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Request social care assessment for older person - 2016-17

Why important

Visits for social care have not historically been in the top tier of reasons why people come to council websites (typically 2% to 2.5%, varying by council type). Numbers receiving social care services from the council are relatively small and until recently will have been catered to mostly through phone and face to face channels. However, with increasing demand for social care from an ageing population, and diminishing resources to meet it, councils need to make the most of the web to deliver as cost-effectively as possible, information about access to services and financial support. As part of their responsibilities under the Care Act, councils in England also need to be managing demand and expectation, and pointing people who do not qualify or are not interested in council support, to other sources of help. This latter responsibility is explored more fully in our companion survey Find local care support for an older person.

Date of assessment

February and March

Coverage

English, Welsh and Scottish unitaries, metropolitan districts, London boroughs, county councils

Overview

Access to councils’ adult social care services is via a needs assessment and where financial support may be needed or requested, a financial assessment. Our survey sought to test how well this process is being presented on council websites and how well the information is linked to related information. Just under half of sites tested provide a good or very good service on this task. England (57%) and Wales (41%) perform notably better than Scotland (16%) – something we touch on in our report. Please see also the companion survey Find local care support for an older person. Question sets for both surveys were developed in collaboration with the older people’s charity Independent Age.

Find your council report

Check ‘coverage’ to see if your council has been surveyed. Go to councils page and select your council. Look for link to task report under 2016-17 results

Headline results

50%

Provide a good or very good online service based on this survey

Better connected rankings

14%
36%
31%
20%
0%
0%
0%

*Discrepancies in the figures are due to rounding off

Key
  • 4 stars (Very Good)
  • 3 stars (Good)
  • 2 stars (Unsatisfactory)
  • 1 star (Poor)

 

Questions

NB Question highlighted in red is an ‘essential question’ that must be answered correctly for the council to meet the standard for this task. Questions highlighted in blue affect star ranking

Questions to be answered "Yes"
Would you recommend that other councils look at this implementation as an example of good practice? 6%
Does a Google search lead me to the task? 89%
Is it clear that the council will always do a needs assessment before arranging any care? 77%
Is there a self-assessment tool for care needs available on the site? 23%
Is it clear from information explicit on web pages (ie not just pdfs) that care packages may need to be fully/partly paid for by the recipient? 73%
Is it clear that the council will assess financial eligibility before contributing to care costs? 71%
Is there a clear statement about savings and income levels that will entitle someone to financial support for care from the council? 49%
Is there a calculator to help site users determine eligibility for council funding for care 7%
Is there clear information about arranging an advocate? 32%
Is there clear information about reporting a safeguarding concern (someone at risk)? 55%
Are sources of information and advice for those not eligible/not interested in council support clearly signposted? 54%
Is it clear that carers are entitled to a free needs assessment from the council? 19%
Is it possible to request a care assessment for an older person online? 32%
Does the home page link me directly to the task? 79%
Does the service landing page link me directly to this task? 81%
Does a search for the task description return the correct result listed in the first five results? 50%
Does the A to Z list include this task? 42%
Do all of the above routes lead to a consistent destination? 30%
Other questions affecting standard achieved
Was the content you reviewed free of any out of date information? 87%
Overall, how do you rate the journey plus task completion? 2.6
Non-scoring questions
Was the content you reviewed concise and free of jargon? 81%

Task report

Access to councils’ adult social care services is via a needs assessment and where financial support may be needed or requested, a financial assessment. Our survey sought to test how well this process is being presented on council websites and how well the information is linked to related information.

People just starting their researches on options for elderly relatives may be aware that councils provide care services for older people. However they are unlikely to know who qualifies to receive them or how they can be accessed.

Some will not necessarily want to use council-provided services, especially if they have to pay for these, but may regard the council as a trusted place to look in the first instance for options, advice and signposting. Our question set, developed in collaboration with Independent Age, was intended to test how good sites were at covering these essential initial stages in understanding and accessing social care services, whoever the eventual provider.

Better Connected starts all service-based surveys by testing whether a Google search can find the relevant service. If a site fails this findability test, it cannot score above 1 star in the assessment. We justify this on the basis that the overwhelming majority of website sessions start in Google, and if sites cannot be found, they may as well not exist.

For this survey we used the search phrase ‘XYZ council social care assessment for elderly person’. An unusually high proportion of sites – more than 10% - were not found for this task, when for most Better Connected surveys the percentage is between 0% and 3%.

High instances of ‘not found in Google’ tend to arise where councils are using third party sites to present information about council services and these sites are not well integrated with the council’s corporate website. Social care departments have invested significantly in third party websites in the last 2-3 years, and it appears that in too many cases too little attention has been paid to the important issue of ‘findability’.

 Being such a broad and complex topic, social care is always going to pose problems when it comes to search engine optimisation. Reviewers frequently had to take a gamble on which link to click in Google search results. Many returned web pages of varying relevance or linked to pdfs, which are effectively dead-ends, since they provide no jumping off points into site navigation. Pages not optimised for search cropped up frequently in this survey.

