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Current chapter – LTS001a


The number of people accessing long term support during the year to 31st March by Primary Support Reason, Age Band, Support Setting and Mechanism of Service Delivery.

Period 01/04/2021 – 31/03/2022. 


General description and business case

This is a ‘through the year’ measure of supported clients where the support is ‘long term’. Long Term support encompasses services provided with the intention of maintaining quality of life for an individual on an ongoing basis, and which has been allocated on the basis of eligibility criteria / policies (i.e. an assessment of need has taken place) and are subject to regular review. Breakdowns by primary support reason and age band allow analysis of these specific groups. Mechanism of service delivery will allow investigation of the differing ways that personal budgets are being delivered while Support Setting gives information on the balance of residential / community services.

This ‘through the year’ measure helps identify the ‘turnover’ of clients in receipt of long term support. The information is important for aligning costs with activity, to establish the balance between short term interventions (covered in the ‘STS’ short term measures) and long term services and to help identify the cohort for whom personalised services could be delivered.


Changes for 2021-22

None identified.


Who to include/exclude?

For clients to be included in LTS001a the following criteria must apply

  • the support is provided or commissioned by the local authority or an NHS health partner under Section 75 Agreements and must be part of a care / support plan following an assessment of need
  • this return is confined to adults aged 18 and over who were ‘on the books’ to receive long term support during the period, 1 April to 3 March

On the books

A  client is deemed to have been 'on the books' for services if there was an allocation of services for that client provided on the basis of eligibility criteria / policies (i.e. an assessment of need had taken place) and was subject to regular review. A person who previously received services during the previous period 1st April to 31st March which had ceased by April of the reporting year would not be considered to be 'on the books' and should not be recorded here.

It is recognised that social services provide other preventative services to people in the community, for example through grants or service agreements. In the LTS measures only those clients who have been assessed by the local authority or by a legally delegated NHS health partner under Section 75 Agreements and receive support specified in their care / support plan can be included in the long term (LTS) measures.

Note that some forms of support which may be in place over a long period or which recur periodically do not count in the LTS measures. This includes all provision of equipment and adaptations.

Three types of service to be aware of are

Service type Do not count in LTS001 but if provided as a sequel to a request for support (STS001) count as:
Equipment and adaptations Ongoing Low Level Support
Professional support Ongoing Low Level Support or Short term Support (other) depending on nature of provision. Exceptionally, could count as long term support (eligible services). This would likely be most relevant to clients receiving mental health support (see
Short term residential support (not respite) Short Term Support (other)

 

Double counting

Individuals should be counted only once, i.e. the sum of rows and columns equals the number of clients in that row / column. Detailed guidance is provided below.


Detailed guidance for data tables

Tables 1a and 1b

Individuals aged 18 to 64 on 31 March should be included in Table 1a. Older clients aged 65 and over should appear in Table 1b.

Support setting / delivery mechanism

This should be worked out for each client from left to right as it appears on the data return workbook (or top to bottom as it appears in the table below). In other words, the first support setting / category which applies (when considering all support settings relevant to the client during the year) should be chosen. This is like the hierarchy used in the STS measures.

For example, if a client is supported in either residential or nursing care (not including short term placements) at any point of the year then they should be counted in the residential or nursing columns, regardless of any additional services received in the community. In other words, the clients who appear in the Community columns should have received only community-based services during the year (any temporary stays in residential or nursing care can be disregarded, see ‘Moves between settings’ below).

If a group of people live together independently with a shared tenancy agreement, then for as long as that continues any services they receive should be classified as community- based.

Moves between settings

The way moves between settings are treated differs between LTS001a and LTS001b/c. This is because of the hierarchy and the way in which LTS001a considers the whole of the year, whereas LTS001b/c is only concerned with long term support being provided on March 31st.

A client may be receiving community-based services for part of the year and then move into residential / nursing care, or vice-versa. For LTS001a the client should be counted in the residential / nursing care setting, even if the move occurs on the last day of the year. The only exception is where placements are temporary (e.g. to provide respite to a carer) and the client will move back to a community setting at the end of a pre-defined period. In such cases, they should be regarded as being in a community setting for SALT purposes.

When a residential/nursing home is deregistered during the year, a client should still be counted in LTS001a with a setting of residential or nursing care.

