Given the complex pattern of need described above, demand for health and social care services is increasing. Resources are reducing, and so we are in the process of changing social care and other services in order to meet increased demand.

However, we also know that the picture is more complex than demand just being driven by population changes because in some areas demand for care is affected, not just by demographic change, but by other factors.

According to Professor John Bolton Predicting and managing demand in social care, discussion paper April 2016 (Institute for Public Care) the local factors that influence the demand for state funded services in adult social care, in addition to pure demographic changes are:

  • The relative wealth in the population (or the opposite in relation to areas of high deprivation);
  • The behaviours of key players in the NHS, the performance of intermediate care and the availability of therapists and nurses in the community;
  • The effectiveness of the council ‘front door’ in finding solutions for people and their problems - the effectiveness of short-term help and the approach to preventive help;
  • The way in which the needs of people with lower care needs are met including the use of assisted technology;
  • The practice and supervision of assessment and care management staff;
  • The approaches taken to progression towards greater independence for those with long-term conditions;
  • The way in which people with long-term conditions are helped to self-manage their conditions including dementia care;
  • The approaches taken to the assets of the person being assessed and the involvement of family and community in a person’s solutions;
  • The way in which providers deliver outcomes including the availability and vibrancy of the voluntary sector;
  • The availability and the nature of supported housing services including Extra-Care Housing;
  • The partnership with carers and carer organisations; and
  • The use of performance measures to judge the outcomes from the care system.

As well as demographic pressures, demand for adult social care services are impacted on by changes in other services areas within the health and social care system. For example the CCG plans to shift investment from hospital beds into the community in line with the new model of care may affect demand for other services in the area.

At June 1 2016 a snapshot of people receiving an adult social care service noted that approximately just under 2,200 people were receiving adult social care care packages funded directly by Torbay Council, or managed and reviewed by adult social care in Torbay.

Table 1: Number of people receiving care packages
Type of care and support Packages Mental Health Under 65 Mental Health Over 65 Learning Disability Adults & Older People (Torquay) Adults & Older People (Paignton & Brixham) Total
Low cost per week packages of care at home 31 14 13 148 125 331
Medium cost per week packages of care at home 52 38 215 291 306 902
Medium cost per week packages of care in a care home 35 133 63 144 148 523
Higher cost per week packages of care at home or in a care home 7 7 136 28 26 204
Care paid for by service user in a care home* - 28 1 28 38 95
Care paid for by service user at home* - 9 - 46 59 114
Totals 125 229 428 685 702 2169

* Managed and reviewed by Adult Social Care at Torbay Council fee levels