Question 1

Understanding social care needs and models of provision

Accepted Answer

Aim To understand the range of needs of social care recipients and explore relationships between needs and types and levels of support. To understand the rationale for different care models, and ways in which different approaches are designed and implemented for different users and carers. We will Assess key drivers of demand for care and aim to identify broad “typologies” of cases and predictors of complexity and volatility to inform the assessment of demand for care at a system-level and to support service commissioning strategies. Assess for the presence of inequalities in service use linked to age, gender, income, ethnicity and place of residence. Understand how attitudes to care of users, carers and council arrangements (local policies and charges) influence choices for different care services, and to evaluate the impact of different care models on people’s needs. Map the range of new care service innovations and seek to understand why and how they respond to need. Build on this work to design and implement individual-level surveys to improve understanding of patterns of needs and support amongst self-payers. Projects Project 1.1 – Understanding needs, services and outcomes Project 1.2 – Strengths-based approaches in social care and social work

Question 2

Impact and quality of services

Accepted Answer

Aim To answer the following questions: How embedded are cost-effectiveness and outcomes-based approaches in the system? Is it possible to measure quality (and outcomes) sufficiently well, and is this developed in policy? The methodological challenges in assessing the cost-effectiveness of social care? We will Take stock of the general state of effectiveness and cost-effectiveness evidence in social care, to contribute to growing this evidence base and to investigate how best to embed cost-effectiveness ideas in social care policy locally and nationally. Work with stakeholders (commissioners and providers) to assess their priorities for developing the quality and cost-effectiveness agenda, and the evaluation culture.  Review quality and cost-effectiveness evidence for key interventions, and develop evidence of impact and cost-effectiveness using secondary data analysis. Support the development of analysis methods, especially for measurement of outcomes and quality (including work on ASCOT) and methods for estimating the causal effects of interventions. Projects Project 2.1 – The impact of short-term residential care home beds on delayed transfer of care (DTOC) among older patients Project 2.2 – Local funding and resource decision-making for adult social care – the role of cost-effectiveness logics

Question 3

System organisation and oversight

Accepted Answer

Aim To explore: The quality and sustainability of care The price of care, and variations in price The cost of oversight. We will Map capacity and demand across care markets, assessing variation in quality and sustainability, and improving knowledge about self-payers and what affects people’s choices in care markets. Assess the drivers of quality, sustainability and price in care and labour markets. Model the effects of changing policy (levers). Projects Project 3.1 – Quality, workforce and competition in home care

Question 4

Social care demand and funding challenges now and for the future

Accepted Answer

Aim Develop evidence and analytical tools to understand: Future demand for social care services and factors associated with changes in demand Likely supply of unpaid care by family and friends Implications of these factors on social care expenditure over the coming years We will Examine how demographic and socioeconomic changes impact upon demand for care services and associated expenditure, and how policy reforms might affect care demand now and in the future. Produce projections to inform the expected social care reforms, for instance the implications of funding reforms. Assess future trends in disability and unpaid care supply. These questions are crucial for planning services and informing funding reform, but there is uncertainty about whether increases in life expectancy will be accompanied by expansion or compression of disability, and about trends in disability earlier in life. Widen the scope of ASCRU simulation models by incorporating indicators of social care outcomes and social care impact on healthcare. Projects Project 4.1 – Enhancing capacity for producing long-term care projections and investigating trends in disability in old age and their implications for future need for long-term care Project 4.2 – Social care demand and funding challenges now and for the future Project 4.3 – Developing adult social care modelling capability for policy analysis Project 4.4 – Revisiting the economic case for social care spending: The case of informal care

ASCRU Research Themes

Our research is arranged around four themes