STS002a

Of new clients where the sequel to a request for support was ‘Short term Support to Maximise Independence’ (STS001) a breakdown of what followed the period of short term support.

Period 01/04/2021 – 31/03/2022 (all tables). 

This measure tracks the sequel to a limited period of short term support and will provide some indication of the outcomes of services intended to maximise the independence of new clients, especially when considered in conjunction with measure STS001 (tables 2a and 2b look at ‘repeat requests’).

Tracking the sequels to short term services will give an idea of the effectiveness of preventing longer-term reliance on social care. When benchmarked, differences between local authorities can be examined so that best practice can emerge and be shared, resulting in wider improvements.

Data from this measure is needed for ASCOF measure 2D which looks at the proportion of new clients provided with ST-Max who subsequently required no ongoing support or support of a lower level. The data is also needed as part of the calculation for ASCOF Measure 2A (Long term support needs met by admission to residential and nursing care homes per 100,000 population).

For clients to be included in STS002a the following criteria must apply:

• the measure is for new clients only
• the measure only includes clients aged 18 and over at the time their request for support was made
• clients in this measure must have appeared in measure STS001 either in this or the previous year
• the sequel to support must be known although service provision or other arrangements might take some weeks or even months to set up
• each instance of ST-Max with a known sequel should be included, including multiple instances for the same client

This measure only includes new clients, i.e. clients not in receipt of long term support at the time the request for support was made. A person who previously received long term support which had ceased before the new request was made must be included as a new client.

There will be some clients recorded in measure STS001 as having a sequel of ‘Short term support to maximise independence’ whose period of short term support is still in progress at year-end, or the sequel may not yet be known. These must be captured in next year’s STS002a data. Consequently, some clients who were included in STS001 for the previous year but whose sequel to support was only known this year, will also be included.

Route of access

Please see measure STS001 for details on this (the Route of Access is the same for each instance of ST-Max in STS002a as was recorded in the request for support in STS001). The treatment of clients with depleted funds applies in the same way. Such clients may first be provided with ST-Max prior to the local authority taking on financial support for eligible long term support.

Sequel to Short Term Support

The sequels are similar to those as in measure STS001, except for additional categories concerning ‘Early cessation of service’ and ‘No Service Provided’. They incorporate the mandatory sequels introduced for STS001 in 2017-18.

Early cessation of service

This describes a circumstance where the period of short term support was forced to be cut short in an unexpected way. It can occur because of unexpected changes in client health, such as if the person suffers a stroke or other sudden event that means the ST-Max is no longer appropriate. Clients may be forced to return to hospital with an uncertain discharge date, causing the suspension or termination of the ST-Max support. In some instances the client may move (or be moved) out of the local area, perhaps to live under the care of relatives. Or relatives may decide mid-way through the period of support to take over that support etc. forcing the end of ST-Max. The client themselves may decide to end the support themselves, on the grounds that they do not need it.

‘Early cessation’ does not simply mean that support has ended prior to a standard service period, such as 4 or 6 weeks. For example, when short term support is ineffective and it is decided to stop provision earlier than planned and transfer the client to long term home care services, the sequel should be recorded as if the short term service period was completed. Here it is possible to draw a conclusion about the ‘success’ of ST-Max so the sequel ‘Long Term Support (community)’ would apply.

There is a ‘grey area’ between support ending prior to the original scheduled end date but with enough time to judge the impact on the client, and support which ends so soon that there cannot be any opportunity for ST-Max to have an impact. A frequently asked question document has been added to further illustrate some of these scenarios and aid selection of the appropriate sequel.

Hierarchy of sequels

The ordering of the hierarchy has not changed since 2017-18. The sequels ‘No services provided – needs identified but self-funding’ and ‘No services provided – needs identified but support declined’ moved up the hierarchy. This followed discussion in the SALT User Advisory Group about how all clients should receive relevant information and advice following introduction of the Care Act. The hierarchy previously used caused some clients who were self-funding or refusing services to be recorded as ‘No Services Provided - Universal Services / signposted to other services’ due to its previous position.

Early cessation of service (not leading to long term support) - NHS funded care/End of Life/ deceased

This sequel shows explicitly that further health care or palliative care was needed, or that the client died before ST-Max was completed.

Early cessation of service (not leading to long term support) – other reason

This sequel should be used for all other instances of ST-Max ending early where long term social care support does not result. For example, the client may move (or be moved) out of the local area, perhaps to live under the care of relatives. Or relatives may decide mid-way through the period of support to take over that support, forcing ST-Max to end.

Early cessation of Service (leading to long term support)

This is used if a client’s short term support ended early and provision of long term services followed.

Long Term Support (any setting)

Long Term support encompasses any service or support which is provided with the intention of maintaining quality of life for an individual on an ongoing basis. It will be allocated on the basis of national eligibility criteria following an assessment of need and be subject to regular review. This sequel includes all the primary settings in which an individual receives services; community, residential and nursing.

