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Scottish Community Care Statistics 2002

CHAPTER 2 - ADULTS WITH LEARNING DISABILITIES

The Balance of Care

Chart 2.1 Balance of Care for People with Learning Disabilities, 1980-2002

Chart 2.1 illustrates the balance of care provided for people with learning disabilities, over time. The most dramatic change is the decrease in occupied hospital beds which, by 2001, had fallen to well under one quarter of the level in 1980.

Over the same time period, there has been a noticeable increase in the number of residents in residential care homes, although this appears to be levelling off in recent years. The number of places in day care centres has remained fairly level over the last seven years. Data on home care clients and residents in nursing homes with learning disabilities have not been collected for long enough to allow comment on any trends.

Domiciliary Care

Tables 2.1 and 2.2 contain information on home care services provided to clients with learning disabilities. Information on home care for other individual client groups is included in chapters 1, 3, 4 and 5. More detailed analysis of home care for all client groups is contained in chapter 1. Please refer to the notes in annex A for definitions on which the data are collected.

Table 2.1: Age Breakdown of Clients with Learning Disabilities Receiving Home Care, 1998-2002

Source: SEHD Community Care Statistics, H1 Return

Table 2.1 presents the number of clients with learning disabilities receiving home care services in 1998 to 2002. Prior to 1998 a full age/client group breakdown was not provided. Between 1998 and 2001 the number of clients with learning disabilities fell slightly from 1,744 to 1,467. However, numbers rose in 2002 to reach 2,135. The highest proportion of clients are in the 18-64 age group which accounted for around two-thirds of all clients in 2002.

Table 2.2: Age Breakdown of Clients with Learning Disabilities Receiving Home Care, 2002

Source: SEHD Community Care Statistics, H1 Return

Table 2.2 presents an age breakdown of clients with learning disabilities receiving home care services within each local authority in 2002.

Highland had the highest level of clients with learning disabilities. This amounted to 21.3 clients per 10,000 of the population aged between 16 and 64. In contrast West Lothian had a very small number of clients with 2.4 clients per 10,000 of the population aged between 16 and 64.

The total number of clients with learning disabilities who received home care in Scotland in 2002 was 2,135; 70 per cent fell within the 16 to 64 age category and 25 per cent in the 65 and over age group. The total number receiving care, per 10,000 of the population aged between 16 and 64, was 6.5.

Day Care

Tables 2.3 and 2.4 provide information on day care services primarily intended for people with learning disabilities. Day care figures for other client groups are included in chapters 1, 3, 4 and 5. Please refer to the notes in annex A for definitions on which the data are collected.

In 1998 a new methodology was introduced for dealing with non-response. Care should be taken when comparing time series data before and after 1998 as the figures may not be directly comparable. Please refer to annex A for more details.

In 2001, a new survey of day care services took place. The figures for "number attending" in 2001 are not comparable with previous years. In 2001 and 2002, information was collected on numbers attending day centres during the census week. In previous years, the numbers attending related to all persons who regularly attended regardless of whether they were there during census week.

Table 2.3: Number of Day Centres ¹ for People with Learning Disabilities, Places and People Attending, 1985-2002

¹ Includes centres with 4 places or less (which are usually attached to residential homes).
Source: SEHD Community Care Statistics - D1-B Return

It can be seen from table 2.3 that the number of day centres for people with learning disabilities in Scotland has risen to 169, the highest during this period. The number of places progressively increased until 1997. Since then, however, there has been a slight downturn.

Table 2.4: Day Centres ¹ for People with Learning Disabilities as at 31 March 2002

¹ Includes centres with 4 or less places (which are usually attached to residential homes).
Source: SEHD Community Care Statistics - D1-B Return

Table 2.4 presents the number of centres, available places and attendees at day care centres as at 31 March 2002 in each local authority.

Edinburgh had 122 people attending per 10,000 of the population aged between 16 and 64. This was the highest attendee rate for Scotland. The overall Scotland attendance per 10,000 of the population aged between 16 and 64 was 23. Edinburgh also had the highest number of available places per 10,000 of the 16-64 population (138) whilst the Scottish equivalent was 27.

Residential Care Homes

Tables 2.5 to 2.12 contain information on residential care homes primarily intended for people with learning disabilities. Homes for other client groups are included in chapters 1, 3, 4 and 5. Please refer to the notes in annex A for definitions on which the data are collected.

In 1998 a new methodology was introduced for dealing with non-response. Care should be taken when comparing time series data before and after 1998 as the figures may not be directly comparable. Please refer to annex A for more details.

Table 2.5: Residential Care Homes for People with Learning Disabilities, 1980-2002

¹ In 1980 the figures for the private and voluntary sectors are grouped together.
Source: SEHD Community Care Statistics - R1 Return

The number of beds in homes for people with learning disabilities has increased considerably since 1980 but has levelled off since 1998.

Between 1995 and 2002 around two-thirds of residential care beds were within the voluntary sector. Over the same period the proportion of beds in the local authority sector reduced slightly from 22 to 18 per cent.

