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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 31 March 2006 and are provisional. As such they are subject to change. The final figures will be published in subsequent statistics bulletins. The information is derived from the Scottish Care Home Census.

Some of the information which used to be collected as part of the Scottish Care Home Census is now collected by the Care Commission. This information is not included in this publication. More details of this can be found in the background information section at the end of this infonote.

All figures in this release omit care homes that deregistered to become Housing Support services.

Main Points

• At 31 March 2006 there were a total of 1,491 registered care homes providing 43,489 places to 38,010 residents. Annexes A and F provide further details.
• There were 38,099 registered places in care homes for older people. The number of places had decreased by 0.5 per cent since September 2005 and by 2.8 per cent from the March 2000 level.
• The average gross weekly charge for a long stay resident in an independent care home for older people was £459 in March 2006 compared to £437 in March 2005 and £418 in March 2004 (Table 5).
• In independent care homes for older people, the average weekly charge for a place without nursing care was £404 compared to £476 for a place with nursing care ( Annex E).

• Of the 32,577 long stay residents in care homes for Older People, 18 per cent had spent 5 years or more in that care home.

Chart 1: Places in Care Homes for Older People per 1,000 population aged 65+

Section One: Care Homes for Older People

Table 1 - Care Homes, Places, Residents by Sector / Places per 1,000 Population, 2000 - 2006

Source: SCHC1 March 2006

In March 2006 there were 960 care homes for older people. Of these 184 (19 per cent) were run by a Local Authority or by the NHS, 633 (66 per cent) were privately owned and the remaining 143 (15 per cent) were in the voluntary sector. In total, there were 100 fewer homes for older people in March 2006 than in March 2000 (when there were 1,060 such homes) and 18 fewer than in March 2006.

The 38,099 registered places in March 2006 represents 45.4 places per 1,000 population and consists of 5,661 places (15 per cent) in the Local Authority/ NHS sector, 28,149 places (74 per cent) in the private sector and 4,289 places (11 per cent) in the voluntary sector. Between March 2000 and March 2006 the total number of registered places had fallen by 1,105 (2.8 per cent). In the Local Authority/ NHS sector there had been a decrease of 795 places (12.3 per cent) whilst in the private sector there had been a small increase with an additional 180 places (an increase of less than 1 per cent). Finally, in the voluntary sector there had been a decrease of 490 places (a reduction of 10.3 per cent). Annex C and chart 1 show the number of places per 1,000 population aged 65+ for each local authority. East Dunbartonshire had 28.6 places per 1,000 population aged 65+, the fewest of all local authorities, whilst South Lanarkshire had the most at 57.2 places per 1,000 population aged 65+.

During the same period, the number of residents had fallen by 1,099 (3.2 per cent) from 34,457 to 33,358.

Table 2 - Registered Places in Care Homes for Older People, Local Authorities with the Largest Increases/Decreases

Source: SCHC1 March 2006

Table 2 shows the local authorities with the largest percentage increases and decreases in the number of registered places in care homes for older people between March 2000 and March 2006. Annex B contains details of registered places for each census between these dates for all local authorities.

The biggest percentage increase in registered places since March 2000 occurred in the Orkney Islands where the number of registered places has risen from 100 in March 2000 to 136 in March 2006 (a 36 per cent increase associated with a net increase of three care homes). Other local authorities to have experienced large increases in the percentage of registered places were North Lanarkshire, Clackmannanshire and South Lanarkshire. The biggest percentage decrease in the number of registered places since March 2000 occurred in Aberdeen City. Here there had been a 18.1 per cent decrease, a reduction of 343 places. This corresponded to a net decrease of 7 homes over the same period. Other local authorities to have experienced a large decrease were Stirling, North Ayrshire and the City of Edinburgh.

Care Homes for Older People: Closures and New Homes

Table 3: Care Home Closures by Sector

Source: SCHC1 March 2006

Table 3 shows that 14 care homes closed between September 2005 and March 2006. The homes that closed had an average of 22.8 places compared to the average size of all open care homes on 31 March 2006 of 39.7 places. Of the 179 homes which have closed since March 2000, 114 homes (64 per cent of closed homes) operated in the private sector. Forty closed homes (22 per cent of closures) were local authority run homes. The remaining 25 closures (14 per cent) operated in the voluntary sector. Annex D provides a local authority split of care home closures between March 2000 and March 2006.

