Adult social care

In 2019, the adult population in Barnet is estimated to be 308,400, which is 77.0% of the total borough population. Between 2019 and 2025, this adult population is predicted to increase by 5.1% to about 324,100.
Based on projections for 2019, Barnet has the highest number of adults with a learning disability (LD) of any London borough (n = 7,247), of which only 16.5% are older adults aged 65+ (n = 1,193).
According to estimates, there are 1,386 younger adults (aged 18-64) with moderate and severe LD and 160 older people, in 2019. Nine out of ten adults in the borough with moderate or severe learning disability are aged under 65.
The Adult Social Care Outcomes Framework (ASCOF) indicator 1G measures the percentage of adults with LD who live with their family or in their own home. During 2017/18, of adults with LD known to Barnet Council, 97.0% where living in stable and appropriate accommodation, compared to 73.3% in London and 77.2% for England, placing the borough 2nd in the national rankings.
Between 2015-16 and 2017-18, the total number of requests for support from Barnet Council by older adults fell by 8.2% and from younger adults (aged 18-64 years) by a third (33.4%). Overall, the total number of adults requesting support fell from 8,455 to 7,143, a drop of 15.5%.
Short Term Support to Maximise Independence (“ST-Max”) aims to be time limited and make users as independent as possible, before a review or formal assessment determines the next steps. The number of existing clients receiving ST-Max fell from 205 to 90, whilst the number of new clients having it increased from 760 to 900, between 2015-16 and 2017-18.
For 2017/18, over half (55.7%) of the gross annual expenditure on long-term care by the London Borough of Barnet (LBB) went on older adults (aged 65+).
For younger adults aged 18-64 (where the main primary support reasons are learning disability, mental health and physical support), the number of long term service users receiving community care services rose by 13%, between 2015-16 and 2017-18.
The number of carers in Barnet reviewed or assessed jointly with the cared for person fell by 80%, those reviewed or assessed separately increased by 43% and those who received no assessment or review during the year declined by 61%, between 2015-16 and 2017-18.
In 2017-18, Barnet received 1,650 safeguarding concerns, started 610 “Section 42” and 35 “Other” safeguarding enquiries and had a conversion rate (the percentage of safeguarding concerns that led to enquiries) of 39%.

8.2 Strategic Needs

As more people with complex needs survive into adulthood, there is a concerted effort to help them live independently within the community. To meet their requirements, requires effective, targeted, locally based provision, which places considerable pressure on support services, often operating within tight budgets. Against this background, the Care Act 2014 is the most significant reform of support and care in many years.
Between 2020 and 2035, the number of younger adults (aged 18-64) in Barnet with moderate to severe learning disability (LD) is projected to increase by 9%. In contrast, over the same period, the number of older people with LD at this level of severity, is predicted to increase by 44%. However, for older people in Barnet with LD, the numbers involved are smaller and the potential duration of care required shorter, compared to their younger counterparts.
In 2017-18, the rate of requests for support by new clients in Barnet was 2,410 per 100,000 adults, which was significantly lower than both London (2,735 per 100,000) and England (4,215 per 100,000). Similarly, for both younger and older adults in Barnet, the rates of requests for support were significantly lower than those for London and England respectively.
“Universal services” refer to any support or service for which national eligibility criteria (based on the Care Act 2014) are not relevant and “signposting” occurs when a client is not supported by either a local authority or a universal service. Over a third (38%) of new Barnet clients in 2017/18, passed to universal services or were signposted; this was higher than both London (24%) or England (29%). An understanding of the reasons underlying this disparity may be useful in the planning of future services.
With the growth of the older population in Barnet and the associated rise in the number of people living with long term conditions and living longer with disability, there is likely to be ongoing pressure on care provision within the borough.
On ASCOF indicator 1C1B (measuring the proportion of carers who receive self-directed support), Barnet scored 100% (compared to 82.5% in London and 83.4% in England) and was ranked joint 1st nationally, in 2017/18. The Council also performed well on the related ASCOF indicator 1C2B (assessing the percentage of carers receiving carer specific services who received self-directed support via direct payments. On this measure, Barnet also scored 100% (compared to 73.4% in London and 74.1% in England) and achieved a joint 1st ranking nationally.
Nearly two-thirds of carers in Barnet were assessed/reviewed separately from those they cared for, almost a quarter were assessed or reviewed jointly (24%) and 13% did not receive an assessment or review, during 2017-18.
In 2017-18, LBB spent £16.03M on short term care for adults, a 12.2% increase on the previous year. Of this gross expenditure, 92.2% was spent on younger adults aged 18-64.
The Council spent £68.84M on long-term care of adults during 2017-18, which represented a 5.6% fall compared to the previous year. In contrast, national spending on long term care rose by 2.7%, despite an ongoing decrease in the number of clients receiving long term care in England, since 2015-16.
In 2017-18, the borough had the 8th highest number of safeguarding concerns of all 33 London local authorities and the 9th highest number of Section 42 enquiries. However, in terms of conversion rate, Barnet was ranked 19th out of 33 local authorities in London and 10th out of 16 against its CIPFA comparators. An understanding of the reasons for this relatively low conversion rate, may yield useful insights into safeguarding within the borough.