In 2002 there were 609 homes with 4,357 places available. These provided accommodation for a total of 4,062 residents.

Table 2.6 presents the number of residential care homes for adults with learning disabilities, their associated places and residents by sector for each local authority area in Scotland.

Midlothian had the highest rate of residents, 32.9 per 10,000 of the population aged 16 to 64. Shetland Islands had the lowest rate (2.1). In comparison, the overall rate for Scotland was 12.4 residents per 10,000 of the population aged between 16 and 64.

Table 2.6: Residential Care Homes for People with Learning Disabilities, 2002

Source: SEHD Community Care Statistics - R1 Return

Table 2.7: Admissions and Discharges in Residential Care Homes for People with Learning Disabilities, 1985-2002

¹ Totals may not equal the sum of their component parts due to the effects of rounding.
Source: SEHD Community Care Statistics - R1 Return

Table 2.7 provides a time series breakdown of admissions and discharges in homes for people with learning disabilities by sector. See Annex A for a definition of short stay.

The vast majority (98%) of admissions and discharges in residential care homes are for short stays.

Short stay admissions and discharges fell sharply in 1997 and 1998 but increased above the previous high for 1999 onwards. Further investigation has indicated that this may be due to under-reporting of short stay activity by some homes rather than an actual drop in short stay provision. Local authority short stay admissions and discharges each rose by five per cent between 2001 and 2002, whereas private short stay admissions and discharges fell by one third. Long stay admissions and discharges have stayed fairly stable since 1990.

In 1985, local authority admissions and discharges accounted for approximately 90 per cent of the total. However this has diminished over the years and now sits at around 41 per cent. Over the same period, the percentage of admissions/discharges in voluntary sector homes has risen from around 10 per cent to 55 per cent, whilst the private sector has remained fairly stable.

Please refer to annex A for a definition of short stay.

Table 2.8: Age of Residents ^1,2 in Homes for People with Learning Disabilities, 1985-2002

¹ Total residents relates to long stay residents only.
² Percentages are based on the number of residents whose age is known.
Source: SEHD Community Care Statistics - R1 Return

Table 2.8 presents a breakdown of the ages of all residents in homes for people with learning disabilities. Since 1985 the proportion of residents aged between 16 and 30 has been steadily decreasing and was down to 13 per cent in 2002. At the same time the proportion of residents aged 46 and over has risen to reach 53 per cent in 2002.

Table 2.9: Incomplete Length of Stay ^1,2 in Homes for People with Learning Disabilities as at 31 March, 1985-2002

¹ Total residents relates to long stay residents only.
² Percentages are based on the number of residents whose length of stay is known.
Source: SEHD Community Care Statistics - R1 Return

Table 2.9 illustrates the distribution of length of stay of residents remaining in residential care homes at 31 March from 1985 to 2002.

The majority of long stay residents with learning disabilities stay in homes for 3 years or more. In 2002, 81 per cent of residents stayed for more than 3 years. In contrast only one per cent of residents remained for less than 3 months.

The proportion of residents who stay for over 5 years has increased steadily over time and is at 66 per cent in 2002.

Table 2.10: Destination on Discharge ^1,2 from Homes for People with Learning Disabilities, 1990-2002

¹ Total residents relates to long stay residents only.
² Percentages are based on the number of residents where destination on discharge is known.
Source: SEHD Community Care Statistics - R1 Return

Table 2.10 presents an overview of the destination of residents on discharge from residential care. There have been fluctuations over time in the proportion of residents being discharged to hospital, amounting to 8 per cent in 2002. Meanwhile the proportion of residents discharged to other homes has generally followed an upward trend, until 2000 where it fell to 34 per cent but has returned to 41 per cent in 2002. Since 1990 the number of residents being discharged to their own homes has fluctuated, percentages range from 22 to 32.

Table 2.11: Financial Support of Residents ^1,2 in Private and Voluntary Residential Care Homes for People with Learning Disabilities, 2002

¹ Total residents relates to long stay residents only.
² Percentages are based on the number of residents when financial support was known.
Source: SEHD Community Care Statistics - R1 Return

Table 2.11 details the funding arrangements for residents in private and voluntary homes. For definitions of categories of funding see annex A.

Table 2.12: Average Weekly Charge per Resident in Homes for People with Learning Disabilities, 31 March 2002

Source: SEHD Community Care Statistics - R1 Return

In 2002, very few residents (1 per cent) supported themselves by private means, whilst 51 per cent received support wholly or mainly by local authority. Forty-eight per cent of residents are supported wholly or mainly by DSS.

Table 2.12 presents the average weekly charge for residential care for people with learning disabilities for each sector in 2002. The figures have been weighted to reflect the capacity of the residential homes.

The average weekly charge in Scotland rose from 486 in 2001 to 564 in 2002. The average weekly cost of residential care in local authority homes was 564 in 2001, compared to 656 in 2002. The charge for residential care in private homes rose from 369 in 2001 to 449 in 2002.

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