Short and Long Term (SALT) Return

Short and Long Term (SALT) Return
Short and Long Term (SALT)
Return
Guidance
     For use in 2014-15 alongside:
      Equalities and Classifications (EQ-CL) Framework




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Short and Long Term (SALT) Return
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Author:                Adult Social Care Statistics team,
                       Health and Social Care Information Centre
Contact:               salt@hscic.gov.uk

Version:               V1.5
Date of publication:   September 2014
Short and Long Term (SALT) Return
Revision History
Version Date                 Summary of Changes

1.0         May 2013         Original Version

1.1         July to          Various enhancement and corrections as a result of local authority feedback and
            September        SALT Technical Group decisions.
            2013

1.2         26/9/2013        Modification to title of Table 4 for measures STS002a and STS002b, in section
                             ‘Summary of Measures’, to match the SALT Proforma.
                             Amended the name of a significant event in measure LTS002a list of significant
                             events from, ‘SAR Concern’ to ‘Safeguarding Concern’.


            15/10/2013       Enhancement of wording in measure LTS001a section ‘On the books’, clarifying
                             who should be included in the measure.

            23/10/2013       Revised wording for measure STS001 FAQ 10 on recording services during
                             transfer from children’s to adults’ services.

            8/11/2013        Moved paragraph ‘Carers who are also Service Users’ before section ‘Detailed
                             Guidance on Tables’ for measure LTS003.

            11/11/2013       Amended measure LTS003, section ‘Who to include / exclude’ paragraph 2, for
                             clarity.

            12/11/2013       Additional FAQs (FAQ 16 onwards) for measure STS001.
                             Additional FAQ for measure STS002a.
                             Added FAQ sections for measures LTS001a, LTS002a, and LTS003.
                             Refresh of link to ASCOF 2013 / 14 Handbook of Definitions.
                             Revised wording in ‘Summary of Measures’ section for clarity
                             Added Appendix with supporting diagrams
                             Minor formatting

            21/11/2013       Revised wording in section ‘Relationship with ASCOF measures’ for measure
                             STS001.

            26/11/2013       Modified title of measure LTS002b for clarity.
                             Removed reference to ‘life event’ when discussing early cessation of short term
                             care to maximise independence.

1.3         12/12/2013       Revised text in measure STS001 ‘Hierarchy of Sequels’ section advising on
                             selection of outcomes.

            3/1/2014         Clarified exclusion based on employment status for measure LTS004



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Short and Long Term (SALT) Return
7/1/2014     Revised wording in measure STS002b section ‘Supporting carers’ paragraph 3.

21/1/2014    Removed superfluous text in the definition of ‘No Change in Setting: Level of long
             term support increased’ in section ‘Sequel to Review’ of measure LTS002a.

10/3/2014    Amended reference to ‘adult placement’ to ‘shared lives’ in relation to SALT
             measure STS004

10/3/2014    Revised text for clarity in section ’Carers who are also service users’ for measure
             LTS003

10/3/2014    Additional text in section ‘Who to include / exclude’ for measure LTS003

10/3/2014    Expanded guidance for route of access ‘diversion from hospital’ added to table of
             routes of access for measure STS001

10/3/2014    Changes to ‘Summary of measures’ to reflect removal of terminology ‘Younger
             Adults’ and ‘Older Adults’ from SALT pro forma

10/3/2014    Addition of new frequently asked question material: FAQ 10 (revised from FAQ 11
             in v1.2), 20 , 21 (revised from FAQ15 in v1.2), 22 and 23 (revised from FAQ 7 in
             v1.2) for SALT measure STS001, FAQ 2 for SALT measure STS002b, FAQ 2 for
             SALT measure LTS002a, FAQ 1 for SALT measure LTS001c, FAQ 2 for SALT
             measure LTS001a

10/3/2014    Expanded guidance for reporting carers services in the sections ‘Who to include /
             exclude’ and ‘Support Direct to the Carer vs. Support Involving the Cared-for
             Person’ for SALT measure LTS003

10/3/2014    Addition of appendix 2 relating to the identification of age banding in SALT.
             Guidance on measures amended to include reference to appendix 2.

10/3/2014    Addition of new ‘Uses of Information’ section within ‘Purpose, overview and
             background’

10/3/2014    Minor change to STS001 route of access table to highlight location of guidance on
             transition

10/3/2014    Amendment to Hierarchy of Sequels table for SALT measure STS001 to improve
             description of ‘No services provided (any reason)’

20/3/2014    Revision to advice for inclusion in category ‘unknown’ in LTS004

20/03/2014   Change to the description of measure STS004 to mirror the descriptions
             elsewhere in the ‘Summary of measures’

20/03/2014   Removal of STS004 FAQ 3 and amendment to FAQ 2 to remove ambiguity over
             assessment for services included in measure
V1.4        20/05/2014       Amendment to the way gender is defined on page 55 to match description in the
                             EQ-CL framework

            20/05/2014       Amendment to figure 2 to highlight the way sequels of long term support are
                             treated in SALT measures STS001a and STS002

            20/05/2014       Significant event ‘ Emergency related to carer’ amended to ‘Issues related to
                             carer’ to reflect feedback that not all carer related reviews result from a sudden or
                             emergency event

            20/05/2014       Appendix 1 amended to reflect above changes to significant events.

            20/05/2014       Figure 17 added to clarify detail on SALT measure LTS002b table 3

            20/05/2014       Addition of FAQ 3 for SALT measure LTS002a

            20/05/2014       Addition of FAQ 24 for SALT measure STS001

            20/05/2014       Addition of FAQ 5 for SALT measure STS0002a

            20/05/2014       Amendment of category utilised within LTS003 ‘No PSR – CARED FOR
                             PERSON NOT RECORDED’ to ‘No PSR – Cared for person not recorded or
                             details not current’. Addition of FAQ 3 for SALT measure LTS003 to reflect this.

            20/05/2014       Addition methods of following up clients location on 91st day for SALT measure
                             STS004 added for clarity, reflecting council feedback

            09/06/2014       Page 13 – amendment to description of SALT measure LTS004 to remove the
                             implication that the SALT and preceding ASC-CAR tables are ‘equivalent’

            09/06/2014       Page 64 – FAQ1 for LTS002a – question shortened and simplified for ease of
                             reading. No change to the meaning or to the response has been made.

