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Overview

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ℹ How to use the local authority pages?

This report separates the topics of social care into different sections. Each section provides an overview of the challenges faced by different groups of people in Gateshead. The report also includes key metrics that can help local authorities understand the social care landscape in their area. You can select these areas on the top menu, or using the “accordion menu” in the top right hand corner on mobile.

This report uses interactive visuals. On desktop, you may hover over the charts to see more information. On mobile, you can click on the charts to see more information.

This report also uses AI to summarise charts (these blocks will have a “✨” icon and a light blue background. You can vote on the accuracy of these summaries by clicking on the green check “✅” or red cross “❌”. We want to hear from you, and your feedback will be taken into consideration for subsequent versions.

The report also uses AI to create summaries of all the series within each section, and also summarises all sections into an overall section. These summaries are denoted with the same icon, and a light green background. Please vote on these blocks, just as you would in the summarising blocks.

About this section:

This page provides an overview of social care in Gateshead, along with key metrics that could affect social care. Understanding these metrics is important because they help contextualise the challenges with social care provision in each local authority. These statistics are important to keep in mind when reviewing the other pages.

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Why is this important?

Why are these metrics important? Population size and density can affect the demand for social care services. For example, if a local authority has a high population (relative to other areas), it may need to allocate more resources to meet care needs. Similarly, areas with high population density may require more care services due to the increased number of people living in close proximity. Inversely, areas with a low population density may have fewer care needs, but residents may face challenges accessing services due to the distance between them. Lastly, people in rural areas might live further away from services, which can impact their ability to access care, or make it more expensive to provide.

Understanding these metrics can help local authorities plan and allocate resources effectively.

What is this chart saying?

The number of people living in Gateshead has changed a little over the years. In 2019, Gateshead had nearly 200,000 people. It was a bit lower in 2020 and 2021 but started to grow again in 2022. In 2023, the population was close to where it started in 2019. Compared to the average for similar areas, Gateshead had fewer people living there each year. Knowing how many people live in Gateshead helps plan services and support needed in the community.

Gateshead has about 1,378 people living in each square kilometre. This is less crowded compared to the average, which is around 2,469 people per square kilometre. Understanding how crowded Gateshead is can help with planning services, like schools and healthcare. When there are fewer people in an area, it might be easier to access services and get help when needed. This information can help make sure everyone in Gateshead gets what they need.

Sources:

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Deprivation decile

Why is this important?

Deprivation decile is a measure of the level of deprivation in a local authority. It is calculated by ranking areas in England from 1 (most deprived) to 10 (least deprived) based on factors such as income, employment, education, and health. A higher decile indicates lower levels of deprivation, while a lower decile suggests higher levels of deprivation. Understanding deprivation levels can help local authorities identify areas that may require additional support and resources to address social care needs.

What is this chart saying?

In 2019, people in Gateshead had more difficulties than the average in England. A lower mean deprivation decile of 4.25 means more challenges, since the average in England is higher at 5.9. The measure of spread, called standard deviation, is also higher in Gateshead at 2.72 compared to the average of 2.3. This means there is more variation in how people experience difficulties in Gateshead. Understanding these numbers helps us see areas where support is needed most.

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Deprivation rank

Why is this important?

Deprivation rank is a measure of the relative deprivation of a local authority compared to other areas in England. It is calculated by ranking areas from 1 (most deprived) to 32,844 (least deprived) Lower Layer Super Output Areas (LSOA), which can be thought of as “small areas”. This rank is based on factors such as income, employment, education, and health. A lower rank indicates higher levels of deprivation, while a higher rank suggests lower levels of deprivation. Understanding deprivation ranks can help local authorities identify areas that may require additional support and resources to address social care needs.

What is this chart saying?

Gateshead has a deprivation rank of around 12,238. This number is lower than the average in some places, which is around 17,686. It measures different areas to see where help is needed. This tells us that Gateshead might need more support to improve things for people who live there. Understanding these numbers can help make life better for everyone in the community.

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Overview of social care in Gateshead

Analysis of Social Care Data for Gateshead

Gateshead is a town with a population of around 199,000 people in 2023. It is less densely populated than England on average, with 1,378 people per square kilometre compared to the national average of 2,468.5. Only 10% of Gateshead is rural, while the national average is 34.6%. Gateshead is more deprived than many areas, with a mean deprivation decile of 4.25, lower than the national mean of 5.9. This means that Gateshead has higher levels of deprivation.

Disability Rates

The proportion of people with disabilities in Gateshead is 21.4%, higher than the national average of 17.6%. This suggests that more people in Gateshead may need support and care services related to disability.

Requests for Care Among Working-Age People

In 2024, there were 1,500 requests for care from people aged 18 to 64 in Gateshead. This is 753 requests per 100,000 people, which is lower than the national average of 1,143 per 100,000. A total of 885 people in this age group received care, amounting to 444 per 100,000 people, compared to the national average of 533 per 100,000.

This lower rate may mean that fewer working-age people in Gateshead are seeking or receiving care. Possible reasons could be better health among this age group, or barriers that prevent them from accessing care services. It is important to understand if needs are being met or if there are unmet demands.

Types of Care for Working-Age People

Different types of care services are provided. In Gateshead, 500 people (251 per 100,000) received "cassr managed personal budget" support, slightly lower than the national average of 267 per 100,000. Other services like "direct payment only" and "part direct payment" were used by fewer people compared to national averages. This might suggest differences in how care services are delivered or accessed in Gateshead.

Requests for Care Among Older People

For people aged 65 and over, there were 5,035 requests for care in Gateshead in 2024. This is 2,528 requests per 100,000 people, slightly higher than the national average of 2,438 per 100,000. A total of 2,865 older people received care, which is 1,439 per 100,000 people, much higher than the national average of 1,003 per 100,000.

The higher number of older people receiving care may be due to Gateshead having a larger proportion of older residents. Between 2019 and 2023, about 20.4% of Gateshead's population were older people, compared to the national average of 18.5%. With more older people, there is likely a greater need for care services.

Types of Care for Older People

Among the older population, 1,320 people (663 per 100,000) received "cassr managed personal budget" support, higher than the national average of 508 per 100,000. Residential care and nursing care were also used more in Gateshead than average. This indicates that older people in Gateshead may rely more on formal care services.

