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

Following a request for support, clients may be provided with a period of short term care.

Short term care falls into two categories;

Short Term Support to Maximise Independence (ST-Max) - This includes all episodes of support provided that are intended to be time limited, with the intention of maximising the independence of the individual and reducing / eliminating their need for ongoing support by the local authorities.

Other Short Term Support - All other short term services, for example, emergency support not otherwise included in short term to maximise independence.

Please Note: There are a number of differences in how information on short term care is collected between the ASC-FR and SALT returns.

For example, activity data includes those receiving short term care to maximise independence with a Primary Support Reason (PSR) of Social Support, whereas this PSR is not included in short term expenditure (instead being recorded elsewhere).

Therefore, care must be taken when comparing the two returns; some comparisons of general trends can be made, but more direct comparisons, such as a cost per episode of care, are not recommended.

Expenditure data combines ST-Max (£332 million) and other short term care spending (£248 million) to give an overall gross current expenditure on short term care of £580 million. This accounts for 3.1% of the total gross current expenditure.

Adults aged 65 and over accounted for 73.8% (£427 million) of the total short term spend. This age group has seen a 9.0% increase since last year whereas expenditure for those 18-64 years old has seen a 6.7% decrease.

Both expenditure on ST-Max (up 4.0%, £13 million) and activity on ST-Max (up 3.8%, 9,240 completed episodes) showed an uplift in 2018-19.

ST-Max is a time limited period of short term support intended to maximise the independence of clients and reduce, or prevent, longer-term reliance on social care. In 2018-19 there were a total of 255,275 completed episodes of ST-Max^[19], an increase of 9,240 (3.8%) since the previous year. Eighty-six per cent (219,390) of these completed episodes were delivered for adults aged 65 and over. Completed episodes for 18-64 year olds increased 20.1% on the previous year.

It is important to note that one person may have multiple episodes of ST-Max within the year. As such, the 255,275 episodes of ST-Max related to 216,150 clients, which equates to an average of 1.2 completed episodes of ST-Max per client during the year.

ST-Max is typically provided to those clients with a primary support reason^[20] of physical support. This is where an individual requires help because they find physical things difficult to do by themselves. Physical support was stated as the primary support reason for 87.5% (223,780) of completed ST-Max episodes in the period.

The same can be seen when considering the £332 million (up £13 million since 2017-18) gross current expenditure on ST-Max, where 82.0% (£272 million) was allocated to services for clients with a primary support reason of physical support.

Although the numbers for learning disability support are small, completed episodes of ST-Max for this primary support reason have more than doubled since 2017-18 from 2,180 to 4,445. For the 18-64 year age group they now account for 11.5% of completed ST-Max episodes.

ST-Max is not only offered to new clients. Many (though not all) local authorities offer this to existing clients, who account for 12.4% (31,670) of the total completed episodes of ST-Max in the period. Given that existing clients already have long term needs, the outcomes are very different.

The following section will only discuss the outcomes for new clients (those not already in receipt of long term care). Data on outcomes for existing clients can be found in the reference tables^[21] and data files accompanying this report.

A primary aim of ST-Max is to provide short term rehabilitative support allowing a client to avoid ongoing long term support needs.

Completed episodes of ST-Max for new clients have increased by 5.1% from 212,835 in 2017-18 to 223,605 in 2018-19. This overall increase is mainly driven by the 18-64 age group where completed episodes increased by 21.7% (5,500) over the same period.

More than a third of all completed episodes (38.5% or 86,005) resulted in the client having no identified needs (up from 32.4% or 212,835 in 2017-18), therefore they had no further ongoing requirement for adult social care support.

As Figure 10 below shows, this was the most frequent outcome for both those aged 18 to 64 and aged 65 over. After this, differences are noted between the age groups, with the second most frequent outcome for those aged 18 to 64 being ‘Universal Services / Signposting to other services’ compared to ‘Long Term Support’ for those aged 65 and over.

Figure 10: Number of completed episodes of ST-Max for new clients, by what happened next and age group, 2018-19