8.3 Overview

Adult Social Care provides important help and assistance to a range of people within Barnet. For details on how this team promotes the independence and improves the wellbeing of borough residents, please use the following link: Adult Social Care in Barnet

Taking adults with learning disability (LD) as an example, we can illustrate how the demands on this service within the borough could increase in the coming years.

Based on projections for the London boroughs during 2019, Barnet has the highest number of adults with a learning disability (n = 7,247) in any borough, of which 84% are aged 18-64 and 16% are aged 65+. These estimates predict that Barnet also has the highest number of adults aged 18-64 with learning disability (n = 6,054) of all the London boroughs and the 2nd highest number of older adults aged 65+ (n = 1,193) with learning disability (see Figure 8.1).[1]

Figure 8.1: Estimated total number of adults with learning disability in London boroughs, 2019

Source: POPPI & PANSI (2018).

Between 2020 and 2035, the number of older people (aged 65+) in Barnet with learning disabilities is projected to increase from around 1,200 to nearly 1,800, a rise of 47%. Over the same period, the number of younger adults (aged 18-64) is predicted to grow from about 6,100 to 6,600, an increase of 8%.[2]

However, these baseline figures include people with mild, moderate and severe disability, so are likely to overestimate the numbers of people both requiring and accessing adult social care services within the borough. As individuals with mild LD are more likely to be independent than those with more severe learning disability and to require less assistance with their activities of daily living (such as washing, dressing etc.), these baseline figures may overstate the impact on council services going forward.

Figure 8.2: Total number of adults with learning disability in Barnet, by age group, 2020 - 2035

Source: POPPI & PANSI (2018).

By looking at adults with moderate or severe learning disabilities (who are more likely to be receiving services), projections may give a clearer picture of the numbers accessing services in the years to come. In 2019, there are 1,386 younger adults (aged 18-64) with moderate and severe learning disability and 160 older people, according to estimates. Nine out of ten (90%) adults in the borough with moderate or severe learning disability are aged under 65.[3]

Based on projections for the London boroughs for 2019, Barnet has the highest number of adults with a moderate or severe learning disability of any borough (n = 1,546) as well as the highest number of adults aged 18-64 with learning disabilities of all the London boroughs and the 2nd highest number of older adults aged 65+ with learning disability (see Figure 8.3). This is a similar pattern to that found when the total number of adults with learning disability is considered.[4]

Figure 8.3: Estimated number of adults with moderate or severe learning disability in London boroughs, 2019

Source: POPPI & PANSI (2018).

Figure 8.4 shows how the number of adults with moderate or severe LD is due to increase in the coming years. For adults aged 18-64, the number of people with learning disability at this level of severity is projected to increase from 1,398 in 2020 to 1,518 in 2035, a rise of 9%. In contrast, over the same period, the number of older people in Barnet with moderate to severe LD is predicted to increase by 44%, from 163 to 234. However, for older people in Barnet with LD, the numbers involved are smaller and the potential duration of care required, potentially shorter, when compared to younger adults with LD in the borough.

Figure 8.4: Projected number of adults with moderate or severe learning disability in Barnet, by age group, 2020 – 2035

Source: POPPI & PANSI (2018).