Unpaid Carers

In 2021, Gateshead had 9,583 unpaid carers per 100,000 people, higher than the national average of 8,204 per 100,000. This suggests that many people in Gateshead care for family or friends without pay. Support for these carers is important to ensure they do not become overburdened.

When asked, 36.6% of carers in Gateshead said they had as much social contact as they would like, compared to the national average of 29.3%. This means carers in Gateshead might feel less isolated than in other areas.

Satisfaction with Services

Among those using care services, 67.1% in Gateshead said they were satisfied with their care and support, higher than the national average of 64.7%. Also, 76.4% found it easy to get information about services, compared to 68.2% nationally. This suggests that services in Gateshead may be more effective or better communicated.

Staffing and Care Providers

Gateshead has 43 community-based adult social care services and 46 residential social care providers. These numbers are lower than the national averages of 63.8 and 91, respectively. The turnover rate for staff is 24.34%, similar to the national average of 24.3%. The vacancy rate is 6.68%, which is lower than the national average of 8.4%. This means Gateshead has fewer unfilled care jobs.

However, 82.5% reported that recruiting staff was more challenging, compared to 79.8% nationally. Retaining staff was also more challenging for 70.5% in Gateshead, slightly higher than the national average of 68.1%. Difficulties in staffing can affect the quality and availability of care services.

Funding and Expenditure

Gateshead spends more on social care per person than the national average. The gross total expenditure is £61,388 per 100,000 people, compared to the national average of £47,758. The net total expenditure is £50,021 per 100,000, higher than the national average of £40,472. This higher spending might reflect the greater demand for services in Gateshead.

Client contributions in Gateshead are £11,366 per 100,000, higher than the national average of £7,286. This means people in Gateshead pay more towards their care. NHS contributions are £5,758 per 100,000, which is lower than the national average of £7,878. This could indicate less NHS funding for social care in Gateshead.

Delays in Hospital Discharges

In November 2024, 99.68% of discharges from hospitals in Gateshead were acceptable, higher than the national average of 89%. However, 31.17% of discharges were delayed, much higher than the national average of 12.3%. The average delay was 1.26 days in Gateshead, compared to 0.7 days nationally. Delays in discharge can impact patient well-being and service efficiency.

Implications for Services

The higher proportion of older people and higher disability rates in Gateshead mean there is greater demand for social care services. Higher spending per person reflects this demand. Ensuring that services are accessible and efficient is important to meet the needs of the population.

Challenges in recruiting and retaining staff could affect the quality of care. Lower vacancy rates suggest that positions are filled, but difficulties in staffing may put pressure on existing staff. Addressing these challenges is important to maintain high-quality care.

Higher client contributions may place a financial burden on those needing care. Lower NHS contributions could indicate a need for more support from the health service. Reviewing funding and support systems might help to balance costs and ensure that people can access the care they need.

Conclusion

Gateshead faces several challenges in social care due to its higher levels of deprivation, larger older population, and higher disability rates. While satisfaction with services is high, there are issues with staffing and delays in hospital discharges. Addressing these areas can help improve care for residents and ensure that services meet the growing demand.

People with needs

About this section:

Many people want care, some receive care, but a significant number go without. What types of care are being requested? What care is actually provided? This section explores the gap between need and provision, the types of care available, and how our own data contributes to the understanding of these challenges.

Access Social Care and other Helplines providers are working to bridge this gap by providing free legal support to people who are struggling to access social care services. This first chart illustrates the types of calls we are getting.

The rest of this page distingushes between the different types of care provided to Working Age People and Older People, as we are able to disaggregate at a greater level of granularity.

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Why is this important?

Note: these values are a work in progress… expect these numbers to go up

This plot shows a breakdown of the types of requests for assistance received by Access Social Care and other helplines. Understanding the themes of these calls can identify areas where additional support and resources may be needed. For example, a high number of calls related to housing may indicate a need for more affordable housing options, while a high number of calls related to social care assessments may suggest a need for improved access to care services. The request types are:

  • Assessments: An assessment is a meeting or form to find out what help someone needs with daily tasks.

  • Care Plan: A care plan is a written agreement that lists the support you’ll get and who to contact if things change.

  • Carers: Carers are people who help a disabled or ill person with daily tasks.

  • Charging: Charging refers to checking if you can afford to pay for some of your care based on your savings.

  • Information Seeking: Information seeking means getting advice about available care options.

  • Legal Issues and Complaints: Legal issues and complaints involve reporting problems with your care to the council or an ombudsman.

  • Safeguarding: Safeguarding is protecting people from abuse or neglect.

Of course, high numbers also mean that people know where to call, and this number can be impacted by advocacy efforts. As a counterpoint, areas with low numbers may indicate a lack of awareness of available services or a need for more outreach to connect people with support.

To protect privacy, our minimum bin size is 5, which means that if we field 1-5 queries on a topic, we display 5.

Are you a helpline and would like to combine data resources? Let us know!

What is this chart saying?

In Gateshead, many people need help with charging for services, which is slightly lower compared to the average in England. Requests for help with assessments and care plans are also common, but these numbers are below the average in England. Fewer people are asking for help with information and carers compared to what is usual, and these numbers are much lower than the England average. Understanding what people need the most help with can improve services for everyone.

Source:

Access Social Care casework, AccessAva data, and helpline partner submissions


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Working Age People

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Why is this important?

Knowing how many people are requesting social care, how many people are recieving care and what percent of people are disabled helps understand need and social care provision at a top level. For example, a high number of people requesting care may indicate a need for additional resources or services, while a low number of people receiving care may suggest a gap in service provision. Understanding these metrics can help identify areas where additional support may be needed.

What is this chart saying?

Gateshead has more people with disabilities needing care than average. For every 100,000 people, 753 ask for care, which is lower than the average of 1,143 per 100,000. Also, 21.4% of people have disabilities, which is higher than the average of 17.6%. This means many more in Gateshead need help compared to other places. Understanding this can help improve care and support for disabled people in Gateshead.

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Case study

MW was diagnosed with Functional Chronic Pain, she cannot walk without support, she holds on to her furniture to move around the house. She uses a wheelchair, especially when she goes out, with support from friends and family. She lives on second floor with 5 flights because of the way the building is designed and there is no lift. She never goes out because of the difficulties she experiences with the stairs. She needs help with cooking, cleaning, shopping and showering. She relies on friends and her mum who has knee replacement.

