The forgotten story of social care

LD Cohort Two: 40+-year-olds with high needs and whose care package is increasing slightly in cost

Figure 14: Average weekly package cost versus average weekly cost increase per year, bubbles indicate relative total cohort spend (LD, PD & MH cohorts, excl. LD6)

£2,500

Priority Cohorts

her meals. She received extra support to go into town a couple times a week as a group. As she has got older, Dawn has found herself feeling less physically mobile. As a result, she now receives some extra support in helping her to use the shower safely each day.

Dawn is 52 years old and loves dancing and music. Her CD collection has grown over the years, and she always prefers the physical nature of picking an album over using a computer. Dawn has Down’s Syndrome and lives in a residential home, where she has lived for the last 25 years. She receives support in the residential home for most of her day-to-day activities – helping her to dress each day and prepare Why is this cohort a priority for improvement? In this cohort, average packages of care are typically high and some variations in cost are evident between authorities. As a result, this cohort appears to be a high priority for potential improvement activity. Individuals in this cohort typically receive a care package with an average weekly cost of £1,417 per person. This has increased £90 per week per year from 2021 to 2024. The cost ranges from £1,214 per week in one participating authority to £1,935 in another participating authority. What are the characteristics of individuals in this cohort? Based on the data analysed for this programme from the participating authorities, this cohort makes up 24% of all individuals with a learning disability, and accounts for 34% of learning disability expenditure. 81% of individuals in this cohort are aged between 40 and 64. On average, they are slightly more likely to be female compared to individuals with a learning disability as a whole. 48% of individuals in this cohort receive residential care and 36% live in supported living accommodation.

LD Cohort 2 LD Cohort 3 LD Cohort 4 MH Cohort 3 PD Cohort 2 Other Cohorts LD Cohort 1 LD Cohort 5 MH Cohort 1 MH Cohort 2 PD Cohort 1 PD Cohort 3

£2,000

£1,500

£1,000

£500

£0

-£500

-£50

£0

£50

£100

£150

£200

How can improved outcomes be delivered for this cohort? This cohort is made up of individuals who have been in some form of adult service accommodated setting for several years, particularly residential accommodation. For many in this cohort, whilst residential care was likely the most common independent setting type available when they were younger, they would be highly unlikely to be placed there now if they presented to adult services at the same age. To deliver optimum outcomes for individuals in this cohort, evidence from more than 30 authorities suggests that approximately 30–50% of individuals would have significantly more autonomous and independent outcomes in a lower need setting than in residential accommodation. This is often supported living but can also include use of local authority social housing with additional support from homecare or a direct payment. It could also include Shared Lives (a national scheme that helps to match an individual with an approved host with whom they live with and share family and community life, whilst the host provides some care and support).

Average Yearly Cost Increase

Figure 15: Average weekly package cost versus average weekly cost increase per year, bubbles indicate relative total cohort spend (LD, PD & MH cohorts, including LD6)

-£500 £0 £500 £1,000 £1,500 £2,000 £2,500 £3,000 £3,500 £4,000

Priority Cohorts

LD Cohort 2 LD Cohort 3 LD Cohort 4 MH Cohort 3 PD Cohort 2 LD Cohort 6 Other Cohorts LD Cohort 1 LD Cohort 5 MH Cohort 1 MH Cohort 2 PD Cohort 1 PD Cohort 3

-£200

£0

£200

£400

£600

£800

£1,000

£1,200

£1,400 £1,600

Average Yearly Cost Increase

These six priority cohorts are described below, along with suggestions of action that can be taken to improve outcomes and reduce costs. Additional cohorts identified are described in Appendix 1.

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