[1] Projecting Older People Population Information (POPPI, 2018) & Projecting Adult Needs and Service Information (PANSI, 2018). Available at: https://www.poppi.org.uk/ and https://www.pansi.org.uk/

[2] Projecting Older People Population Information (POPPI, 2018) & Projecting Adult Needs and Service Information (PANSI, 2018). Available at: https://www.poppi.org.uk/ and https://www.pansi.org.uk/

[3] Projecting Older People Population Information (POPPI, 2018) & Projecting Adult Needs and Service Information (PANSI, 2018). Available at: https://www.poppi.org.uk/ and https://www.pansi.org.uk/

[4] Projecting Older People Population Information (POPPI, 2018) & Projecting Adult Needs and Service Information (PANSI, 2018). Available at: https://www.poppi.org.uk/ and https://www.pansi.org.uk/

8.4 Care Act 2014

The Care Act 2014 represents a radical and significant reform of adult social care and intends to create “a single, consistent route to establishing an entitlement to public care and support for all adults with needs for care and support.” In doing this, the Act establishes a new legal duty for the local authorities to meet an adult’s “eligible needs” based on their financial circumstances.[1]

The Care Act 2014 also places a duty on local authorities to promote an individual’s “well-being” and defines this in terms of:

physical and mental health (including emotional well-being)
individual’s control over day-to-day life, as well as their contribution to society
social and economic well-being, including their participation in work, education, training or recreation
domestic relationships (family and personal) as well as protection from abuse and neglect
personal dignity (including treating the person with respect) and
suitability of their living accommodation.[2]

In addition, the Act specifies that local authorities have a responsibility in preventing needs for support and care, providing advice and information, promoting the integration of support and care with health services, promoting quality and diversity in service provision, as well as co-operating both generally and in specific cases, in the delivery of care.[3]

For details of the Care Act legislation, use the following link: Care Act 2014

Further details on the responsibilities of local authorities and changes brought about by the Act are available here: Factsheets

[1] Department of Health and Social Care (2016). Guidance: Care Act factsheets. Available at: https://www.gov.uk/government/publications/care-act-2014-part-1-factsheets/care-act-factsheets#factsheet-4-personalising-care-and-support-planning

[2] HM Government (2014). Care Act 2014. The Stationery Office, London. Available at: http://www.legislation.gov.uk/ukpga/2014/23/contents/enacted

[3] HM Government (2014). Care Act 2014. The Stationery Office, London. Available at: http://www.legislation.gov.uk/ukpga/2014/23/contents/enacted

8.5 New Service Users

The Care Act 2014 created major changes in the delivery of adult social care, so when assessing services, it is advisable to look at the years following the introduction of this legislation. Figure 8.5 shows how the total number of requests for support by new clients in Barnet has changed between 2015-16 and 2017-18.

Between 2015-16 and 2017-18, the total number of requests by older adults (aged 65+) fell from 6,010 to 5,516, a decrease of 8.2%. In contrast, the number of younger adults (aged 18-64 years) seeking support from Barnet decreased from 2,445 to 1,627 over the same period, representing a fall of a third (33.4%). Overall, the total number of adults (aged 18+) requesting support from Barnet fell from 8,455 in 2015-16 to 7,143 in 2017-18, a drop of 15.5%.[1]

Figure 8.5: Total requests for support from new clients in Barnet, by age group, 2015-16 to 2017-18

Source: Short and Long Term Support (SALT) data (STS001) from Adult Social Care Team at London Borough of Barnet (LBB).

In 2017-18, requests for support by new clients in Barnet was at a rate of 2,410 per 100,000 adults, which was significantly lower than both London (2,735 per 100,000) and England (4,215 per 100,000). Similarly, for younger adults in Barnet (aged 18-64 years) the rate was 675 per 100,000, which was also significantly lower than the rates for London (1,005 / 100,000) and England (1,555 / 100,000). For older adults, the rates of request for support in London (12,350 / 100,000) and England (13,160 / 100,000) were also significantly higher than in Barnet (10,020 / 100,000), during 2017-18.[2]

[1] London Borough of Barnet (2019). Adult Social Care data.

