Adult Services
Key Points
• In 2001/02, adult services accounted for 81.7% (£41.7 million) of
the total expenditure on PSS by Trusts.
• Per capita expenditure on adult’s services by Trusts was £338.5
in 2001/02, compared with £342.4 in 2000/01.
• In 2001/02, the elderly POC accounted for 53.3% of PSS
expenditure, 6.7% on physical disability, 13.9% on learning
disability, and 6.9% on mental health.
• In 2001/02, adult services accounted for 88.1% (£1,316 million)
of the total expenditure on PSS by Boards.
• Per capita expenditure on adult’s services by Boards was
£1,067.1 in 2001/02, compared with £976.2 in 2000/01.
• At 31st March 2002, there were 17,359 care packages in effect,
an increase of 12.1% (1,874) over the three previous years.
• Almost three quarters (7,538) of all care packages were
delivered by the private sector, 13.8% (1,398) by the statutory
sector and 11.9% (1,202) by the voluntary sector.
• Almost 8 in 10 (13,159) care packages at 31st March 2002 were in
the elderly programme of care.
• In 2001/02, 5,101 adults were admitted to statutory residential
homes in Northern Ireland, an 11% (57) decrease compared
with 2000/01.
• Almost 8 in 10 (77.6%) people receiving a home help service in
2001/02 were older people aged 65 & over, 6.6% were
physically disabled, 1.9% had mental health needs, 2.2% had
learning difficulties and 11.8% were in respect of other
circumstances.
• Almost half the admissions (1,261) and discharges (1,300) in
statutory residential homes for older people were in the Eastern
Board.
CHAPTER 2: Adult Services
Health & Social Services Trusts provide a wide range of personal
social services to adults. Social services for adults can be split into
three main categories: residential accommodation, day care and
domiciliary care, with four service user groups: elderly, physical
disability, learning disability and mental health needs. Information is
presented for the last three years were available.
SECTION 8: Adult Population and Expenditure
Table 8.1 : Adult Population by Age Group and Trust (2001 Population Census)
Trust Age 18-64 Age 65-74 Age 75 & over Total Pop.
No. % No. % No. %
North & West Belfast 82,080 56.5 12,232 8.4 9,116 6.3 145,372
South & East Belfast 123,912 62.4 16,589 8.4 15,367 7.7 198,507
Ulster Community & Hosp. 91,746 61.3 11,755 7.9 11,062 7.4 149,568
Down Lisburn 103,405 59.9 11,726 6.8 9,277 5.4 172,521
Eastern Board 401,143 60.2 52,302 7.9 44,822 6.7 665,968
Causeway 59,481 60.0 7,553 7.6 6,366 6.4 99,144
Homefirst 199,365 60.8 24,094 7.3 18,639 5.7 327,832
Northern Board 258,846 60.6 31,647 7.4 25,005 5.9 426,976
Armagh & Dungannon 59,833 58.7 7,113 7.0 5,495 5.4 101,999
Craigavon & Banbridge 73,115 59.9 8,618 7.1 6,769 5.5 122,061
Newry & Mourne 50,645 58.2 5,825 6.7 4,362 5.0 87,059
Southern Board 183,593 59.0 21,556 6.9 16,626 5.3 311,119
Foyle 98,577 59.9 9,635 5.9 6,725 4.1 164,552
Sperrin Lakeland 68,269 58.5 8,053 6.9 6,972 6.0 116,670
Western Board 166,846 59.3 17,688 6.3 13,697 4.9 281,222
Northern Ireland 1,010,428 60.0 123,193 7.3 100,150 5.9 1,685,285
As mid-year estimates are not available at Trust level the population
base used is the 2001 population census.
In 2001, 13.2% of the population in Northern Ireland were aged 65
& over, with 7.3% aged 65-74 and 5.9% aged 75 & over.
In 2001, the adult working population (aged 18-64) accounted for
60% of the total population in Northern Ireland. Across Trusts, this
ranged from 62.4% in South & East Belfast to 56.5% in North &
West Belfast.
Table 8.2 : 2002 Mid-Year Population Estimates of Adult Population
(18 years & over) by Board
Board Aged 18-64 Aged 65-74 Aged 75 & over Total Adult
Population
Number % Number % Number % Number
Eastern 402,680 39.4 52,187 41.9 45,646 44.4 500,513
Northern 261,125 25.6 32,272 25.9 25,930 25.2 319,327
Southern 187,400 18.3 22,137 17.8 17,019 16.6 226,556
Western 170,623 16.7 18,039 14.5 14,119 13.7 202,781
Northern Ireland 1,021,828 81.8 124,635 10.0 102,714 8.2 1,249,177
80
Adult Services
Socio-Economic Indicators
The socio-economic indicators listed below are to provide a context
within which adult social services are delivered. They are not
intended to be indicators of social services need. It is difficult to
assess need for social services within specific areas. In the absence of
any objective assessment of need, the indicators presented highlight
the different circumstances that exist across the 11 Health & Social
Services Trusts in Northern Ireland.
Information on the Social Security Agency, provides details on
claimants and their dependents. It allows an up to date analysis of
socio-economic circumstances within Trusts.