Care Homes for Older People: Newly Opened Care Homes

Table 4: New Care Homes by Sector

Source: SCHC1 March 2006

Since March 2000, 79 care homes have opened in Scotland. Around 61 per cent of these (48 homes) opened in the private sector whilst 18 homes opened in the local authority sector (23 per cent) and the remaining 13 (16 per cent) were in the voluntary sector. In the 6 months prior to the most recent census night in March 2006, 4 homes opened and had an average of 19.75 places (again compared to the average size of all open care homes on 31 March 2006 of 39.7 places). Annex D provides details of new care homes which opened between March 2000 and March 2006. The information is split by local authority.

Care Home Average Gross Weekly Charge

Table 5 shows the average gross weekly charge per long stay resident in care homes for older people. The table is broken down into local authority run homes and independent (private and voluntary) run homes. It gives charging information by local authority for March 2004, March 2005 and March 2006.

The average gross weekly charge per home is equal to the amount the home charges in total to all residents each week divided by the number of residents. This is before any deductions are made (such as income from local authorities for accommodation or free personal care).

The figures in the table have been weighted to reflect the capacity of care homes within each local authority.

The overall average gross weekly charge for all care homes for Older people in Scotland in March 2006 was £467. This was an increase of 4.7 per cent from the March 2005 level of £446 and of 10.4 per cent from the March 2004 level of £423. During the two year period there was a 13 per cent increase in the average charge of local authority run homes (£453 to £512) and a 9.8 per cent increase in the charge of private/voluntary homes (£418 to £459).

Table 5: Average gross Weekly Charge
March 2004 - March 2006

Source: SCHC1 March 2006

* Where the average is based on 1, 2 or 3 homes in the independent sector, the figure has been supressed to maintain care home confidentiality
-- This symbol indicates that there were no LA care homes in the local authority area
1. In 2004 and 2005 City of Edinburgh council supplied figures based on the total cost of running their care homes and the number of residents.
In 2006 the figures supplied were the charges to residents (some / all of which would generally have been paid by the council)
2. In 2004 and 2005 seven care homes in Shetland were operated by independent sector providers. Between March 2005 and March 2006, operation of six of these was transferred to Shetland Islands Council and the 2006 figures more accurately reflect the cost of running the care homes
3. The Local Authority figures for South Lanarkshire reflect charges to residents whereas some other local authority figures relate more closely to the cost of running the care home. There is a council commitment to keep the charge to a minimum for the elderly population of South Lanarkshire

Excluding Shetland Islands (see note 2 at the bottom of table 5), the largest percentage increase between March 2004 and March 2006 in the average gross weekly charge occurred in North Lanarkshire (an increase of 17.3 per cent from £404 to £474). Argyll & Bute and Eilean Siar also showed an increase of over 15 per cent during the 2 years.

The lowest percentage increase occurred in Clackmannanshire which had an increase in the gross weekly charge of 4.3 per cent between March 2004 and March 2006.

Between March 2005 and March 2006 (and again excluding Shetland Islands) the largest percentage increase occurred in Orkney Islands (an 11.3 per cent increase from £595 to £662).

There is a large amount of variation in charges between local authorities. Charges may vary for a variety of reasons, for example, some homes offer nursing care to residents while others (former residential care homes) do not. Similarly charges may vary between privately funded and local authority funded residents or between rooms of different sizes or between rooms with ensuite facilities and those without. The gross weekly charge as it is presented in table 5 does not distinguish between these factors.

Average Weekly Charge for Different Residents

From March 2006 the Scottish Care Home Census asked care homes to supply a breakdown of the different charges applied to long stay residents in four different categories as follows:

• Local authority funded, without nursing care
• Local Authority funded and receiving nursing care
• Privately funded, without nursing care
• Privately funded and receiving nursing care

Table 6: Average weekly charge in independent care homes by source of funding and whether nursing care required

Source: SCHC1 March 2006

Table 6 shows the average charges across Scotland for long stay residents in each category in independent care homes. Charges have been weighted to reflect the number of long stay residents in each category within each care home.

