Adult Social Care Activity and Finance Report, England - 2018-19 [PAS]

This chapter shows the number of requests for support received by local authorities from new clients^[15] and the outcome of those requests^[16]. Depending on the structure in each local authority, these requests may be received directly into adult social care departments, into partner agencies such as mental health trusts, via a contact centre handling all requests for support from the local authority, or a combination of any of these.

The finance collection does not specifically breakdown expenditure related to frontline requests and so it is not possible to identify the spend on these activities.

A total of 1,914,535 requests for support were received from new clients by local authorities in 2018-19, compared with 1,843,920 requests for support in 2017-18. This equates to an average of 5,245 requests for support from new clients received each day, up from 5,050 last year. Those aged 65 and over accounted for 71.2% (1,364,095) of all requests.

Data is now collected on how many clients these requests relate to. In 2018-19, there were an average of 1.4 requests for support per person as the 1,914,535 requests for support were made by 1,335,535 clients.

As can be seen in Figure 7 below, the East Midlands region reported the largest number of requests for support per client with 1.9 requests per client. East of England reported the lowest number of requests per client (1.2).

Figure 7: Number of requests for support per client, by region, 2018-19

A client can request social care support while detained in prison. This route of access was made mandatory in the 2017-18 collection, although not all local authorities in England have a prison within their area^[17]. There were 2,185 (0.1% of all requests) requests for support via a prison route in 2018-19, up 755 requests since last year.

Although requests for support have increased over the last four years, the proportions of requests for support by route of access have remained largely similar. The majority of all requests (76.8%, 1,470,595) originated from the community. The next highest category was discharge from hospital, where 20.3% (388,710) of all requests originated from. Planned entry, diversion from hospital, self-funders with depleted funds and prison referrals made up the remaining 2.9% of requests.

As seen in Figure 8 below, the proportion of requests differ by age group with a higher volume of 65 and over clients requesting support at the point of discharge from hospital.

Figure 8: Proportion of requests for support, by route of access and age, 2018-19

The outcome of the request for support can be categorised into three main support areas; short term care to maximise independence (ST-Max), long term care, and other support. Around one in eight requests (12.6%) resulted in clients receiving short term care to maximise independence and 8.5% of requests resulted in long term care being provided to the client. These areas of support are covered in more detail later in the report.

Figure 9 below shows how outcomes of the requests for support by new clients differ by age group.

For 18 to 64 year olds, 6.4% of requests resulted in the client being offered ST-Max whereas for clients aged 65 and over, 15.1% of requests were resulted in ST-Max.

Just over a third (34.5%) of requests from 18 to 64 year olds resulted in no services provided compared to just over a quarter (25.6%) of requests from those aged 65 and over. Where no services were provided, there were 34,860 requests (6.5%) where the client died after requesting services, but before receiving any.

Nearly one in three (30.8%) requests for support from 18 to 64 year olds resulted in universal services^[18] compared to one in four (25.4%) requests for support from clients aged 65 and over.

When compared to 2017-18, for all ages combined there has been a shift away from ‘Universal Services / Signposted to other services’ (28.8% of all requests in 2017-18 decreasing to 27.0% in 2018-19) and an uplift in ‘No services provided’ (25.1% of all requests in 2017-18 increasing to 26.3% in 2018-19).

These outcomes to a request for support can sometimes be difficult to interpret and should not be seen as reflecting negatively on a local authority, but more as a statement about the nature of request for support that was made.

Another noticeable change is for clients aged 65 and over where the request for support resulted in ongoing low level support. This has increased by 29,560 requests since last year and as a proportion of all requests for clients aged 65 and over has risen from 17.2% in 2017-18 to 18.4% in 2018-19

Figure 9: Overview of requests for support relating to Adult Social care received by local authorities, 2018-19