ASCOF Outcomes Intelligence — Kent & Medway

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What ASCOF measures

Annual published scores for each council — quality of life, independence, empowerment, safety, social connection, continuity of care. It tells commissioners how the current system is performing on people already in it.

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What ASCOF misses

People not yet in formal care — the Missing Middle — don't appear in ASCOF denominators. Their outcomes aren't measured. They are exactly the population Assistiv is designed to reach before the crisis that brings them into the system.

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Why this matters here

Pairing ASCOF performance with FEP district risk closes the loop: current outcomes + upstream risk = commissioning argument. Where outcomes are weak and FEP is high, the case for early intervention is strongest and most defensible.

Headline ASCOF Measures — South East Region 2024–25 (survey-based, directly comparable)

Measure 1A · Quality of Life

Social care-related quality of life score

19.1 /24

England: 19.0 ▲ Above avg

South East is above the England average. Covers control, dignity, personal care, food, safety, occupation, social participation. Older adults (65+) score 18.8 — below the 18–64 score of 19.4.

Measure 1D · Satisfaction

Overall satisfaction with care and support

65.1%

England: 65.1% = National avg

65+ satisfaction is 63.3% — materially lower than 18–64 (68.9%). Nearly 1 in 3 older adults are not satisfied with the care they receive.

Measure 3A · Control

People with control over daily life

78.2%

England: 77.3% ▲ Above avg

5% of all service users nationally report having no control at all. Control over daily life is the domain with the highest unmet or partially met need after how time is spent.

Measure 5A · Social Connection

People with as much social contact as they'd like

46.2%

England: 45.4% = Near avg

Fewer than half of people receiving care have sufficient social contact. Nationally, 23% have partially met or unmet social contact needs — the second highest unmet domain after occupation.

New 2024–25 Metrics — CLD-Derived · Official Statistics in Development · Not comparable with prior years

Measure 2A · Reablement

No further support needed after reablement

80.0%

England: 77.1% ▲ Above avg

South East performs well on reablement effectiveness. New metric — cannot compare with prior 2D1 figure. Reflects short-term independence outcomes only.

Measure 2C · Residential Care

Admissions to residential care per 100k (65+)

559.8 /100k

England: 592.5 ▼ Below avg

Lower admissions rate is better — South East outperforms England. New data source (CLD), not comparable to 2023–24 SALT figures. Lower rates in the South East vs North East (755.5) is substantial.

Measure 2D · Post-discharge

Remained in community 12 weeks post-discharge

65.1%

England: 60.7% ▲ Above avg

South East leads all regions (69.2% female, 61.0% male). This replaces the old 91-day at-home metric with a different methodology — the drop from 83.8% to 60.7% nationally reflects the change in measure, not a deterioration.

Measure 2E · Independence

Long-term support users living at home (65+)

58.1%

England: 60.3% ▼ Below avg

South East is below the England average for older adults living at home while receiving long-term support. Contrasts with strong 2C admission rate — a nuance worth interrogating at CASSR level.

Quality of Life Score by Region

Measure 1A · 2024–25 · Out of 24 · England avg 19.0

Sufficient Social Contact by Region

Measure 5A(1) · 2024–25 · % with as much contact as they'd like

Residential Care Admission Rate (65+)

Measure 2C · 2024–25 · Per 100,000 population · CLD-derived · Lower is better

ASCOF Performance vs FEP Risk — Kent Districts

1A QoL (regional) · FEP upstream risk (district) · High FEP + weak QoL = priority zone

Full ASCOF Measure Set — South East Region vs England 2024–25

Survey metrics (1A, 1D, 3A, 4A, 5A) are year-on-year comparable. Purple = CLD-derived official statistic in development, not comparable to prior years. Exact Kent CASSR figures available in DHSC Power BI dashboard.

Metric	Outcome domain	South East	England	Direction	Status
1A	Quality of life score (out of 24) 8 domains: control, dignity, personal care, food, safety, occupation, social participation, accommodation.	19.1	19.0	+0.1	Above avg
1B	Adjusted quality of life (social care contribution) Removes non-service factors. Measures the specific impact of LA-funded social care on QoL.	0.411	0.419	−0.008	Below avg
1D	Overall satisfaction with care and support % extremely or very satisfied. 65+ satisfaction (63.3%) lower than 18–64 (68.9%).	~65%	65.1%	≈ avg	Near avg
2A ⚗	No further support needed post-reablement New CLD-derived metric. Not comparable to prior years. Short-term independence outcome.	80.0%	77.1%	+2.9pp	In development
2C ⚗	Residential care admissions per 100k (65+) New CLD-derived metric. Lower is better. Not comparable to prior SALT figures.	559.8	592.5	−32.7	In development
2D ⚗	Remained in community 12 wks post-discharge New metric replacing 91-day at-home. Different definition — England dropped from 83.8% to 60.7% due to methodology, not outcomes.	65.1%	60.7%	+4.4pp	In development
2E ⚗	Long-term support users living at home (65+) New CLD-derived metric. Measures independence among those already in the system.	58.1%	60.3%	−2.2pp	In development
3A	Control over daily life % with adequate or full control. 5% nationally have no control.	78.2%	77.3%	+0.9pp	Above avg
4A	Feeling as safe as they want % feeling adequately or fully safe. 70.1% nationally; older adults slightly safer than 18–64.	70.1%	70.1%	= avg	Near avg
5A(1)	Sufficient social contact (service users) Second highest unmet need domain. 23% have partially or unmet social contact needs nationally.	46.2%	45.4%	+0.8pp	Near avg
5A(2)	Sufficient social contact (unpaid carers) South East lowest nationally at 25.9% — significantly below England average of 30.0%.	25.9%	30.0%	−4.1pp	Below avg
6A	Care workforce turnover rate % of formal care workers leaving roles in 12 months. South East is highest nationally.	25.2%	23.7%	+1.5pp	Above avg ↑
6B	Care homes rated Good or Outstanding (CQC) % of residential providers at Good/Outstanding. South East performs above England average.	82.9%	81.7%	+1.2pp	Above avg