No services provided – needs identified but self- funding

This category applies to clients for whom it can be identified that they or their carer(s) intend to purchase support privately and are withdrawing from assistance offered by the council, including care planning support, annual reviews etc.

This will help gather intelligence nationally on the numbers of self-funders who would otherwise have been supported by a local authority. It is accepted that it may not always be possible to find out the client’s plans if they decline local authority support.

Ongoing low level support

Should be used where a local authority decides to provide an ongoing service such as a community alarm / minicom line / telecare, but no ‘long term support’. Such services will be based in the community. All equipment and adaptations (including those with ongoing costs for maintenance and safety checks) should be included in this category. ‘Ongoing Low Level Support’ recognises the importance of these services but captures that they continue ‘in the background’, supporting clients with minimal care management from the local authority.

Short Term Support (other)

Includes all episodes of support that are intended to be time limited without intending to maximise independence / reduce the need for ongoing support. An example of this might be a short term intervention for a younger adult with impaired mobility following an operation but expected to make a full recovery without any long term intervention. Emergency support provided for all new clients should be included in this category.

No services provided – needs identified but support declined

This category applies to clients where local authority support was offered on the basis of eligible needs, but the client declined such support (for any reason except that they will be self-funding). This may occur when clients wish to try and remain independent without any outside help, or for any number of other reasons unconnected with their self-funding status.

Universal services / Signposted to other support

A ‘universal service’ is any service or support (other than those above) for which national eligibility criteria (following Care Act) are not relevant. It includes the provision of information and advice. ‘Signposting’ indicates that the client will not be supported by the council and there is no universal service which will help them. Details are therefore given of other organisations (for example. in the voluntary sector) that might be able to provide assistance.

No services provided – no identified needs

The client may have low-level needs which cannot be supported by the local authority and there is no universal service or obvious third party which could help them.

If for some reason the process of assessing needs is terminated then this sequel applies (N.B. if temporarily suspended, wait until the assessment process has re-started and reached a conclusion before determining the sequel).

Clients who die before/during/immediately following assessment of need should not be counted in this sequel – they are captured in the first sequel at the top of the hierarchy.

As for measure STS001, there can only be one sequel for each provision of short term support and there is a hierarchy that determines which sequel you should choose if more than one applies. The order in the data return workbook, when read from left to right, is the order in which you should identify the most relevant outcome.

Short term support followed by Short term support

Measure STS001 distinguishes between short term support for the purpose of maximising the client’s independence and other forms of short term support that do not play a role in ‘rehabilitation’, ‘reablement’ etc. This measure includes the sequel ‘Short Term Support (other)’ to allow for the outcome of a ‘non-reablement’ period of support. If the sequel is another period of ST-Max then, for SALT purposes, the period of ST-Max is not complete, and a sequel should only be recorded in measure STS002a when that support comes to an end.

Short term and Long term Support in the same year

It is possible that clients will be in receipt of a long term service and then be referred for a short term intervention designed to maximise their independence. Such cases should be captured in measure STS002b and NOT in this measure (which is for new clients only).

Tables 2a and 2b

Total Clients in Table

A count of ‘Total Clients in Table’ was added in 2017-18 to compare the number of ST-Max service provisions and the number of people going through ST-Max (because more than one provision of ST-Max may be provided to a client during the year).

In addition, the ‘of which, also counted in LTS001a’ count cross-references clients counted in STS002a with those included in LTS001a. Any client who appears in both LTS001a AND STS002a should be counted here. This allows a ‘total number of clients supported’ count to be calculated including both ST-Max and Long Term Support, without double-counting.

For clients who are going on to receive long term support, the setting of that support should be given. Only one setting can be chosen per sequel to short term support.

Additional rows have been added to separately identify those who have a change of setting following ST-Max who had the appropriate Route of Access and 12 week disregard/DPA status. This was recently introduced in Table 1; however the age breakdown is required to ensure there is no double counting in ASCOF 2A.

Note that the Support Setting categories are identical to those used in the Long Term Support section of SALT (e.g. measure LTS001b).

It is assumed that although the exact details of a care package being set up following a period of short term support may take some time to finalise, the sequel will be known and recorded when the client’s final short term support review or subsequent assessment determines their eligible needs. It is accepted this may take several weeks to determine in some cases. This may mean clients whose short term support ended in one reporting year may have their sequel recorded in the following year. Where the sequel is not determined by 31 March, include these cases in the next year’s return.

Note that the ‘residential’ and ‘nursing’ sequels here indicate placements that are intended to be long term. Trial placements for a fixed period in order to assess suitability are included in this, as the expectation would be for clients to remain in long term care home support, but short term temporary stays, in which the client has a planned return to a community setting, are not, and should be counted in the ‘community’ categories.