residential care homes or hospitals. There is significant though narrowing variation across councils in relation to the balance of care, ranging from 22.9% to 50.4% across Scotland. There is no systematic relationship in the balance of care provided and deprivation, rurality or size of council.. In Falkirk, in 2015/16 30.9% of people aged 65 or over with intensive needs were receiving care at home (ranking 24th out of the 32 local authorities in Scotland). In 2016/17, this increased to 31.4% and Falkirk’s rank improved to 20th highest in Scotland, with the Scotland average being 35.3%. It should also be noted that the data from 2015/16 onwards is not comparable with previous years’ data due to changes made to the definitions and source data used to report the number of people in continuous care placements in hospitals.
SW4a and SW4b Percentage of Adults Satisfied with Adult Social Care Services
In 2015/16, two measures from the biennial Health and Care Experience Survey were introduced to the benchmarking suite to reflect service user satisfaction with social care services. These indicators are: SW4a The % of adults receiving any care or support who rate it as excellent or good. In 2015/16 Falkirk’s performance was 82.28, which was just below the Scotland Average of 85. SW4b The % of adults supported at home who agree that their services and support had an impact in improving or maintaining their quality of life. In 2015/16 Falkirk’s performance was 84.13, which was in line with the Scotland average of 84. Social Work Adult Services collect and report on additional service users and carers’ experience measures. These are reported every two months through the Health & Social Care Partnership’s Performance Report to the Integration Joint Board (IJB) These measures show high levels of service user and carer satisfaction (ranging between 90 to 98%).
SW5 Residential costs per week per resident for people aged 65 or over
This indicator takes the total Net Expenditure on Care Homes for Older People and divides this cost by the number of long-stay residents aged 65+ supported in Care Homes. This is then divided by 52 to arrive at the weekly cost per care home resident. Across Scotland, in 2016-17, the average cost per week increased by 0.6% from £373 to £375 per resident, reflecting a small increase in net expenditure (0.1%) and a small reduction in the number of residents (-0.5%) from the previous year. In Falkirk, these costs also increased from £324.60 in 2015-16, (ranking 7th lowest cost in Scotland) to £359.30 in 2016-17 (ranking 12th lowest cost in Scotland). However, the Improvement Service acknowledges this data should be treated with caution. Work within LGBF Family Groups and the Scottish Government report on Free Personal and Nursing Care have both identified that a key factor determining expenditure on residential care is the proportion of self-funders locally. Self funders are those care home residents who pay for their care home place. So levels of expenditure on residential places will reflect the levels of affluence of different local authority areas. This means that in an area with a high number of self funders, the local authority contribution is limited to the cost of free personal/nursing care for each resident, whereas for residents paid for by the local authority the full weekly cost is paid by the local authority.
What the Health and Social Care Partnership is doing to improve services
A wide range of actions are being taken to improve services for people who need Social Work Adult Services. These were reported in a Falkirk Integration Joint Board: Performance Report 1 April 2017 – 31 January 2018 to the Council’s External Scrutiny Panel on 17th May 2018. These actions include:
- Establishment of a Reablement Project Team and development of an Integrated Reablement Pathway
- Redesign of day services for younger adults
- The introduction of a Home First [Discharge to Assess] approach to discharge planning for people who are in hospital
- Introduction of Living Well Falkirk – an online self assessment enabling people to find readily accessible solutions to tasks of daily living
- Service review of the Support at home service (home care)
- Development of a locality model to service delivery of Health & Social Care
Further details on these service improvements can be found in Appendix 1 of the report.
The national LGBF performance data will be monitored and the reasons for variations in the service areas reported will be explored through participation in the Improvement Service’s Benchmarking Family Groups. These will enable learning to be developed on the data and on areas where improvement may be identified.
There is also a 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 Local Government Benchmarking indicators, including those for adult social care services. Some 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.
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 Adult Social Care indicators 1 and 5.