Trends in Social Care Service Delivery

Services funded by Social Services following assessment include ‘one off’ short term and long term services from the provision of an equipment aid to daily living, professional support and short term homecare through to longer term rehabilitation provided at home, a long term homecare package and residential or nursing placements either on a long term or respite basis. The length of time someone needs a funded social care service varies from days to years.

The table below shows all provisions being provided in each year for each care group within the categories of community provisions (services to people living in their own homes, and carers support) and residential and nursing care provisions. Community provisions include Direct Payments allocated to service users to purchase and arrange their own care. The community provisions include supported living which has increased steadily as an alternative to care homes and is predicated on the availability of suitable accommodation for adults with disabilities.

Table 4 shows the total number of service provisions funded in each year over the last 4 years by Barnet Adult Social Services and indicate the changes across the categories as well as the changes in overall volume.

Table 4 2007/8 2006/7 2005/6 2004/5

Total

Total

Total

Total

Physical & sensory impairment

831 765 51 22 801 743 35 19 704 655 29 14 542 507 42 13

Learning Disabilities

687 428 277

6 716 418 327 1 700 427 307 2 588 497 298 1

Mental health

998 910 84 4 1103

1002

114 2 1053

929 137 4 596 490 132 4

Older Adults

4805

3757

859

361

4969

4969

3813

969

5187

3933

1072

421

5021

3810

1110

429

Community provisions Residential placements Nursing placements

Volumes of service provision are only one indicator of level of needs and of the costs of meeting that need. There has been a general rise in the complexity of need for individuals who are referred to social services and living at home. This is due in part to people with long term conditions living longer and general increases in life expectancy. This has a knock on effect to the care homes who are now meeting much higher levels of need.

In line with the national picture there has been a significant fall of permanent residents in care homes supported by the council and an increase in community provisions. The drop overall in older people using services in 2007/8 is in line with a national reduction in the numbers of older people using services reported for March 2003 to March 2006 by CSCI as a result of increasingly tight application of eligibility criteria (ref. The state of social care in England 2006/7, September 2008) at a time when the over 75 population has increased by 3%.

The pattern and delivery of community provisions has changed significantly in Barnet and reflects an increase in professional support, Direct Payments, community equipment and

breaks for carers. More data is required about patterns and use of services including changes in the lengths of stay in care homes and particularly about the impact of changes in health provisions and the impact on demand for social care services.