30 May 2016
Nora Cooke O'Dowd

Nora Cooke O'Dowd

Research Analyst
QualityWatch

This month’s updates relate to social care and community care for people with mental health problems or learning disabilities.

They are made in the context of a range of reports released this month about caring and carers, from the CQC, Age UK, Carers UK and NHS England (cited below).

Our indicator on adults with learning disabilities living in their own home coincides with our publication last week of a blog by Chris Hatton about the challenges of obtaining data and monitoring quality of care for people with learning disabilities.

Follow the links to review our indicators in more depth.

Carers’ perspectives on quality of social care

Over half of carers reported that they felt they had been involved or consulted as much as they wanted to be in discussions about the support and services provided to the person they cared for. The proportion who felt consulted decreased slightly in England after 2012-13. The CQC this month released a report encouraging providers and commissioners to ensure people and their families are involved in care decisions.

There was a fall in all regions in the proportion of carers who found it easy to find information and advice about support, services or benefits. Age UK recently highlighted the increasing number of carers aged over 80. Our indicators show that those aged 85+ were most likely to report they found it easy to access information, while those aged 45–64 were most likely to say they were involved in discussions around the person they cared for.

Carer-reported quality of life was highest in the North East of England, but fell marginally across the country. Carers UK has undertaken a survey of carers in the UK to build a better picture of the state of caring in the UK, finding that unpaid care is worth roughly £132bn. NHS England has published a 'commitment to carers' in an attempt to improve carer health and wellbeing as they are estimated to be twice as likely to suffer from ill-health as non-carers.

Social care spending: home care

Since 2004/05, there has been a 26% decrease in real social care spending. Seventy six per cent (£13bn) of this gross current expenditure was spent on long term support, 3% on short term support and the remaining 20% (£3.4bn) on other social services expenditure. Fifty three per cent (£7.2bn) was spent on people aged 65 and over, compared to 47% (£6.4bn) on people aged 18-64.

Forty per cent (£5.2bn) of expenditure on long term support is spent on residential care: £2.1bn on those aged 18-64 and the remaining £3bn on people aged 65+. For those aged 65+, 20% of the total long term support expenditure is spent on each of community home care and nursing. For those aged 18-64, more money is spent on support living (£1.1bn) and via direct payments (£944m).

Social care workforce

The social care workforce is shrinking. The number of whole time equivalent council-employed adult social service jobs has decreased by 23% since 2011 to 97,100. Those providing direct care (such as care workers and support workers) make up almost half of the council-employed adult social service workforce. However, the number of WTE employed in direct care roles has decreased by 31% since 2011.

The average number of sick days in the social care workforce has increased to 10.5 in 2015. This was highest for those directly involved in providing care and support.

Use of community mental health services

Since 2010, roughly 15% of people using community mental health services have said they did not receive information that they were able to understand when prescribed a new medication. Users increasingly felt less supported by the services – particularly in terms of finding or keeping accommodation.

Concerning how service users feel about community mental health services, overall, 92% of people felt decisions had been made together with the NHS mental health services worker in a formal meeting to discuss how their care is working. However, when broken down further, people using community mental health services increasingly felt that they did not have enough time to discuss their needs and treatment. Seventy three per cent felt they had definitely been treated with respect and dignity by the NHS healthcare organisation providing their care, 20% felt it only to some extent and 7% felt they had not been treated with respect and dignity.

Adults with learning disabilities who live in their own home

Just under three-quarters of adults with a learning disability live in their own home or with their family. However, there is huge variation nationally in the proportion of people with learning disabilities who live in their home: there is a 25 percentage point difference between the North West (88%) and the West Midlands (63%).

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