She was referred by the Social Prescriber who referred her onto also referred her to Croydon Adult Support, they told her they are short of staff to allocate her a social worker, so she was placed on a long waiting list. MW case still hadn’t progressed until the Social Prescriber, who had been recently trained on the Care Act, referred her to Access Social Care’s free legal Chatbot letter clinic.

The legal clinic volunteer completed a letter to Croydon Council with MW within a week which was sent to Adult Social Services. Access Social Care then called her after two weeks to complete a follow up survey. MW informed them that she had had an assessment and was waiting to hear back from Croydon following the panel meeting. Social Services has now done the assessment after which the panel offered MW 9 hours of social care support.

This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!

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Types of care provided

Why is this important?

This plot shows the types of care provided to working-age people in Gateshead. Understanding the types of care available can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people receiving personal care may indicate a need for more support with daily living activities, while a high number of people receiving respite care may suggest a need for additional support for carers.

What is this chart saying?

In Gateshead, more young people with disabilities get care in the community than in other places. Most receive help through a personal budget, which is slightly lower than the average for England. Nursing care numbers are a bit higher than average, but residential care is much lower. This means more people in Gateshead get care at home rather than in care homes.

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Overall summary of the Working-age people challenges in this locality

Analysis of Disability Data in Gateshead

The proportion of people with disabilities in Gateshead is 21.4%, which is higher than the national average of 17.6%. This means that more people in Gateshead live with disabilities compared to other areas in the country. Higher disability rates can increase the need for care services and support.

In 2024, there were 1,500 requests for care from working-age adults in Gateshead. This is 753.24 requests per 100,000 people, which is lower than the national average of 1,143.48 per 100,000. Fewer requests might suggest that not all people who need help are asking for it. There could be barriers that prevent people from seeking support.

A total of 885 people aged 18 to 64 received care services in Gateshead. This number equals 444.41 per 100,000 people, slightly below the national average of 532.68 per 100,000. This could indicate that fewer people are accessing care services, even though there is a higher proportion of disabilities in the area.

Looking at the types of care received:

    Nursing care: 30 people received nursing care, which is 15.06 per 100,000 people. This is slightly higher than the national average of 13.75 per 100,000.

    Residential care: 80 people were in residential care (40.17 per 100,000), which is lower than the national average of 60.61 per 100,000.

    Community care with direct payment only: 220 people received this type of care (110.48 per 100,000), compared to the national average of 122.17 per 100,000.

    Community care with part direct payment: 30 people received this service (15.06 per 100,000), which is lower than the national average of 47.95 per 100,000.

    Community care with managed personal budget: 500 people received care this way (251.08 per 100,000), slightly below the national average of 266.67 per 100,000.

The preference for community-based care suggests that people in Gateshead might choose to stay in their own homes while receiving support. The lower numbers in residential care could mean there are fewer facilities or that people prefer other forms of care.

Gateshead's population was around 199,139 people in 2023. The area has a population density of 1,378 people per square kilometre, which is less crowded than the national average of 2,468.5 people per square kilometre. About 10% of the area is rural, compared to the national average of 34.6%.

The mean deprivation decile in Gateshead is 4.25, while the national average is 5.9. A lower decile means higher levels of deprivation. This suggests that Gateshead has more areas with social and economic challenges. Higher deprivation is often linked to greater health needs and disabilities.

In 2025, the numbers of people requesting help with assessments, care plans, carers, charging, and information were low, ranging from 1 to 9 people. These rates are below national averages. This could mean that people are not seeking these services, possibly due to lack of awareness or difficulties in accessing them.

The higher rate of disabilities combined with lower engagement in care services might indicate unmet needs in the community. There could be barriers such as lack of information, stigma, or limited availability of services preventing people from getting support.

Service providers and policymakers may need to focus on improving access to care services in Gateshead. Raising awareness about available support and addressing any barriers can help ensure that people with disabilities receive the help they need. Allocating resources to community-based care might be beneficial since there is a preference for receiving care at home.


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Older People

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Why is this important?

Just like with Working Age people, knowing how many older people are requesting social care, how many people are recieving care and what percent of the population is 65+ helps understand need and social care provision at a top level.

What is this chart saying?

More older people in Gateshead want and receive care than before. The number of older people in Gateshead who need care is higher compared to nearby areas. About 2,528 requests for care came from every 100,000 older people, which is more than the average of 2,438 per 100,000. For those receiving care, Gateshead has 1,439 for every 100,000 older people, which is also more than the average of 1,003 per 100,000. This means Gateshead is supporting more older people than other places, showing the importance of care services for the community.

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Case Study

Jamaican female, blind and in her 40s. She was in an emergency Bed & Breakfast with her Niece, who acts as her unofficial carer, she is unable to work but would like to go to University. She is receiving PIP but not the Daily Living Allowance which she applied for in June 2021. She is vulnerable and has a history of self harm so was assigned a rehab Support Worker. Vanessa supported her using the Chatbot to chase up her PIP Daily Living allowance application, after waiting for several months and they received a reply within a week but was awarded the lower rate.

Another Chatbot letter was sent to request an urgent assessment due to her vulnerability and this was action quickly by the LA. Vanessa also supported her to use the chatbot and ask the Social worker to be moved to a place that supports her needs and rights. As she was having to use a shared bathroom, toilet and kitchen in a place with drug/alcohol abusers and being blind with no carer, this left her vulnerable. The Chatbot was used again to raise this issue and after a few weeks she was successfully moved to a private property in another area.

This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!

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Types of care provided

Why is this important?

As above, it is important to see what type of care older people are being provided because it can help explain where additional work is needed.

What is this chart saying?

In Gateshead, many people aged 65 and over receive different types of care. Most of them have a personal budget managed by the local council, with 663 per 100,000 people, which is higher than the England average of 508. In care homes, 464 out of 100,000 receive residential care, much more than the 250 England average. This means more people in Gateshead get care in homes compared to other areas. However, fewer people receive direct payment, with only 50 out of 100,000 choosing this option, slightly below the average of 55 in England. These numbers show that for older people in Gateshead, getting help through organized services is more common than in other parts of the country.

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Overall summary of the older people challenges in this locality

Analysis of Older People's Care in Gateshead

The number of older people in Gateshead has been growing over the past few years. In 2019, about 19.9% of the population were older people. This increased to 20.4% in 2023. This is higher than the national average, which was 18.5% in 2023.

