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Statistics Release
CARE HOMES, SCOTLAND SEPTEMBER 2003

A SCOTTISH EXECUTIVE NATIONAL STATISTICS PUBLICATION

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Introduction

The purpose of this Statistics Release is to present national figures for care homes for adults in Scotland. All figures relate to the 30 ^th September 2003 and are provisional and, as such, subject to change. The final figures will be published in the next care home census statistical release. The final figures for the 31 ^st March 2003 are included within this publication.

The information is derived from the Scottish Care Home Census which combines two former surveys - 'The Residential Care Homes Census' and the 'Private Nursing Home Census'. Returns are made to the Scottish Executive by individual care homes directly or via Scottish local authorities. Refer to the background note for further details relating to the census of care home establishments.

All figures in this release omit care homes that deregistered to become Housing Support services. Information on the number of former care homes deregistering for this reason can be found in annex E .

Main Points

• At 30 ^th September 2003 there were 1,576 registered care homes providing 43,125 places to 38,929 residents ( see Annex F).
• The number of registered places in care homes for older people has remained steady at 36,777 (a decrease of 118 places since March 2003).
• The occupancy rate in registered care homes for older people (the number of occupied or unavailable places) remained unchanged at 93 per cent. See Chart 1.

Information collected on registered care homes shows that:-

• 273 are in the local authority/NHS sectors compared to 734 in the private sector and 569 in the voluntary sector.
• All care homes provide a registered 43,125 places throughout Scotland of which 85 per cent (36,777) are for older people and those with dementia.

Section One: Care Homes for Older People

Table 1 - Care Homes by Sector, Places and Residents

Table 2 - Care Homes, Places and Residents, 2002/2003

In September 2003, there were 36,777 places in 979 care homes for older people (including 22 homes specifically for those with dementia). Chart 1 shows the occupancy rate within care homes for the whole of Scotland and by local authority. Overall 33,379 places were occupied on census night (91 per cent). A further 784 places were unavailable (2 per cent). The overall occupancy rate was therefore 93 per cent. This ranged from 88 per cent in Dumfries and Galloway to 98 per cent in the Shetland Islands.

During the six months up until census night in September 2003, 8 local authorities had an increase in occupancy rate of 2 per cent. The largest decrease occurred in East Ayrshire (4 per cent). Annex A provides a local authority breakdown of occupancy rates and the changes between March and September. A definition of unavailable places is also included.

2,614 places in care homes for older people were vacant on census night. This represented 7 per cent of all registered places in Scotland.

For Scotland overall there were 45 registered places in care homes for older people for every 1,000 of the population aged 65 and over. This remains unchanged compared to March 2003. The number of registered places per 1,000 of the local population ranged from 29 in the Orkney Islands to 56 in Aberdeenshire. Annex B shows a local authority breakdown of registered places relative to population and the change in registered places.

65 per cent of care homes primarily for older people are run privately. 634 establishments are in this sector and collectively provided 73 per cent of all registered places. An average privately run care home contained 42 places compared to 30 and 28 respectively for its local authority and voluntary run counterparts.

Private care homes have a much higher occupancy rate compared to local authority and voluntary homes. 94 per cent of all places (up from 93 per cent in March ) within privately run homes are either occupied or unavailable. The overall occupancy rate for homes in the local authority/voluntary sector is 91 per cent.

The number of occupied places is slightly greater than the number of residents as some places on census night are empty but allocated to a specific individual (for example a new entrant or a resident temporarily in hospital).

Care Home Closures

Table 2 shows the number of homes that have opened and closed since March 2002. During the 18 months up until September 2003 a total of 40 care homes have closed and 7 have opened.

Of the 40 care homes that closed 28 were within the private sector, 9 were voluntary and 3 were run by a local authority. Those 40 homes used to collectively provide 917 registered places. On average each home had 23 places. Comparing this to an average of 38 places in each open home for the September census suggests that closures are occurring disproportionately within smaller care establishments. Annex C provides a local authority breakdown of care home closures.

New Homes

7 homes primarily for older people have opened during the 18 months up until September 2003. They collectively provide 165 newly registered places. 3 of the new homes are run by local authorities whilst a further 3 are in the voluntary sector and 1 is in the private sector. Annex C provides a local authority breakdown of new care homes opening.

Care Home Facilities

Table 3 - Facilities in Care Home Places

Table 3 shows the number of occupied/vacant places that are in single rooms, double rooms and rooms with 3 or more places. It also shows whether or not the places are in rooms with ensuite facilities. Overall 84 per cent of occupied/vacant care home places for older people are in rooms with one place registered. This proportion has increased from 83 per cent in March 2003.