            12/06/2014       Amendment to Relationship with ASCOF measures sections throughout to align
                             with the 2014-15 ASCOF Handbook of Definitions

            12/06/2014       Amendment to SALT measure LTS004 to remove obsolete reference to
                             assessment and review of clients within the criteria for inclusion in the measure

            12/06/2014       Page 74, new content relating to LTS004 to outline the two main differences
                             between LTS004 and the ASC-CAR ‘L’ tables

            12/06/2014       Addition of FAQ 25 for STS001 (also referenced in FAQ for STS002a/b and
                             LTS002a)

            12/06/2014       Pages 29 and 35, addition of description of sequel ‘Needs identified – but support
                             declined’ omitted from earlier versions of the guidance.

V1.5        04/09/2014       Addition of new sentences to clarify reporting within cells labelled ‘total clients in
                             table’ within SALT LTS002 measures.


Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                                     5
04/09/2014   Revision to web link for ASCOF Handbook of Definitions 2014-15 within STS001
                     section headed ‘How to include equipment’

        04/09/2014   Replacement of obsolete reference to ‘Primary Care Trusts’, addition of ‘data’ in
                     respect to local records of deaths within STS004

        09/09/2014   Addition of FAQ 3 for LTS001a


        09/09/2014   Amendment and additional text for clarity on the reporting of paid employment in
                     LTS004.

        09/09/2014   Addition of FAQ 26 for STS001


        09/09/2014   Addition of FAQ 5 for LTS002a


        09/09/2014   Addition of FAQ 4 for LTS001a.


        15/09/2014   Amendment to the definition of sequel ‘No Services Provided – Needs Identified
                     but Support Declined’ in LTS002a for clarity that this refers to eligible needs.

        15/09/2014   Removal of references to the ASCOF Handbook of Definitions 2014-15 not having
                     been published at the time of writing as the document is now available.

        22/09/2014   STS001 small amendment for clarity to description of table describing prior
                     requests for support


To aid identification of changes in version 1.5 of this guidance new or amended text is
highlighted in this colour.
Contents
Revision History                                                                              3
Contents                                                                                      7
Table of Figures                                                                             11
Purpose, Overview and Background                                                             12
  Purpose                                                                                    12
  Overview                                                                                   12
  Background                                                                                 12
  Uses of information collected                                                              14
  SALT queries                                                                               14

Summary of Measures                                                                          15
  STS – SHORT TERM SUPPORT                                                                   15
     STS001         Requests for support for new clients broken down by the different sequels 15
     STS002a Short Term support to maximise independence sequels for NEW clients             15
     STS002b Short Term support to maximise independence sequels for EXISTING clients
                                                                                    15
     STS003 Snapshot Short Term support to maximise independence (temporary
     measure)                                                                                15
     STS004 Proportion of older people (65+ who were still at home 91 days after discharge
     from hospital into reablement / rehabilitation                                     15
  LTS – LONG TERM SUPPORT                                                                    15
     LTS001a Long Term support anytime in the year                                           15
     LTS001b Long Term support at year end                                                   15
     LTS001c Long Term Support for 12+ months at year end                                    15
     LTS002a Clients in receipt of Long Term support (Unplanned reviews and Planned
     reviews leading to a care home admission)                                               16
     LTS002b Clients in receipt of Long Term support for more than 12 months at the year-
     end (LTS001c) with a review during the year and the sequel to that review          16
     LTS003 Carer support                                                                    16
     LTS004 Accommodation and Employment Status of working age Learning Disabled
     clients                                                                     16
  Changes to the Measure Descriptions since the Consultation                                 16




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Guidance on Measures                                                                                               17
STS001                                                                                                             17
    General description and business case                                                                           17
    Detailed Guidance for Data Tables                                                                               18
     Tables 1a and 1b                                                                                               18
     Tables 2a and 2b                                                                                               21
    Frequently Asked Questions for STS001                                                                           25

STS002a                                                                                                            31
    General description and business case                                                                           31
    Detailed Guidance for Data Tables                                                                               32
     Table 1                                                                                                        32
     Tables 2a and 2b                                                                                               33
     Table 3                                                                                                        33
     Table 4                                                                                                        33
    Frequently Asked Questions for STS002a                                                                          35

STS002b                                                                                                            37
    General description and business case                                                                           37
    Detailed Guidance for Data Tables                                                                               37
     Table 1                                                                                                        37
     Tables 2a, 2b and 3                                                                                            38
     Table 4                                                                                                        39
    Frequently Asked Questions for STS002b                                                                          41

STS003 (temporary measure)                                                                                         42
    General description and business case                                                                           42
    Detailed Guidance for Data Table                                                                                42

STS004                                                                                                             44
    General description and business case                                                                           44
    Detailed Guidance for Data Table                                                                                44
    Frequently Asked Questions for STS004                                                                           46

LTS001a                                                                                                            49
    General description and business case                                                                           49
    Detailed Guidance for Data Tables                                                                               50
     Tables 1a and 1b                                                                                               50
    Frequently Asked Questions for LTS001a                                                                          53
8                                      Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
LTS001b                                                                             55
  General description and business case                                             55
  Detailed Guidance for Data Tables                                                 56
     Tables 1a and 1b                                                               56
     Tables 2a and 2b                                                               57
     Table 3                                                                        57
     Tables 4a and 4b                                                               58

LTS001c                                                                             60
  General description and business case                                             60
  Detailed Guidance for Data Tables                                                 60
     Tables 1a and 1b                                                               60
  Frequently Asked Questions for LTS001c                                            61

LTS002a                                                                             63
  General description and business case                                             63
  Detailed Guidance for Data Tables                                                 64
     Tables 1a and 1b                                                               64
     Table 2                                                                        67
  Frequently Asked Questions for LTS002a                                            68

LTS002b                                                                             70
  General description and business case                                             70
  Detailed Guidance for Data Tables                                                 70
     Tables 1a and 1b                                                               70
     Table 2                                                                        71
     Table 3                                                                        71

LTS003                                                                              72
  General description and business case                                             72
  Detailed Guidance for Data Tables                                                 74
     Table 1                                                                        74
     Table 2                                                                        75
     Table 3                                                                        75
  Frequently Asked Questions for LTS003                                             77




