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Scottish Community Care Statistics 2002

Private Nursing Homes

Information on private nursing homes registered under the terms of the Private Nursing Homes Registration (Scotland) Act 1938 (as amended), or the Mental Health Act 1960/1984, has been collected by the Information and Statistics Division of NHSScotland. In addition to the data shown here, further information is published on their web site at http://www.isdscotland.org under the heading: Information and Statistics/Health and Care/Care Homes.

Since the previous Community Care Statistics publication, figures from year ending March 1997 onwards have been revised: quality assurance work has been undertaken and, additionally, for each home which did not supply data, figures have been imputed from data for those years which were available, so that the data should now be considered complete for all homes. However, since some of the figures have been imputed, totals should be considered to be estimated rather than actual figures. This may result in discontinuities between figures for earlier years (prior to year ending March 1997) and those for later years. For more detail on the numbers of homes for which data have been imputed, and on how the imputation was performed, see the footnotes to each table and the Annex to this publication.

Private nursing homes are not designated for specific client groups in the same way as are residential care homes. Client group and age is recorded for residents within homes. The number of residents can be analysed by client group, however the number of homes or beds cannot.

Tables 1.21-1.24 include all private nursing homes and all client and age groups - not just homes for older people or older residents. These tables are included in this chapter as the majority of residents in private nursing homes are older people. However, it should be noted that other client and age groups are included in the figures as well: around 8 per cent of residents in private nursing homes are under 65 years of age, and some residents in the older age group have specific needs not necessarily related to their age. Table 1.25, does however only refer to older people (that is people aged 65 and over).

Tables in chapters 2 to 5 give information on private nursing home residents in specific client groups.

Table 1.21: Private Nursing Homes ¹ numbers of homes, beds, and residents, and occupancy as at 31 March, 1990-2002

¹ Private Nursing Homes subject to the Nursing Homes Registration (Scotland) Act 1938 (as amended), or the Mental Health Act
1960/1984. The data include hospices registered under the Act, but data for private hospitals have been excluded. ^r Data are based on information supplied by nursing homes at the end of each financial year. However, since the previous publication,
figures have been revised from year ending 31 March 1997 onwards: quality assurance work has been undertaken, and addtionally, for each home which did not supply data, figures have been imputed, using data for those years which were available. The number of homes which did not supply data and for which figures have been imputed are as follows: 1997: 29 homes; 1998: 31 homes; 1999: 49 homes; 2000: 52 homes; 2001: 75 homes; 2002: 65 homes. In addition a small number of records have been modified or deleted. (Data for 2002 have not previously been published here, but have been published elsewhere.) Note that information has not been available to impute missing data prior to year ending March 1997, nor is it known how many homes failed to submit data at that time. This is expected to result in discontinuities in the figures.
Source: ISD Scotland - ISD(S)34 Return

Table 1.21 shows the trend from March 1990 to March 2002 in numbers of private nursing homes, beds, residents, and percentage occupancy. Note that numbers prior to March 1997 are not comparable to those for later years because of the data cleaning and imputation of missing data, which have been carried out from year ending 1997.

It can be seen that numbers show a slow increase from 1997 to 2001 and a slight decrease in March 2002. Numbers of available beds show a similar pattern, whilst the numbers of residents have continued to rise, so that since year ending March 1997 occupancy rates have also risen. By March 2002 there were estimated to be 558 homes, 25,225 beds, and 22,784 residents, that is, an average of 45 beds and 41 residents per home, with an occupancy rate of over 90%.

Table 1.22: Private Nursing Homes ^{1 2}, beds, residents and percentage occupancy, together with rates per 1,000 population aged 65 and over, by local authority ³, as at 31 March 2002

¹ Private Nursing Homes subject to the Nursing Homes Registration (Scotland) Act 1938 (as amended), or the Mental Health Act 1960/1984. The data include hospices registered under the Act, but data for private hospitals have been excluded.
² Data are based on information supplied by nursing homes at the end of each financial year. For the 65 homes which did not supply data, figures have been imputed using data from previous years.
³ The local authority is the one to which the home belongs, and is not necessarily the local authority from which the residents originally came.
⁴ 2001 mid-year population estimates: General Register Office for Scotland.
Source: ISD Scotland - ISD(S)34 Return

Table 1.22 shows for private nursing homes, by local authority, the total numbers of beds and residents, with rates per 1,000 members of the population aged 65 and over, together with the percentage occupancy as at March 2002. Note that this refers to the local authority to which the home belongs, and is not necessarily the one from which the residents originally came. Rates per thousand have been calculated for the age group 65 and over, as the majority of nursing homes residents are in this age group. However, it should be noted that, overall, around 8 per cent of nursing home residents are aged under 65, and also that this percentage may vary between local authorities.

