Setting the scene - Adult Social Care in a changing landscape
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 the next few pages give you an indication of the position for Adult Social Care during 2021/22 in respect of;
- Budget - money matters
- Activity - facts and figures
- Demographic - The people who come to us for support
- Our Workforce - The people that provide support where required
The Council is a large organisation spending a net £252.8m on revenue activity during 2021/22. The gross Adult Social Care Spend in 2021/22 minus citizens and other contributions was £110.4m
as shown below. This includes £8.2m of additional resources provided to support the care market during the pandemic.
Adult Social Care spend (£110.4m)
This compares to a spend of £103.2m in 2021. The largest element of the increase relates to Spend on People (provision of services.)
- £85.m spent on people
- £17.m spent on community, assessment and overheads
- £6m spent on central recharges
- £0.3m spent on transport
- £0.7m spent on other
2021/22 spend on people (£85.8m)
The 'Spend on People' referred to in the chart has increased from £79.5m in 2020/21. 'Spend on People' is money spent directly on the following services:
- £25.9m spent on homecare
- £22.1m spent on residential
- £9.3m spent on direct payments
- £8.2m spent on COVID
- £7.8m spent on nursing
- £6.3m spent on housing with care
- £2.3m spent on supported living
- £2.4m spent on day opportunities
- £1.1m spent on equipment and adaptations
- £0.4m spent on individual service funds
How do we compare?
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 but you can view information for 2021/22.
Facts and figures
COVID-19 and the country’s response to the pandemic continued to impact on work of Adult Social Care during 2021/22, with national lockdowns and limited family contact impacted on the activity of Adult Social Care, those accessing our support and how we needed to work. We are now starting to understand the long-term impact of the pandemic and are seeing more needs associated with mental health and well-being.
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.
- 11,316 new requests for support (an increase of 14% on last year's figure of 9,902)
- 6.5% of requests resulted in a long-term service (an increase on last year's 5%
- 18% received low-level support (a reduction on last year's 34%)
- 28% received a short-term service to promote independence (a decrease on last year's 30%)
- 2,539 people had been in long-term support for over 12 months as of 31 March 2022
- 1,364 people received a planned or unplanned review throughout the year (compared to 1284 last year)
- 31 people transitioned from Children's Services to Adult Social Care compared to 23 last year.
Carers receiving an assessment
Adult Social Care has 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.
- 1,211 carers had their needs assessed, of which 335 received a separate assessment
- 1,364 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. To 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 31 a day compared to the national average of 35 in 20/21.
- continued lower rate of people receiving long-term support per 100,000 population compared with our comparators
- 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
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.
2021/22 safeguarding information
- 5,858 safeguarding concerns received, a 36% increase from the previous year (4,321)
- 899 safeguarding enquiries, an 82% increase from the previous year (493)
- 15% - the rate of concerns that led to an enquiry was up from 11% last year
- 869 completed safeguarding enquiries were undertaken in the year compared to 508 in the previous year
- 768 people (88%) were asked about their outcomes, an increase from 83% of people asked last year (423)
- 97% of people reported fully achieved/partially achieved outcomes compared to 94% 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 compared?
Coventry has a higher rate of concerns per 100,000 population in 2021/22 (1962) compared to 2020/21 for England (1121) and West Midlands (1038). Coventry has a comparable number of enquiries started in 2021/22 (301) with England (343) and West Midlands (217) rates per population. The high number of concerns started compared to England and West Midlands has meant that Coventry’s conversion rate (15%) is lower than England (34%) but comparable to the median West Midlands conversion rate (15%).
2021/22 comparator data is due to be published in November 2022 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 a 14% (307) increase in the number of applications, from 2,237 in 2020/21 to 2,544 in 2021/22
- 469 (18%) are in due process compared to 349 (16%) in 2020/21
- In 2021/22 there were 2,075 applications completed, which is a 10% increase from 1,889 in 2021/22
- There was an increase of applications granted after 6 months of being received from 27 (4%) in 2020/21 to 127 (14%) in 2020/21.
Our work during year continued to be impacted as a result of the pandemic due to reduced staffing capacity and assessments taking longer to complete. Liberty Protection Safeguards are due to replace DOLs for which the service is actively preparing for.
Demographic
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 are 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
- 81% female staff
- 19% male staff
- Average age of workforce is 48.2 years
- 48.4 of the workforce is aged over 50
- 73.1% of the workforce is white
- Vacancy rate is 11.5% compared to 6% nationally
- 20.6% of the workforce is Black, Asian, Minority Ethnic
- Leaver rate is 15.3% (141) people
- New starter rate is 14.7% (135) people
- The wider Adult Social Care workforce in Coventry amounts to 9,500 jobs which includes staff working in 181 CQC-registered establishments.