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LTS004                                                                                                          79
     General description and business case                                                                       79
     Detailed Guidance for Data Tables                                                                           79
      Table 1                                                                                                    79
      Table 2                                                                                                    80

Appendix 1: SALT Diagrams                                                                                       82
Appendix 2: Identification of age banding in SALT measures                                                      92




10                                  Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
Table of Figures
Figure 1: Customer Pathways through SALT ....................................................................... 13
Figure 2: Customer journey mapped to data recorded for measures. .................................. 19
Figure 3: Summary of SALT collection. ................................................................................ 82
Figure 4: Measure STS001 Tables 1a & 1b. ........................................................................ 83
Figure 5: Measure STS001 Tables 2a & 2b. ........................................................................ 83
Figure 6: Measure STS002a Tables 1, 2a, 2b & 3................................................................ 84
Figure 7: Measure STS002a Table 4.................................................................................... 84
Figure 8: Measure STS002b Tables 1, 2a, 2b & 3................................................................ 85
Figure 9: Measure STS002b Table 4.................................................................................... 85
Figure 10: Measure LTS001a Tables 1a & 1b. ..................................................................... 86
Figure 11: Measure LTS001b Tables 1a, 1b, 2a, 2b, 3, 4a & 4b. ......................................... 86
Figure 12: Measure LTS001c Tables 1a & 1b. ..................................................................... 87
Figure 13: Measure LTS002a Tables 1a & 1b. ..................................................................... 87
Figure 14: Measure LTS002a Table 2. ................................................................................. 88
Figure 15: Measure LTS002b Tables1a & 1b. ...................................................................... 88
Figure 16: Measure LTS002b Table 2. ................................................................................. 89
Figure 17: Measure LTS002b Table 3. ................................................................................. 89
Figure 18: Measure LTS003 Tables 1 & 2. ........................................................................... 90
Figure 19: Measure LTS003 Table 3 .................................................................................... 91
Figure 20: Measure LTS004. ................................................................................................ 91




Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                                          11
Purpose, Overview and Background
Purpose

This document gives the specifications for the Short and Long Term Return (SALT).

Overview

The SALT data collection is a set of measures produced through consultation with stakeholders as
part of the Zero Based Review (ZBR) of social care data collections. It comprises two main sections,
short term support (described in the Guidance as ‘STS’ measures) and long term support (described
as ‘LTS’ measures). It also derives some of its structure from the Equalities and Qualifications (EQ-
CL) Framework.

This SALT document should be read alongside the EQ-CL Framework, which establishes a set of
data ‘standards’ and timeframes for the collections, and also addresses issues common to all three
collections (ASC-FR, SALT and SAR) identified in the 2012 ZBR Consultation.

The EQ-CL Framework contains the full definitions attached to Primary Support Reasons (PSRs) and
support settings and is included on the Health and Social Care Information Centre (HSCIC) website 1.

Background

The Health and Social Care Information Centre (HSCIC) was asked to develop and consult on new
proposals for adult social care data collections, taking account of the changing context of social care.
This request came from the Outcomes and Information Development Board (OIDB), which is jointly
chaired by the Department of Health (DH) and the Association of Directors of Adult Social Services
(ADASS).

During 2011 a number of stakeholder groups were established with members from the Health and
Social Care Information Centre, secondees to the ZBR Programme, a range of local authorities from
across the country, the Department of Health, Skills for Care and others. They considered what
council level adult social care data should be collected nationally to meet the changing requirements.
This programme was known as the 'Zero Based Review'.

The stakeholders collaborated to develop proposals for three new national collections, namely the
Safeguarding Adults Return (SAR), Short and Long Term support (SALT), and Finance return (ASC-
FR), which would replace the existing Abuse of Vulnerable Adults (AVA), Referrals, Assessments
and Packages of care (RAP), Adult Social Care Combined Activity (ASC-CAR) and Personal Social
Services Expenditure (PSSEX1) collections. A new standards framework, called the Equalities and
Classifications (EQ-CL) Framework, was designed to support the three new collections by setting out
common data items, data standards and timeframes.

The HSCIC and the stakeholder groups considered whether national minimum data requirements
were met by the proposals and whether the size and complexity of the proposed data collections
appeared feasible. A consultation was launched in the summer of 2012 and ran for 8 weeks, asking
for feedback on the proposals. Although the significant majority of responses were broadly supportive
of the proposals, concerns were raised regarding timescales involved in order to implement all three
collections. Development of SALT has taken into account this and other concerns which were raised
in the consultation.

The SALT stakeholder group, working alongside colleagues in the ASC-FR and EQ-CL groups, used
the consultation responses to help produce the final collection presented here. The result is a true co-
production of the different stakeholders, taking into account local as well as national requirements.

1
    http://www.hscic.gov.uk/socialcarecollections2015
12                                          Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
The HSCIC would like to recognise the vital contribution made by local authority representatives who
gave up their time to ensure that the measures in SALT were relevant and focussed on the priorities
facing adult social care.

The diagram below outlines the types of information collected by the SALT Return.




Figure 1: Customer Pathways through SALT



SALT has been designed to track customer journeys through the social care system, demonstrated
by the arrows which represent the ways in which clients can move between different forms of
support. Support to carers is also vital to and is referenced in both the long and short term sections of
the return, as well as having its own measure.

Following a request for support, clients may be provided with a period of short term support designed
to maximise their independence (e.g. a ‘reablement service’) or be referred directly for long term
support (e.g. an emergency care home admission) or receive support such as ongoing low level
support (e.g. an item of assistive equipment). Short Term Support to Maximise Independence is
intended to be time-limited with the aim of ensuring clients become as independent as possible,
ending with a formal assessment or review to determine what will follow. Long term support
encompasses support provided with the intention of maintaining quality of life for an individual on an
ongoing basis.

The emphasis is on recording key events and the sequels to those events. The 'STS' and 'LTS'
measures in SALT should not be thought of as counts of short term and long term services. Those
familiar with RAP and ASC-CAR should therefore read this Guidance carefully and get in touch with
any queries.

