Using administrative records to understand the needs of older social care recipients

Background: Little is known about the complexity and magnitude of care needs of social care users in England, and about the extent to which well-defined typologies can be identified among social care recipients. The present study aims to achieve a better understanding of social care user needs by exploring information from administrative records from two local councils in England.  

Methods: The analysis includes approximately 13,500 older adults (aged 65+) who received publicly funded community services in two Local Authorities (LAs) in England. We extracted indicators of care needs from needs assessments carried out between 2012-2015. Latent Class Analysis was used to identify underlying patterns of needs and to develop broad typologies of care users. Differences in  care needs trajectories between these typologies were examined. 

Results: Four main classes of social care recipients were identified. Class 1 was characterised by relatively younger individuals with relatively low needs, often with difficulties travelling or moving independently and receiving short-term support. Class 2 identified users with moderate care needs related to safety and personal care, mostly associated with mobility problems, sensory impairment or a physical disability. Class 3 included older people with relatively higher needs than Classes 1 and 2, with specific needs for support with decision-making sometimes linked to dementia. Class 4 included the oldest group of users and was characterised by very high levels of both ADL and IADL needs and  high prevalence of dementia and other health conditions (such as stroke). Their community care  packages were more intense, and users in this group were more likely to be helped by unpaid carers. Forty percent of older community users saw an increase in their social care needs after 24 months of assessment and one in ten users experienced an improvement in their condition. Significant differences in the risk of deterioration in care needs were found across the four latent classes. 

Conclusions: Despite challenges associated with the use of administrative data for research, social care records were found to be a rich source of evidence on care needs. The identification of key typologies of care users using administrative data could help councils plan and commission care and target their resources effectively.