[2] NHS Digital (2018). Adult Social Care Activity and Finance: Comparator Report. Available at: https://app.powerbi.com/view?r=eyJrIjoiMjkwZjI3M2QtZjM3ZC00ZDNlLTkwNjMtYmZmOTU4OGU1NGQ3IiwidCI6IjUwZjYwNzFmLWJiZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9

8.5.1 Service User Journeys

After a request for support has been made to Adult Social Care, a service user can follow a number of different routes, according to needs and circumstances. For example, they can be referred directly for long term support intended to maintain an individual’s quality of life on an ongoing basis (e.g. admission to a care home), or receive low-level support through access to assistive equipment. Alternatively, service users can receive a period of short term support to maximise their independence. This option of “Short Term Support to Maximise Independence” (ST-Max) is designed to be time limited and aims to make users as independent as possible, before a review or formal assessment determines the next steps.[1]

Figure 8.6 shows how the number of new and existing clients, of all ages, receiving ST-Max changed between 2015-16 and 2017-18. Over this period, the number of existing clients receiving this intervention fell from 205 to 90, whilst the number of new clients having ST-Max increased from 760 to 900.[2]

Figure 8.6: Total outcomes of Short Term Support to Maximise Independence (ST-Max) for new and existing clients of all ages in Barnet, 2015-16 to 2017-18

Source: London Borough of Barnet (LBB, 2019). Adult Social Care team.

Sequels are; “the substantive actions taken in relation to the request for support.” However, what actually happens in response to a request to adult social care may be complex and the sequel can represent a simplification of the situation that unfolds. SALT aims to track client journeys through the social care system, so records sequels in terms of the types of support provided. In this context, “Sequel to Request for Support” records the response made to client’s request in terms of the type of support provided.[3]

Figure 8.7 shows the “Sequel to Request for Support” for new service users in Barnet during 2017/18. Only 11% of new clients received ST-Max and 20% got low level ongoing support. Long term support was provided to 15% of new clients, with the following breakdown, based on the main setting where the individual received services:

Community (13%) – where people live independently (in warden supported accommodation, sheltered housing etc.) and receive home or community based services.
Nursing (1%) – for those living in care homes where nursing care is provided.
Residential (1%) – which applies to those clients who live in residential care homes (even if they also receive community based services, such as day services).[4]

“Universal services” refer to any support or service for which national eligibility criteria (based on the Care Act 2014) are not relevant and “signposting” occurs when a client is not supported by either a local authority or a universal service.[5] Over a third (38%) of new Barnet clients in 2017/18, passed to universal services or were signposted; this was higher than both London (24%) or England (29%). However, the proportion of new clients in Barnet receiving long term care, ST-Max and on-going low level support, was all higher than both London and England averages (see Figure 8.8).

Figure 8.7: Types of support provided to new clients (Sequel to Request for Support), Barnet, all ages, 2017-18

Source: London Borough of Barnet (LBB, 2019). Adult Social Care team.

Figure 8.8: Types of support provided to new clients (Sequel to Request for Support), Barnet, London and England, 2017-18

Source: London Borough of Barnet (LBB, 2019). Adult Social Care team.

[1] NHS Digital (2018). Short and Long Term (SALT) Data Return. 2017-18 Guidance Version 0.8 Final. Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2018#short-and-long-term-support-salt-

[2] London Borough of Barnet (2019). Adult Social Care Team (SALT return).

[3] NHS Digital (2018). Short and Long Term (SALT) Data Return. 2017-18 Guidance Version 0.8 Final. Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2018#short-and-long-term-support-salt-

[4] NHS Digital (2018). Short and Long Term (SALT) Data Return. 2017-18 Guidance Version 0.8 Final. Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2018#short-and-long-term-support-salt-

[5] NHS Digital (2018). Short and Long Term (SALT) Data Return. 2017-18 Guidance Version 0.8 Final. Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2018#short-and-long-term-support-salt-

8.6 Adult Social Care Outcomes Framework (ASCOF)

The Adult Social Care Outcomes Framework (ASCOF) aims at providing an indication of the strengths and weaknesses of social care services when delivering better outcomes for service users, by measuring how well they achieve these important outcomes.[1]