The measures were designed to be useful at both a local and national level. SALT will provide a
much richer national picture of short term preventative services than was possible in the RAP and
ASC-CAR returns. The dataset should allow for easier integration with survey and other outcome
measures and sharing of best practice through benchmarking.

Please note that over the past year the collections have taken account of a range of feedback and
there have been revisions to plans at various points. It is therefore important to consider these new
materials even if you have looked at earlier versions in some detail.

Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                       13
In July 2013 councils received funding from the Department of Health to prepare for the
implementation of the new collections. Along with changes needed for EQ-CL an important aspect of
this is setting up client databases so that cases can be tracked over time – recording the significant
events and sequels to those events. This means some requests for support and provision of support
may have occurred in the prior performance year. In some measures data from the previous
performance year is explicitly referenced. Tables where this is required are optional for the first year
but in order to ease the transition and obtain as complete a dataset as possible it is recommended
councils prioritise development work for those measures. Please see the detailed guidance for each
measure for more details.

Uses of information collected

The new SALT return is intended to offer scope for genuine comparability between CASSRs, and
reliable aggregation to provide national and regional overviews.

The information is required for:

        Providing data on council activity for use within the Adult Social Care Outcomes Framework
         (ASCOF)
             o Monitoring the uptake of Self Directed Support, direct payments and personal budgets
             o Monitoring permanent admissions to residential and nursing care
             o Providing data on support for carers
             o Providing data on employment and accommodation status for adults with learning
                 disabilities
             o Proving data on outcomes for older people discharged from hospital into rehabilitative
                 / reablement settings
        Providing new data on the outcomes for customers in receipt of short term care to maximise
         independence, an area that has not previously been subject to local, regional and national
         benchmarking
        Providing new data on the sequels to requests for support for new clients
        Providing an evidence basis to allow councils to plan resources and to help to develop
         policies on resource allocation
        Enabling CASSRs to monitor their own provision, develop local performance indicators and
         make comparisons between their own and other CASSRs
        Answering Parliamentary Questions and contributing to ministerial briefing
        Answering a range of requests from external customers, for example Freedom of Information
         requests

SALT queries

If you have any queries, please send them to the following e-mail address:


salt@hscic.gov.uk




14                                     Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
Summary of Measures
STS – SHORT TERM SUPPORT

STS001        Requests for support for new clients broken down by the different sequels

                   Table 1a: Age band 18-64
                   Table 1b: Age band 65+
                   Table 2a/b: Repeat sequels of Short Term Support to Maximise Independence

STS002a Short Term support to maximise independence sequels for NEW clients

                   Table 1: Sequels by Route of Access
                   Table 2a: Sequels by Primary Support Reason (18-64)
                   Table 2b: Sequels by Primary Support Reason (65+)
                   Table 3: Sequels by Carer Support
                   Table 4: Short term support to maximise independence leading to long term support

STS002b Short Term support to maximise independence sequels for EXISTING clients

                   Table 1: Sequels by Route of Access
                   Table 2a: Sequels by Primary Support Reason (18-64)
                   Table 2b: Sequels by Primary Support Reason (65+)
                   Table 3: Sequels by Carer Support
                   Table 4: Short term support to maximise independence leading to long term support

STS003        Snapshot Short Term support to maximise independence (temporary measure)

                   Table 1: By Age Band
                   Equivalent to STS vs. RAP P2s

STS004 Proportion of older people (65+ who were still at home 91 days after discharge
from hospital into reablement / rehabilitation

LTS – LONG TERM SUPPORT

LTS001a Long Term support anytime in the year

                   Table 1a: Age band 18-64
                   Table 1b: Age band 65+

LTS001b Long Term support at year end

                   Table 1a: By Primary Support Reason (18-64)
                   Table 1b: By Primary Support Reason (65+)
                   Table 2a: By Reported Health condition (18-64)
                   Table 2b: By Reported Health condition (65+)
                   Table 3: By Carer Support
                   Table 4a: By Ethnicity & Gender (Males)
                   Table 4b: By Ethnicity & Gender (Females)

LTS001c Long Term Support for 12+ months at year end

                   Table 1a: Age band 18-64
                   Table 1b: Age band 65+

Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                      15
LTS002a Clients in receipt of Long Term support (Unplanned reviews and Planned reviews
leading to a care home admission)

              Clients from LTS001a only
              Table 1a: Unplanned Reviews (18-64)
              Table 1b: Unplanned Reviews (65+)
              Table 2: Planned Reviews leading to a change in setting

LTS002b Clients in receipt of Long Term support for more than 12 months at the year-end
(LTS001c) with a review during the year and the sequel to that review

              Clients from LTS001c only
              Table 1a: Unplanned Reviews (18-64)
              Table 1b: Unplanned Reviews (65+)
              Table 2: Planned Reviews (18-64 & 65+)
              Table 3: Total planned and unplanned (Tables 1a/b & 2)
              NB: Tables 1a/b & 2 count events. Table 3 counts clients.

LTS003    Carer support

              Table 1: By Age Group of carer
              Table 2: By Primary Support Reason of cared for person
              Table 3: By method of Assessment or Review

LTS004    Accommodation and Employment Status of working age Learning Disabled
clients
              Related to ASC-CAR tables L1 & L2 for ASCOF 2013/14 measures 1E & 1G


Changes to the Measure Descriptions since the Consultation

Please note that since the consultation the naming of the measures has changed. The changes are
shown below.

           Previous Identifier                        New Identifier

                                        Short Term Support

           REA001                                     STS001

           REA002a and b                              STS002a and b

           REA003                                     STS003

           REA005                                     STS004

                                        Long Term Support

           PSS001a, b, c                              LTS001a, b, c

           PSS002a, b                                 LTS002a, b

           PSS003                                     LTS003

           PSS007                                     LTS004




16                                   Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
Guidance on Measures
STS001
Numbers of requests for support received from NEW CLIENTS, broken down by the different
sequels to that request.

Period 01/04/2014 – 31/03/2015 (Tables 1a and 1b)
Period 01/09/2013 – 31/03/2015 (Tables 2a and 2b)

General description and business case

This captures the level of demand for social care services from new clients. Tracked over time, this
will help with future demand prediction, human resource planning and commissioning. Clients
previously in receipt of short term services intended to maximise their independence (which may be
termed ‘reablement’) who return with further requests for service are also captured within a period of
6 months (even if this occurred in the previous year). This will help determine (in conjunction with
measures STS002a and STS002b) whether ‘reablement’ type interventions help prevent further
demands on social care services and gives basic details of the nature of ongoing support required.