The higher proportion of older people means that more people may need care services. In 2024, there were 5,035 requests for care from people aged 65 and over in Gateshead. This is about 2,528 requests per 100,000 people. The national average is slightly lower, at 2,438 requests per 100,000 people. This shows that more older people in Gateshead are asking for help than in other areas.

Also in 2024, 2,865 older people in Gateshead were receiving care. This is around 1,439 people per 100,000. The national average is 1,003 people per 100,000. This means that a higher number of older people in Gateshead are getting support compared to the rest of the country.

The increase in the older population might be due to people living longer. It could also mean that younger people are moving away, leaving a higher proportion of older residents. This can affect how services are planned and provided.

Gateshead has some challenges that might affect older people. The area is more deprived than the national average. The mean deprivation decile is 4.25, while the national mean is 5.9. Lower numbers mean more deprivation. This suggests that many people in Gateshead might have lower incomes or fewer opportunities.

The population density in Gateshead is lower than the national average. There are 1,378 people per square kilometre in Gateshead, compared to 2,468.5 in England overall. This might make it harder for people to access services, especially if they live in more remote areas.

The higher levels of deprivation and the growing number of older people might mean that more people need support but have fewer resources. This can increase the demand for care services. It might also put pressure on the local council and health services to provide enough support.

Over time, the trend shows that the number of older people in Gateshead is increasing. Care services may need to prepare for this continued growth. Planning for more staff, funding, and resources might be necessary to meet the needs of the community.

In conclusion, Gateshead has a higher and growing proportion of older people compared to the national average. More older people are requesting and receiving care. The area faces higher levels of deprivation, which can increase the need for support. Service providers may need to consider these factors when planning for the future to ensure that older residents receive the care they need.

Carers

About this section:

When government support falls short, unpaid carers step in to provide care. However, many struggle with burnout, financial pressure, lack of social contact, and a lack of support. This section explores the number of unpaid carers, their increasing workload, and what forms of support are available.

Carers play a vital role in supporting vulnerable adults, often stepping in to provide care when professional services are unavailable or insufficient. The percentage of carers receiving direct payments highlights financial empowerment, the number of carers accessing services reflects local authority outreach, and the number turning to charities underscores unmet needs. Together, these data points reveal systemic strengths and weaknesses: low direct payment uptake may push carers toward charities, while effective services can reduce dependence on charitable support. Understanding these metrics enables targeted interventions to ensure carers receive the recognition and resources they deserve.

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Estimated number of unpaid carers

Why is this important?

Unpaid carers play a crucial role in supporting vulnerable adults, often stepping in to provide care when professional services are unavailable or insufficient. Understanding the number of unpaid carers in a local authority can be complicated. On the one hand, a relatively high proportion might be indicative of not enough being done by the local authority, and/or a strong community. On the other hand, a relatively lower number can mean good service provision, lower need, lower availability to look after family, or a problem with reporting.

Still, understanding the number of unpaid carers is a baseline number that must be considered.

What is this chart saying?

In Gateshead, there are about 9,583 unpaid carers per 100,000 people, which is more than the average of 8,204 per 100,000 people in England. This means that Gateshead has more people who help family or friends without getting paid. More unpaid carers can show that many people need support in the community or prefer to help each other at home. This information is important because it helps us understand how much people in Gateshead care for each other. Knowing this can help planners think about how to support both carers and those they care for.

Source:

NOMIS NM_2213_1

Note:

These values are widely considered to be an underestimate. See this report from Carers UK for more information.

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Carer Case Study

August 2021 - Patient with dementia who lives in a shared lives setting. Carer had been requesting respite from the council since September 2020. Croydon Social Prescriber helped with a referral to the local authority in March 2021. Assessment conducted, with the promise they would come back with support, which did not happen. 25 August, social prescriber used the chatbot to find the right legal wording for the situation. The email was sent at 4.52pm that day. At 5.12pm the council contacted the carer to discuss the respite. This was the impact of one letter, addressed to a senior team.

This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!

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How much social contact do carers have?

Why is this important?

Social contact is important for carers’ well-being, as it can help reduce feelings of isolation and loneliness. Understanding the level of social contact that carers have can help local authorities identify areas where additional support and resources may be needed. For example, a low level of social contact may indicate a need for more social activities or support groups for carers, while a high level of social contact may suggest that carers have a strong support network.

What is this chart saying?

In Gateshead, over 36 in 100 carers feel they get enough social contact. This is better than the average in England, where only about 29 in 100 carers feel the same. This information is important because feeling connected with others is good for our well-being. When carers have more social contact, they feel happier and less alone. It helps them take care of others better too. Knowing this can help us support carers and make sure they feel part of the community.

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Carer Support Type

Why is this important?

The type of support available to carers can vary significantly, impacting their ability to provide care effectively. Understanding the types of support available can help identify areas where additional resources may be needed. For example, a high number of carers receiving respite care may indicate a need for more support with caregiving responsibilities, while a low number of carers receiving financial support may suggest a need for additional financial assistance.

What is this chart saying?

In Gateshead, the most common support for carers is providing information, advice, and other services, with 419 out of 100,000 people receiving it. This is more than the England average, making it easier for carers to find help. On the other hand, not getting any direct support is much lower in Gateshead compared to the England average, at about 30 for every 100,000 people. This means more carers in Gateshead receive some form of help compared to other places in England.

Source:

ASCFR/SALT Sheet T47

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Carer ease to get information

Why is this important?

Access to information is crucial for carers to navigate the social care system effectively. Understanding how easy it is for carers to get information can help local authorities identify areas where additional support and resources may be needed. For example, a high number of carers finding it difficult to get information may indicate a need for improved communication and support services, while a low number of carers finding it difficult to get information may suggest that existing services are effective.

Would you like social care information? Try our Chatbot!

What is this chart saying?

In Gateshead, 65 out of 100 carers find it easy to get information about services. This is better than the average across England, where only 59 out of 100 feel the same. This means that carers in Gateshead have an easier time finding the help and support they need. It's good for carers because they can get the right services quickly and take care of their loved ones better.

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Carers coming to us for help

Why is this important?