Figure 8.9 depicts the performance of Barnet Council on ASCOF measures for 2017/18 against both regional (London) and England scores and provides a national ranking for each of the indicators. Based on this data from NHS Digital, Barnet was ranked in the top five councils nationally for the following ASCOF indicators:

1C1B: The proportion of carers who receive self-directed support
1C2B: The proportion of carers who receive direct payments
1G: The proportion of adults with a learning disability who live in their own home or with their family
2A2: Long-term support needs of older adults (aged 65 and over) met by admission to residential and nursing care homes, per 100,000 population
2D: The outcome of short-term services: sequel to service.[2]

Figure 8.9 Summary of ASCOF performance for Barnet Council against London and England for 2017/18

Source: NHS Digital (2019). ASCOF All measures summary.

On ASCOF indicator 1C1B, which measures the proportion of carers who receive self-directed support, Barnet scored 100% in 2017/18, compared to 82.5% in London and 83.4% in England and was ranked joint 1st nationally. Barnet Council also performed well on the related indicator 1C2B, which assesses the percentage of carers receiving carer specific services who received self-directed support via direct payments. On this measure, Barnet scored 100%, compared to 73.4% in London and 74.1% in England and achieved a joint 1st ranking nationally.[3]

Indicator 1G measures the percentage of adults with a learning disability (LD) who live with their family or in their own home. During 2017/18 in Barnet, 97.0% of adults with LD known to the council where living in stable and appropriate accommodation, either in their own home or with their parents. In London, the average was 73.3% and the national (England) average was 77.2%, placing Barnet 2nd in the national rankings.[4]

ASCOF indicator 2A2 measures the rate of council supported older people (aged 65+) per 100,000 whose long-term support needs were met by a change of setting to nursing or residential care. Since avoiding placement in a residential care setting is considered a good way of delaying dependency (because people usually prefer to live in their own homes), a lower rate on this indicator is desirable. For 2017/18, the rate for Barnet was 261.6 per 100,000, which was considerably lower than both London (406.2 per 100,000) and England (585.6 per 100,000), giving the council a national ranking of 5th.[5]

Indicator 2D in ASCOF assesses the percentage of people who have received short term services during the year for which the outcome (sequel) was either support at a lower level or no ongoing support. Since the aim of short term services is to promote independence and the reablement of people, this measure provides evidence of good outcomes in terms of supporting recovery and delaying dependency. The Barnet Council score was 94.5% in 2017/18, which was higher than both London (78.5%) and England (77.8%) and ranked the council 4th nationally on this measure.[6]

For detailed descriptions of the indicators used by the Adult Social Care Outcomes Framework (ASCOF) use the following link: ASCOF Handbook of Definitions

[1] NHS Digital (2019). Social Care Collections: Adult Social Care Outcomes Framework (ASCOF). Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collections#adult-social-care-outcomes-framework-ascof-

[2] NHS Digital (2019). Measures from the Adult Social Care Outcomes Framework (ASCOF), England 2017-18. ASCOF All measures summary. Available at: https://app.powerbi.com/view?r=eyJrIjoiZTZlNDUwMTQtZjI3ZC00MDJiLWEzNzEtMmQ4YzkzYWIzZmYzIiwidCI6IjUwZjYwNzFmLWJiZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9

[3] NHS Digital (2018). Data set: 1C - The proportions of users and carers receiving self-directed support, and self-directed support via direct payments. Available at: https://digital.nhs.uk/data-and-information/publications/clinical-indicators/adult-social-care-outcomes-framework-ascof/current/enhancing-quality-of-life-for-people-with-care-and-support-needs/1c-the-proportions-of-users-and-carers-receiving-self-directed-support-and-self-directed-support-via-direct-payments

[4] NHS Digital (2018). Data set: 1G - Proportion of adults with a learning disability who live in their own home or with their family. Available at: https://digital.nhs.uk/data-and-information/publications/clinical-indicators/adult-social-care-outcomes-framework-ascof/current/enhancing-quality-of-life-for-people-with-care-and-support-needs/1g-proportion-of-adults-with-a-learning-disability-who-live-in-their-own-home-or-with-their-family