The proportion of places with ensuite facilities has also increased from 61 per cent in March 2003 to 62 per cent in September. In total over half (55 per cent) of all registered places are in single rooms with ensuite facilities (19,776, an increase of 329 since March 2003).

The percentage of available places with ensuite facilities varies greatly between individual local authorities. The Orkney Islands have the lowest figure with 35 per cent and Argyll & Bute have 40 per cent of rooms with ensuite facilities. At the other end of the scale, rooms with ensuite facilities account for 90 per cent of registered places in Clackmannanshire and every available place in the Shetland Islands.

Annex D provides a local authority breakdown of available places with/without ensuite facilities.

Admissions/Discharges in Care Homes

Table 4: Number of Admissions, Discharges and Deaths in Homes for Older People
March - September 2003

Table 4 shows the number of admissions, discharges and deaths within care homes for older people in the six months between the two census dates. 33,369 residents were in care homes for older people on the September census night. 98 per cent of them (32,578) were long stay residents and 2 per cent (791) were in for respite care or other short stay.

There were 16,854 admissions into care homes of which just under 40 per cent (6,668) were long stay and over 60 per cent (10,186) were short stay.

Local Authority run care homes account for just over one third (34 per cent) of all admissions with 5,765 during the census period. 4,839 (84 per cent) of those admissions were on a short stay basis. Local authority run homes collectively provide 16 per cent of all registered places. Despite this, they account for 48 per cent (4,839) of all short stay admissions to care homes for older people. Conversely only 14 per cent of all long stay admissions were to local authority run homes (926).

9,396 admissions were to care homes in the private sector (56 per cent). In contrast to care homes in the local authority sector, the majority of private admissions were for long stay residents. 55 per cent (5,129) of admissions to private care homes were on a long stay basis.

10 per cent of all admissions were to care homes in the voluntary sector. Of the 1,693 admissions to voluntary care homes, 36 per cent (613) were long stay and 64 per cent (1,080) were short stay.

12,138 adults were discharged from care homes in the six months leading up to the end of September. 2,160 (18 per cent) of those discharges were long stay residents. Those residents may have discharged for a number of reasons. They may for example have transferred to another care home, entered hospital or moved back to their own home.

There were 4,775 deaths in care homes for older people. The vast majority of those who died during the census period (98 per cent) were former long stay residents and 82 per cent (3,923) were residents in private care homes.

The number of residents overall in care homes for older people during the census period remained practically unchanged. It fell by only 59 from 33,428 in March to 33,369 in September.

Section Two: Care Homes for Physically Disabled People

Table 5 - Care Homes by Sector, Places and Residents

Table 6 - Care Homes, Places and Residents, 2002/2003

In September 2003 there were 869 places in 52 care homes for adults with physical disabilities. Those places were spread across 18 local authorities. 47 of these 52 registered care homes for adults with physical disabilities were in the voluntary sector.

The number of registered places has remained level between March and September 2003. This followed a drop of 7 per cent (64 places) during the previous year. Table 6 omits any homes that deregistered to become housing support services (more information on those can be found in annex E).

Of the 869 places registered, 780 (90 per cent) were occupied on census night. 67 places were vacant and 22 were unavailable.

The overall occupancy rate in care homes for adults with physical disabilities was 92 per cent. This has increased by 3 per cent since March 2003 when occupied and unavailable places accounted for 89 per cent of all registered places.

742 of all available care home places for adults with physical disabilities (88 per cent) were in single rooms (rooms with only one place registered). 69 per cent of all available places (581) have ensuite facilities. Overall 63 per cent of places for this client group are in single rooms with ensuite facilities.

Section Three: Care Homes for Adults with Mental Health Problems

Table 7 - Care Homes by Sector, Places and Residents

Table 8 - Care Homes, Places and Residents, 2002/2003

In September 2003 there were 113 homes registered with the Care Commission providing 1,176 places for adults with mental health problems. 91 of those homes were run by the voluntary sector. The overall occupancy rate in care homes for mental health problems was 92 per cent. This has increased by 1 per cent over the previous 6 months.

The 113 care homes registered are spread geographically across 23 different local authorities in Scotland. However, a large number are concentrated within specific areas (23 in Edinburgh City and 26 in Glasgow City). As before Table 9 omits any homes that have deregistered to become housing support services (more information on those can be found in annex E).

The number of residents in care homes for adults with mental health problems fell by over 5 per cent between March 2002 and March 2003. The overall drop in the number of residents of 57 was partially reversed in the following six months as the total number of residents increased slightly from 1,051 in March 2003 to 1,062 by the end of September 2003.

Section Four: Care Homes for Adults with Learning Disabilities

Table 9 - Care Homes by Sector, Places and Residents

Table 10 - Care Homes, Places and Residents, 2002/2003

In September 2003 there were 354 registered care homes for adults with learning disabilities. They provided 3,032 places to 2,650 residents. The vast majority of care homes were in the voluntary sector (224 homes).