Where Google did land reviewers on introductory pages about assessment, these were rarely clear enough its role as the gateway to council support and services. We were looking for simple information that would set expectations and answer key questions by explaining that: 

  • the council will always make a needs assessment before discussing care services that might be offered in individual cases
  • assessment is free, but most people will have to contribute something towards the cost of care services they may qualify for, based on their income and assets
  • contributions to cost are based on a financial assessment to determine whether an individual’s income and assets are below the qualifying levels (and what these levels are)

Each step of the journey from initial contact with the council to the final result – whether it be receiving care/funding or becoming a self-funder – should ideally be provided as an overview and then mapped out as a logical sequence of webpages.

In many cases, information about the financial assessment was not set out with, or linked to, information about having a needs assessment. Instead the financial assessment and thresholds information were on separate webpages and sometimes in separate sections of the adult social care pages. Sometimes information about funding was only presented under headings like ‘residential care’ or ‘care at home’.

In only 42% of cases were reviewers able confirm that there was ‘a clear statement about savings and income levels that will entitle someone to financial support for care from the council.

Some councils seem reluctant to ‘tell it how it is’, burying information about eligibility under reams of producer-focused content about policy or approaches to service delivery. Others tuck the information away in lengthy pdfs. Some mention financial assessment but fail to link to any further information.

This reluctance to be upfront about funding (or lack of) may be informed by concerns on the part of social care managers that mentioning eligibility and cost might deter vulnerable people from seeking services. However, wasting people’s time by not providing relevant information, and leaving them with no option but to phone the council or abandon their research, may not be the best way to deal with this concern.

Third party sites commissioned by councils to carry their social care content cropped up frequently during this review. The user journey between the council site and third party sites and indeed within third party sites was often poor. Problems included duplicating content on both sites, or lack of deep linking between a task on the council site and the relevant page in the third party site.

The latter – which was common - could lead to whole sections of content being missed completely during reviews. Reviewers would land on a site’s assessment page from Google, and be unable to find links to the rest of the adult social care content where answers to related questions like ‘paying for care’ or ‘local services’ might be found.

This wasn’t just a problem where councils were linking to third party sites. Sometimes it was only as the reviewer went back to the corporate home page and the adult social care landing page, or the site search or A-Z, that whole new sections of content on the council’s own site were discovered. Sometimes there would be a single link from a single page to a key area of content containing pages covering many key topics.

Jarring differences in the look, feel and style of content between the main council site and third party sites are not helpful. This is particularly the case where the corporate site has adopted a GOV.UK-like image-light, pared content style, and the third party site is full of images, icons and labelling like ‘how can I help you? or ‘what do you want to do today?’. While these approaches are intended to be user-friendly they are actually distracting, contrary to web content best practice, and are likely to slow down the user journey.

Content categorisation in third party sites is also very poor and seems to depend on pre-determined, off-the-shelf modules and titles. These tend to be topic based rather than task based and it's often difficult to know where to look for information. Labels such as ‘Information and advice’ were often used (meaningless, as everything on the sites is information and advice) making it almost impossible to guess what the sub pages might contain.

These sites were often over-engineered, resulting in over-long user journeys, with visitors having to identify themselves as being in a particular category or define who they were seeking information for. Once particular site gets visitors to go through this process and then delivers everyone to the same place anyway.

Only 20% of sites reviewed were marked down for being over-wordy or containing jargon, although many sites would benefit from dramatic, GOV.UK style content pruning that would enable visitors to find information much more quickly. Better ‘writing for the web’ would also make a huge difference, using standard methods such as:

  • more and shorter subheads
  • using the active voice
  • shorter paragraphs and shorter sentences
  • using bulleted lists

Site editors should also ensure that content reflects the logical steps a user would take when trying to complete typical tasks. Only relevant information should be added for each step so that tasks can be completed as quickly as possible. Simple changes can have a big impact on the user experience and journey.

It isn’t clear why some sites choose to tell visitors that ‘the way we deliver services is changing’ or have links or sections simply labeled ‘Care Act’. Potential service users need information about the consequences of changes, under meaningful headings, not what has driven the changes, and certainly not at length.

Where phrases like ‘personal budgets’, ‘deferred payments’, and (a Better Connected favourite) ‘reablement’ are used, they need to be introduced and explained. Safeguarding is a frequently used term whose meaning can be implied, but isn’t really ‘plain English’.

Other terminology and labeling around safeguarding was also problematic and in particular ways in which sites invited people to report concerns about someone. Most broached the topic in terms of abuse (Report abuse) and even if they explained later that this could include self-neglect, many people wouldn't read beyond the heading and therefore miss the call to action.