[5] NHS Digital (2018). Data set: 2A - Long-term support needs met by admission to residential and nursing care homes. Available at: https://digital.nhs.uk/data-and-information/publications/clinical-indicators/adult-social-care-outcomes-framework-ascof/current/delaying-and-reducing-the-need-for-care-and-support/2a-long-term-support-needs-met-by-admission-to-residential-and-nursing-care-homes

[6] NHS Digital (2018). Data set: 2D - The outcome of short-term services: sequel to service. Available at: https://digital.nhs.uk/data-and-information/publications/clinical-indicators/adult-social-care-outcomes-framework-ascof/current/delaying-and-reducing-the-need-for-care-and-support/2d-the-outcome-of-short-term-services-sequel-to-service

8.7 Expenditure on Short and Long-Term Care

To set the context, the adult population (aged 18+) in Barnet for 2019 is estimated to be around 308,400, which represents 77.0% of the total borough population, based on projections. Between 2019 and 2025, this population is projected to increase by about 5%, to about 324,100.[1]

In 2017-18, the London Borough of Barnet (LBB) spent £16.03M on short term care for adults, which represented a 12.2% increase on the previous year, compared to a 23.4% rise in London and a 0.6% fall in England overall. In Barnet, 92.2% of this gross expenditure was spent on adults aged 18-64 and 7.8% on older adults (aged 65+). In contrast, LBB spent £68.84M on long-term care of adults during 2017-18, which represented a 5.6% fall compared to the previous year. In London, the decrease in expenditure on long-term care for adults was 1.1%, whilst there was a 2.7% increase in England overall, for 2017-18. Over half (55.7%) of the gross annual expenditure on long-term care in Barnet for 2017/18 went on older adults, with 44.3% spent on adults aged 18-64.[2]

For additional information on expenditure on adult social care in councils, London and England, use the following link: Adult Social Care Activity and Finance: Comparator Report

[1] Greater London Authority (GLA, 2018), Borough Preferred Option population projections.

[2] London Borough of Barnet (2019). Adult Social Care Team based on SALT and ASC-FR data.

8.8 Long-Term Care

Nationally, the area of adult care with the greatest increase in expenditure in 2017-18 was long term care which rose by 2.7% in England to £13.97 billion, despite a continuing decrease in the number of clients receiving long-term care since 2015-16. However, whilst the number of clients aged 18-64 receiving long term care has increased slightly over that period, nationally the number of older people receiving long term care has fallen.[1]

However, between 2015-16 and 2017-18, the number of long term service users in receipt of community care services in Barnet has increased for both adults aged 18-64 and older adults, despite a decrease in expenditure in 2017-18. For younger adults aged 18-64 (where the main primary support reasons are learning disability, mental health and physical support), the number of long term service users receiving community care services rose by 13% over this period. The number of older adults (aged 65+) receiving such services (where physical support is the main primary support reason, followed by support for memory and cognition, mental health and learning disability) increased by 5% over the same period (see Figure 8.10).[2]

Figure 8.10: Total number of long term service users in Barnet receiving Community Care Services, 2015-16 to 2017-18

Source: London Borough of Barnet (LBB, 2019). Adult Social Care team.

[1] NHS Digital (2018). Adult Social Care Activity and Finance Report, England - 2017-18. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/adult-social-care-activity-and-finance-report/2017-18

[2] London Borough of Barnet (LBB, 2019). Adult Social Care Team. SALT return data.

8.9 Carers

For details on the support available to carers from Barnet Council follow this link: Carers Support

Information, advice and support (both practical and emotional) to carers in the borough is also available through the Barnet Carers Centre using the following link: Barnet Carers Centre

Additional resources for carers can be accessed through this link: Resources available to carers

Under the Care Act 2014, a carer is defined as: “… someone who helps another person, usually a relative or friend, in their day-to-day life. This is not the same as someone who provides care professionally, or through a voluntary organisation.” The Care Act mainly deals with adult carers (people aged 18+ who are caring for another adult), since young carers (aged under 18) as well as adults who care for disabled children, can be assessed, then supported, under children’s law.[1]

According to Barnet Council, a carer is an unpaid person who supports or looks after someone who needs help with their daily life for reasons such as:

age
long-term illness,
disability,
mental health or
substance misuse.[2]

