LD Cohort One: Individuals with a very low level of need whose package of care is not changing in cost
Figure 21: Learning disabled cohorts broken down by volume
The following section breaks down individuals with a learning disability into six specific cohorts who share similar characteristics (as identified by the cohorting analysis), namely: • LD Cohort One : Individuals with a very low level of need whose package of care is not changing in cost • LD Cohort Two: 40+-year-olds with high needs and whose care package is increasing slightly in cost • LD Cohort Three: 18–39-year-olds with high needs and whose care package is increasing slightly in cost • LD Cohort Four: Individuals with low levels of need and whose package of care is escalating in cost • LD Cohort Five: Individuals with low levels of need and whose package of care is not changing in cost • LD Cohort Six: individuals with high needs and whose packages of care are increasing significantly To inform improvement activity and the prioritisation of effort, evidence is provided about the reasons why these different groups require social care support, the volumes of individuals receiving different types of social care support, and the costs associated, in addition to other factors such as age, gender, and levels of deprivation in the local area which may contribute to need and outcomes. Insight into the extent to which any of these factors are staying constant or changing is also provided. Figure 21 shows the way in which the overall group of individuals with a learning disability is broken down into the specific cohorts. Individuals with a very low level of need whose package of care is not changing in cost (cohort one) and 40+-year-olds with high needs and whose care package is increasing slightly in cost (cohort two) are the largest sub-groups. In comparison, Figure 22 shows that cohort one only accounts for 3% of expenditure whereas cohort two accounts for 33%.
LD Cohort Six 6%
Additional LD 2%
Since her routine has been the same for the last few years, Sarah hasn’t reached out to her social worker/local authority learning disability service.
Sarah is 34 years old and has a moderate learning disability. She lives with her sister and their two rabbits. She has been volunteering at a local charity shop twice a week for the last 10 years and enjoys catching up with her colleagues and the routine it provides. She has a direct payment of £130 per week which she uses for a PA who supports her to manage her finances and correspondence, as well as access the community.
LD Cohort One 24%
LD Cohort Five 14%
She hasn’t received a review for the last two years. Sarah would like to have more money for socialising and would love to explore paid employment at some point (such as with animals or in a café). However, she doesn’t know how to find a job as it was a social worker she had 10 years ago that helped her get a volunteering role at the charity shop.
LD Cohort Four 14%
LD Cohort Two 24%
LD Cohort Three 16%
Figure 22: Learning disabled cohorts broken down by spend
What is known about this cohort:
Volumes
Based on the data analysed for this programme from the participating authorities, this cohort on average makes up 24% of all individuals with a learning disability, but accounts for only 3% of total expenditure on support for individuals with a learning disability. On average, individuals in this cohort are slightly more likely to be under 50 years old than individuals with a learning disability as a whole, but there are no defined age trends within this cohort.
Additional LD 1%
LD Cohort One 3%
Demographics
LD Cohort Six 19%
Expenditure The average weekly expenditure is £133 per person , and this cost has not increased over the last four years. Support types 33% of individuals in this cohort have a direct payment as their main
LD Cohort Two 33%
LD Cohort Four 10%
support type, 31% use day services as their main support type, and 15% receive a small homecare package as their main support type. The remainder of individuals receive a range of other low support types. The proportion of working age and lifelong disabled individuals in this cohort ranged from 6.1% in one participating authority to 24.6% in another. Significant variation in cost of packages was evident for this cohort. The average cost of packages of care for individuals in this cohort ranged from £71 per week in one participating authority to £175 in another.
LD Cohort Three 28%
LD Cohort Five 7%
Variation between authorities
How can improved outcomes be delivered for this cohort? Individuals in this cohort are likely to have a low-need learning disability (on the cusp of eligibility), or high levels of met needs (such as those living with their parents who provide the majority of their day to day support).
From a sample analysis of five participating authorities’ data, the average rate of annual Care Act reviews being completed was approximately 35% for individuals with a learning disability, likely due to lack of capacity. Individuals in this cohort are likely to be in the ‘infrequently reviewed’ group as it is uncommon to see an unplanned request for support or safeguarding arise.
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