Numbers of beds per 1,000 population averaged 31 for Scotland as a whole, and ranged from 12 (Eilean Siar) to over 41 (Aberdeenshire, North Ayrshire, South Lanarkshire). Percentage occupancy ranged from just under 84% in North Ayrshire and Highland, to over 96% in Moray.

Table 1.23: Private Nursing Homes, Number of Admissions, Discharges and Deaths ¹: year ending 31 March, 1995-2002

¹ Private Nursing Homes subject to the Nursing Homes Registration (Scotland) Act 1938 (as amended), or the Mental Health Act 1960/1984. The data include hospices registered under the Act, but data for private hospitals have been excluded.
^r Data are based on information supplied by nursing homes at the end of each financial year. However, since the previous publication, there have been revisions to figures for admissions (from year ending 31 March 1997 onwards), and for discharges and deaths (from year ending March 1999 onwards): quality assurance work has been undertaken, and addtionally, for each home which did not supply data, figures have been imputed, using data for those years which were available. The number of homes which did not supply data and for which figures have been imputed are as follows: 1997: 29 homes; 1998: 31 homes; 1999: 49 homes; 2000: 52 homes; 2001: 75 homes; 2002: 65 homes. In addition a small number of records have been modified or deleted. (Data for 2002 have not previously been published here, but have been published elsewhere.)
Note that information has not been available to impute missing data prior to year ending March 1997, and other data prior to year ending March 1999. Prior to these dates it is not known how many homes failed to submit data. This may result in discontinuities in the figures. Note that for years ending March 1997 and March 1998, numbers of long term admissions, and of short term admissions (for which revised information is not available), do not sum to the revised total admission figures.
Source: ISD Scotland - ISD(S)34 Return

Table 1.23 shows, for private nursing homes in Scotland, the trend between years ending March 1995 and March 2002 in numbers of long term and short term admissions, together with discharges and deaths. It should be noted that there are likely to be some discontinuities in the figures from 1997 onwards, because of the data quality and imputation work that has been carried out on the data from that date onwards; see the footnote to the table for more detail.

Numbers of admissions, discharges and deaths all increased between 1997 and 1999, and have remained fairly stable since then. In the year ending March 2002, there were in total an estimated 23,928 admissions, 13,776 discharges and 9,851 deaths.

There has been a decline in the proportion of people admitted who were long term residents, from two thirds of all admissions in the year ending March 1995, to 42 per cent by year ending March 2002. By this date short term admissions comprised 58% of the total, and of these, just under two thirds, that is one third of all residents, were admitted for respite care.

Table 1.24: Private Nursing Homes; residents by client group and age ^{1, 2} as at 31 March 2002

Age Group

¹ Private Nursing Homes subject to the Nursing Homes Registration (Scotland) Act 1938 (as amended), or the Mental Health Act 1960/1984. The data include hospices registered under the Act, but data for private hospitals have been excluded.
² Data are based on information supplied by nursing homes at the end of each financial year. For the 65 homes which did not supply data, figures have been imputed using data from previous years.
Source: ISD Scotland - ISD(S)34 Return

Table 1.24 shows residents in private nursing homes as at 31 March 2002 by age and client group. Note that the client group shown is the main client group to which the client has been assigned by the home. Residents with multiple health care needs are put into the category which best fits.

Ninety-two per cent of residents were aged 65 and over and 45 per cent were aged 85 and over.

