1. 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) Eastern Region Performance Network BSPS Conference, University of Kent, 13 Sept 2005

2. © 2005 Tribal Plc Page 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. © 2005 Tribal Plc Page 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. © 2005 Tribal Plc Page 4 HTLAH – starting point

5. © 2005 Tribal Plc Page 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. © 2005 Tribal Plc Page 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. © 2005 Tribal Plc Page 7 People who come in to the Social Services ‘domain’ Referrals Assessments Care provision Res/NH care Intensive Other HTLAH No service Voluntary organisations/direct access? Eligibility Criteria NO YES

8. © 2005 Tribal Plc Page 8 Are there any predictors? Correlations with data from 2001 census and DWP - links to deprivation: 4 Older people living alone 4 Older people in rented accommodation 4 Index of Multiple Deprivation (IMD 2004) 4 Pensioners receiving Income Support 4 Pensioners in overcrowded accommodation

9. © 2005 Tribal Plc Page 9 What about CSSR response? FSS is allocated according to deprivation factors £££ £££ - The more you get, the more you can give …and so you should!

10. © 2005 Tribal Plc Page 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. © 2005 Tribal Plc Page 11  Predictive model demonstrates that you can use the demographic data to calculate indicative data for HTLaH  Compared this to the actuals for 2003 & 2004 Predicted vs. actual PAF C32 PI

12. © 2005 Tribal Plc Page 12 Predicted vs. actual PAF C32 PI

13. © 2005 Tribal Plc Page 13 C32 and banding of performance

14. © 2005 Tribal Plc Page 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. © 2005 Tribal Plc Page 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