As a self-confessed social care geek, my second favourite publication of the year is CQC’s State of Care report. My favourite is, of course, the NHS Information Centre’s final Personal Social Services Expenditure and Activity report.
Here are some of the findings that stood out for me from this year’s report, roughly themed by some (hopefully useful) headings. Comments in (brackets) are my own observations on the preceding point.
Useful statistics
- There are 53.1m people in England, of which 8.7m were 65+ and 1.2m were 85+
- There are estimated to be 800,000 living with dementia across the UK, and it is forecast that one in three people over 65 will develop dementia. (The current number seemed very low to me, especially since the latter figure suggests nearly 3 million people living with dementia in the future – a huge leap. This is further exacerbated by the statement on p39 that “over the next 30 years the number of people with dementia is expected to double”, which would still only get us to 1.6m people. Can anyone shed any light on these stats?)
- 1.35m people work in the NHS workforce in England. This compares to 1.63m who work in social care
- The majority of the increase in social care jobs came from Direct Payments (i.e. Direct Payments are good for the economy!)
- In September 2011, there were 8,316 GP practices in England, with 35,319 FTE GPs. The number of patients per practice has grown and stands at 6,651 per practice
Social care
- Only one third of men (33%) and one in six women (33%) will never need social care
- 83% of councils set their FACS eligibility as “substantial” in 2011/12 (this is a rise from 78% in 2010/11 and from 70% in 2009/10)
- 45% of care home places are occupied by self funders. A further quarter are topped-up by people or their families to make up for the gap between what the local council will pay and what the residential care costs
- Around 220,000 of the 1.1m people who receive domiciliary care are self funders (this is likely to be a significant under-representation of people who pay for their own care, since it will only include those who have made contact with their local council)
- The number of people with a Personal Budgets in 2011/12 was 527,000 – a growth of 40% from 2010/11. Of these, 139,000 receive a Direct Payment – a growth of 11% from 2010/11
- Expenditure on Direct Payments has increased 15% in real terms, to £960m
- 25% of people referred themselves to social care
- 22% were referred from secondary health source (e.g. hospital)
- 14% were referred from primary health sources (e.g. GP)
- 14% were referred by family, friends of neighbours
- It was interesting to note from the table on p.29 that social care providers are much less geographically dispersed than health providers
Poor care and user involvement
- There are three considerable factors which underpin poor quality care: cultures where unacceptable care becomes the norm, an attitude to care that is “task-based” and not person-centre, and managing high staff vacancy or turnover rates
- A recurring issue, particularly for people in learning disability or mental health services, is a lack of involvement in their care plans or having the chance to share their views on how their care is delivered
- More work is felt to be required by commissioners and providers to ensure person-centred planning is embedded into all care for people who use services
- In hospital wards that performed well on people’s quality of care there was strong consistency in the involvement of people in decisions about their care. In those hospital wards that performed poorly on quality of care, a common complaint was that people received little or no information about their care and what to expect
- In social care, problems often arose in people’s quality of care where there had been a lack of person-centred planning, with little information about people’s individual preferences
arbitrary constant 