Note: these values are a work in progress… expect these numbers to go up

Access Social Care and other Helplines help people with information, advice, and support related to social care. Understanding the types of calls received by carers can highlight areas where additional support and resources may be needed. For example, a high number of calls related to financial support may indicate a need for more financial assistance for carers, while a high number of calls related to respite care may suggest a need for additional support with caregiving responsibilities.

It is important to note that, just as in the previous section, low numbers of requests might indicate that people don’t know where to get help, don’t feel they can get (or deserve) help, or other outreach problems. This is particularly important because we often work with people where the role of a carer is not recognised, or where the carer themselves does not recognise their role.

What is this chart saying?

In Gateshead, very few people are seeking help for carers. For every 100,000 people, only about half a person asked for support. This is less than the average for other areas, which is around 0.75 people per 100,000. This means that people in Gateshead may need more encouragement or resources to ask for help when caring for others. Understanding this can help communities and services in Gateshead provide better support for carers who may feel alone or overwhelmed.

Source:

Access Social Care casework, AccessAva data, and helpline partner submissions

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Overall summary of the unpaid carer challenges in this locality

Analysis of Carer Data in Gateshead

In Gateshead, unpaid carers play a vital role in supporting family and friends who need help. This analysis looks at the situation of carers in Gateshead, comparing it to the national picture, and considers what it means for services and support.

Number of Unpaid Carers

In 2021, there were 9,583 unpaid carers for every 100,000 people in Gateshead. This is higher than the England average of 8,203.68 per 100,000 people. With a population of about 196,179 people in Gateshead at that time, this means there were around 18,800 unpaid carers in the area.

The higher number of unpaid carers might be because Gateshead has more people who need care. Gateshead has higher levels of deprivation, with an average deprivation decile of 4.25 compared to the England average of 5.9. This means that Gateshead is more deprived than many other areas. Higher deprivation often leads to more health problems, so more people may need support from family and friends.

Social Contact for Carers

In 2024, 36.6% of carers in Gateshead said they had as much social contact as they would like. This is better than the national average of 29.3%. It suggests that carers in Gateshead may have good access to social groups or community networks. However, it also means that most carers still feel they do not have enough social contact, which can affect their well-being.

Support Services for Carers

Gateshead offers different types of support to carers. In 2024, 419.3 carers per 100,000 people received information, advice, or were signposted to services. This is higher than the England average of 338.7 per 100,000 people. It shows that Gateshead is making efforts to inform carers about available help.

But in other areas, support is lower than the national average. Only 12.55 carers per 100,000 people received direct payments in Gateshead, compared to 149.93 per 100,000 people across England. Direct payments help carers by giving them money to arrange their own support. The lower number in Gateshead suggests that carers may not be getting as much financial help as elsewhere.

Finding Information About Services

Also in 2024, 65.4% of carers in Gateshead felt it was easy to find information about services. This is higher than the national average of 59.3%. This means that carers in Gateshead are more likely to know where to go for help and advice. Good information can make a big difference in how well carers can support others and look after themselves.

Implications for Services

The data shows that carers in Gateshead have some strengths, like better social contact and access to information. But there are also challenges. The high number of unpaid carers and lower financial support suggest that services may need to do more to help carers manage their roles.

Because Gateshead has higher deprivation levels, there may be more demand for support services. Carers might face more stress and health issues themselves. Services could focus on providing more financial help, like direct payments, and creating more opportunities for social contact.

Conclusion

Carers are essential to the community in Gateshead. They provide valuable support but also need help themselves. By improving support services and addressing areas where help is lacking, Gateshead can ensure that carers continue to thrive and provide the care that is so important to many people.

Care Providers

About this section:

Care providers are essential for delivering social care services, including home care agencies and care homes. The quality of care they provide can vary significantly, impacting the well-being of service users. This section examines the number and types of care providers, their quality ratings, and some of the difficulties of maintaining high standards. Understanding these metrics is crucial for ensuring that vulnerable individuals receive high-quality care.

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Number and types of care providers (home care agencies, care homes)

Why is this important?

The number and types of care providers in a local authority can impact the availability and quality of social care services. Understanding the distribution of care providers directly influences people’s ability to get the care they need.

What is this chart saying?

In Gateshead, there are fewer community-based adult social care services compared to other places, with only 43 available, while the average is about 64. Residential social care providers are also fewer here, with 46 places available, compared to an average of 91. This means people in Gateshead have fewer choices for both community and residential care than people in other areas. It highlights the importance of finding more care options locally to better support the needs of disabled people. More services can help ensure everyone has the care they need nearby.

Source:

CQC

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Quality ratings from the Care Quality Commission (CQC)

Why is this important?

The Care Quality Commission (CQC) rates care providers based on their quality of care, safety, and effectiveness. Understanding the quality ratings of care providers can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers with low ratings may indicate a need for improved training and support, while a high number of care providers with high ratings may suggest that existing services are effective.

What is this chart saying?

In Gateshead, 15.7% of care providers need improvement or are rated inadequate. This is a bit better than the average rate, which is 16.8%. This means Gateshead is making good progress in caring for people. It's important because it shows the quality of care so you can make safe choices.

Source:

CQC

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Framework rates?

Why is this important?

Framework rates are the agreed prices that local authorities pay care providers for social care services, such as home care and residential care. These rates are crucial because they determine the affordability, availability, and quality of care in a city. If rates are too low, providers may struggle to sustain services, leading to workforce shortages, poor care quality, and limited access for those relying on council-funded care.

Understanding framework rates helps assess whether local authorities are adequately funding social care, ensuring fair pay for care workers, and maintaining a sustainable care market that meets residents’ needs.

What is this chart saying?

There is no local authority level data for Framework Rates

Source:

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Provider collapse data?

Why is this important?

Several providers are finding it increasingly difficult to stay in business, and sometimes several providers collapse at once. For example, when pay rises are approved without consultation and effective immediately, providers may not be able to afford to pay their staff. This can cause a chain-effect which leads to collapse in the market, and a lack of care for those who need it.

What is this chart saying?

There is no local authority level data for the risk of Providers collapsing.

Source:

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Workforce Turnover rate

Why is this important?

Workforce turnover rate is a measure of the number of staff leaving a care provider over a specific period. High turnover rates can indicate issues with staff retention, such as low pay, poor working conditions, or lack of training and support. Understanding workforce turnover rates can help local authorities identify areas where additional support and resources may be needed to improve staff retention and ensure high-quality care services.

NOTE: This data series is based on regional data

What is this chart saying?