In independent sector care homes for older people the average weekly charge for a long stay resident receiving nursing care was £476 compared to £404 for a resident without nursing care. Charges for residents in both these categories varied depending on the main source of funding and, overall, the average charge for a local authority funded resident was £431 and, for a privately funded resident, was £527.

Annex E shows a local authority level analysis of these charges. The maximum and minimum average charges quoted below omit local authorities in which there were fewer than 4 homes, these charges have been withheld to maintain confidentiality.

Average charges for privately funded residents without nursing care ranged from £384 in Renfrewshire to £534 in East Renfrewshire, the Scottish average figure was £434. For privately funded residents receiving nursing care the Scottish average charge was £564. At local authority level charges ranged from £445 in Dumfries & Galloway to £721 in Edinburgh. Overall, for all residents without nursing care, irrespective of their source of funding, the average charge ranged from £350 in West Dunbartonshire to £488 in East Renfrewshire whilst the average charge for residents with nursing care ranged from £440 in Scottish Borders to £601 in Edinburgh.

Table 7: Number of Admissions, Discharges and Deaths in Homes for Older People
September 2005 - March 2006

Source: SCHC1 March 2006

Admissions and Discharges.

In care homes run by local authorities or by the NHS there were a total of 5,422 admissions. These accounted for 35 per cent of all admissions (13 per cent of all long stay and 52 per cent of all short stay admissions). In the Local Authority/ NHS sector, the majority of admissions (85 per cent) were for a short stay or respite care.

In the private sector there were a total of 8,238 admissions, 5,029 (61 per cent) of which were long stay and 3,209 (39 per cent) short stay or respite. In total these represented 54 per cent of all admissions and included 78 per cent of all long stay and 36 per cent of all short stay admissions.

Admissions in the voluntary sector accounted for the remaining 11 per cent of all admissions including 10 per cent of all long stay and 12 per cent of all short stay admissions.

Between 30 September 2005 and 31 March 2006, 10,916 residents were discharged from care homes. Two thousand and thirty nine of these discharges were long stay residents and 8,877 were short stay residents. Discharges from local authority run homes accounted for 46 per cent of all discharges whilst a further 41 per cent of discharges were of residents in the private sector and 12 per cent were in the voluntary sector.

During the 6 months preceding the most recent census 4,936 care home residents died.

Of these the majority, 4,814 were long stay residents and 3,915 of these (81 per cent) were in the private sector.

Section Two: Long Stay Residents in Care Homes for Older People

Table 8: Gender and Age of Residents March 2003 - March 2006

Source: SCHC1, March 2006

Of the 32,577 long stay residents in care homes for older people on 31 March 2006, 23,724 (almost three-quarters) were female and 8,852 were male. More than half of the female long stay residents were aged 85 or over and a further 35 per cent were aged between 75 and 84. Amongst male residents, 36 per cent were aged 85 and over and 40 per cent were aged 75-84. Since March 2003 the percentage of long stay residents aged 85 and over has fallen slightly amongst both male and female residents. There has been a corresponding increase in the percentage of residents aged 75-84.

Chart 2 shows where long stay residents were before being admitted to a care home. This covers all residents admitted in each census period between April 2002 and March 2006.

Between October 2005 and March 2006, 48 per cent of long stay residents were admitted from a hospital. A further 34 per cent were admitted from their own home. This distribution has remained fairly steady since the March 2003 census.

Chart 3 shows the destination of long stay residents who were discharged from care homes in each census period back to April 2002 - March 2003. Between October 2005 and March 2006, 71 per cent of discharges were due to deaths. Generally more deaths are reported in the March censuses which cover

the winter period. A further 13 per cent exited to another care home..

Chart 4 shows the incomplete length of stay of residents in care homes on census nights. On 31 March 2006, 32 per cent of long stay residents had been there for between 1 and 3 years. Eighteen per cent had been in the care home for 5 years or more. There has been little variation in this distribution since March 2003 although the percentage staying in care homes for more than 3 years has risen steadily from 33 per cent in March 2003 to 38 per cent in March 2006.

