Guidance

Annex B: updates to the Adult Social Care Outcomes Framework (ASCOF) from April 2023

Published 20 December 2023

Applies to England

The Adult Social Care Outcomes Framework (ASCOF) is a set of annual indicators of outcomes and performance that measure how well care and support services achieve the outcomes that matter most to people. It is published annually as an official statistics publication, and is intended to be used both locally, regionally and nationally to:

• set priorities for care and support
• measure progress
• strengthen transparency and accountability

Given ASCOF was last updated in 2014, we committed to working with the sector to update the framework, to maximise its value at local, regional and national levels. The updates utilise recent or upcoming changes to data flows and collections, and better reflect local authorities’ duties under the Care Act 2014 and the government’s priorities for adult social care (ASC) as outlined in People at the Heart of Care: adult social care reform white paper.

Updates to ASCOF will be delivered in 2 phases, as set out below.

Phase 1: updated framework (from April 2023)

Aligned with the Care Act and our vision for reform, we are replacing the current 4 domains with 6 objectives that set out our priority outcomes:

• quality of life: people’s quality of life is maximised by the support and services which they access, given their needs and aspirations, while ensuring that public resources are allocated efficiently
• independence: people are enabled by adult social care to maintain their independence and, where appropriate, regain it
• empowerment: information and advice - individuals, their families and carers are empowered by access to good quality information and advice to have choice and control over the care they access
• safety: people have access to care and support that is safe and which is appropriate to their needs
• social connections: people are enabled by adult social care to maintain and, where appropriate, regain their connections to their own home, family and community
• continuity and quality of care: people receive quality care, underpinned by a sustainable and high quality care market and an adequate supply of appropriately qualified and trained staff

This update also:

• removes metrics that we agree with the sector do not effectively measure these outcomes or are no longer available through national collections
• includes metrics that reflect people outside of those who use services and their carers, such as the care workforce
• replaces metrics that are currently produced using annual Short and Long Term (SALT) data with metrics that will be sourced from quarterly client level data (CLD)

The metrics used in ASCOF from April 2023 are set out below. For more information, see Adult social care outcomes framework 2023 to 2024: draft handbook of definitions. Worked examples are not yet available. We are working with NHS England and local authorities to develop aggregations and metric calculations from CLD. A final version of the handbook will be published by autumn 2023, once the first mandatory returns for CLD are received and worked examples for each metric can be developed.

ASCOF indicators (from April 2023)

Objective: quality of life

ASCOF indicator:

• 1A (formerly 1A) quality of life of people who use services (it is based on the following outcomes: control, personal care, food and nutrition, accommodation, safety, social participation, occupation and dignity) (data source: Adult Social Care Survey (ASCS))
• 1B (formerly 1J) quality of life of people who use services - adjusted to account only for the additional impact of local authority-funded social care on quality of life, removing non-service related factors (underlying health and care needs, gender, and so on) (data source: ASCS)
• 1C (formerly 1D) quality of life of carers (it is based on the following outcomes: occupation, control, personal care, encouragement and support, safety and social participation) (data source: Survey of Adult Carers in England (SACE))
• 1D (formerly 3A) overall satisfaction of people who use services with their care and support (data source: ASCS)
• 1E (formerly 3B) overall satisfaction of carers with social services (for them and for the person they care for) (data source: SACE)

Objective: independence

ASCOF indicator:

• 2A (formerly 2D) the proportion of people who received short-term services during the year, who previously were not receiving services, where no further request was made for ongoing support (split by age: aged 18 to 64; aged 65+) (data source: CLD)
• 2B (formerly 2A1) the number of adults aged 18 to 64 whose long-term support needs are met by admission to residential and nursing care homes (per 100,000 population)(data source: CLD)
• 2C (formerly 2A2) the number of adults aged 65 and over whose long-term support needs are met by admission to residential and nursing care homes (per 100,000 population) (data source: CLD)
• 2D (formerly 2B) the proportion of older people (65 and over) who were still at home 91 days after discharge from hospital (data source: CLD)
• 2E (formerly 1G) the proportion of people who receive long-term support who are enabled to live in their home or with family (split by age: aged 18 to 64; aged 65+) (data source: CLD)

Objective: empowerment – information and advice

ASCOF indicator:

• 3A (formerly 1B) the proportion of people who use services who report having control over their daily life (data source: ASCS)
• 3B (formerly 3C) the proportion of carers who reported that they have been involved in discussions about the person they care for (data source: SACE)
• 3C (formerly 3D1 and 3D2) the proportion of people and carers who use services who have found it easy to find information about services and/or support (data source: SACE and ASCS)
• 3D (formerly 1C) the proportion of people who use services who receive direct payments (split by age: aged 18 to 64; aged 65+) (data source: CLD)

Objective: safety

ASCOF indicator:

• 4A (formerly 4A) the proportion of people who use services who feel safe (data source: ASCS)
• 4B the proportion of section 42 safeguarding enquiries where a risk was identified and the reported outcome was that this risk was reduced or removed (data source: Safeguarding Adult Collection)

Objective: social connections

ASCOF indicator:

• 5A (formerly 1I) the proportion of people who use services who reported that they had as much social contact as they would like (data source: ASCS)

Objective: continuity and quality of care

ASCOF indicator:

• 6A the proportion of staff in the formal care workforce leaving their role in the past 12 months (data source: Adult Social Care Workforce Data Set (ASC-WDS))
• 6B the percentage of adult social care providers rated good or outstanding by the Care Quality Commission (data source: CQC Directory)

Phase 2: updated framework (from 2025 to 2026)

We will launch a second phase of updates to ASCOF from 2025 to 2026. We will continue working with stakeholders, including local authorities, people who draw on care and support and their carers, to develop the second phase of the refresh. This will seek to utilise new data streams coming online over the coming years, such as updates to SACE and ASCS, and will ensure ASCOF reflects changes being delivered across the sector as a result of reform.