Figure 8.11 shows how the number of carers supported by Barnet Council has changed between 2015-16 and 2017-18, based on method of assessment / review. Over this period, the number of carers reviewed or assessed jointly with the cared for person fell from 774 to 153, a drop of 80%. In contrast, the number of carers who were reviewed or assessed separately from the cared for person increased from 290 to 414, a rise of 43%. However, the number of carers who received no assessment or review during the year, fell from 215 in 2015-16 to 83 in 2017-18, a decline of 61%. In 2017-18, nearly two-thirds of carers were assessed/reviewed separately from those they cared for (64%), almost a quarter were assessed or reviewed jointly (24%) and 13% did not receive an assessment or review during that year.[3]

Figure 8.11: Number of carers supported by Barnet Council by method of assessment / review, 2015-16 to 2017-18

Source: London Borough of Barnet (2019). Adult Social Care Team (based on SALT data LTS003).

Between 2015-16 and 2017-18, physical support was the primary support reason for most people receiving care (from carers) in Barnet, although this proportion fell from 64% to 51%, over that period (see Figure 8.12). There was also a decline in the number of cared for people whose primary support reason was “physical support,” from 839 (in 2015-16) to 340 (in 2017-18). The percentage of cared for people receiving learning disability, mental health or social support showed little change over this period, although the numbers of people receiving care in all these categories declined considerably. In contrast, the proportion of cared for people with no primary support reason (PSR) increased from 0% to 12%, rising from less than 5 people in 2015-16 to 79 in 2017-18.[4]

Figure 8.12: Percentage of cared for people in Barnet by primary support reason, 2015-16 to 2017-18

Source: London Borough of Barnet (2019). Adult Social Care Team (based on SALT data LTS003). [Totals may not sum to 100 due to rounding.]

[1] Department of health and Social Care (2016). Guidance: Care Act factsheets: Factsheet 8: the law for carers. Who is a carer? Available at: https://www.gov.uk/government/publications/care-act-2014-part-1-factsheets/care-act-factsheets#factsheet-8-the-law-for-carers

[2] London Borough of Barnet (2019). I want to know about my rights as a carer. Available at: https://www.barnet.gov.uk/adult-social-care/i-am-carer-family-member-or-friend/i-want-know-about-my-rights-carer

[3] London Borough of Barnet (2019). Adult Social Care Team (based on SALT data LTS003).

[4] London Borough of Barnet (2019). Adult Social Care Team (based on SALT data LTS003).

8.10 Safeguarding

Safeguarding refers to measures undertaken to protect the health and wellbeing of vulnerable individuals as well as their human rights, to ensure that they are free from harm, abuse or neglect.[1] Advice and resources to assist safeguarding boards, local authorities and other stakeholders involved in safeguarding is available from the Social Care Institute for Excellence (SCIE) here: Safeguarding adults

In Barnet, a multi-agency Safeguarding Adults Board has been established to improve protection (safeguarding) practices for local adults at risk of abuse. Details of this board as well as related resources are available through this link: Safeguarding Adults Board. For more general advice and support on protecting yourself, use this link: Keeping safe.

8.10.1 Concerns

A safeguarding concern is defined as; “A sign of suspected abuse or neglect that is reported to the local authority or identified by the local authority…[and]…can include cases of domestic abuse, sexual exploitation, modern slavery and self-neglect.”[2] In 2017-18, Barnet received 1,650 safeguarding concerns, representing a rate of 556 per 100,000 adults.[3] The borough had the 8th highest number of safeguarding concerns of all the London local authorities, and was ranked 4th out of 16 (see Figure 8.13) when compared to its CIPFA[4] nearest neighbour comparators (which are similar local authorities to Barnet based on a range of socio-economic indicators).[5]

Figure 8.13: Number of safeguarding concerns received by Barnet and its CIPFA nearest neighbours, 2017-18

Source: NHS Digital (2018). Safeguarding Adults Collection (SAC).