Table 9: Characteristics of residents in care Homes for Older People, March 2006

Source: SCHC1 March 2006

Table 9 shows the number of long stay residents with various characteristics. Residents may have more than one of these characteristics. In total, 67 per cent of older people in care homes required nursing care). A total of 15,109 long stay residents (46 per cent) had dementia (of these, 72% had their dementia medically diagnosed).

Chart 2: Location Resident Admitted From, April 2002 - March 2006

Chart 3: Destination on discharge, April 2002 - March 2006

Chart 4: Average incomplete length of stay, March 2003 - March 2006

Section Three: Care Homes for Physically Disabled People

Table 10 - Care Homes, Places and Residents by Sector, March 2000 - March 2006

Source: SCHC1 March 2006

On 31 March 2006 there were 46 care homes for physically disabled people providing 552 places and housing 493 residents.

Since March 2000 the number of care homes has increased by 7 from 39. In the same period, the number of registered places has fallen from 823, a reduction of 271 places, and the number of residents has dropped from 723, down by 230. In March 2000, there were, on average, 21 places in a care home for people with physical disabilities. By March 2006 the average size had fallen to 12 places. Of the 46 care homes for physically disabled people, the majority, 35 (or 76 per cent) were operated by voluntary organisations. These voluntary homes offered 429 places to residents (78 per cent of all places). Of the remaining 11 care homes, 3 were operated by local authorities and 8 were in the private sector. The private sector has grown in size since March 2000 with an additional 5 care homes and 38 places by March 2006.

Chart 5: Age of residents, March 2006

Around 29 per cent of long stay residents in care homes for physically disabled people were aged between 45 and 54 (Chart 5).

Chart 6: Average incomplete length of stay, March 2006

Around 64 per cent of long stay residents in care homes for physically disabled people had been there for 5 years or more. Just over 12 per cent had been in the care home for less than 1 year (Chart 6).

Section Four: Care Homes for Adults with Mental Health Problems

Table 11 - Care Homes, Places and Residents by Sector, March 2000 - March 2006

Source: SCHC1 March 2006

On the most recent census night there were 101 care homes in Scotland for adults with mental health problems. Of these 78 per cent (79 homes) were run by voluntary organisations. The 101 care homes offered a total of 1,203 places and were an average of 12 places in size.

The 79 care homes in the voluntary sector offered a total of 784 places and had an average of 10 places each. This compares to an average size of 20 places amongst the 17 privately owned care homes which offered a total of 338 places and housed 305 residents.

The 5 local authority run care homes offered a total of 81 places and had an average of 16 places.

Since March 2000, the number of care homes offering services in this client group has dropped by 28, from 129. In the same period the number of places has decreased by only 22 and the number of residents by 12. The average size of a care home in March 2000 was 9 places.

Chart 7: Age of residents, March 2006

Over a quarter of long stay residents in care homes for adults with mental health problems were aged 65 and above and around half were aged 55 or over. Around 3 per cent of residents were aged between 16 and 24 (Chart 7).

Chart 8: Average incomplete length of stay, March 2006

Eighteen per cent of long stay residents in care homes for adults with mental health problems had been there for less than 1 year whilst 41 per cent had been resident in the care home for 5 years or more (Chart 8).

Section Five: Care Homes for Adults with Learning Disabilities

Table 12 - Care Homes, Places and Residents by Sector, March 2000 - March 2006

Source: SCHC1 March 2006

On 31 March 2006 there were 330 care homes for adults with learning disabilities. These homes offered a total of 2,906 places and had 2,499 residents.

Just over 65 per cent (215) of the care homes in this client group and 51 per cent (1,492) of the registered places were in the voluntary sector whilst 70 (21 per cent) were in the private sector and 45 (14 per cent) were run by local authorities. The average size of these care homes varied between sectors. Homes were, on average, 7 places in size the voluntary sector, 10 places in local authority homes and 14 places in privately operated care homes.

Since March 2000, the number of care homes has fallen by 56 from 386 in 2000 to the current level of 330 homes. There has been a corresponding drop in the number of places from 3,624 to 2,906. This is a reduction of 718 places (20 per cent). The number of residents in care homes for adults with learning disabilities has fallen by 822 from 3,321 in March 2000 to 2,499 in March 2006.