When benchmarked, differences between local authorities can be examined so that best practice can
emerge and be shared, resulting in wider improvements.

The information is important for aligning costs with activity, to establish the balance between short
term interventions and long term services (covered in the ‘LTS’ measures) and to identify the cohort
for who short term services were offered.

Who to include / exclude?
The intention is to count the sequels of requests for support (contacts from new clients or their
representative, or someone acting on their behalf) being made in relation to the provision of adult
social care services, excepting ‘casual contacts’ (see EQ-CL Glossary) and matters relating to adult
safeguarding procedures, which are dealt with by the SAR collection. Sequels are the substantive
actions taken in relation to the request for support.

For clients to be included in STS001 the following criteria must apply:

        STS001 is concerned with numbers of requests for support, not numbers of clients

        Requests may come from, or be made on behalf of, new clients

        The return is for adult clients aged 18 and over only at the time of request

        Requests for support are only included where the sequel to that request has been determined during
                          st         st
         the year (April 1 – March 31 )

Note that although this measure is about requests for support, the sequels for these clients may not
be known until weeks or even months later. It may require a full Community Care Assessment and
commissioning of a suitable long term care package before this sequel is known. This may mean
clients whose request was made in one reporting year only have a clear sequel in the following year.
Clients that have requested support but where the response to that request is not determined by 31st
March should be included in the following year’s return.

Note in the first year of the SALT collection it may not be possible for councils to check back through
records for previous years. Tables 2a and 2b are therefore voluntary for the first year. Please see
‘Transitional Arrangements’ below for more details.



Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                             17
This measure only includes requests for support relating to new clients. For SALT the definition of
‘new’ is that the client is not in receipt of any long term support at the time the contact was made. For
a fuller definition of ‘long term support’ see the EQ-CL Glossary and read the guidance for the Long
Term Support measures (LTS001-004) later in this document. Note that a person who previously
received long term support which ceased before the request was made, is considered a new client
and should be included.

All requests for support relating to social care needs are included even if this comes from someone
other than the client (e.g. a carer or family member). CASSRs do need to identify whether a particular
request is for social care needs or carer support needs. CASSRs should only include requests for
support here that relate to social care needs (carer support is captured in measure LTS003).

If multiple requests for support are made within a short period of time for the same client and same
presenting issue, then there should be only one request counted. If subsequent requests are
received for that client then that client may be included in the tables multiple times as long as the
sequels to those requests occur in the current year (1st April – 31st March). It is recognised that
determining whether a client contact is for the same or a different presenting issue may be difficult
and technical solutions to this will vary between authorities. Comments on any ‘rules of thumb’ you
have used to collect this data should be written in the feedback section at the end of the online
return.

Note that the measure includes work done in a contact centre where suitably trained staff are
handling the initial requests for access to services. CASSRs will need to ensure that any data
captured by a contact centre can be reported on for SALT purposes.

Detailed Guidance for Data Tables

Tables 1a and 1b
Individuals aged 18-64 on 31st March should be included in Table 1a. Older clients should appear in
Table 1b.

Route of Access

 Planned Entry     These are requests for clients moving from children’s social care into potential support
 (Transition)      from adults. See STS001 FAQ 10 for further detail on transition.

 Discharge from    These are requests relating to clients who are being referred for support following a
 Hospital          planned or an emergency admission to hospital.

 Diversion from    These are requests relating to clients who are being referred for support as a means of
 Hospital          preventing admission to hospital. Diversion will include some kinds of falls prevention and
                   falls response services, as well as reablement type services aimed at avoiding hospital
                   admission. It is intended to pick up those referrals made specifically to prevent admission
                   to hospital. Councils will have well-defined programmes for preventing admissions, such
                   as reablement. The request is likely to be made by a health professional wanting to
                   access a particular service, where prevention of hospital admission is a specific outcome
                   sought, rather than a request for support made for or by someone in the community who
                   is not at risk of hospital admission, despite their presenting needs.

 Community /       These are requests from clients (or on behalf of clients) based in the community,
 Other route       residential / nursing care or any other route of access.


Response to Request for Support
This is the sequel identified as the response made to the client in terms of any type of support
provided. This includes decisions to provide short term interventions or long term services, as well as
issuing equipment or signposting to universal or voluntary sector services.


18                                       Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
Each request for support can only have one sequel counted. Because SALT is built around tracking
client ‘journeys’ through social care, there is a need to choose the most relevant outcome. Where
more than one response is actually made, CASSRs should refer to the diagram and instructions
below. The diagram is best understood if you consider how you would treat an individual client in
measure STS001. The shaded area concerns follow-up in STS002a for those who received short
term support to maximise independence (‘ST-MAX’ in the diagram).




Figure 2: Customer journey mapped to data recorded for measures.


When working out how to treat a new client’s request, consider first whether they are going to be
offered short term support to maximise their independence (this may occur in any setting, such as the
client’s own home, or even a residential home). If they are, record this outcome. This client would
next appear in SALT measure STS002a, looking at the outcome of that short term support.

If not offering ‘ST-Max’, check to see whether the client was, as an eventual response to the initial
request for support, provided with long term support. This may occur only after considerable
assessment and commissioning activity. Any clients with outcomes that include long term support
should be counted in this category.




Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                       19
Hierarchy of Sequels
One of the outcomes should be selected from the following table, choosing the first which applies
according to the order in which they appear, from top to bottom.

Short Term            Includes all episodes of support provided that are intended to be time limited, with the
Support to            intention of maximising the independence of the individual and reducing / eliminating
Maximise              their need for ongoing support by the CASSR. At the end of the support a review or
Independence          assessment for ongoing care will take place to determine what will follow.

                      Note that there is no requirement to know what will follow in order to be counted in this
                      measure.

                      While episodes of 'respite care' may also be ‘time limited’, the support is usually provided
                      as part of a longer term support package for a client, is commissioned only because of
                      the existence of a carer who needs support, and in SALT is considered a carers service
                      and should therefore be excluded. Any support provided to existing clients should be
                      excluded, as these are not new clients. Emergency support (i.e. not reablement but a
                      crisis support service) should be included in the Short Term Support (Other) category,
                      and not in this one.