SN80 Per capita expenditure on social security benefits (£)
SN81 Percentage of over 16’s receiving Job Seekers Allowance
(JSA) or Income Support (IS)
SN82 Percentage of population receiving Disability Living
Allowance (DLA)
SN83 Percentage of persons aged 16 & over in receipt of
Housing Benefit
SN84 Percentage of population dependent on JSA/IS
(claimant, partner and children)
Table 8.3 : Social Security Agency Benefit Indicators (2002)
Trust SN81 SN82 SN83 SN84
North & West Belfast 32.4 15.1 19.1 41.0
South & East Belfast 12.9 7.1 8.9 15.8
Ulster Community & Hosp. 10.0 5.6 6.4 12.0
Down Lisburn 13.7 7.8 7.7 17.8
Eastern Board 16.5 8.7 10.2 20.9
Causeway 15.7 6.0 8.8 19.4
Homefirst 12.8 6.8 7.4 15.8
Northern Board 13.5 6.6 7.7 16.6
Armagh & Dungannon 16.4 9.0 7.4 20.8
Craigavon & Banbridge 14.3 8.9 8.7 17.8
Newry & Mourne 20.5 9.7 8.7 26.8
Southern Board 16.7 9.2 8.3 21.3
Foyle 24.2 10.7 13.1 31.6
Sperrin Lakeland 19.2 8.9 7.4 23.4
Western Board 22.1 10.0 10.7 28.2
Nortern Ireland 16.9 8.8 10.5 21.3
Job Seekers Allowance (JSA) or Income Support (IS)
(February 2002)
At February 2002, 16.9% of adults aged 16 & over were in receipt of
Income Support or Job Seekers Allowance in Northern Ireland. Across
Trusts, this varied from 10.0% in Ulster Community & Hospitals to
32.4% in North & West Belfast. After North & West Belfast, Foyle
(24.2%) also had the highest proportion of adults aged 16 & over in
receipt of JSA/IS (Table 8.3 and Figure 8.1).
81
Adult Services
Figure 8.1 : SN81 - Claimants of JSA/IS as a percentage of all Adults aged 16 &
over (February 2002)
Trust SN81
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
Northern Ireland
0 5 10 15 20 25 30 35
%
Dependents on JSA/IS (claimant, partner and children)
(February 2002)
The proportion of the population dependent on JSA/IS provides a
board picture of benefit dependency, within the whole community.
This indicator takes account of dependents, their partners, and their
children. In February 2002, over one fifth (21.3%) of the population
in Northern Ireland were dependent on JSA/IS.
Dependency on JSA/IS varied significantly across Trusts, from 12.0%
of the total population in Ulster Community & Hospitals to 41.0% in
North & West Belfast. Foyle (31.6%) and Newry & Mourne (26.8%)
also had relatively high proportions of their populations dependent
on JSA/IS (Table 8.3 and Figure 8.2).
Figure 8.2 : SN84 - Dependents on JSA/IS (February 2002)
Trust SN84
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
Northern Ireland
0 5 10 15 20 25 30 35 40 45
%
82
Adult Services
Disability Living Allowance (DLA)
At February 2002, 8.8% of the total population in Northern Ireland
were receiving Disability Living Allowance (DLA). Across Trusts, North
& West Belfast (15.1%) had the highest proportion of its population
receiving DLA, whilst Ulster Community & Hospitals had the lowest
proportion (5.6%). Across Boards, the Western Board (10.0%) had
the highest proportion of its population receiving DLA, whilst the
Northern Board had the lowest (6.6%) (Table 8.3 and Figure 8.3).
Figure 8.3 : SN82 - People in Receipt of Disability Living Allowance
(February 2002)
Trust SN82
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
Northern Ireland
0 2 4 6 8 10 12 14 16
%
Housing Benefit
People who rent their homes but have difficulty meeting their
housing costs are eligible to claim Housing Benefit (HB). It can be
paid to recipients of any other benefit depending on their
circumstances and income.
At February 2002, 10.5% of adults aged 16 & over were in receipt of
Housing Benefit. Across Trusts, this ranged from 6.4% of adults aged
16 & over in Ulster Community & Hospitals to 19.1% in North & West
Belfast (Table 8.3 and Figure 8.4).
83
Adult Services
Figure 8.4 : SN83 - People in Receipt of Housing Benefit (February 2002)
Trust SN83
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
Northern Ireland
0 5 10 15 20 25
%
Expenditure on Adult Services by Trusts
EX08a Percentage of expenditure on adult services by Trusts (%)
EX09a Per capita expenditure on adult services by Trusts (£)
Table 8.4 : Expenditure on Adult Personal Social Services by Trusts
(1999/00 – 2001/02)
Trust EX08a EX09a
1999/00 2000/01 2001/02 1999/00 2000/01 2001/02
North & West Belfast 79.7 78.9 78.4 408.6 442.3 488.6
South & East Belfast 85.7 84.2 84.6 359.9 366.4 414.9
Ulster Community & Hosp. 79.9 78.6 78.1 269.8 283.6 310.8
Down Lisburn 83.1 82.3 81.8 266.6 277.0 315.4
Eastern Board 82.4 81.3 81.0 326.0 340.8 381.4
Causeway 84.7 83.4 82.7 245.4 274.8 293.7
Homefirst 84.1 83.5 83.4 239.8 263.6 290.6
Northern Board 84.3 83.5 83.2 241.1 266.2 291.3
Armagh & Dungannon 87.1 85.3 83.9 296.7 322.5 363.2
Craigavon & Banbridge 84.5 84.4 85.7 268.8 294.4 317.5
Newry & Mourne 88.1 85.4 84.0 323.6 334.7 361.5
Southern Board 86.4 85.0 84.6 292.9 314.6 344.5
Foyle 76.0 76.4 72.2 250.7 273.5 248.0
Sperrin Lakeland 84.6 84.7 84.3 318.8 330.5 369.0
Western Board 79.9 80.1 78.0 279.3 297.5 298.9
Northern Ireland 83.1 82.2 81.7 290.8 310.0 338.5
During 2001/02, 81.7% (£417 million) of the total expenditure on
Personal Social Services (PSS) by Trusts was spent on adults services.
These services include: elderly, learning disability, physical disability
and mental health programmes of care. Some PSS expenditure in the
Acute and Health Promotion POC’s are also included within the
overall expenditure on PSS.
84
Adult Services
Over the last three years, the proportion of PSS expenditure on
adults services by Trusts decreased slightly, from 83.1% in 1999/00 to
81.7% in 2001/02. Although, there has been a slight decrease in the
proportion of PSS actual expenditure on adults services by Trusts, per
capita expenditure on adults services has increased from £290.8 per
person aged 18 & over in 1999/00 to £338.5 in 2001/02.
Across Trusts, the proportion of PSS expenditure on adults services
ranged from 72.2% in Foyle to 85.7% in Craigavon & Banbridge. Per
capita expenditure on adults services, ranged from £248.0 per person
aged 18 & over in Foyle to £488.6 in North & West Belfast (Table 8.4
and Figure 8.5).
