The forgotten story of social care

08: Summary of analysis

PD Cohort Two: 40–65-year-olds with average levels of need and whose packages of care are increasing in cost

Martha is a 59-year-old with multiple sclerosis. She has had a homecare package with the local authority for the past 10 years to support her weekly food shop.

Her condition has declined in recent years, and this has impacted her ability to swallow, to move around her home safely, and to carry out personal care. This has resulted in an increase in support twice over the last four years for Martha, as well as input from the council’s Occupational Therapy team.

Individuals in this cohort are significantly more likely to be female than male, but there is no defined trend in the ethnicity of individuals in this cohort nor in their levels of deprivation. 50% of individuals in this cohort are aged 56–65, and 34% are aged 40–55. In terms of social care support provided, 50% of individuals in this cohort are supported through home support and 34% are supported through direct payments. How can improved outcomes be delivered for this cohort? Delivering optimum outcomes for this cohort typically involves maximising independence wherever possible, and ensuring that increases in support are proportionate and support the individual to remain in their own home where safe to do so. This often involves utilising support with multi-disciplinary input from occupational therapists and physiotherapists, to ensure that the individual’s physical and mobility needs are best accounted for.

Why is this cohort a priority for improvement? In this cohort, the average cost of care for individuals is similar without much variation, but with significant levels of escalation in cost each year. As a result, this cohort appears to be a high priority for potential improvement activity. The average weekly package cost is currently £511 per person, and this has increased by an average of £138 per week each year between 2020/21 and 2023/24. For 80% of authorities, the average cost of packages of care for individuals in this cohort was close to £511 per week, but the remaining few authorities showed a ranged from £445 to £788 per week. What are the characteristics of individuals in this cohort? Based on the data analysed for this programme from the participating authorities, this cohort accounts for 16% of individuals aged 18–64 with a physical disability, and accounts for 16% of total working age physical disability expenditure. The proportion of working age and lifelong disabled individuals in this cohort ranged from 0.7% in one participating authority to 7.2% in another.

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