Scottish Government

Paolo Vestri
Hexagon Research and Consulting

ISSN 0950 2254
ISBN 978 0 7559 6497 0

This document is also available in pdf format (670k)

CONTENTS

Acknowledgements

Executive Summary

1. Introduction
Free Personal and Nursing Care
The evaluation of the operation and impact of Free Personal Care
Methodology
The operation of Free Personal and Nursing Care

2. Application
Public awareness, understanding and support for Free Personal Care
The application process and referral practices
Groups not applying for Free Personal Care
Improving the application process
Summary and recommendations

3. Assessment
The assessment process
Delays in assessments
Improving the assessment process
Summary and recommendations

4. Provision
Managing service provision
Involving carers and offering choice
Contractual arrangements for self funders in care homes
Summary and recommendations

5. Review
Monitoring and reviewing individuals' needs
Monitoring and evaluation of Free Personal Care
Summary and recommendations

6. The Impact of Free Personal Care
Informal care
The balance of care
Care providers
The quality of care
Summary and recommendations

7. Potential Barriers to the Successful Operation of Free Personal Care
Guidance
Staffing/ workforce issues
Relationship with the NHS
Funding
Summary and recommendations

8. Conclusion and Recommendations
Conclusion
Recommendations

APPENDICES
1. Interviews with Stakeholders
2. Survey of Local Authorities
3. Public Attitude Surveys
4. Case Studies
5. Stakeholder Workshop
6. Tables
7. Definition of Personal Care
8. Bibliography

TABLES and DIAGRAMS
Chapter 1:
Flowchart 1: The Operation of FPC - routes into care services

Chapter 2:
Table 2.1: How much would you say you know about the issue of FPC?
Table 2.2: How much would you say you know about the issue of FPC (by age of respondent)?
Table 2.3: Ways in which respondents have come to know about FPC
Table 2.4: Which of these tasks should be provided free to ALL older people who need help?
Table 2.5: Support for the various options placing limits on the cost of care at home against no limit
Table 2.6: Balance of referrals (case study councils)
Table 2.7: Reasons given by carers of older people for the cared for person not receiving FPC

Chapter 3:
Table 3.1: Target times for assessments

Chapter 4:
Flowchart 2: Process for prioritising service provision
Table 4.1: Number of people waiting 6 weeks or more for the provision of personal care services following an assessment of need
Table 4.2: Home care package capping limits
Table 4.3: Support for Direct Payments

Chapter 6:
Table 6.1: Tasks carried out by unpaid carers
Table 6.2: Home care clients aged 65+ and receiving FPC (2002 - 2006)
Table 6.3: Care home places and residents by sector (2002 - 2005)
Table 6.4: Distribution of home care clients and hours between various providers
Table 6.5: Proportion of home care services provided by in-house home care staff or private or voluntary sector providers in case study councils

Appendix 4:
Table A4.1: Local authority staff interviewed
Table A4.2: Characteristics of people interviewed
Table A4.3: Involvement of service users and carers in interviews
Table A4.4: Service users' needs
Table A4.5: Level of free personal care provided to service user's own home (hours per day)
Table A4.6: Level of free personal care provided to service users own home (days per week)
Table A4.7: Nature of residential care
Table A4.8: Independent Sector Care Homes Survey
Table A4.9: Independent Sector Home Care Providers' Survey

Appendix 6:
Table A6.1: Numbers Waiting for Community Care Assessments and Median Wait: Scottish Executive and Scottish Parliament Health Committee Surveys
Table A6.2: Priority Levels and Thresholds for Service Provision
Table A6.3: Numbers Waiting for Provision of Services following an Assessment and Median Wait: Scottish Executive and Scottish Parliament Health Committee Surveys
Table A6.4: Number of self funders waiting for FPC/ FNC payments following assessment
Table A6.5: Number of people waiting for personal care services following an assessment
Table A6.6: Number of people waiting for Direct Payments for personal care services following an assessment
Table A6.7: Care home capacity in the six case study areas
Table A6.8: Recording and monitoring of unmet need in the six case study councils

The views expressed in this report are those of the researcher and
do not necessarily represent those of the Department or Scottish Ministers.