Figure 8.5 : Per Capita Expenditure on Adult Personal Social Services by Trusts
(2001/02) (£)
Trust EX09a
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
Northern Ireland
0 100 200 300 400 500 600
£
Expenditure on Adult Services by Boards
EX08b Percentage of expenditure on adult services by Boards (%)
EX09b Per capita expenditure on adult services by Boards (£)
Table 8.5 : Expenditure on Adult Personal Social Services by Boards (2000/01-2001/02)
Board EX08b EX09b
2000/01 2001/02 2000/01 2001/02
Eastern Board 87.7 88.0 1,006.7 1,107.1
Northern Board 88.8 89.1 903.4 969.3
Southern Board 89.3 89.4 1,009.7 1,101.5
Western Board 86.2 85.5 994.8 1,083.5
Northern Ireland 88.0 88.1 978.9 1,067.1
During 2001/02, over £1,300 million was spent on adults services by
HSS Boards in Northern Ireland, accounting for 88.1% of the total
expenditure on PSS.
Per capita expenditure by Boards on adult services was £1,067.1,
£88.2 higher than in 2000/01 (£978.9). Across Boards, the Eastern
Board (£1,107.1) had the highest per capita expenditure on adult
services, whilst the Northern Board had the lowest (£969.3)
(Table 8.5).
85
Adult Services
SECTION 9: All Adults Services
The main adult personal social services provided include residential
accommodation, respite care, day care, and domiciliary services, such
as meals on wheels and home helps. Each Trust decides the
mechanisms for the delivery of social care. These services can be
provided by statutory authorities or purchased through voluntary or
private organisations. Adult personal social services, are delivered
through five programmes of care:
• older people;
• people with mental health needs;
• people with learning disabilities;
• people with physical disabilities;
• adult health.
Information in this section is presented for all adult services.
Care Packages
A care package is the main form of care recommended for a service
user through the care management process. This process involves
assessing need, planning care, co-ordinating and reviewing services.
Service users are screened initially, to determine whether a care
management assessment is necessary, if a service user passes the
initial screening, a care management assessment is carried out to
determine the form of care which best meets the service users needs.
At the end of the assessment, a care package is recommended. There
are three main types of care package – residential care, nursing
home care and domiciliary care. Although a care package may
incorporate a number of these services, it is the main form of care
(i.e. the form of care which takes up the majority of the service user’s
time) which is recorded for the purpose of this analysis.
Information relating to number of screenings and initial screenings is
no longer collected.
86
Adult Services
AC15 Number of assessments started during year per 10,000-
population aged 16 & over
AC16 Number of assessments completed during year per 10,000-
population aged 16 & over
Table 9.1 : Care Management Activity – Assessments Started and Completed
(1999/00 – 2001/02)
Trust AC15 AC16
1999/00 2000/01 2001/02 1999/00 2000/01 2001/02
North & West Belfast 101.5 107.1 102.4 71.9 86.4 88.3
South & East Belfast 55.9 55.7 59.2 52.5 54.4 56.7
Ulster Community & Hosp. 54.3 58.0 58.8 54.0 56.8 59.8
Down Lisburn 21.9 33.0 25.6 24.6 32.3 26.1
Eastern Board 56.6 61.3 59.8 49.9 56.1 56.3
Causeway 73.7 62.2 73.4 77.1 73.5 59.7
Homefirst 44.6 43.0 46.8 44.6 43.0 46.8
Northern Board 51.3 47.4 53.0 52.1 50.1 49.8
Armagh & Dungannon 93.3 26.3 106.5 87.4 95.9 98.2
Craigavon & Banbridge 48.7 13.9 40.8 48.7 53.5 40.8
Newry & Mourne 54.0 18.0 53.8 51.8 53.0 50.4
Southern Board 64.8 19.1 65.9 62.2 67.3 62.2
Foyle 40.5 9.5 40.9 39.2 36.1 39.3
Sperrin Lakeland 32.2 5.1 18.2 33.1 26.8 23.7
Western Board 37.0 7.7 31.3 36.6 32.2 32.8
Northern Ireland 53.6 41.5 54.5 50.6 52.7 51.9
During 2001/02, 7,018 care assessments were started, 54.5
assessments being started per 10,000-population aged 16 & over.
During this period, 6,681 care assessments were completed, 51.9
completed assessments per 10,000-population aged 16 & over.
Across Trusts, Armagh & Dungannon (106.5) had the highest number
of care assessments started per 10,000-population aged 16 & over,
whilst Sperrin Lakeland (18.2) had the lowest. Since 1999/00, the
number of assessments started per 10,000-population has increased
in 7 of the 11 HSS Trusts, particularly in Armagh & Dungannon, with
an increase from 93.3 in 1999/00 to 106.5 in 2001/02.
Armagh & Dungannon (98.2) had the highest number of assessments
completed per 10,000-population aged 16 & over in 2001/02, whilst
Sperrin Lakeland (23.7) had the lowest (Table 9.1).
