Measures from the Adult Social Care Outcomes Framework, England - 2014-15, Final release
Publication date: 09:30 October 06, 2015
Please note: As part of the 2015-16 validation round, councils were invited to resubmit SALT 2014-15 data. 50 councils submitted restated data to NHS Digital and the revised data are now available as part of the 2015-16 SALT publication. Additionally, this restated data has been used to refresh the 2014-15 SALT-based indicators contained within the 2015-16 ASCOF publication. These outputs are available via the following links:
- SALT 2015-16: http://content.digital.nhs.uk/pubs/commcaressa1516
- ASCOF 2015-16: http://content.digital.nhs.uk/pubs/aduscoccareof1516fin
This report provides the findings from the Adult Social Care Outcomes Framework (ASCOF) in England for the period 1 April 2014 to 31 March 2015. The ASCOF draws on data from a number of collections; details of these data sources and which measures they are used for can be found in the Data Sources chapter within this report. Further details of the measures, including the purpose of the framework, can be found in the ASCOF Handbook of Definitions, which is published by the Department of Health.
The ASCOF is part of a range of outcomes frameworks (alongside those of Public Health and the NHS) which collectively reflect the joint contribution of health and social care to improving outcomes. The ASCOF is used both locally and nationally to set priorities for care and support, measure progress and to strengthen transparency and accountability. Its purpose is three-fold:
• Locally, the ASCOF supports councils to improve the quality of care and support.
• The ASCOF fosters greater transparency in the delivery of adult social care, supporting local people to hold their council to account for the quality of the services they provide.
• Nationally, the ASCOF measures the performance of the adult social care system as a whole and its success in delivering high-quality, personalised care and support.
The ASCOF measures how well care and support services achieve the outcomes that matter most to people. The measures are grouped into four domains which are typically reviewed in terms of movement over time. A number of these measures however have seen changes to their source data or definition which have resulted in year-on-year comparisons not being appropriate. Time-based comparisons are therefore not always provided and further explanation can be found in Chapter 3 (Comparability). In summary however, the new Short and Long Term Support (SALT) data collection has replaced the previous activity (RAP and ASC-CAR) collections. This impacts on the following measures: 1C, 1E, 1G, 2A, 2B and 2D. Furthermore, the introduction of SALT has also affected the eligible population used in determining the Adult Social Care Survey (ASCS) samples. The following measures are therefore also impacted 1A, 1B, 1I(1), 3A, 3D(1), 4A and 4B.
As mentioned above, some of the measures included use survey data (the Adult Social Care Survey and the Survey of Adult Carers in England) and are therefore based on a sample of possible respondents. It is not possible to know the true value for the overall population in these cases however the variation present in the sampled data can be used to assess whether a change or difference is statistically significant. Where this is the case, statistical significance will be stated in the report. The non-survey-based measures use transactional data drawn from operational systems and so use all available data points. Any changes or differences presented, on the assumption of robust data quality, can therefore be taken as conclusive.
ASCOF Indicator 1J
The existing ASCOF Indicator 1A (Social Care related Quality of Life) tells us about the current (care-related) quality of life of people using social care. Following discussions in 2011 at the Outcomes and Information Development Board (OIDB), it was agreed that the Department of Health would commission a research project from the Quality and Outcomes of Person Centred Care Policy Research Unit (QORU) to develop a 'value added' measure of social care-related quality of life. This indicator, to be known as ASCOF Indicator 1J, will form part of the 2016-17 framework.
The summary paper below (IIASC Report Summary 2014-15) describes the background, methods and results of the QORU study; the application of this calculation to existing data flows to derive aggregate local authority-level data; and the interpretation of these individual and aggregate measures, again drawing on the QORU study. A section covering the impact of changing the source of the eligible population for the survey from RAP in 2013-14 to SALT in 2014-15, as well as the change from Primary Client Group to Primary Support Reason as part of the inclusion criteria, is also included. A dataset of local authority data (based on 2014-15 Adult Social Care Survey Submissions) is provided (IIASC Dataset 2014-15) along with a calculator (IIASC 2014-15 Calculator) to enable councils to calculate and analyse their individual-level scores using their own 2014-15 ASCS data return.