The turnover rate in Gateshead for 2023/24 is almost the same as the average for England. This means the number of workers leaving their jobs is similar to other parts of the country. Understanding the turnover rate helps us know how stable social care jobs are in Gateshead. Lower turnover rates are better because they mean more workers stay in their jobs, which is good for the quality of care. Knowing this helps us focus on making sure people get the best care possible.

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Workforce: Challenge retaining Staff

Why is this important?

Staff retention is crucial for maintaining high-quality care services. Understanding the challenges faced by care providers in retaining staff can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers struggling to retain staff may indicate a need for improved training and support, while a low number of care providers facing retention challenges may suggest that existing services are effective.

This dataset describes the results of a survey asking care providers about their challenges in retaining staff.

NOTE: This data series is based on regional data

What is this chart saying?

In Gateshead, keeping staff in social care jobs is harder than in many other places. About 70 out of every 100 people find it more or much more challenging to keep staff. This is a bit higher than the average in England, which is around 68 out of 100. This means that Gateshead faces a bigger problem in keeping staff in social care jobs. Understanding this challenge can help find ways to support and assist staff better.

Source:

Workforce_survey_data_tables, Tab 6_2

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Workforce: Vacancy rate

Why is this important?

Vacancy rate is a measure of the number of unfilled positions within a care provider over a specific period. High vacancy rates can indicate issues with staff recruitment, such as low pay, poor working conditions, or lack of training and support. Understanding vacancy rates can help local authorities identify areas where additional support and resources may be needed to improve staff recruitment and ensure high-quality care services.

What is this chart saying?

The vacancy rate for social care jobs in Gateshead is 6.7%. This number is lower than the England average, which is 8.4%. This means it is easier to find workers for social care in Gateshead compared to other places in England. Having more workers available helps disabled people receive better and quicker support. It is important because good care can improve the quality of life for many people.

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Workforce: Challenge recruiting Staff

Why is this important?

Recruiting staff is essential for maintaining high-quality care services, and for backfilling staff when they leave. Understanding the challenges faced by care providers in recruiting staff can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers struggling to recruit staff may indicate a need for improved training and support, or can point to a systemic problem, such as low pay, poor working conditions, or not enough people interested in this job type.

Staff recruitment is important as it’s one of the areas that have levers to pull outside of social care, for example, by changing how many visas are awarded to social care workers.

NOTE: This data series is based on regional data

What is this chart saying?

In Gateshead, it is harder to find staff for social care compared to other places. In this area, about 83 out of every 100 people think recruiting staff is more challenging. The average in England is lower, with 80 out of 100 people feeling this way. This means Gateshead finds it a bit harder to get the right workers for social care than most places in England. Understanding this can help make better plans to support disabled people.

Source:

Workforce_survey_data_tables, Tab 6_2

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Overall summary of the Care Provider challenges in this locality

Care Providers in Gateshead: An Analysis

Gateshead has a population of about 199,000 people in 2023. This is smaller than the average population in England, which is around 377,000. The area has a population density of 1,378 people per square kilometre, less than the England average of 2,468.5. Gateshead is more urban, with only 10% of its area being rural, compared to 34.6% for England.

Number of Care Providers

In 2024, Gateshead has 43 community-based adult social care services and 46 residential social care providers. These numbers are lower than the national averages of 63.8 and 91, respectively. This might be due to Gateshead's smaller population and lower rural percentage. Fewer providers could limit options for people needing care services.

Quality of Care Providers

The proportion of care providers in Gateshead that need improvement or are inadequate is 15.7%. This is slightly better than the national average of 16.8%. This suggests that the quality of care providers in Gateshead is similar to the rest of the country. Maintaining or improving this quality is important for the well-being of residents.

Staff Turnover and Retention

In the North East region, which includes Gateshead, the turnover rate for care staff is 24.3% in 2023/24. This is the same as the national average. A high turnover rate can affect the continuity of care. Additionally, 70.5% of care providers in the Yorkshire and the North East region find it more challenging or much more challenging to retain staff. This is slightly higher than the national average of 68.1%. Challenges in retaining staff can lead to shortages and affect service quality.

Vacancy Rates

The vacancy rate for care staff in Gateshead is 6.7%. This is lower than the national average of 8.4%. A lower vacancy rate means most positions are filled, which can help ensure that care services are delivered effectively. However, ongoing challenges in recruitment may change this in the future.

Challenges in Recruiting Staff

About 82.5% of care providers in the Yorkshire and the North East region find it more challenging or much more challenging to recruit staff. This is higher than the national average of 79.8%. Difficulty in recruiting staff can lead to increased workloads for existing staff and may affect the quality of care.

Impact of Deprivation

Gateshead has a mean deprivation decile of 4.25, lower than the England average of 5.9. A lower decile indicates higher levels of deprivation. Higher deprivation can lead to greater health and social care needs. This may increase demand for care services in Gateshead. The standard deviation of deprivation is 2.72, suggesting varied levels of deprivation across the area.

Implications for Service Delivery

The smaller number of care providers in Gateshead may limit access to services, especially if demand increases due to higher deprivation levels. Challenges in recruiting and retaining staff could strain existing services. While the vacancy rate is currently lower than average, ongoing staffing challenges may impact future service delivery.

Conclusion

Gateshead faces several challenges in its care provider sector. While the quality of care providers is slightly better than the national average, there are fewer providers available. Staffing issues, such as high turnover and recruitment challenges, may affect the delivery of care services. The area's higher levels of deprivation may increase demand for these services. Addressing staffing challenges and supporting care providers are important steps to meet the needs of Gateshead's population.

Quality Improvement

About this section:

Historically, hospital delays have been due in large part, to the inability to discharge patients into social care. We no longer have DTOC data, but we can still look at the number of hospital delays and the number of facilities requiring improvement.

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CQC Rating of this local authority

[1] "No data available for this local authority"

Why is this important?

CQC, as the regulator of health and social care services in England, is beginning to rate Local Authorities on their social care provision. Understanding the CQC rating of a local authority should be used as the most official evaluation of service care provision. For example, a low rating may indicate a need for improved service delivery, while a high rating may suggest that existing services are effective.

What is this chart saying?

The CQC LA assessment in Gateshead is about checking the quality of local care services. It helps to know how well the services support disabled people. This is important because good support means people can live healthier and happier lives. Looking at this information helps to see if services in Gateshead meet people's needs.