87
Adult Services
Care Packages Commenced during year
AC17 Number of care packages commenced during year
AC18 Percentage of care packages commenced during year
within Elderly POC
AC19 Percentage of care packages commenced during year
within Mental Health POC
AC20 Percentage of care packages commenced during year
within Learning Disability POC
AC21 Percentage of care packages commenced during year
within Physical Disability POC
Table 9.2 : Residential/Nursing Home Care Packages Commenced during year (by POC)
(2000/01 – 2001/02) 1
Trust AC17 AC18 AC19 AC20 AC21
2000/01 2001/02 2000/01 2001/02 2000/01 2001/02 2000/01 2001/02 2000/01 2001/02
North & West Belfast 562 504 84.7 84.1 2.3 5.2 3.2 3.6 6.0 4.8
South & East Belfast 576 587 93.1 95.2 2.6 1.5 1.4 0.7 2.8 2.6
Ulster Community & Hosp. 412 435 95.9 96.8 0.2 0.2 1.2 1.4 2.7 1.6
Down Lisburn 217 184 91.7 94.0 2.8 1.1 0.9 1.6 4.6 3.3
Eastern Board 1,767 1,710 90.9 92.2 2.0 2.2 1.9 1.8 4.0 3.0
Causeway 59 63 94.9 93.7 0.0 1.6 1.7 3.2 3.4 1.6
Homefirst 827 946 79.2 79.6 5.6 5.2 2.9 5.7 3.3 2.2
Northern Board 886 1,009 80.2 80.5 5.2 5.0 2.8 5.6 3.3 2.2
Armagh & Dungannon 258 269 88.8 90.7 7.8 5.2 3.1 2.2 0.4 1.9
Craigavon & Banbridge 231 155 85.3 91.6 1.3 1.9 12.6 3.9 0.9 2.6
Newry & Mourne 139 144 90.6 88.9 4.3 6.3 4.3 4.2 0.7 0.7
Southern Board 628 568 87.9 90.5 4.6 4.6 6.8 3.2 0.6 1.8
Foyle 108 128 90.7 74.2 0.0 2.3 0.0 11.7 9.3 11.7
Sperrin Lakeland 89 73 91.0 93.2 7.9 2.7 1.1 1.4 0.0 2.7
Western Board 197 201 90.9 81.1 3.6 2.5 0.5 8.0 5.1 8.5
Northern Ireland 3,478 3,488 87.6 87.9 3.4 3.4 2.9 3.5 3.3 2.9
1
Information not available for domiciliary care.
During 2001/02, 3,488 residential and nursing home care packages(1)
commenced, almost 50% (1,710) of which were in the Eastern Board.
Between 2000/01 and 2001/02, the number of care packages
commenced increased slightly from 3,478 in 2000/01 to 3,488 in
2001/02.
Over 85% (3,066) of the care packages commenced in 2001/02 were
in the elderly programme of care, 3.5% (121) in learning disability,
3.4% (119) in mental health, and 2.9% (101) in physical disability.
The proportion of all care packages commenced within the elderly
POC ranged from 96.8% of all care packages commenced in Ulster
Community & Hospitals to 74.2% in Foyle.
Foyle (11.7%) had the highest proportion of care packages
commenced in the physical disability POC, whilst Newry & Mourne
(0.7%) had the lowest (Table 9.2 and Figure 9.1).
88
Adult Services
Figure 9.1 : Care Packages in Effect by Programme of Care (2001/02)
Elderly 87.9
Physical Disability 2.9
Learning Disability 3.5
Mental Health 3.4
AC22 Percentage of care packages commenced during year in
residential homes
AC23 Percentage of care packages commenced during year in
nursing homes
AC24 Percentage of care packages commenced during year in
the statutory sector
AC25 Percentage of care packages commenced during year in
the voluntary sector
AC26 Percentage of care packages commenced during year in
the private sector
Table 9.3 : Residential/Nursing Home Care Packages Commenced during year (2000/01 – 2001/02)
Trust AC22 AC23 AC24 AC25 AC26
2000/01 2001/02 2000/01 2001/02 2000/01 2001/02 2000/01 2001/02 2000/01 2001/02
North & West Belfast 18.9 19.4 81.1 80.6 6.8 6.9 23.5 20.2 69.8 72.8
South & East Belfast 38.9 36.5 61.1 63.5 8.2 6.1 19.6 19.4 72.2 74.4
Ulster Community & Hosp. 30.3 32.0 69.7 68.0 12.4 12.4 9.7 8.5 77.9 79.1
Down Lisburn 52.1 41.3 47.9 58.7 17.1 13.6 5.5 4.3 77.4 82.1
Eastern Board 32.1 30.8 67.9 69.2 9.8 8.8 16.8 15.3 73.4 76.0
Causeway 45.8 44.4 54.2 55.6 10.2 12.7 0.0 1.6 89.8 85.7
Homefirst 66.6 60.3 33.4 39.7 19.6 21.5 11.1 7.5 69.3 71.0
Northern Board 65.2 59.3 34.8 40.7 19.0 20.9 10.4 7.1 70.7 72.0
Armagh & Dungannon 26.7 26.8 73.3 73.2 4.7 2.2 0.8 0.7 94.6 97.0
Craigavon & Banbridge 35.9 21.3 64.1 78.7 21.2 3.9 1.7 1.3 77.1 94.8
Newry & Mourne 12.9 16.7 87.1 83.3 7.2 8.3 15.1 18.8 77.7 72.9
Southern Board 27.1 22.7 72.9 77.3 11.3 4.2 4.3 5.5 84.4 90.3
Foyle 34.3 35.9 65.7 64.1 23.1 26.6 7.4 3.9 69.4 69.5
Sperrin Lakeland 27.0 28.8 73.0 71.2 7.9 6.8 2.2 4.1 89.9 89.0
Western Board 31.0 33.3 69.0 66.7 16.2 19.4 5.1 4.0 78.7 76.6
Northern Ireland 39.6 37.9 60.4 62.1 12.8 12.2 12.2 10.7 75.0 77.2
During 2001/02, over 60% (2,167) of residential and nursing home
care packages commenced were in respect of nursing homes. Across
Trusts, this ranged from 83.3% in Newry & Mourne to 39.7% in
Homefirst. The proportion of residential and nursing home care
packages commenced, in residential homes, ranged from 60.3% in
Homefirst to 16.7% in Newry & Mourne.
Over three quarters (77.2%) of all residential and nursing home care
packages commenced in 2001/02 were delivered by the private
sector, compared with 12.2% by the statutory sector, and 10.7% by
the voluntary sector.
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Adult Services
The proportion of residential and nursing home care packages
commenced that were delivered by the private sector, ranged from
97.0% in Armagh & Dungannon to 69.5% in Foyle (Table 9.3, Figure
9.2 and Figure 9.3).
