Around 1,500 older people with moderate care needs and 850 unpaid carers will be interviewed face-to-face and by phone across 15 English local authorities to map how different types of social care support affect their lives. This matters because the proportion of older people with moderate needs receiving publicly-funded care in England has fallen sharply in recent years, yet no one knows what consequences these changes have had for their wellbeing, independence, or costs to the health and care system. Without evidence, councils and central government cannot tell which support models work best or whether cuts to moderate-need care simply shift costs onto carers and the NHS. If the research succeeds, it will identify which local patterns of support deliver better outcomes—such as delaying care home admissions and hospitalisations—and at what cost. This could help councils target limited funds more effectively, improve quality of life for hundreds of thousands of older people, and reduce pressure on unpaid carers and acute health services. The findings will be shared directly with local authorities, central government, and the voluntary sector through workshops and policy briefings.
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There has been a significant decline in the proportion of older people with moderate care needs receiving publicly-funded care in England and changes in the social care support provided to them. Yet we lack evidence to understand their consequences on care outcomes for this group of older people and their carers. The proposed study aims to provide critical new evidence about how best to support them. The study s objectives are to: Assess the need-related characteristics of older people with moderate care needs and their carers. Develop a typology of local patterns of support for this group. Describe and evaluate the care associated with different support types. Compare the impact of the different support types on outcomes, costs and cost-effectiveness. Identify best practice in provision of support for this group and key barriers and facilitators for its implementation. We propose a mixed-methods study in three phases. Phase I will comprise: development and testing of a typology which groups English LAs into support types; recruitment of 15 local authorities; characterising care models for older people with moderate needs; designing and piloting survey instruments and methodology; assessing in 6 pilot authorities key features of the care system to be explored in later phases. Phase II will comprise: the two-wave survey piloted in phase I; statistical and econometric analyses; exploration of how far implementation of the care model vision leads to change. The survey will involve face-to-face interviews with 1,500 people with moderate care needs and telephone interviews with 850 carers. The analyses will examine links between care needs and receipt of services and associated costs, impact of services on outcomes at 6 months, differences in outcomes and costs at 6 months between support types and relative cost-effectiveness of different support types. Phase III will involve: long-term follow-up of health and social care use by the study participants at 1.5 and 2.5 years following initial contact; and comparison of care use across care models focusing on time to care home admission and hospitalisation and total social care and health care costs. The study involves a collaboration between researchers from leading health and social care research organisations: CPEC at LSE and KCL, as well as Ipsos MORI as subcontractors. We will work closely with care professionals, older people and carers to test our approach and discuss early findings. Public and Patient Involvement and Engagement (PPIE) supporters will help us make our approach to older people and carers meaningful and accessible. A steering group will advise us on strategies for sharing our findings and will provide methodological and practical advice on the implementation of the research. It will help decide the continuation of the study post-piloting phase. We will seek ethics approval from the HRA National Research Ethics Committee and ADASS approval. We will produce easy-read summaries of all written outputs; short videos illustrating key findings; a policy-friendly leaflet outlining recommendations; papers for professional and academic journals. We will hold two workshops for local authorities and the voluntary sector and annual workshops with central government.
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