Overall, 40 per cent of residents suffered from dementia, 31 per cent from physical disabilities, 4 per cent had mental health problems, 4 per cent had learning disabilities, 3 per cent had alcohol or drug related problems, while 18 per cent had other health care needs. There were variations with age: learning disabilities formed the highest proportion in the youngest age group (62 per cent of residents under 18), whilst for residents in the age group 18-64, 17 per cent suffered from alcohol or drug related problems, 12 per cent had mental health problems and 22 per cent had learning disabilities; in the 65 and over age group, dementia was the most common client group; in all except the youngest age group, about a third of residents suffered from physical disabilities.

Table 1.25 shows, as at 31 March 2002, by local authority, nursing home residents aged 65 and over, with rates per 1,000 members of the population aged 65 and over, together with numbers of residents in this age group by client group. Note that this refers to the local authority to which the home belongs, and is not necessarily the one from which the residents originally came.

In March 2002 there were estimated to be 20,902 residents aged 65 and over in private nursing homes in Scotland, with an average of 26 residents per 1,000 members of the population aged 65 and over. This rate varied from 12 per cent in Eilean Siar to 36 per cent in Aberdeenshire

Table 1.25: Private Nursing Homes ¹, residents aged 65 and over by local authority area ² and client group ³, as at 31 March 2002

¹ Private Nursing Homes subject to the Nursing Homes Registration (Scotland) Act 1938 (as amended), or the Mental Health Act 1960/1984. The data include hospices registered under the Act, but data for private hospitals have been excluded.
² The local authority is the one to which the home belongs, and is not necessarily the local authority from which the residents originally came.
³ Data are based on information supplied by nursing homes at the end of each financial year. For the 65 homes which did not supply data, figures have been imputed using data from previous years.
⁴ 2001 mid-year population estimates: General Register for Scotland.
Source: ISD Scotland - ISD(S)34 Return

Hospitals

Information on hospitals is collected by ISD Scotland, and further information can be found on their website at http://www.isdscotland.org under the headings: Information and Statistics/Health and Care/Acute activity, and Information and Statistics/Health and Care/Older People.

Prior to 31 March 1996, figures for 'Geriatric Long Stay' and 'Geriatric Assessment' were derived using separate specialty codes. Thereafter followed a transition period, as Trusts began to use the new codes; from the year ending 31 March 1998 all data were being analysed and reported for one specialty, Geriatric Medicine, and activity is divided into that which occurs in long stay units for care of the elderly (equivalent to 'Geriatric Long Stay'), and activity which occurs in other types of unit (equivalent to 'Geriatric Assessment'). There may be discontinuities when comparing figures before and after this change and so comparisons over time should be made with caution.

The data are derived from three ISD national data sets: ISD(S)1, which collects aggregated data on hospital bed numbers and hospital activity for a range of services and of patient types; SMR01, which collects patient-based data on inpatient and day case episodes in general and acute wards; and SMR50, which collects patient-based data on inpatient admissions to and discharges from hospitals and units providing Geriatric Long Stay Care.

Table 1.26: Geriatric Medicine specialty ^{1 2}, selected hospital inpatient activity statistics ³: year ending 31 March 1980-2002

¹ Data for apecialty 'GP other than Obstetrics' are not included.
² Figures for 1998 onwards are shown on the basis of new specialty groupings (see notes 4 and 5). There may be discontinuities, and comparisons between pre-1998 and post-1998 activity should be made with caution.
³ Includes joint-user and contractual hospitals for which data are available. Note that there will be some overlap with information on activity shown for those private nursing homes with which NHS boards have sub-contractual arrangements.
⁴ Geriatric Medicine (units other than long stay care of the elderly): prior to 1998 based on Geriatric Assessment specialty; from 1998 onwards based on Geriatric Medicine specialty excluding long stay units for care of the elderly.
⁵ Geriatric Medicine (in long stay care of the elderly units only): prior to 1998 based on Geriatric Long Term specialty; from 1998 onwards based on Geriatric Medicine specialty in long stay units for care of the elderly.
⁶ Mean stay per episode is calculated for each year as: total number of occupied bed days / total number of inpatient episodes.
⁷ Throughput, the average number of inpatient episodes per bed per year, is calculated for each year as: total number of inpatient episodes / average number of available staffed beds.
Source: ISD Scotland - ISD(S)1 Return

Table 1.26 presents, for the specialty Geriatric Medicine, the trend between 1980 and 2002 in: average numbers of available and occupied hospital beds, mean stay in hospital, and throughput (average number of episodes per bed per year).