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Number of hospital delays

Why is this important?

Hospital delays can have a significant impact on patient care and outcomes, and are in large part the result of not having invested sufficiently in social care. Understanding the number of hospital delays in a local authority can be a sympthom of a poorly working social care sector. For example, a high number of hospital delays may indicate a need for improved discharge planning and coordination, not enough places to discharge people to, lack of sufficient staff to assess patients, or a lack of care providers.

What is this chart saying?

In Gateshead, almost 100 out of 100 people are discharged from trusts quickly, which is much better than the England average of 89 out of 100. However, about 31 out of 100 discharges are delayed in Gateshead, which is more than twice the England average of about 12 out of 100. This means while people are getting care faster in Gateshead, too many are waiting longer than they should when leaving care. It is important to improve this so everyone can have better and quicker support.

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Average delay

Why is this important?

This metric illustrates how long patients are delayed in hospital before being discharged. Higher average delays mean that patients are spending more time in hospital than necessary, which can lead to increased costs, reduced bed availability, and poorer patient outcomes. This also means that the beds are not available for people that might desperately need them for life-saving procedures.

What is this chart saying?

In Gateshead, people are waiting longer to leave care than the average in England. The delay is about 1.26 days, while the average in England is around 0.7 days. This means people in Gateshead are waiting almost double the time to be discharged compared to other places. It's important to make this better so everyone can get the care they need on time.

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Delayed Transfer of Care

Why is this important?

Delayed Transfer of Care (DTOC) refers to the time between a patient being declared medically fit for discharge and actually leaving the hospital. Understanding the number of DTOCs in a local authority can help identify precisely where the social care system is failing.

Unfortunately, this dataset is no longer being generated.

What is this chart saying?

Data about Delayed Transfers of Care is no longer gathered.

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Reablement Statistics

Why is this important?

Reablement is a short-term service that helps people regain independence and confidence after a period of illness or injury. Understanding the number of people receiving reablement services can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people receiving reablement services may indicate a need for more support with daily living activities, while a low number of people receiving reablement services may suggest that existing services are effective.

What is this chart saying?

Data about reablement is not available at a local authority level.

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arc data

Coming soon!

Why is this important?

What is this chart saying?

Source:

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Service User Satsfaction

Why is this important?

Service user satisfaction is a key indicator of the quality of social care services. Understanding service user satisfaction can help local authorities identify areas where additional support and resources may be needed. For example, a low level of service user satisfaction may indicate a need for improved service delivery, while a high level of service user satisfaction may suggest that existing services are effective.

It is important to note that the people surveyed are already receiving service care. Notably absent are all the people that are not yet lucky enough to be receiving care.

What is this chart saying?

In Gateshead, more people are happy with their care and support than the average in England. For every 100 people, about 67 say they are satisfied. This is better compared to the average in England, where about 65 out of 100 feel the same. Even though many are happy, some still feel unsatisfied with social care. Understanding these numbers helps us see how Gateshead is doing and where it might improve. It's important to keep trying to make care better for everyone.

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People using services: Easy to get information

Why is this important?

Access to information is crucial for people using social care services to navigate the system effectively. Understanding how easy it is for people to get information can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people finding it difficult to get information may indicate a need for improved communication and support services, while a low number of people finding it difficult to get information may suggest that existing services are effective.

Would you like social care information? Try our Chatbot!

What is this chart saying?

In Gateshead, most people find it easy to get information about services. In 2024, 76 out of 100 people said it was easy. This is better than the England average, where only 68 out of 100 people felt the same. This is important because finding information easily helps people get the support they need. If more people can find the right information, they can access services that improve their lives.

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Ombudsman

Why is this important?

An ombudsman is a person who has been appointed to look into complaints about companies and organisations. The number of cases received and decided by the Ombudsman is important because it provides insight into the volume of complaints about a local authority’s social care services and how effectively these complaints are being addressed. The number of cases received indicates the level of dissatisfaction or systemic issues within a council’s care provision, while the number of cases decided shows how efficiently the Ombudsman is processing and resolving complaints. A large gap between the two may suggest delays in complaint handling, leaving individuals waiting.

It is important to note that contacting the Ombudsman is widely considered a last resort, often discouraged, and sometimes penalised.

What is this chart saying?

In Gateshead, the ombudsman gets more complaints from disabled people compared to the England average. For every 100,000 people, there are about six complaints in Gateshead, while in England, there are about four and a half. This means more people in Gateshead are asking for help about social care problems. Also, in Gateshead, more of these complaints are completed compared to the rest of England. More people in Gateshead are using the ombudsman to solve their problems. This highlights the importance of social care and making sure everyone gets the help they need.

Source:

Ombudsman

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Overall summary of the quality improvement challenges in this locality

Quality Improvement in Gateshead

Gateshead is a borough with about 199,000 people in 2023. The area shows different trends in health and social care compared to national averages. Understanding these can help improve services.

CQC Local Authority Assessment

In November 2024, 99.68% of discharges in Gateshead were from acceptable trusts, which is better than the national average of 89%. This means most patients are leaving good hospitals.

However, 31.17% of these discharges were delayed, which is higher than the national average of 12.3%. The average delay was 1.26 days, compared to 0.7 days nationally. This suggests patients are waiting longer to be discharged, which may show problems in arranging care after hospital.

Patient Satisfaction

In 2024, 67.1% of people in Gateshead said they were satisfied with their care and support, slightly more than the national average of 64.7%. This is a positive sign.

But another survey by NatCen shows that 57% of people were dissatisfied with social care. This difference might mean that not everyone is happy, or that the surveys measured satisfaction differently.

Finding Information about Services

In Gateshead, 76.4% of service users felt it was easy to find information about services, higher than the national average of 68.2%. Good communication might help people get the care they need more easily.

Ombudsman Complaints

In 2024, there were 6.03 complaints per 100,000 people to the Ombudsman in Gateshead, higher than the national average of 4.45. Also, 5.52 complaints per 100,000 were decided upon, compared to 4.12 nationally. More complaints might mean there are issues with services, or people are more willing to report problems.

Contextual Factors

Gateshead has fewer people per square kilometre (1,378) than the national average (2,468.5). The area has more deprivation, with a score of 4.25 out of 10, where 10 is the least deprived. The national average is 5.9. Areas with more deprivation may have higher needs for health and social care.