Figure 9.2 : Percentage of Residential and Nursing Home Care Packages
commenced during year in Nursing Homes (2001/02)
Trust AC23
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
Northern Ireland
0 10 20 30 40 50 60 70 80 90
%
Figure 9.3 : Percentage of Residential and Nursing Home Care Packages
commenced during year in Residential Homes (2001/02)
Trust AC22
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
Northern Ireland
0 10 20 30 40 50 60 70
%
90
Adult Services
Care Packages in Effect at 31st March
AC1 Care packages in effect at 31st March
Table 9.4 : Number of Care Packages in Effect at 31st March (2000 - 2002)
Trust 2000 2001 2002
Number % Number % Number %
North & West Belfast 1,335 8.6 1,680 10.1 1,921 11.1
South & East Belfast 1,842 11.9 1,930 11.6 1,913 11.0
Ulster Community & Hosp. 1,424 9.2 1,561 9.4 1,658 9.6
Down Lisburn 1,527 9.9 1,629 9.8 1,624 9.4
Eastern Board 6,128 39.6 6,800 41.0 7,116 41.0
Causeway 1,306 8.4 1,459 8.8 1,568 9.0
Homefirst 2,610 16.9 2,514 15.2 2,648 15.3
Northern Board 3,916 25.3 3,973 24.0 4,216 24.3
Armagh & Dungannon 1,127 7.3 1,263 7.6 1,272 7.3
Craigavon & Banbridge 1,116 7.2 1,263 7.6 1,311 7.6
Newry & Mourne 816 5.3 923 5.6 994 5.7
Southern Board 3,059 19.8 3,449 20.8 3,577 20.6
Foyle 1,235 8.0 1,189 7.2 1,311 7.6
Sperrin Lakeland 1,147 7.4 1,176 7.1 1,139 6.6
Western Board 2,382 15.4 2,365 14.3 2,450 14.1
Northern Ireland 15,485 100.0 16,587 100.0 17,359 100.0
At 31st March 2002, there were 17,539 care packages in effect, an
increase of 12.1% (1,874) since 31st March 2000. Most (41.0%) care
packages in effect were in the Eastern Board, compared with 24.3%
in the Northern Board, 20.6% in the Southern Board, and 14.1% in
the Western Board.
Across Trusts, Homefirst had the most care packages in effect
(15.3%), whilst Newry & Mourne (5.7%) had the lowest proportion.
Over the last three years, the number of care packages in effect
decreased in one Trust (Sperrin Lakeland) (Table 9.4 and Figure 9.4).
Figure 9.4 : Care Packages in Effect at 31st March 2002
Trust AC1
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
0 2 4 6 8 10 12 14 16 18
%
91
Adult Services
AC2 Percentage of care packages in effect where main form of
care is residential home care
AC3 Percentage of care packages in effect where main form of
care is nursing home care
AC4 Percentage of care packages in effect where main form of
care is domiciliary care
Table 9.5 : Care Packages in Effect by Main Form of Care at 31st March (2000 - 2002)
Trust AC2 AC3 AC4
2000 2001 2002 2000 2001 2002 2000 2001 2002
North & West Belfast 14.3 23.2 21.3 55.8 47.6 44.8 29.9 29.3 33.9
South & East Belfast 29.8 29.0 29.0 40.3 39.7 37.7 30.0 31.3 33.4
Ulster Community & Hosp. 25.5 23.1 23.8 32.2 33.6 34.3 42.3 43.2 41.9
Down Lisburn 26.5 27.8 29.7 22.5 24.4 24.7 51.1 47.8 45.6
Eastern Board 24.6 25.9 25.9 37.3 36.6 35.8 38.1 37.5 38.3
Causeway 21.6 19.5 17.8 18.4 16.8 17.5 60.0 63.7 64.7
Homefirst 29.8 34.5 32.1 33.0 38.0 39.0 37.2 27.4 28.9
Northern Board 27.1 29.0 26.8 28.1 30.2 31.0 44.8 40.8 42.2
Armagh & Dungannon 13.0 12.1 13.1 35.0 34.9 35.8 52.0 53.0 51.1
Craigavon & Banbridge 18.1 16.5 16.1 44.4 43.9 43.6 37.5 39.7 40.3
Newry & Mourne 9.8 9.0 8.9 39.1 38.1 37.8 51.1 52.9 53.3
Southern Board 14.0 12.9 13.0 39.5 39.1 39.2 46.5 48.1 47.7
Foyle 19.0 21.4 21.4 32.7 37.6 37.7 48.3 41.0 40.9
Sperrin Lakeland 22.1 22.4 23.4 33.0 34.0 34.9 45.0 43.6 41.6
Western Board 20.5 21.9 22.4 32.8 35.8 36.4 46.7 42.3 41.2
Northern Ireland 22.5 23.4 23.0 34.7 35.5 35.4 42.8 41.2 41.6
Most care packages in effect at 31st March 2002 were domiciliary care
packages (41.6%), slightly less than the proportion in 2000 (42.8%).
Over the same period, the proportion of residential care packages
increased from 22.5% to 23.0%, and nursing home care packages
increased from 34.7% to 35.4%.
Four Trusts (North & West Belfast, South & East Belfast, Homefirst,
and Craigavon & Banbridge) indicated that nursing home care
accounted for most care packages in effect at 31st March 2002. The
proportion of care packages in effect where the main form of care
was residential care, ranged from 32.1% in Homefirst to 8.9% in
Newry & Mourne. Over the last three years, the proportion of care
packages in effect where the main form of care was residential care,
decreased in 5 of the 11 HSS Trusts.
At 31st March 2002, the proportion of care packages in effect where
the main form of care was nursing care, ranged from 44.8% in North
& West Belfast to 17.5% in Causeway. Since 31st March 2000, the
proportion of care packages in effect where the main form of care
was nursing care, decreased in 5 of the 11 HSS Trusts. The most
significant decrease was in North & West Belfast, from 55.8% at 31st
March 2000 to 44.8% at 31st March 2002.
The proportion of care packages in effect where the main form of
care was domiciliary care, ranged from 64.7% in Causeway to 28.9%
in Homefirst. Over the last three years, the proportion of care
packages in effect where the main form of care was domiciliary care,
decreased in 6 of the 11 HSS Trusts. The largest decrease was in
Homefirst, from 37.2% at 31st March 2000 to 28.9% at 31st March
2002 (Table 9.5 and Figure 9.5).