The overall occupancy rate (the number of occupied or unavailable places) for care homes aimed at this client group was 91 per cent. This however varied largely depending on what sector the care home was within. The 60 homes run by local authorities for adults with learning disabilities collectively had an occupancy rate of 79 per cent while the figure was much higher (94 per cent) for private sector homes. The occupancy rate in all care homes for adults with learning disabilities remained unchanged between March and September 2003. The gap between the occupancy rates in local authority and private sector homes did however widen. It grew from 12 per cent in March 2003 (81% local authority homes, 93% private homes) to 15 per cent by September 2003 (79% in the local authority sector and 94% in the private sector).

The number of care home places available for adults with learning disabilities continues to fall. Having decreased by 165 places the previous year, the census period of March to September 2003 showed another drop in places of 33 to 3,032. During the 18 months between March 2002 and September 2003, 20 care homes for adults with learning disabilities have closed and 3 have opened (Annex E gives information on the number of homes that deregistered to housing support).

Section Five: Care Homes for Adults in Other Client Group

Table 11 - Care Homes by Sector, Places and Residents

Table 12 - Care homes, Places and Residents, 2002/2003

Care homes registered for other types of user can includes adults with acquired brain injuries, mothers and children, alcohol related problems, drugs related problems, AIDS/HIV and other vulnerable groups.

In September 2003 there were 78 registered care homes across 19 local authorities providing places for adults in the above categories. In total those 78 homes contained 1,271 places and catered for 1,068 residents. The overall occupancy rate for care homes for other client groups was 86 per cent. On average each care home for other client groups contained 16 places. There is however a large difference between sectors with private care homes containing on average 46 places, over 3 times as many as local authority or voluntary run homes.

The number of registered care homes for other client groups has fallen by 7 overall between March 2002 and September 2003. There has also been a fall of 116 places (8 per cent) during the same period. Table 12 omits information on care homes for other clients groups that have deregistered to become housing support services ( See Annex E).

Background information on the Census of Care Home Establishments

The Scottish Care Home census is intended to cover all adult care home establishments that are registered with the Care Commission. The Care Commission is responsible for regulating a wide range of social services, and was established under the Regulation of Care (Scotland) Act 2001.

This is a relatively new census (first issued in March 2003) that replaces two previous surveys. It combines the former 'Residential Care Home Census - R1' (run by the Scottish Executive) and the 'Private Nursing Homes Census' (run by ISD Scotland).

The figures from this census cannot be directly compared with the figures from the Residential Care Homes and Private Nursing Homes census as many homes were dual registered. Therefore simply adding together the final statistics published in those two surveys would result in double counting.

The 2002 figures presented in this statistics release remove this element of double counting by combining the information from the residential care home census and nursing home census and comparing this with the information received in March 2003. The 2002 figures and the March 2003 figures are final.

This census is issued twice a year (whereas the previous surveys were annual). The figures in this release relate to the 30 ^th September 2003. They are provisional and subject to change. Final figures will be published in the next care home census release which will relate to the situation on the 31 ^st March 2004.

The number of open establishments covered by the September census was 1,576. Full or partial responses were received from 1,406 open care homes giving an estimated response rate of approximately 89 per cent.

The figures in this statistics release have been grossed up to take account of non-response. The methodology adopted was based on carrying forward previous records available for the care home in question. This methodology is different to that used previously for non-response, therefore care should be taken when making comparisons with the 2002 data.

A large number of homes across clients groups have continued to deregister with the Care Commission as providing care for clients. These homes have not closed but have been omitted entirely from this statistics release. They are still operational and will be re-registering with the Care Commission as Housing Support services. Information on the number of homes deregistering for this reason is available in annex E.

Further Information

Further details and analysis of the data presented in this Statistics Release is available on request from the address following. The Statistics Release is also available on the Scottish Executive web site ( www.scotland.gov.uk). This release was published on the 30 ^th June 2004.

Social Work Statistics
Room 3.WR
St Andrew's House
Edinburgh, EH1 3DG
Contact: Steven Gillespie
Tel: 0131 244 3777
E-mail: SWStat@scotland.gov.uk

30th June 2004

Annex A Occupied, Vacant and Unavailable Registered Places by Local Authority Care Homes for Older People
Annex B Registered Places, Percentage Change and Places Relative to Population by Local Authority Care Homes for Older People
Annex C Care Home Closures and New Care Homes by Local Authority Care Homes for Older People
Annex D Care Home Places with Ensuite Facilities in Homes for Older People
Annex E Care Homes that have Closed, Deregistered or Opened during Census Period
Annex F Care Homes by Client Group: March 2002, March 2003 and September 2003

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