Only 10.23% of Gateshead is rural, less than the national average of 34.6%. Urban areas can have more services but also more demand.

Implications for Services

The data shows that Gateshead does well in some areas, like discharges from good hospitals and helping people find information. But there are challenges, like delays in discharges and more complaints. The higher deprivation might add pressure on services.

To improve, Gateshead could work on reducing discharge delays by better coordinating hospital and social care. Understanding why there are more complaints can help fix problems and make people happier with their care.

By focusing on these areas, Gateshead can provide better health and social care services, meet the needs of its people, and use resources wisely.

Finances

About this section:

We need to understand how much money is being spent on social care, and what this provides. First, let’s look at values reported by local authorities.

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Gross Total Expenditure

Why is this important?

Gross Current Expenditure (2023-24) captures the total operational cost of services, indicating overall demand and financial commitment. This includes spending on residential and non-residential care, direct payments, and other social care services. Understanding gross expenditure helps assess the scale of social care provision and financial pressures on local authorities.

What is this chart saying?

In Gateshead, spending on social care is high. For every 100,000 people, it is about 61,388 pounds. This is a lot more than the England average, which is around 47,758 pounds. This means Gateshead is spending more to help its people with social care needs. It shows a strong focus on supporting disabled people in the community. This can help make sure that everyone gets the care they need and can live a better life.

Source:

ASCFR/SALT Sheet T3

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Net Total Expenditure

Why is this important?

This figure reflects the net cost of social care provision to the local authority, indicating the extent of financial support required to meet service demands. Understanding net expenditure helps assess the financial sustainability of social care services and the commitment level of the local authority.

What is this chart saying?

Gateshead spends more money on social care for every 100,000 people than the average in England. Gateshead's spending is about 50,021 pounds per 100,000 people, while the England average is around 40,471 pounds. This means Gateshead is putting more resources into helping people in need of social care compared to other areas in England. This is important because it shows Gateshead's strong commitment to supporting people with disabilities and ensuring they get the help they need.

Source:

ASCFR/SALT Sheet T3

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Client Contributions

Why is this important?

Client Contributions, otherwise known as “Charging”, show the extent to which service users offset costs. Understanding client contributions helps assess the financial burden on individuals and the local authority, highlighting the need for fair and equitable funding mechanisms.

It is important to note that not all local authorities charge for social care services, and that charging can be a barrier to accessing care for some individuals.

What is this chart saying?

The spending on social care from clients in Gateshead is important to understand. For every 100,000 people, Gateshead spends more than the England average. Gateshead's amount is 11,366, while the England average is 7,286. This means people in Gateshead contribute more to social care than in many other places. Understanding this can help the community make decisions about care and support.

Source:

ASCFR/SALT Sheet T3

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NHS Contributions

Why is this important?

Income from NHS reflects external funding and collaboration with the health sector. Understanding NHS contributions helps understand the level of integration between health and social care.

What is this chart saying?

In 2024, NHS contributions for social care in Gateshead are £5,758 per 100,000 people. This amount is lower than the England average, which is £7,878 per 100,000 people. Knowing how much the NHS spends is important because it helps us see where support is needed most for disabled people in Gateshead. Comparing it to the England average shows if the area gets more or less help. This information helps us think about where social care money should go to best support everyone's well-being.

Source:

ASCFR/SALT Sheet T3

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Budget Cuts

Why is this important?

Budget Cuts indicate financial constraints and potential service reductions. Sometimes, budget cuts are explicit, but other times, they aren’t mentioned directly, making tracking this information difficult to access.

As such, this data is not consistently available for all local authorities.

Source:

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Assessment of sufficiency

Why is this important?

Access Social Care have made a series of Freedom of Information requests about the government’s own assessment of sufficiency of social care funding. The social care sector is in crisis, yet the government refuses to disclose how it determines funding sufficiency. Without transparency, there is little accountability, no independent scrutiny to improve decision-making, and government trust heavily impacted. Evidence from across the sector indicates a severe funding gap, but without open data, meaningful reform remains impossible. True solutions require honesty about the scale of the problem to then work towards a fair and equitable funding model.

The government appears to know how much money is required for social care, and yet they are not making that known.

Source:

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Overall summary of the budget and financial challenges in this locality

Social Care Spending in Gateshead in 2024

In 2024, Gateshead spent more on social care per person than the average in England. The gross total expenditure per 100,000 people was £61,388 in Gateshead, while the England average was £47,758. This means Gateshead is spending over £13,000 more per 100,000 people than other areas.

The net total expenditure per 100,000 people in Gateshead was £50,021, compared to the England average of £40,472. This shows that even after taking income into account, Gateshead spends more on social care.

Client and NHS Contributions

People in Gateshead contribute more towards their care. Client contributions per 100,000 people were £11,366, while the England average was £7,286. This suggests that residents are paying more out of their own pockets for social care services.

NHS contributions in Gateshead were lower than the national average. The NHS contributed £5,758 per 100,000 people in Gateshead, compared to £7,878 across England. This means Gateshead receives less funding from the NHS for social care.

Reasons for Higher Spending

Gateshead has a population of about 199,000 people, which is smaller than the England average of around 377,000. The area is less densely populated, with 1,378 people per square kilometre, compared to the national average of 2,468.5.

Gateshead is more deprived than many other areas. The mean deprivation decile is 4.25, while the England average is 5.9. A lower decile means higher deprivation. The mean deprivation rank for Gateshead is 12,238, compared to the national average of 17,686. This indicates that Gateshead has higher levels of poverty and need.

Higher deprivation often leads to greater demand for social care services. People may have more health problems or need more support. This could explain why Gateshead is spending more on social care.

Impact on Services

The lower NHS contributions mean that Gateshead must use more of its own funds to provide care. The higher client contributions suggest that residents are bearing a larger financial burden. This could be difficult for people already facing hardship.

These factors may affect how social care services are delivered in Gateshead. The council might need to find ways to support people who cannot afford to pay more. They may also need to seek additional funding to meet the higher demand.

Conclusion

Gateshead spends more on social care per person than the national average. Higher levels of deprivation may lead to greater need for services. Lower contributions from the NHS and higher payments from clients impact how care is funded.

Understanding these factors is important for planning and providing social care services. Gateshead may need to address funding gaps and support those who are most in need.