92
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Figure 9.5 : Main Form of Care Provided at 31st March 2002
Residential 23.0
Nursing 35.4
Domicilliary 41.6
AC5 Percentage of residential or nursing home care packages in
effect which were delivered by the statutory sector
AC6 Percentage of residential or nursing home care packages in
effect which were delivered by the voluntary sector
AC7 Percentage of residential or nursing home care packages in
effect which were delivered by the private sector
Table 9.6 : Delivery of Residential and Nursing Home Care Packages in Effect (1999/00 – 2001/02) 1
Trust AC5 AC6 AC7
1999/00 2000/01 2001/02 1999/00 2000/01 2001/02 1999/00 2000/01 2001/02
North & West Belfast 0.5 15.7 15.0 25.4 23.5 22.8 74.0 60.8 62.3
South & East Belfast 9.7 9.4 7.9 19.1 20.1 22.0 71.2 70.5 70.0
Ulster Community & Hosp. 17.8 16.5 16.3 13.0 13.2 13.7 69.2 70.3 70.0
Down Lisburn 19.5 18.8 19.9 9.5 10.0 9.2 71.0 71.2 70.9
Eastern Board 11.1 14.5 14.2 17.4 17.6 17.8 71.4 67.9 68.0
Causeway 17.8 16.6 15.2 7.7 7.0 6.9 74.5 76.4 77.9
Homefirst 22.9 20.3 18.8 3.5 4.0 4.5 73.6 75.7 76.8
Northern Board 21.6 19.5 18.0 4.5 4.7 5.0 73.8 75.8 77.0
Armagh & Dungannon 5.7 3.5 3.5 2.6 2.4 2.3 91.7 94.1 94.2
Craigavon & Banbridge 10.7 9.7 7.0 2.9 2.0 2.9 86.4 88.3 90.0
Newry & Mourne 11.0 11.5 11.4 16.3 15.9 15.3 72.7 72.6 73.3
Southern Board 9.2 8.1 7.0 6.0 5.5 5.8 84.8 86.4 87.3
Foyle 20.2 19.4 19.5 16.6 15.5 14.7 63.2 65.0 65.8
Sperrin Lakeland 9.0 8.7 8.3 11.9 11.9 11.3 79.1 79.3 80.5
Western Board 14.6 14.2 14.3 14.3 13.8 13.1 71.1 72.0 72.6
Northern Ireland 13.8 14.5 13.8 11.7 11.7 11.9 74.4 73.8 74.4
1
Excludes domiciliary care, as a breakdown by sector is not available.
At 31st March 2002, almost three quarters (7,538) of all care packages
in effect were delivered by the private sector, 13.8% (1,398) by the
statutory sector, and 11.9% (1,202) by the voluntary sector.
The proportion of all care packages in effect delivered by the
statutory sector, ranged from 19.9% in Down Lisburn to 3.5% in
Armagh & Dungannon. The proportion delivered by the voluntary
sector ranged from 22.8% in North & West Belfast to 2.3% in
Armagh & Dungannon, and the proportion delivered by the private
sector, ranged from 94.2% in Armagh & Dungannon to 62.3% in
North & West Belfast (Table 9.6).
93
Adult Services
Care Packages in Effect by Programme of Care
AC8 Percentage of care packages in effect in the Elderly POC
AC9 Percentage of care packages in effect in the Mental
Health POC
AC10 Percentage of care packages in effect in the Learning
Disability POC
AC11 Percentage of care packages in effect in the Physical
Disability POC
AC12 Percentage of care packages in effect in the Adult
Health POC
Table 9.7 : Care Packages in Effect at 31st March by POC (2001 - 2002)
Trust AC8 AC9 AC10 AC11 AC12
2001 2002 2001 2002 2001 2002 2001 2002 2001 2002
North & West Belfast 75.9 76.0 3.5 4.0 13.4 12.6 6.9 6.9 0.3 0.5
South & East Belfast 79.7 78.7 6.4 6.4 7.6 8.2 6.1 6.6 0.2 0.2
Ulster Community & Hosp. 84.9 84.4 0.7 0.7 6.8 7.5 7.6 7.4 0.0 0.0
Down Lisburn 76.3 77.7 3.5 1.9 9.0 9.5 11.2 10.9 0.0 0.0
Eastern Board 79.2 79.1 3.7 3.4 9.2 9.5 7.9 7.9 0.1 0.2
Causeway 79.9 79.3 3.0 4.1 5.1 5.2 9.2 8.0 2.7 3.4
Homefirst 76.2 75.9 6.9 6.9 9.3 9.7 5.3 5.2 2.3 2.3
Northern Board 77.6 77.2 5.5 5.8 7.8 8.0 6.7 6.2 2.5 2.7
Armagh & Dungannon 73.9 72.4 5.0 5.7 13.1 13.8 8.0 8.2 0.0 0.0
Craigavon & Banbridge 71.2 70.3 6.7 7.2 14.5 15.0 7.7 7.6 0.0 0.0
Newry & Mourne 66.7 67.6 9.0 9.7 9.4 9.5 14.8 13.3 0.0 0.0
Southern Board 71.0 70.3 6.7 7.4 12.6 13.0 9.7 9.4 0.0 0.0
Foyle 76.9 75.6 8.9 8.4 5.6 5.6 8.6 10.5 0.0 0.0
Sperrin Lakeland 67.6 68.0 20.0 19.9 6.1 5.9 6.3 6.1 0.0 0.0
Western Board 72.3 72.1 14.4 13.8 5.9 5.7 7.4 8.4 0.0 0.0
Northern Ireland 76.1 75.8 6.3 6.3 9.1 9.3 7.9 7.9 0.7 0.7
At 31st March 2002, over three quarters (75.8%) of all care packages
in effect were in the elderly POC, 9.3% (1,622) in the learning
disability POC, 7.9% (1,364) in the physical disability POC, 6.3%
(1,087) in the mental heath POC, and 0.7% (127) in adult health POC.
Across Trusts, the pattern was quite similar. The proportion of all
care packages in effect in the elderly POC, ranged from 84.4% in
Ulster Community & Hospitals to 67.6% in Newry & Mourne (Table
9.7 and Figure 9.6).
