The ASC Client Level Data (CLD) collection represents an evolution of the annual aggregated Short and Long Term (SALT) collection by asking Councils to submit the underlying data instead.

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cld-guidance-release-1.pdf

release-1-message-final.docx

<span>The specification has been co-developed with LAs and stakeholders, ensuring continuity with the current aggregate collections which were designed jointly with LAs,
ADASS, NHSD and DHSC. The ASC CLD Specification includes data items needed to reproduce the SALT metrics, as well as additional data items that will enhance the collection and provide essential information across a range of areas, including charging reform. Most of the content from the existing SALT collection in relation to service users and carers is covered, except for intermediate care data currently reported in the SALT STS004 table.</span>
<span>Key additions to the specification include additional carer information and a new client funding status field to enable monitoring of the impact of charging reform on LA activity. This new field is intended to support the identification of client funding arrangements and their journey through ASC as part of the Care Act reform which is scheduled to go-live in October 2023. Changes have been kept to a minimum, to avoid undue burden on LAs.</span>


Digitising Social Care Data Catalogue

Person level data is required for carers in direct contact with the LA during the year – a request, an assessment, a service or a review. This can include direct contact with a commissioned carers support provider.

Carers who are not in direct contact with LAs (i.e. they do not have any events in the year where they are the primary focus of the intervention such as a carer request, a carers assessment or carer support: Direct to Carer) still need to be included in the dataset provided the carer is linked to a client and has been involved in the assessment and care management process for the person they care for. i.e. there is evidence of a joint assessment or review or the provision of ‘Carer Services: Support involving the person cared-for’. This is the only instance where a row of data will show the person details for the carer and the linked service user Person IDs only and not contain any event details. This record will be used for linking purposes only using Client type of ‘Carer known by association’.

Where either a carer or an adult service user is receiving LA support, but the reciprocal client or carer is not, the details of the latter should not be shared, since there is no purpose / consent to hold and share this data. This therefore implies we will not be able to disaggregate carer outputs for all parties e.g. cared for PSR/age, carer age/gender.

The carer specific events should represent the direct interactions of LAs and carers in respect of their needs as a carer only i.e. a carers request, a carers assessment, carer review or ‘carer support: direct to carer’.

Should the carer aged 18+ also be a service user then the person should be reflected in CLD as both including all events relating to their role as a carer, and all events relating to their needs as a service user, with the activity recorded and identified by Client Type: Service user or carer.

Carers and linked service users (Carers only)

Financial information is highly valuable information to have at client level. The intention is that CLD will be the means of collecting spend at service level in future, as it provides valuable information for:

• monitoring of expected metering towards the care cap, once funding reform
legislation is implemented
• informing the “fair cost of care” exercise
• analysing cost variation between services, including analysis of costeffectiveness
• understanding cost variation across clients, as a key marker of the intensity of
service required,
• Assessing changes over time for individual clients.

From April 2023, the CLD collection will capture planned costs associated with services, rather than actual spend which is captured separately in the ASC-FR return. Despite the limitations of using planned cost information, we understand that planned spend is likely to be easier for LAs to provide and that in many respects it can be a preferred measure, reflecting care needs better and for insight into intensity of care.

The service categories below should have an associated cost in the CLD collection.

• All Long Term Support, excluding CASSR Commissioned Support Services
• Short Term Residential Care, Short Term Nursing Care and Carer Respite
• Carers Support, excluding CASSR Commissioned Support Services

The methodology of recording financial information is based on the trials in the North West Pilots, and consideration of the LGA Markets and Modelling Project where service costs were collected from volunteer Local Authorities.

Collecting the fields of ‘unit cost’, ‘cost frequency’ and ‘planned units per week’ will enable DHSC to have more timely data as well as the distributions underlying each local authority's progress towards a fair cost of care, compared to the fee rates in the existing local authority average data returns (ASC-FR and iBCF). This will enable DHSC to better understand the range of costs that local authorities face and the impacts of those when making policy decisions. It will also enable DHSC to better understand care market risk.

Costs (Services Only)

All occurrences of the event types which occur in the local authority within the reported timeframe should be captured for service users and carers. 

This includes:
• Requests received in the reporting period
• Assessments and reviews commenced and/or completed in the reporting period. No open or ongoing assessment or review events are required.
• Service events that started or ended within the reporting period, or where the service was open and ongoing at the end of the reporting period. This includes events where the start date was before the start of the reporting period, were open at the end of the reporting period or ended after the reporting period. Service events are the only event type in CLD that can be open and ongoing, with an event start date, but no event end date.
• Cancelled events should be excluded from the collection.
• Suspended services should be included as originally intended.

It is recognised that different LA’s have different business rules and practices, but the four key steps in the social care pathway are common to all, with data collected on each aspect reported by LAs at some point in the past. These are Requests, Assessments, Services, and Reviews. The diagram below maps out the typical care pathway. (See pg.26 of https://www.ardengemcsu.nhs.uk/media/2835/cld-guidance-release-1.pdf)

Events (All)

Assessments were previously reported for Referrals, Assessments and Packages of Care (RAP) but were dropped with the introduction of SALT in 2014/15. Assessments are a key event in the social care process and has therefore been re-introduced in the CLD collection to capture the full pathway for an adult.

Events (Assessments only)

This includes requests for support (contacts from clients or their representatives, or someone acting on their behalf) being made in relation to the provision of adult social  care services, excepting ‘casual contacts’ where no client details are captured. In a change from SALT, this should be for NEW and EXISTING clients, and for carers. As with SALT, matters relating to adult safeguarding procedures and Deprivation of Liberty Safeguards are excluded.

Events (Requests only)

A ‘review’ is a full re-examination of client needs and should include a (formal) reassessment of need and direct contact with the client. CLD is flexible enough to accommodate a single review event which incorporates a review of needs, and where LAs undertake a review and a separate re-assessment event.

A review cannot be completed without input from the client (and/or the client’s representative). The outcome must be the offering of new or continuation of current services as well as services being ceased. Note, however, that closing case files or checking that services have stopped following the death of a client does not count as a review for CLD purposes. Similarly, reviews that are not completed before a client dies (or for any other reason) should not be included.

Events (Reviews only)

All services starting, ending or open within the reporting period for people that are.

• Funded fully or jointly by the Local Authority
• Full cost – these are clients who would be self-funding but pay the full cost of
their care directly to the LA under 18(3) – see Annex C

In relation to services that have been suspended during the period, please treat these services as open with the client 'on the books' for the purposes of the return. If it is decided that the suspended service will indeed terminate, for example an extended stay in hospital where needs are likely to change, or the care home is unable to keep the bed available, then this should be reflected as an ended service as normal and a new service recorded as appropriate.

Only services provided by Adult Care in respect of needs as an Adult should be included in reporting (cases in which clients are transitioned to adult social care before turning 18 should still be included). As such, any services provided by Children’s Services during transition to Adult Care should be excluded.

Events (Services only)

Present on ALL rows with unique values for each data item repeated for all events relating to a person (NOT event specific)

The ASC CLD activity template includes person information fields. All person details should be reported as correct at the end date of the Reporting Period, with unique values provided for every event row in the data. This will ensure a single value for each variable replicated for each event row for the same person.

Adult Social Care - Client Level Data (CLD)

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