Since 1990 there has been a considerable decline in available beds in long-stay care of the elderly units, and in the overall number of beds available in Geriatric Medicine. In contrast, the number of available beds in units other than long stay (formerly 'Geriatric Assessment') increased until 1998 and then decreased. Average numbers of occupied beds follow similar trends.

Table 1.27: Geriatric Medicine specialty ¹; selected hospital inpatient activity statistics ² by NHS board area of treatment: year ended 31 March 2002

¹ Data for specialty 'GP other than Obstetrics' are not included.
² Includes joint-user and contractual hospitals for which data are available. Note that there will be some overlap with information on activity shown for those private nursing homes with which NHS boards have sub-contractual arrangements.
Source: ISD Scotland - ISD(S) 1 Return

Table 1.27 shows the number of available and occupied beds by NHS board area of treatment for the year ending March 2002. The occupancy rate in Geriatric Medicine was 88 per cent for Scotland, and ranged from 65 per cent in Highland to 95 per cent in Forth Valley and in Shetland.

Table 1.28: Hospital units for long stay care of the elderly, admissions (by place admitted from) and discharges (by destination): years ending 31 March 1998-2001

¹ Transfers comprise patients transferred from another hospital, or within the same hospital. A large proportion of transfers were from, or to, acute specialities or within Geriatric Medicine specialty.
^r Revised
Source: ISD Scotland, SMR50

Table 1.28 shows, for hospital units for long stay care of the elderly, the trend between 1998 and 2001 in numbers of admissions and discharges by place from which admitted and by destination on discharge. The data file has undergone some quality assurance work this year, and this has resulted in changes to the figures compared with the equivalent figures published last year. Note that figures are not shown for the year 2002 as the data are not yet complete.

Only 27% of patients admitted came from outwith NHS hospitals. Most patient admissions (73% in 2001) were categorised as transfers (from another hospital, or within the same hospital). The majority of transfers were from acute specialties or within Geriatric Medicine specialty. Most discharges were to private residences (32%) or were deaths (33%). Only 15% of discharges were classified as transfers.

Table 1.29 shows, for specialty Geriatric Medicine, the age breakdown of patients discharged over the period 1980-2002. The age breakdown of patients discharged from long stay units in 2002 is not shown as the data are not yet complete. In 2001, 78 per cent of patients were aged 75 or over. The proportion has remained fairly stable over time with little difference in age proportions between patients in long stay units and patients in other units.

Table 1.29: Geriatric Medicine specialty ^{1 2}, numbers of discharges (inpatients and day cases) ³ and percentage by age group ⁴, years ended 31 March 1980-2002

¹ Data for specialty 'GP other than Obstetrics' are not included.
² Figures for 1998 onwards are shown on the basis of new specialty groupings (see notes 5 and 6). There may be discontinuities, and comparisons between pre-1998 and post-1998 activity should be made with caution.
³ 'Discharges' includes patients who are transferred to other hospital care.
⁴ Age group on discharge.
⁵ Geriatric Medicine (units other than long stay): prior to 1998 based on Geriatric Assessment specialty; from 1998 onwards based on Geriatric Medicine specialty excluding long stay units for care of the elderly.
⁶ Geriatric Medicine (in long stay units only): prior to 1998 based on Geriatric Long Term specialty; from 1998 onwards based on Geriatric Medicine specialty in long stay units for care of the elderly.
⁷ Data for long stay care of the elderly units for the year ending 31 March 2002 are incomplete and are not shown.
^r Revised
Source: ISD Scotland - SMR1, SMR01 & SMR50 Returns.

Table 1.30: Geriatric Medicine specialty1; day patient activity in hospitals2, by NHS board area of treatment: year ending 31 March 2002

¹ Data for specialty 'GP other than Obstetrics' are not included.
² Includes NHS day hospitals and day patient units (and excludes for instance residential care homes or day centres).
^e Estimated
Source: ISD Scotland, form ISD(S)1

Table 1.30 presents a summary of day patient activity in Geriatric Medicine specialty for the year ending 31 March 2002. During this year, there were almost 160,000 hospital day patient attendances, and at the end of the year there were over 4,400 patients 'on the books'.

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