Figure 9.6 : Care Packages in Effect by Programme of Care at 31st March 2002
Elderly 75.8
Physical Disability 6.3
Learning Disability 9.3
Mental Health 7.9
Adult Health 0.7
94
Adult Services
Residential Accommodation
AA01 Residential places in residential homes at 31st March
AA02 Percentage of residential places that are in private homes
at 31st March
AA03 Percentage of residential places that are in voluntary
homes at 31st March
AA04 Percentage of residential places that are in statutory homes
at 31st March
Table 9.8 : Residential Accommodation in Residential Homes at 31st March (2000 - 2002)
Trust AA01 AA02 AA03 AA04
2000 2001 2002 2000 2001 2002 2000 2001 2002 2000 2001 2002
North & West Belfast 411 410 438 6.3 6.3 5.9 38.2 38.3 42.2 55.5 55.4 51.8
South & East Belfast 1,141 1,090 1,090 31.9 29.9 29.9 36.0 36.3 36.3 27.0 28.4 28.4
Ulster Community & Hosp. 714 729 699 28.6 29.1 29.0 37.1 38.7 40.5 29.1 27.2 27.9
Down Lisburn 849 880 789 41.1 43.4 37.0 17.0 16.4 18.9 37.7 36.1 39.5
Eastern Board 3,115 3,109 3,016 30.3 30.4 28.1 31.4 31.5 33.6 34.2 33.9 34.6
Causeway 457 456 448 51.0 51.1 52.0 13.8 13.8 14.1 21.4 21.3 21.7
Homefirst 1,086 903 1,104 30.7 38.3 30.8 8.0 9.1 9.6 40.1 48.1 39.3
Northern Board 1,543 1,359 1,552 36.7 42.6 36.9 9.7 10.7 10.9 34.5 39.1 34.2
Armagh & Dungannon 310 295 306 38.1 39.0 51.6 13.2 13.9 6.5 17.7 12.9 11.8
Craigavon & Banbridge 259 279 237 18.9 19.4 30.4 14.7 13.6 16.0 58.3 53.0 44.7
Newry & Mourne 224 272 268 14.3 15.8 14.2 29.9 33.8 34.3 37.9 35.7 36.6
Southern Board 793 846 811 25.1 25.1 33.0 18.4 20.2 18.5 36.7 33.5 29.6
Foyle 552 550 547 12.3 12.4 12.4 46.9 47.1 46.4 40.0 39.8 40.4
Sperrin Lakeland 529 544 538 50.1 50.2 46.1 18.9 18.4 18.4 24.8 24.1 27.3
Western Board 1,081 1,094 1,085 30.8 31.2 29.1 33.2 32.8 32.5 32.6 32.0 33.9
Northern Ireland 6,532 6,408 6,464 31.2 32.4 31.0 25.0 25.8 26.1 34.3 34.6 33.8
At 31st March 2002, there were 6,464 residential places in residential
homes, slightly less than the number at 31st March 2000 (6,532). Most
residential places were in the Eastern Board (46.7%).
At 31st March 2002, the highest proportion (33.8%) of residential
places available in Northern Ireland were in the statutory sector,
31.0% in the private sector, and 26.1% in the voluntary sector. In the
private sector, the proportion of residential places available in Trusts
ranged from 52.0% in Causeway to 5.9% in North & West Belfast.
Most residential places were provided by the private sector in 3 of
the 11 HSS Trusts (Causeway, Armagh & Dungannon and Sperrin
Lakeland).
The proportion of residential places available within Trusts provided
by the voluntary sector at 31st March 2002, ranged from 46.4% in
Foyle to 6.5% in Armagh & Dungannon. Most residential places
available were provided by the voluntary sector in 4 of the 11 HSS
Trusts (North & West Belfast, South & East Belfast, Ulster Community
& Hospitals and Foyle) (Table 9.8).
95
Adult Services
Residential Accommodation by Programme of Care
Table 9.9 : Residential Accommodation by POC (2000/01 – 2001/02)
Trust Elderly Physical Disability Learning Disability Mental Health
00/01 01/02 00/01 01/02 00/01 01/02 00/01 01/02
North & West Belfast 68.3 63.9 0.0 0.0 12.9 12.1 18.8 24.0
South & East Belfast 81.2 81.2 3.0 3.0 8.1 8.1 7.7 7.7
Ulster Community & Hosp. 76.3 75.4 0.0 0.0 22.1 23.3 1.6 1.3
Down Lisburn 76.0 73.9 1.4 1.5 18.1 18.3 4.5 6.3
Eastern Board 76.9 75.4 1.4 1.5 14.8 14.9 6.9 8.2
Causeway 82.9 82.6 0.0 0.0 17.1 17.4 0.0 0.0
Homefirst 79.1 80.6 0.0 0.9 11.2 10.9 9.7 7.6
Northern Board 80.4 81.2 0.0 0.6 13.2 12.8 6.5 5.4
Armagh & Dungannon 70.5 71.6 0.0 0.0 24.4 23.5 5.1 4.9
Craigavon & Banbridge 70.6 73.0 0.0 0.0 20.4 16.5 9.0 10.5
Newry & Mourne 43.8 42.9 0.0 0.0 53.7 54.5 2.6 2.6
Southern Board 61.9 62.5 0.0 0.0 32.5 31.7 5.6 5.8
Foyle 51.6 52.3 0.0 0.0 26.2 26.3 22.2 21.4
Sperrin Lakeland 53.1 49.8 0.0 0.0 22.2 22.5 24.6 27.7
Western Board 52.4 51.1 0.0 0.0 24.2 24.4 23.4 24.5
Northern Ireland 71.5 71.1 0.7 0.9 18.4 18.1 9.4 10.0
In 2001/02, over 7 in 10 (71.1%) residential places available were in
the elderly POC, 18.1% in learning disability, 10.0% in Mental
Health, and 0.9% in physical disability. Across Trusts, the proportion
of residential places available in the elderly POC ranged from 42.9%
in Newry & Mourne, to 82.6% in Causeway. The majority (54.5%) of
residential places available in Newry & Mourne, were in the learning
disability POC (Table 9.9).
