Predicting the numbers of older people “helped to live at home”

1. Eastern Region Performance Network Predicting the numbers of older people “helped to live at home” A needs-based model and its implications Project undertaken for ADSS Eastern Region – Project Chair Hugh Gault (Cambridge CC Social Services) BSPS Conference, University of Kent, 13 Sept 2005

2. Who is “Tribal”? • A leading provider of professional support services, offering a broad range of consultancy and managed services. • Employs over 2,000 people and operates from a network of 60 offices across the UK and Eire. • Operates across the public sector, within education; health and social care; local government, housing & regeneration; and central government. • Works with 80% of secondary schools; 75% of local authorities; 90% of further education colleges; and the majority of strategic health authorities and NHS trusts.

3. What does Tribal do? • Provides a wide range of services: • Change management • Performance improvement • Benchmarking • Executive resourcing & interim management • Organisational development • Direct service • Strategy development & implementation

4. HTLAH – starting point

5. Our hypothesis • Are authorities actually providing services at a level appropriate for the needs of their population? • If so, why is this not reflected in the performance judgements? • Can we identify predictors of need?

6. Social care needs model Older People No need for social care Private care Need for public social care Family networks Housing quality Health – mortality/ morbidity Income (IS) Voluntary organisations “Social Capital” Transport/access Preventive services Availability of private sector Self-funders/income

7. People who come in to the Social Services ‘domain’ Eligibility Criteria Assessments Referrals NO YES Care provision Res/NH care Intensive Voluntary organisations/direct access? Other HTLAH No service

8. Are there any predictors? Correlations with data from 2001 census and DWP - links to deprivation: • Older people living alone • Older people in rented accommodation • Index of Multiple Deprivation (IMD 2004) • Pensioners receiving Income Support • Pensioners in overcrowded accommodation

9. What about CSSR response? FSS is allocated according to deprivation factors £££ - The more youget, themoreyoucangive …and so you should!

10. The technical analysis • Started with full set of demographic data (IMD, Census and DWP) at LA level. • SPSS (stepwise regression) to identify the strongest predictors • Statistical tests to check robustness and statistical validity • Strongest combination of predictors: “lone pensioners” and “LLTI”

11. Predicted vs. actual PAF C32 PI • Predictive model demonstrates that you can use the demographic data to calculate indicative data for HTLaH • Compared this to the actuals for 2003 & 2004

12. Predicted vs. actual PAF C32 PI

13. C32 and banding of performance

14. So What? • Not all authorities have the same levels of community need • LA funding is based on assumptions of different need levels • The model isn’t perfect, but need levels can be predicted • Provision is generally consistent with predicted need levels

15. Messages for LAs and CSCI • “More does not necessarily equal better” • It’s wrong to assume that there is a universal linear target • Performance must be judged in context of community needs. • Trying too hard to “improve” may lead to wasteful allocation of scarce resources. • Research, benchmarking and needs mapping are essential to understanding performance