8.10.2 Enquiries

According to NHS Digital, a safeguarding enquiry is; “The action taken or instigated by the local authority in response to a concern that abuse or neglect may be taking place…[and]…could range from a conversation with the adult to a more formal multi-agency plan or course of action.”[6]

There are two types of safeguarding enquiry (namely; “Section 42” and “Other”):

Section 42 safeguarding enquiries – where the adult meets ALL the criteria from Section 42 of the Care Act 2014 i.e.
- the adult has support AND care needs (whether or not the authority is meeting these needs)
- the adult is at risk of, or experiencing, abuse or neglect
- due to those needs the person is unable to protect himself / herself against the neglect or abuse or the risk of it.
Other safeguarding enquiries - where an adult does not meet all of the Section 42 criteria, but where the local authority considers it both proportionate and necessary to have a safeguarding enquiry.[7]

During 2017-18, there were 610 Section 42 enquiries started in Barnet, at a rate of 207 enquiries per 100,000 adults. In that year, Barnet had the 9th highest number of Section 42 enquiries of all 33 London local authorities and was ranked 7th highest (out of 16), when compared to its CIPFA nearest neighbour comparators (Figure 8.14). In contrast, there were only 35 Other safeguarding enquiries for Barnet in 2017-18, which equated to a rate of 12 Other enquiries per 100,000 adults. Overall, 94% of all safeguarding enquiries commenced in Barnet during 2017-18 were Section 42 enquiries, which was higher than the national average of 88% for that year.[8]

Figure 8.14: Number of Section 42 enquiries commenced by Barnet and CIPFA nearest neighbours, 2017-18

Source: NHS Digital (2018). Safeguarding Adults Collection (SAC).

8.10.3 Conversion Rate

In safeguarding, the “conversion rate” is the percentage of safeguarding concerns that lead to enquiries. For Barnet, in 2017-18, the conversion rate was 39%, which was similar to the national (England) average for that year (38%). On conversion rate, Barnet was ranked 10th out of 16 against its CIPFA comparators and 19th out of 33 against all London local authorities (see Figure 8.15).

Figure 8.15: Conversion rate for Barnet and its CIPFA comparators, 2017-18

Source: NHS Digital (2018). Safeguarding Adults Collection (SAC).

[1] NHS Digital (2018). Guidance for completing the Safeguarding Adults Collection (SAC) 2017-18. Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2018#safeguarding-adults-collection-sac-

[2] NHS Digital (2018). Guidance for completing the Safeguarding Adults Collection (SAC) 2017-18. Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2018#safeguarding-adults-collection-sac-

[3] NHS Digital (2018). Safeguarding Adults Collection (SAC): Safeguarding Adults, England 2017-18-Interactive Report. Available at: https://app.powerbi.com/view?r=eyJrIjoiYjEyMDIzMzItM2ExMS00ZTUzLWJmZDYtOWJhMTkzYjZjOWFhIiwidCI6IjUwZjYwNzFmLWJiZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9

[4] The Chartered Institute of Public Finance and Accountancy (CIPFA, 2019). Research and Analytics: Nearest Neighbours Model. Available at: https://www.cipfastats.net/default_view.asp?content_ref=17569

[5] NHS Digital (2018). Safeguarding Adults Collection (SAC): Safeguarding Adults, England 2017-18-Interactive Report. Available at: https://app.powerbi.com/view?r=eyJrIjoiYjEyMDIzMzItM2ExMS00ZTUzLWJmZDYtOWJhMTkzYjZjOWFhIiwidCI6IjUwZjYwNzFmLWJiZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9

[6] NHS Digital (2018). Guidance for completing the Safeguarding Adults Collection (SAC) 2017-18. Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2018#safeguarding-adults-collection-sac-

[7] NHS Digital (2018). Guidance for completing the Safeguarding Adults Collection (SAC) 2017-18. Available at: https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/social-care-collection-materials-2018#safeguarding-adults-collection-sac-

[8] NHS Digital (2018). Safeguarding Adults Collection (SAC): Safeguarding Adults, England 2017-18-Interactive Report. Available at: https://app.powerbi.com/view?r=eyJrIjoiYjEyMDIzMzItM2ExMS00ZTUzLWJmZDYtOWJhMTkzYjZjOWFhIiwidCI6IjUwZjYwNzFmLWJiZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9