Our questions about carers and advocates were generally not well answered. On 31% of sites we found clear information about arranging an advocate, and there were too few examples of deep linking to a useful, customer-friendly webpage about how to ask for an advocate, whether free of charge, who might be eligible to have and advocate and so on. This was particularly a problem where the council outsources the advocate service and simply dumps the visitor onto the homepage of another 3rd party website.

With regard to carers, general information can be found, but only 18% made it clear that the carer assessment is free of charge. This seems surprising when supporting a carer might make the difference between a person continuing home care or having to be accommodated in residential care.

Very few councils (6%) offer a calculator to help people see if they might qualify for financial assistance – perhaps because the rules are actually relatively simple. More value could be added more quickly by making these figures more explicit than they are currently.

Some councils (around 20%) are starting to offer care needs self-assessment tools. We asked this question mainly to see the extent to which councils are encouraging people (who may be self-funders) to understand current and future needs in order to point them in the direction of equipment and services available in the community.

Nearly a third of sites enable assessments to be requested online and sometimes these forms cover very similar ground, gathering information that will enable councils to readily identify those that should be prioritised for a full assessment according national eligibility criteria.

Others sites provide examples of the forms people will be taken through during an assessment, or examples of the questions. These approaches are useful because they help make the assessment process more transparent and less daunting.

One striking aspect of our research is the finding that Scottish sites do dramatically less well on this task (16% good, none very good) than English sites (57%) and Welsh sites (41%)

The reasons behind this is need further investigation, but are likely to be connected with the fact that Scotland has not been subject to the Care Act, and that health and social care services are more integrated with the NHS in Scotland. 

Generally speaking, social care pages on Scottish sites provide far less information than do their English and Welsh counterparts about the assessment process, eligibility for financial support, and related information and services. It has been suggested that as most referrals for care assessments in Scotland come from professionals, it is not necessary to publish much information on the topic.

The culture of encouraging self-help and the requirement to publish information for self-funders, which are consequences of the Care Act, and has had a dramatic effect on web publishing by social care departments in England, is also absent.

Sites that we recommend

Barnsley

Well written information that logically walks me through the key bits of info and provides links at the most relevant points.

https://www.barnsley.gov.uk/services/adult-health-and-social-care/

 

Coventry

Excellent all round - logical, well written guidance provided in a sensible, easy to digest order with relevant links throughout.

http://www.coventry.gov.uk/adultsocialcare

 

Derby

This was a superb experience …. I completed the task really quickly and the user journey was very smooth, with hardly any clicking around. Pretty much all the information is contained on one long page. If not done properly this can cause readability problems but Derby doesn't make this mistake…… alternative sources of support information is provided early on so I can explore other avenues if I am only starting to look into care options. A good overview of the financial side of things is provided upfront, with the opportunity to delve deeper……….

http://www.derby.gov.uk/health-and-social-care/your-life-your-choice/

 

Hertfordshire

What an easy experience this was. I was able to find all the info I needed very quickly and easily. The content was concise, easy to follow and free from jargon. Signposting is very strong and the customer journey was well planned. This is a good model for other councils to follow.

https://www.hertfordshire.gov.uk/services/Adult-social-services/Adult-social-services.aspx

 

Kingston

This was a really good user experience. I could find all the information I needed and whilst the information is very thorough, it is structured in logical steps so I can pick out what I need and don't feel overwhelmed. It is also very well signposted so I can get to the task really easily from any route. Where the site could be improved is to have a few more in-page links to other relevant sections.

https://www.kingston.gov.uk/info/200181/adult_social_care

 

Northamptonshire

It was very easy to find the information I was looking for about assessments. Signposting was strong and I would have felt confident to complete the online self referral. Clear explanations were given about the process of needs assessments and financial assessments. There were a couple of areas where additional links would have helped. Other council web teams could benefit from looking at the assessments content on this site.

http://www3.northamptonshire.gov.uk/councilservices/adult-social-care/Pages/default.aspx

 

Suffolk

Assessments are well signposted on this site and I was encouraged to complete the online self assessment form. I was told that this would then provide me with lots of information and, if the form found that I was likely to be eligible, I could send it to adult social care. The information about both needs and financial assessments was well thought through. Large clickable signposts with expanding content were used for key pieces of information. Good links were provided to further information on the database site "infolink"'.

https://www.suffolk.gov.uk/adult-social-care-and-health/

 

 

Waltham Forest

Content is really well laid out and well written. The design also helps me find everything I'm looking for easily and quickly. Although most of the content is within the directory, the user journey is excellently executed so you don't really notice you've jumped sites.

https://www.walthamforest.gov.uk/service-categories/adult-social-care

 

Wokingham

This is great example of how to execute complicated content in a way that makes it easy for visitors to find and understand answers to their questions. The How adult social care works page gave me a fantastic overview of what I could expect and outlined well the steps I'd go through. The information is very succinct but contains good links to more detail if I need it. This is pretty much the only example I have seen of user journey being well executed between the council's main site and a directory site. Great!

http://www.wokingham.gov.uk/care-and-support-for-adults/

 

 

 

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