Chart 9: Age of residents, March 2006

Seven per cent of long stay residents in care homes for adults with learning disabilities were aged between 16 and 24 and 13 per cent were aged 65+ (Chart 9).

Chart 10: Average incomplete length of stay, March 2006

Three quarters of all long stay residents in care homes for adults with learning disabilities on 31 March 2006 had spent 5 years or more in that care home. Around 6 per cent had been in the care home for less than 1 year (Chart 10).

Further information on adults with learning disabilities and those who live in their own tenancies is available from: http://www.scotland.gov.uk/Publications/2006/05/22101802/0

Section Six: Care Homes for Adults in Other Client Group

Table 13 - Care Homes, Places and Residents by Sector, March 2000 - March 2006

Source: SCHC1 March 2006

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

In March 2006 there were a total of 54 care homes for adults in other client groups. These homes offered a total of 729 places, an average of 13.5 places per home, and had 589 residents. The majority of the 54 homes (47 homes or 87 per cent of all homes) operated in the voluntary sector and these homes offered a total of 585 places. Of the remaining 8 care homes, 4 were run by local authorities and 3 were privately run. The local authority run homes offered a total of 43 places whilst the 3 private homes offered 101 places.

Since March 2000 the number of care homes in this client group has fallen by 17, from 71 to 54. This has coincided with a reduction of 246 places, from 975 to 729 and of 195 residents from 784 to 589.

Chart 11: Age of residents, March 2006

Around 18 per cent of long stay residents in care homes for adults in other client groups were aged between 16 and 24. A further 20 per cent were aged between 25 and 34 (Chart 11).

Chart 12: Average incomplete length of stay, March 2006

More than a fifth (21 per cent) of long stay residents in care homes for adults in other client groups had been there for less than 3 months. Roughly the same proportion had been in the care home for more than 5 years (Chart 12).

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 census was first issued in March 2003 and replaced two previous surveys. It combined the former 'Residential Care Home Census - R1' (run by the Scottish Executive) and the 'Private Nursing Homes Census' (run by ISD Scotland). In March 2006 some of the data collection, relating mainly to care home places, was taken over by the Care Commission. It was intended that this would be made available to be included in this publication and the date of the publication was delayed as a result. Unfortunately, due to problems in the Care Commission's data collection this data has not yet been made available and, consequently, this publication excludes tables relating to places in single rooms, ensuite places and occupancy rates that have been published in infonotes for previous censuses. The information relating to registered places that is published in this release is largely taken from Scottish Care Home Census figures collected in September 2005. Where the Care Commission register shows the number of places in a care home to have changed since September 2005 this has been reflected in the published figures.

Figures showing the number and percentage of care home places in single rooms and the number and percentage of ensuite places in care homes are available from Audit Scotland. This data is shown as indicator 3 in the adult social work performance indicators at http://www.audit-scotland.gov.uk/performance/ compendium/service/index.htm

Care should be taken when interpreting this data. The local authority split shows places that are funded by each local authority as opposed to places located in each authority as is the case in this infonote.

The figures in this release relate to 31 March 2006. They are provisional and subject to change.

The number of open establishments covered by the March census was 1,491. Full or partial responses were received from 1,308 open care homes giving a response rate of approximately 88 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.

All figures in this release omit care homes that deregistered to become Housing Support services.

This release contains details of long stay residents in care homes. Forms are received for approximately 75 per cent of all long stay residents. The remaining 25 per cent are estimated using a series of computer programs. If resident details are missing from a particular home, the programs will identify 'similar' homes for which resident details are available and will estimate the details of the missing records based on these.

Further Information

Further details and analysis of both the establishment and resident data presented in this Statistics Release is available on request from the following address. The Statistics Release is also available on the Scottish Executive web site ( www.scotland.gov.uk). This release was published on 27 March 2007

Community Care Statistics
Basement Rear
St Andrew's House
Edinburgh, EH1 3DG

Contact: Steven Gillespie
Tel: 0131 244 3777
E-mail: SWStat@scotland.gov.uk

27th March 2007

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