Coventry Adult Social Care Annual Report 2022/23 (Local Account)

The demand for Adult Social Care rises every year as people live longer and there are more people living longer with more complex needs. 

The illustrations on this page give you an indication of the challenges we face:

• Budget – Money matters
• Activity – Facts and figures
• Demographic – The people who come to us for support
• Our workforce - The people who provide support where required

The Council is a large organisation spending a net £243.9m on revenue activity during 2022/23.

Budget – Money Matters

The Gross Adult Social Care Spend in 2022/23 minus citizens and other contributions was £118.8m as shown below.

This compares to a spend of £110.4m in 2021/22. The largest element of the increase relates to spend on people.

• £91.5m spent on people
• £20m spend on community, assessment and overheads
• £6.2m internal cost for support services including finance, HR and legal.
• £0.8m spent on transport
• £0.3m spent on other.

Spend on people

The ‘Spend on People’ referred to has increased to £91.5m in 2022/2023  from £85.8m in 2021/22. ‘Spend on People’ is money spent directly on the provision of care.

• £31.9m spent on homecare
• £26m spent on residential
• £10.2m spent on nursing
• £10.1m spent on Direct Payments
• £6.5m spent on housing with care
• £2.6m spent on day opportunities
• £2.4m spent on supported living
• £1.3m spent on equipment and adaptions 
• £0.5m spent on individual service funds

How do we compare?

Coventry still continues to be a comparatively low spending local authority per 100,000 population.

In recent years we know that Coventry demonstrates comparatively low spending as a local authority per 100,000 population. The Local Government Association publish information about spend later on in the year. View information for 2021/22.

Activity- Facts and figures

People receiving support 

Adult Social Care receives a large volume of requests for support on a day-to-day basis. Our aim is to maximise people’s independence and support people in the least intrusive way.  

• 10,772 new requests for support (an increase of 3% on last year’s figure of 10,430). Mental Health data was not available for 22/23 due to an ICT system issue. Historically this has added approximately 2,000 new requests which, when added to the 10,772 new requests recorded would equate to a 22% increase.
• 5% of requests resulted in a long-term service (decrease on last year’s 7%).
• 25% received low level support (reduction on last year’s 35%).
• 25% received a short-term service to promote independence (increase on last year’s 24%).
• 4,730 people received long term support during the year out of which 3,595 people received long term support as of 31 March 2023.
• 2,597 people had been in long term support for over 12 months as at 31 March 2023.
• 1,297 people received a planned or unplanned review throughout the year (compared to 1140 last year).
• 29 people transitioned from Children’s Services to Adult Social Care compared to 31 last year.

Carers receiving an assessment

Adult Social Care have an equal responsibility for anyone providing unpaid care within the city.  Anyone providing necessary care to another adult is entitled to a carer’s assessment.

• 1,124 carers have their needs assessed in 2022/23
• 2,757 carers received support  

How do we compare?

CQC Local Area Analysis data suggests in Coventry, compared to other local authorities that have similar populations, that we think of other solutions first, signposting to universal services and other community support rather than looking at traditional models of support.  Explore the Local Area Analysis in more detail you can view the most recent reports from CQC.

In comparison to other local authorities Coventry continues to have;

• low rates of new requests for Adult Social Care, with an average of 30 a day compared to the national average of 36 in 2021-2022;
• a lower rate of new requests for Adult Social Care support going straight into an ongoing long-term service than comparators;
• a higher proportion of new requests for people aged 65+ going on to receive short term support to maximise independence than comparators;
• continued lower rate of people receiving long term support per 100,000 population compared with our comparators.

Safeguarding

Protecting adults to live in safety, free from abuse and neglect is a core duty of Adult Social Care.  The rising rate of safeguarding concerns reported suggests people know how to report abuse and we are addressing concerns without the need for an enquiry or investigation. 

• 6,278 safeguarding concerns received, a 7% increase from the previous year (5858).
• 1,055 safeguarding enquiries, a 17% increase from the previous year (899).
• The rate of concerns that led to an enquiry was 17% compared to 15% last year.
• 985 completed safeguarding enquiries were undertaken in the year compared to 869 in the previous year.
• 890 people (90%) were asked about their outcomes, an increase from 88% of people asked last year (768).
• 94% of people reported fully achieved/partially achieved outcomes compared to 97% last year.

We continue to closely monitor our all activity and use ‘sampling’ audits and develop improvement plans when we need to look into our approaches in more depth.

How do we compare?

Coventry has a higher rate of concerns per 100,00 population in 2022/23 (2352) compared to 2021/22 England (1218) and West Midlands (1331).  Coventry has a higher rate of enquiries started in 2022/23 (395) compared to 2021/22 England (364) and significantly higher than West Midlands (192).  The high number of concerns started compared to England and West Midlands has meant that Coventry’s conversion rate (17%) is lower than England (30%) but slightly higher than the West Midlands conversion rate (15%). 2022/23 comparator data is due to be published in November 2023 on the NHS Digital Adult Social Care Analytical Hub.

Deprivation of Liberty Safeguards (DoLS)

The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. The safeguards aim to make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

• There has been an 8% (213) increase in the number of applications from 2,544 in 21/22 to 2757 in 22/23.
• 458 (17%) are in due process compared to 469 (18%) in 21/22.
• In 2022/23 2299 applications were completed, which is a 11% increase on 2,075 in 21/22.
• There was a decrease of applications granted after 6 months of being received from 127 (14%) in 21/22, to 106 (10%) in 22/23.

How do we compare?

Comparator information will be published at the end of 2023 however we know last year, we saw a higher proportion of applications compared to other regions that Coventry share similarities with.  And similarly, we completed a higher proportion of assessments than our comparators. Nationally local authorities completed on average 564 DoLS applications per 100,000 of the population in 2021/2022 and in Coventry this figure was 861 applications per 100,000 in 2022/2023.

It has been announced by Central Government that Liberty Protection Safeguards, the replacement for DOLs will be delayed beyond the life of this Parliament.

Demographics

Coventry's population is growing, changing and increasingly diverse.

• Coventry is home to 345,300 residents (census 2021).
• 14.6% of the population is 65+.
• 2% of the population is aged 85 and over.
• Recent census information suggests that population growth has been lower than projected but Coventry has a slightly faster rate of population growth than the West Midlands average of 6.2% and the England average of 6.6%.
• Life expectancy in Coventry remains consistently below England, but healthy life expectancy is similar to England.
• Health outcomes are worse in the most deprived areas where people not only live shorter lives, but spend a bigger portion of their years in poor health, and are more likely to die of preventable causes.

National data suggests that between 2015-2017 and 2017-2019, life expectancy between the richer and poorer increased further. In particular, there was a decrease in life expectancy for females in poorer areas - resulting in a widening of inequality in the life expectancy gap among females (7.4 years). Although, the gap for males (9.4 years) remains larger.

Our workforce

• 920 internal staff
• 80.4% Female / 19.6% Male
• Average age of the workforce was 48.4 years
• 48.5% workforce aged over 50
• 72.5% of the workforce is white
• 22.2% of workforce is Minority Ethnic
• Vacancy rate is 11.5%
• Leaver rate is 15.3% (141 people)
• New starter rate 14.7% (135 people)
• The wider Adult Social Care workforce in Coventry amounts to 9,700 jobs which includes staff working in 152 CQC-registered establishments.