Long Term Support     Long Term support encompasses any service or support which is provided with the
(eligible services)   intention of maintaining quality of life for an individual on an ongoing basis, and which
                      has been allocated on the basis of eligibility criteria / policies (i.e. an assessment of need
                      has taken place) and is subject to regular review. This category is further split into the
                      primary settings in which an individual receives services:

                      Community will apply to those who live independently (including those in small group
                      homes, sheltered housing or warden supported accommodation) who receive home or
                      community based services.

                      Residential will apply to those clients who live in registered care homes, even if they are
                      in receipt of some community based services.

                      Nursing will apply to those clients who live in registered care homes where nursing
                      services are also provided.

                      Note that the categories ‘residential’ and ‘nursing’ should be used for placements that
                      are intended to be permanent. Trial placements for a fixed period in order to assess
                      suitability are included in this, as the expectation would be for clients to remain in long
                      term care home support, but short term temporary stays in which the client has a
                      planned return to a community setting are not, and should be counted in the ‘Community’
                      category.

End of Life           EOL care is considered to be any episode of social care support provided as part of
                      palliative care, and which is intended to support the individual until the care is no longer
                      required. While the period of this support may be short, it falls outside the definition for
                      ‘short term support’, both because the time period for the provision of the support may
                      not be known, and because there is no expectation to review any need for further service
                      at the end of the period.

Ongoing Low Level     Should be used where a Local Authority decides to provide an ongoing service such as
Support               the provision of a minicom line / telecare, but no other service needs have been
                      identified. Such services will be based in the community. All equipment and adaptations
                      (including those with ongoing costs for maintenance and safety checks) should be
                      included in this category as described above. This category doesn’t suggest services are
                      limited or ‘minor’ in scope but it does suggest that they may continue ‘in the background’
                      supporting clients with minimal attention required by the local authority.




20                                         Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
Short Term               Includes all episodes of support provided that are intended to be time limited without
Support (Other)          intending to maximise independence / reduce the need for ongoing support. An example
                         of this might be a short term intervention for a younger adult with impaired mobility
                         recovering from an operation, who is expected to make a full recovery without any
                         additional intervention. Emergency support provided for all new clients should be
                         included in this category, while emergency support provided to existing clients should be
                         excluded, as this will be part of ongoing Long Term support.

Universal Services       A ‘universal service’ is any service or support (other than those above) for which there is
/ Signposted to          no test of eligibility and no requirement for review. Signposting indicates that the client
other support            will not be supported by the CASSR and there is no universal service which will help
                         them. Details are therefore given of other organisations (e.g. in the voluntary sector) that
                         might be able to provide assistance.

No Services              The client may have low-level needs which cannot be supported by the CASSR and
Provided (any            there is no universal service which will help them
reason)
                         This will also apply if the client dies or for some reason the process of assessing needs
                         is terminated (if just temporarily suspended, wait until the assessment process has re-
                         started and reached a conclusion before entering data here). Selecting this sequel
                         should not be seen as reflecting negatively on the local authority but more about the
                         nature of the request for support or client circumstances



Again, any clients whose request was made in the previous reporting year but where the response
was only determined this year, should be included (although in the first year of SALT this will not
always be possible – see ‘Transitional Arrangements’ below). Clients who have requested support
but where the response to that request was not determined before 31st March should not be included
until next year.

Arrangements vary between CASSRs as to the means by which clients can access short and long
term support at the point of contact. Regardless of the process and eligibility criteria applied,
CASSRs should be able to identify the appropriate sequel to the request for support, although this
may require tracking of case files over time (perhaps several weeks).

How to include Equipment
In a change and simplification from the RAP return, all provision of equipment and adaptations
should be counted in SALT as 'Ongoing Low Level Support' even if it needs to be maintained over
time (e.g. through ongoing maintenance contracts, safety inspections etc.). In the ASC-FR return
equipment is treated separately and will be appropriately accounted for, but in SALT, checks on
safety and maintenance do not constitute ‘long term support’ if the client has no other services (such
as ongoing home care, etc.). This also helps with the interpretation of the ASCOF indicator 1C on
personal budgets, as within the revised definition from 2014-15 onwards clients with equipment and
adaptations only are not expected to be in the denominator (please see the ASCOF Handbook of
Definitions for more details).

Tables 2a and 2b
These tables are intended to capture instances of short term support to maximise independence, for
requests recorded in Tables 1a and 1b where either short or long term support was provided. (In the
proforma, requests captured in the green highlighted columns are the ones that need to be checked).
The intention is to be able to help assess how effectively short term support is preventing subsequent
re-referral and admission to long term services and to pick up repeated short term interventions.




Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                                    21
Prior Requests for Support
For each request in Tables 1a and 1b with a response of Long Term Support or Short Term Support
to maximise independence (columns are shaded green although this may change in the final
proforma) count any prior requests from those clients which also resulted in short term support to
maximise independence (the CASSRs should count as many prior instances as there are for each
entry in Table 1a/b although there’s a limit as to how far it is necessary to go back – see below).

Note that the prior request is only relevant if the response to it occurred within 6 months of an entry in
Tables 1a and 1b. Because Tables 1a and 1b capture the response to each request, the 6 month
check is applied to the dates of response, rather than the dates of contact. Responses to requests
made in the previous year (i.e. before 1st April) should be included if they fall within the 6 month
window, but see ‘Transitional Arrangements’ below for guidance on what to do in the first year of
SALT.

In all cases these checks are only relevant for new clients (i.e. at the time of request, the client was
not in receipt of long term support). Therefore, all the repeat requests captured in tables 2a and 2b
will also appear in Tables 1a and 1b, either this or the previous year. Please see the table below for
some examples of how these rules would work in practice. Many other combinations are possible,
but this should give a clearer understanding of how to handle potential combinations of support
requests.

Note that in the first year of the SALT collection councils may not be able to check back through
records for the previous year. This means that Tables 2a and 2b are voluntary for the first year. See
section on ‘Transitional Arrangements’ below for more details and suggestions.