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The commissioning argument in plain terms: The South East region — which includes Kent — performs above average on most ASCOF metrics in 2024–25. But there are two pressure points that matter specifically for Assistiv's offer. First, the adjusted quality of life score (1B) is below average — meaning social care is delivering less additional quality of life improvement here than in other regions, despite the gross score appearing acceptable. Second, and strikingly, South East carers report the lowest social contact of any region nationally (25.9% vs 30.0% England average). Carers are among the highest-risk individuals for frailty in their own right, and their isolation is a direct indicator of system strain.

The workforce turnover figure (25.2%, highest nationally alongside the South West) compounds this: the care system in the South East is structurally under pressure in a way that will not improve without upstream demand management. Assistiv's FEP intelligence shows that the highest-risk districts — Thanet (FEP 77), Dartford (FEP 55), Medway (FEP 54) — are precisely where that system pressure lands first.

How ASCOT Connects Individual Screening to ASCOF Population Measures

Population level · ASCOF

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1A: Quality of Life Score · 19.1 /24

South East · 8 domains · Annual publication

Tells commissioners how the region is performing but not where outcomes are weakest within it, or who is pulling the score down.

Individual level · ASCOT-SCT4

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Person-level quality of life · same 8 domains

Assistiv screening tool · control · safety · social participation

Assistiv's ASCOT questions map directly onto ASCOF domains — enabling sub-regional aggregation by district, age band or risk tier in a way the published data cannot provide.

Upstream risk level · FEP

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Frailty Emergence Probability · district-level

0–100 scale · Thanet 77 · Dartford 55 · Medway 54

FEP identifies where demand is building before it enters the system that ASCOF measures. High-FEP + weak ASCOF = the sharpest commissioning case for prevention.

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The Missing Middle gap in ASCOF: Every metric in this table is calculated from people already in contact with adult social care services. Nationally, around 2.4 million adults aged 65+ are estimated to have care needs but receive no formal support. They do not appear in any ASCOF denominator. In high-FEP coastal Kent districts — where self-referral rates are lowest and deprivation highest — this gap between measured and actual need is widest. ASCOF underestimates unmet need in precisely the places where it is most severe. Assistiv's screening tool is designed to make the invisible legible.

Metric	2015–16	2018–19	2021–22	2023–24	2024–25	5-yr direction	Predictive signal
1A Quality of life /24	19.1	19.2	19.1	19.1	19.0	Flat / slight ↓	Stable for a decade then fractional decline in 2024–25. No improvement despite investment. Ceiling effect or genuine stagnation — further analysis at CASSR level needed.
1D Satisfaction %	67.3	68.1	65.1	65.4	65.1	Declining	Down ~3pp from pre-COVID peak. Has not recovered. Structural signal of workforce pressure and delayed intervention arriving at crisis point rather than earlier.
3A Control %	77.7	78.4	78.0	77.6	77.3	Flat / slight ↓	Marginally below its own historical range. Control is the ASCOT domain most directly linked to Successful Autonomy — decline here is the most important signal for Assistiv's offer.
4A Feeling safe %	69.8	71.5	70.8	70.5	70.1	Flat	Broadly stable. Small post-COVID dip has not fully recovered. The safety domain is where Assistiv's home sensor stack (mmWave, acoustic AI) most directly intervenes.
5A(1) Social contact %	42.1	44.2	44.1	—	45.4	Slowly improving	Gradual improvement over the decade, but fewer than half of people receiving care still have sufficient social contact. The absolute level remains a major unmet need despite the positive direction.
2C ⚗ Residential admissions /100k (65+)	~620	600	559	566	593 ⚗	Unclear (CLD break)	The SALT-derived series showed a gradual reduction 2015–2022. The 2024–25 CLD figure (593) is not directly comparable — do not interpret as reversal without further validation.

Adult Social Care OutcomesKent & Medway

Adult Social Care Outcomes
Kent & Medway