A similar dataset will be made available for 2015-16 in due course before this measure is included as part of the standard ASCOF reporting outputs for 2016-17.
For further details, QORU's papers detailing the conclusions of the research and development phase of their work can be found via the 'Related links' section below. Any queries or comments should be directed to email@example.com in the first instance.
• The overall social care-related quality of life (SCRQoL) score (measure 1A) for England in 2014-15 was 19.1. The North East and South East have reported the highest outcomes at 19.4, whilst the London region has the lowest outcome at 18.5. The 18-64 group had a higher score at 19.4 for England, compared to 18.9 for 65 and over. This pattern of 18-64 scoring more highly than 65 and over was repeated across all regions, although to varying degrees. Similarly, 77 per cent of services users felt they had control over their daily lives (measure 1B), with a higher percentage (81 per cent) of 18-64 year olds as compared to those aged 65 and over (75 per cent).
• On measures 1C, 84 per cent of service users receive self-directed support, compared to 77 per cent of carers. Conversely, 26 per cent of service users receive direct payments, compared to 67 per cent of carers. (Measures 1C(1) and 1C(2))
• Carer reported quality of life (measure 1D) has decreased from 8.1 in 2012-13 to 7.9 in 2014-15. Similarly, the overall satisfaction of carers with social services (measure 3B) has dropped from 43 per cent (sample size 46,840) in 2012-13 to 41 per cent (sample size 45,940) in 2014-15. Both of these changes are statistically significant.
• A higher proportion of service users (45 per cent) reported having as much social contact as they would like than for carers (39 per cent). This 39 per cent for carers however, is a statistically significant difference compared to 2012-13 (41 per cent). As with measure 1A, service users in England in the 18-64 age band saw a higher proportion (48 per cent) having as much social contact as they would like compared to 43 per cent in the 65 and over age band. This is in contrast to carers', where the 65 and over age group report a higher proportion (40 per cent), as compared to the 18-64 age group (36 per cent). (Measures 1I(1) and 1I(2))
• Following an increase between 2012-13 (81 per cent) and 2013-14 (83 per cent), the proportion of older people (age 65 and over) who were still at home 91 days after discharge from hospital into reablement / rehabilitation services has reduced to 82 per cent in 2014-15. Additionally, 3.1 per cent of people aged 65 and over received reablement services following discharge from hospital. Stability in the numerator (the number of people discharged to rehabilitation where the intention is for the person to go back home) coupled with an increase in the denominator (the total number of people discharged from hospital) has resulted in this measure reducing from 3.3 per cent in 2013-14. (measures 2B(1) and 2B(2))
• 11.1 people per 100,000 population in England experienced a delayed transfer of care in 2014-15. Of these, 3.7 were attributable to social care or jointly to social care and the NHS. West Midlands (15.4), South West (15.0) and East Midlands (14.3) had the highest percentages of delayed transfers of care per 100,000 population with West Midlands (7.0) and South West (5.9) also having the highest percentage of delayed transfers that were attributable to social care or jointly to social care and the NHS. East Midlands, however, has a lower than average percentage that are attributable to social care or jointly to social care and the NHS compared to the England average (3.0 compared to 3.7). (measures (2C(1) and 2C(2))
• Furthermore, the total number of delayed transfers of care has increased in both 2013-14 and again in 2014-15, with the numerator (average number of delayed transfers of care) increasing by 16 per cent since 2013-14. Conversely, the number of delayed transfers of care which were attributable to social care or jointly to social care and the NHS decreased each year from 2010-11 (4.1) to 2013-14 (3.1). This rate however then increased in 2014-15 to 3.7 as a result of an increase in the numerator (the average number of delayed transfers of care that are attributable to social care or jointly to social care and the NHS) of 19 per cent. (measures (2C(1) and 2C(2))
• On measure 3D (1), 75 per cent of service uses find it easy to find information about services, with regional scores ranging from 80 per cent (North East) to 72 per cent (East Midlands). On measure 3D(2), 66 per cent of carers in England find it easy to find information about services. This is a statistically significant reduction from 69 per cent in 2012-13. Regional scores range from 73 per cent (North East) to 62 per cent (East Midlands).
|Date Range:||01 April 2014 to 31 March 2015|
|Geographical granularity:||Councils with Social Services Responsibilities|