AA20a Admissions to statutory residential homes during year
AA20b Discharges from statutory residential homes during year
AA05 Occupancy rate in statutory residential homes at
31st March
AA27a Respite admissions to statutory residential homes during year
Table 9.10 : Admissions, Discharges, Occupancy Rates and Respite Admissions to Statutory
Residential Homes (1999/00 – 2001/02)
Trust AA20a AA20b AA05 AA27a
99/00 00/01 01/02 99/00 00/01 01/02 2000 2001 2002 99/00 00/01 01/02
North & West Belfast 450 468 535 444 470 549 96.1 94.7 96.0 391 406 482
South & East Belfast 951 936 1,038 943 909 1,082 92.2 85.5 83.2 674 634 779
Ulster Community & Hosp. 272 276 288 266 290 266 97.1 95.5 96.4 199 210 222
Down Lisburn 654 1,629 1,611 616 1,594 1,608 96.3 96.5 99.0 575 1,591 1,589
Eastern Board 2,327 3,309 3,472 2,269 3,263 3,505 95.2 92.7 93.2 1,839 2,841 3,072
Causeway 76 27 43 51 45 44 92.9 90.7 93.8 38 32 33
Homefirst 735 705 632 772 701 729 95.9 97.2 96.5 420 427 431
Northern Board 811 732 675 823 746 773 95.3 96.0 96.0 458 459 464
Armagh & Dungannon 69 45 46 105 53 45 83.6 78.9 77.8 50 18 10
Craigavon & Banbridge 686 445 515 687 635 535 90.1 86.5 88.7 642 553 479
Newry & Mourne 86 67 79 80 67 87 96.5 93.8 85.7 67 56 67
Southern Board 841 557 640 872 755 667 90.7 88.0 85.8 759 627 556
Foyle 219 204 174 206 192 177 90.5 95.0 96.8 110 153 165
Sperrin Lakeland 437 356 140 391 338 323 71.8 78.6 77.6 322 289 257
Western Board 656 560 314 597 530 500 83.5 88.9 89.1 432 442 422
Northern Ireland 4,635 5,158 5,101 4,561 5,294 5,445 92.8 92.3 92.4 3,488 4,369 4,514
96
Adult Services
In 2001/02, 5,101 adults were admitted to statutory residential
homes in Northern Ireland, an increase of 10.1% (466) from the
number admitted in 1999/00 (4,635). Over the same period, 5,445
adults were discharged from statutory residential homes, almost
20% (884) more than in 1999/00 (4,561).
Over two thirds (68.1%) of all admissions to statutory residential
homes, and 64.4% of all discharges from statutory residential homes
were in the Eastern Board. Across Trusts, the number of admissions
to statutory residential homes in 2001/02, ranged from 43 in
Causeway to 1,611 in Down Lisburn, whilst the number of adults
discharged ranged from 44 in Causeway to 1,608 in Down Lisburn.
In 2001/02, the occupancy rate in statutory residential homes was
92.4%. Across Trusts, this ranged from 77.6% in Sperrin Lakeland to
99.0% in Down Lisburn. During the last three years, the occupancy
rates in statutory residential homes decreased in 6 of the 11 HSS
Trusts (Table 9.10 and Figure 9.7).
Figure 9.7 : Occupancy Rates for Statutory Residential Homes (2001/02)
Trust AA05
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
Northern Ireland
0 20 40 60 80 100
%
A total of 4,514 adults were admitted for respite care in statutory
residential homes during 2001/02, 29.4% (1,026) more than the
number admitted in 1999/00 (3,488). Over one third (1,598) of all
respite admissions were in Down Lisburn, whilst Armagh &
Dungannon (10) had the lowest number (Table 9.10 and Figure 9.8).
97
Adult Services
Figure 9.8 : Respite Admissions to Statutory Residential Homes during year
(2001/02)
Trust AA27a
North & West Belfast
South & East Belfast
Ulster Community & Hosp
Down Lisburn
Causeway
Homefirst
Armagh & Dungannon
Craigavon & Banbridge
Newry & Mourne
Foyle
Sperrin Lakeland
0 200 400 600 800 1,000 1,200 1,400 1,600 1,800
Number of Admissions
Day Care
AA51b Number registered at statutory day centres per 10,000-
population aged 16 & over
Table 9.11 : People Registered at Statutory Day Centres at 31st March (2000 – 2002)
Trust 2000 2001 2002
Number % Number % Number %
North & West Belfast 1,157 106.5 1,172 107.9 1,213 111.6
South & East Belfast 1,521 94.8 1,483 92.4 1,531 95.4
Ulster Community & Hosp. 447 37.6 569 47.9 540 45.4
Down Lisburn 722 55.5 651 50.1 719 55.3
Eastern Board 3,847 74.3 3,875 74.8 4,003 77.3
Causeway 515 67.4 479 62.7 495 64.8
Homefirst 1,866 74.1 1,848 73.3 1,600 63.5
Northern Board 2,381 72.5 2,327 70.9 2,095 63.8
Armagh & Dungannon 1,397 183.6 1,455 191.2 1,460 191.9
Craigavon & Banbridge 510 55.2 486 52.6 501 54.2
Newry & Mourne 461 72.1 461 72.1 465 72.7
Southern Board 2,368 101.9 2,402 103.4 2,426 104.4
Foyle 880 72.8 880 72.8 1,010 83.5
Sperrin Lakeland 973 111.1 1,003 114.5 1,052 120.1
Western Board 1,853 88.9 1,883 90.3 2,062 98.9
Northern Ireland 10,449 81.2 10,487 81.5 10,586 82.2
At 31st March 2002, 10,586 people were registered at statutory day
centres, 82.2 people per 10,000-population aged 16 & over. Over the
last three years, the number of people registered at statutory day
centres increased slightly from 10,449 in 2000 to 10,586 in 2002.
Across Trusts, the number of persons registered at statutory day
centres ranged from 191.9 people per 10,000-population aged 16 &
98