The table that follows shows some examples - prior responses to requests highlighted with grey
ellipses are those captured for SALT table 2a/2b, whilst the prior responses to requests shown in
bold should not be captured in SALT table 2a/2b. The italicised dates represent dates of responses
to prior requests for support which should not be captured in SALT table 2a/2b.




22                                      Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
Most         Most         Prior        Prior request   Earlier      Earlier      Request      Request      WHAT TO        WHAT TO COUNT:
recent       recent       request      (response)      request      request      last year    last year     COUNT:          Table 2a/b
request      request      response                     response     (response)   response     (response)   Table 1a/b
response     (response)   date                         date                      date
date
                                                                                                                        Prior request (within 6
             Long term                                                                                       Both
25.03.2015                02.01.2015     ST-Max            -            -             -           -                     months of the most
              support                                                                                      requests
                                                                                                                        recent request)
                                                                                                                        Prior request only
25.03.2015   Long term                                                                                     All three    (within 6 months of
                          02.01.2015     ST-Max        02.05.2014    ST-Max           -           -
              support                                                                                      requests     the most recent
                                                                                                                        request)
                                                                                                                        Prior and earlier
                                                                                                                        requests (the earlier
                                                                                                                        request response
             Long term                                                                                                  occurs less than 6
25.03.2015    support                                                                                      All three    months before the
                          02.01.2015     ST-Max        09.07.2014    ST-Max           -           -
                                                                                                           requests     prior request response,
                                                                                                                        and the prior request
                                                                                                                        response occurs within
                                                                                                                        6 months of the most
                                                                                                                        recent response date)
                                                                                                                        Prior request only
                                                                     Short                                              (because the earlier
25.03.2015   Long term                                                term                                 All three    request did not result
                          02.01.2015     ST-Max        09.11.2014                     -           -
              support                                               support                                requests     in short term support
                                                                    (OTHER)                                             to maximise
                                                                                                                        independence)
                                                                                                                        Nothing (the prior and
                                                                       No                                               earlier requests were
                                       Signposted                   support                                             within 6 months but
             Long term                                                                                     All three
25.03.2015
              support
                          02.01.2015     to other      09.11.2014    (client          -           -
                                                                                                           requests
                                                                                                                        neither had a sequel of
                                         services                      not                                              short term support to
                                                                    eligible)                                           maximise
                                                                                                                        independence)
                                                                                                                        Earlier request only
                                                                                                                        (this occurred less than
                                                                                                             Most
                                                                                                                        6 months before the
                                                                                                            recent,
                                                                                                                        prior request. The
             Long term                                                                        Universal    prior and
25.03.2015                19.08.2014     ST-Max        14.06.2014    ST-Max      15.03.2014                             most recent request
              support                                                                         services      earlier
                                                                                                                        was a long time
                                                                                                           requests
                                                                                                                        afterwards and outside
                                                                                                              only
                                                                                                                        of the 6 months
                                                                                                                        window)
                                                                                                             Most
                                                                                                            recent,     Request from last year
             Long term                                                                                     prior and    only (this occurred
25.03.2015                19.08.2014   Signposting     27.05.2014    ST-Max      15.03.2014    ST-Max
              support                                                                                       earlier     within 6 months of the
                                                                                                           requests     earlier request)
                                                                                                              only

[NOTE: ST-Max = Short Term Support to Maximise Independence]

Route of Access
The definition is the same as for Table 1a and Table 1b above.

Calculation of age in SALT measure STS001

Please refer to the table in Appendix 2: Identification of age banding in SALT measures for
confirmation of how age banding should be identified for this measure.

Relationships and Data Validation
Relationship with ASCOF measures
Data from Tables 1a and 1b is used for ASCOF measure 2A (Permanent admissions to residential
and nursing care). For more details on the definition and calculation of this measure, see the ASCOF
Handbook of Definitions published by the Department of Health.



Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                                                        23
Previous versions of this section of the SALT guidance discussed the way that tables 2a and 2b
could be used to calculate what proportion of new clients going on to receive short term support to
maximise independence or long term support had previously received a period of short term support
to maximise independence. By extension this could provide a context for a measure of what
percentage of clients receiving short term support to maximise independence do not require ongoing
support.

It is not now expected that the ASCOF placeholder 2E on the effectiveness of reablement services
will reference tables 2a and2b, but local authorities are encouraged to utilise this data in their
consideration of the short term care to maximise independence.

Data Validation
Note the rules given below are not the complete or final set of validation checks that will be applied
by the final HSCIC collection system. Councils should ensure their data at least meets the conditions
below. The HSCIC will confirm the full set of validation checks in an update to this Guidance.

Within the measure
Rule 1: the total number of requests for support in Table 2a cannot exceed the number recorded in
Table 1a. Similarly, Table 2b cannot exceed Table 1b.

Between measures
Rule 2: the total number of sequels to requests for support of ‘Short term support to maximise
independence’ in Tables 1a and 1b combined should be within 5% of the total number of outcomes of
‘Short term support to maximise independence’ captured in measure STS002a Tables 1, 2a, 2b, 3
and 4*.

The total of Table 1a should be within 5% of STS002a Table 2a, and Table 1b should be within 5% of
STS002a Table 2b. The totals are unlikely to be equal because clients referred for short term support
in measure STS001 may not have come to an end of that support before the return is needed on 31st
March. Others will have ended their short term services within the year (appearing in measure
STS002a) but had the decision to provide that support made in the previous year (and therefore do
not appear in this year’s STS001).

* Note that the 5% rules above are suggestions and may not be applied or be changed depending on
first year results.

Transitional Arrangements
During 2013-14 councils will be preparing for the new collections. Along with changes needed for
EQ-CL an important aspect of this is setting up client databases so that cases can be tracked over
time – recording the significant events and sequels to those events. This is particularly important for
measure STS001. Tables 2a and 2b are voluntary for the first year, but in order to get as good a data
collection as possible councils are encouraged to develop systems that will allow them to check back
for prior requests for support.

This means in order to get complete data for this measure, provisions of short term support intended
to maximise independence would need to be captured on the client database from September 2013.

For councils where the complete set of data is not available, partial data can still be used where
available to populate Tables 2a and 2b. Comments reflecting the extent to which a complete dataset
was available should be made in the end section of the online return.