If a person moves between residential and nursing care during the year (in either direction) then they should be counted in nursing care for LTS001a.

Changes in type of support during the year

The hierarchy works similarly for LTS001a with direct payments and personal budgets. If a client based in the community during the year with their support initially comprising direct payments then moves to council arranged support (i.e. from ‘direct payment’ to ‘CASSR Commissioned Support only’) then they should be counted in LTS001a as ‘direct payment only’, since that is the first category in the hierarchy that applies. Again, this would be recorded differently in measures LTS001b and c to reflect the service being provided at 31st March (‘CASSR Commissioned Support only’).

The following table has fuller explanations of each support setting / delivery mechanism, in the hierarchical order they appear in the data return workbook. Each client should appear only once in each table of LTS001a.

Hierarchy of support setting / delivery mechanism

How to count each client Support setting/delivery mechanism Explanation
First, consider whether a client should be counted as being in a residential / nursing setting Nursing Residential

Include supported residents in

CQC registered local authority staffed care homes for residential care

CQC registered independent sector care homes for residential care

CQC registered care homes for nursing care Some clients living in care homes may additionally

receive community-based services (e.g. attendance

at day centres). For SALT purposes these clients should be counted as in residential or nursing care. If a group of people live together independently with a shared tenancy agreement, then any services they receive should be classified as community-based
If not, check whether they should be counted as a ‘fully cash’ client Direct Payment only

Direct payments are defined as monetary payments made by local authorities directly to adult clients aged 18 and over in lieu of social service provisions, who have been assessed as needing certain services.

A person who chooses to take their entire personal budget (receives all their services through) a direct payment would be recorded in this category
Or a ‘part cash’ client Part Direct Payment A person who chooses to take part of their personal budget as a direct payment but receives the remainder of their support through personal budget funds managed by the local authority or a third party (e.g. through an ISF) would be counted here.
Or if their personal budget is managed entirely through council commissioned services CASSR managed Personal Budget Clients in receipt of a personal budget should be recorded here if none of their personal budget allocation is being taken as a direct payment. In order to be counted as a personal budget other criteria apply – see the definition of ‘personal budget’, above. This category includes flexible provision made to clients which does not meet the definition of a ‘direct payment’ above (e.g. vouchers or other forms of credit).
Or if they receive council commissioned services which aren’t under a Personal Budget

CASSR

Commissioned support only
Finally, a client with a package of services provided by the local authority but not under a personal budget, with no cash payments or payment schemes, should be counted in this category. As described above, those clients receiving services such as equipment or adaptations are excluded from the LTS measures. Relevant mental health professional support may be counted here if the value of the support has not been calculated and offered through a personal budget. This would only be for clients receiving ongoing mental health support which is part of a support / care plan following an assessment.

It is mandatory to record if the client is detained in a prison setting.

 

For those councils where there is no prison in the area, the cells should be left blank.
CASSR managed personal budget

Clients detained in a prison setting in receipt of a personal budget should be recorded here. In order to be counted as a personal budget client criteria apply

– see the definition of ‘personal budget’, above. This category includes flexible provision made to clients which does not meet the definition of a ‘direct payment’ above (e.g. vouchers or other forms of credit).

CASSR

commissioned support only

Finally, a client detained in a prison setting with a package of services provided by the local authority but not under a personal budget should be counted in this category. As described above, those clients receiving services such as equipment or adaptations are excluded from the LTS measures. Relevant mental health professional support may be counted here if the value of the support has not been calculated and offered through a personal budget.

This would only be for clients receiving ongoing mental health support which is part of a support / care plan following an assessment.

 


Direct payments and long term needs

The LTS001 measures exclude short term or ongoing low level support needs, such as assistive equipment or home adaptations, etc. When considering how to include any direct payment(s) made to the client, only include payments made for long term support needs. These needs will be recorded in the care and support plan as being met via a direct payment. There’s no requirement to know exactly what the client spends the money on so long as it is for long term support needs.

Terminology will vary between councils but a direct payment left ‘open’ on recording systems as at year-end would be reported in both LTS001a and LTS001b / c. Direct payments that are ‘closed’ in recording systems either due to change in care planning or because the payment was a genuine ‘one-off’ would not be included in LTS001b/c, but would appear in LTS001a if the payment was for long term support needs.

Last edited: 11 May 2022 9:24 am