24                                     Copyright © 2014, Health and Social Care Information Centre. All rights reserved.
Frequently Asked Questions for STS001

1) Why isn’t ‘short term support to maximise independence’ just called ‘reablement’?

There is no nationally agreed definition for what constitutes ‘reablement’. Local authorities will be
offering a range of services that are of short duration (typically being provided for a few weeks) and
have the explicit aim of trying to minimise the person’s use of ongoing social care services, i.e.
maximise independence and the improved level of independence should continue even after the
service is removed (some ongoing support may still be required of course). This is why equipment or
telecare should not be seen as a ‘Short term support to maximise independence’ in SALT – it
remains with the client and provides low level support on an ongoing basis, but without it, the client
would lose whatever benefits the service provides.

2) How long should I wait to determine the outcome of a 'request for support' before
   recording on STS001?

Each client’s case is different and before recording on STS001, the sequel needs to be clear. This
may mean waiting several weeks for the outcome of a full Community Care Assessment. If the
sequel is not known before the year end (31st March) then that request for support should be counted
in the following year.

3) Where do we include the provision of blue badges?

Blue badges are ‘universal services’ and this sequel should therefore be recorded for STS001.
Remember though that only one sequel can be recorded. If several sequels apply to any particular
request for support, there is a hierarchy for determining which sequel to count for STS001. The
hierarchy is the same as the ordering of columns (from left to right) within the STS001 tables (refer to
the section on Hierarchy of Sequels for STS001 above).

4) Where do we include the provision of National Bus and / or Freedom Passes?

National Bus and Freedom passes are not seen as social care support which matches the way they
were considered within the previous RAP collection. For SALT the sequel of ‘no service provided’
would apply – i.e. the request for support is captured, but the sequel does not suggest any social
care support has been given.

5) For some basic services such as the issue of a blue badge, or registration as disabled, we
   often have a waiting list. When do we record their ‘sequel’ in STS001?

When the sequel is known (i.e. at the point of placing them on a waiting list) it can be recorded for
STS001 purposes.

6) Where do we record contacts and referrals with the outcome of “No Further Action”?

If a client is NOT given information, advice or any sort of social care service following the request for
support (whether an assessment is needed or not), they would be recorded in STS001 as ‘no service
provided’ if their details had been recorded on the social care database. It is accepted that many
‘casual contacts’ (for example, people dropping in to pick up a leaflet) will not be captured and do not
need to be captured for SALT purposes.

In some CASSRs the defining difference will be whether the reception staff consider it worth taking
some personal details from the individual or not (a casual contact). In others the difference will be
whether or not reception staff take the individual through some form of screening process. The key is
whether or not a request for support leads to information and / or advice or other action such as
signposting. Taking some personal details from a new contact and giving them information on the
range of services that might be relevant should be recorded in STS001. Simply responding to a
request for the phone number of an area office would be a casual contact.

Copyright © 2014, Health and Social Care Information Centre. All rights reserved.                       25
7) Where do we record ‘professional support’ now?

In most cases it is expected that professional support would be time-limited and fit under the sequel
‘short term support (other)’. If for some reason (see FAQ 9 below) it is expected to continue for more
than a few weeks, ‘Ongoing Low Level Support’ could be chosen instead. In most cases anyone
going on to receive a Community Care Assessment and receive services on the basis of eligibility
criteria will be receiving more than just professional support, but if this was the ONLY service in the
care / support plan then ‘long term support (eligible services)’ could be selected. This may be most
relevant to clients receiving mental health support.

8) Where do we include support services provided to clients receiving welfare benefits, for
   example tribunal representation? These clients are not necessarily assessed and are not
   given care / support plans.

Again, remember that only one sequel can be counted for each request for support. Providing
information and advice on welfare benefits at a general level, or providing a one off piece of
assistance in assessing possible individual eligibility will be counted in STS001 with the sequel
‘universal services’. If the case is passed on for further assessment leading to ongoing social care
support provided by the CASSR, such as assistance in gaining due benefits (e.g. providing help at a
tribunal) or handling financial matters then this should be treated as either ‘short term support (other)’
if the support will be given for no more than a few weeks, or ‘Ongoing Low Level Support’ if it is
expected to continue beyond that. Because no support plan is provided, this type of intervention
would not be counted as ‘long term support (eligible services)’.

9) If a child becomes 18 during the reporting year and transfers from Children’s Services to
   Adults’ Services, are they regarded as a “new client” for SALT and therefore recorded as a
   ‘request for support’ to the adult team, or are they considered to already be “on the
   books” of the CASSR and therefore not a “new client”?

We recognise that authorities will have a variety of arrangements in place for dealing with transition
between children’s and adults teams. In many instances this process will be underway well before
the client’s 18th birthday; equally some individuals may not transfer until after their 18th birthday.

Transition from children’s to adult’s services should be treated as a request for support from a new
client and dealt with within SALT as follows:

If the formal transfer of services occurred in advance of (or on) their 18th birthday then the client
should start to be reported in SALT once they have turned 18. Their 18th birthday should be treated
as a ‘request for support’ and be reported in SALT measure STS001 (Route of access = Planned
entry (transition)), with any eligible services or review captured at that point in the LTS measures.
Their 18th birthday should be recorded for use within SALT LTS001c when considering clients who
have accessed long term support for more than 12 months.

If the formal transfer of services occurs after the clients 18th birthday then this should be treated as
the ‘request for support’ and reported within SALT measure STS001, with any eligible services or
review also captured at that point in the LTS measures. Again this date should be recorded for us
within SALT LTS001c. In some cases this formal transfer may occur months or even years after the
clients 18th birthday. Authorities will need to consider locally how they track transition of such cases.

10) What if two contacts are made by the same client (regarding the same problem)?

In RAP this would have been recorded as two separate contacts, as long as the client was still
‘new'. In SALT, what matters is whether any additional contacts are being dealt with as part of the
same screening/assessment process. If they are, then there would still be just one request for
support with one sequel recorded. After the assessment processes are completed and a sequel has
occurred a new contact is received which necessitates a new screening/assessment process to be
started then this should be recorded as a separate request for support in SALT, with its own sequel
recorded (even if the sequel turns out to be the same as for the earlier contact).

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