This page provides an overview of social care in Hertfordshire, 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.
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.
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.
IMD 2019 for the Lower Tier Local Authorities: Broxbourne, Dacorum, Hertsmere, North Hertfordshire, Three Rivers, Watford, St Albans, Welwyn Hatfield, East Hertfordshire, Stevenage
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.
IMD 2019 for the Lower Tier Local Authorities: Broxbourne, Dacorum, Hertsmere, North Hertfordshire, Three Rivers, Watford, St Albans, Welwyn Hatfield, East Hertfordshire, Stevenage
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.
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!
Access Social Care casework, AccessAva data, and helpline partner submissions
Working Age People
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.
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!
This plot shows the types of care provided to working-age people in Hertfordshire. 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.
ASCFR and SALT Data Tables 2023-24 Sheet T34
The age-standardised rate of disability in Hertfordshire is 15.1 per cent. The England rate is 17.6 per cent. The difference fits with the profile of the county. Hertfordshire has low deprivation scores, many areas in decile 7 to 9, and a large share of professional jobs. These factors often link to better health and a smaller risk of long-term illness. The county’s population is also slightly younger than many shire areas, which can lower the proportion who report a disability.
In 2024 the council recorded 9,210 requests for support from adults aged 18–64. This is a high absolute number because Hertfordshire is a large county of over 1.2 million residents. Yet the rate is 758 per 100,000 people, well below the national figure of 1,143. A lower rate can mean that fewer residents need formal help, perhaps because employment is higher and informal family support is strong. It may also point to unmet need if people find it hard to ask for help, especially in rural pockets to the north and west of the county.
There are 5,345 working-age adults in long-term care. That equates to 440 per 100,000 people compared with an England rate of 533. Most receive community-based support rather than institutional care:
• Residential care: 730 people, 60 per 100,000 – almost the same as the national rate.
• Community direct payment only: 1,350 people, 111 per 100,000 – slightly below the England rate of 122.
• Community council-managed personal budget: 2,215 people, 182 per 100,000 – well below the England rate of 267.
The similar use of residential beds suggests that when intensive support is needed the council funds it at the same level as elsewhere. The lower rates in community services may indicate effective early help that delays entry to formal care. On the other hand, the gap in council-managed budgets could show that some residents are buying low-level services themselves, a pattern seen in affluent areas.
In 2025 only 0.91 requests per 100,000 people were logged for information and 0.16 for assessments, both far below national averages. For safeguarding, the rate of 0.25 is about double the local levels seen for other advice topics and slightly above the England mean of 0.21. Low advice volumes may mean that online information is clear and people can self-serve. It could also hide silent need among residents who do not know the system well, such as recent migrants or isolated rural households.
The combination of a large population, low disability prevalence and below-average care rates points to manageable demand but also to the risk of hidden need. The council may wish to:
• Keep investing in early-help and employment support to sustain lower disability rates.
• Test access routes in rural and deprived pockets to ensure people can ask for help easily.
• Monitor direct payment take-up, checking that choice is genuine and not driven by gaps in council-managed options.
• Maintain strong safeguarding outreach, as the slightly higher reporting here suggests good awareness that should be preserved.
Continued attention to these areas will help Hertfordshire match resources to the real level of need and keep outcomes strong for disabled residents.
✨ ✅ ❌Older People
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.
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!
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.
ASCFR and SALT Data Tables 2023-24 Sheet T34
The share of residents aged 65 and over has risen each year, from 16.9 per cent in 2019 to 17.4 per cent in 2023. England as a whole is older, sitting at 18.5 per cent in 2023, but the gap is closing. Because Hertfordshire’s total population also grew by about 23,000 during the period, the number of older people went up by roughly 10,000, to just above 210,000. The county is therefore facing both a larger and an ageing population. With 730 people per square kilometre it is not as dense as many urban areas, yet services still need to reach a wide, mixed landscape. Most neighbourhoods sit in higher deprivation deciles (around 7–8), showing relative affluence. This can change how and where older residents look for help, as many have more personal resources than the national average.
The council recorded 23,585 requests for support from people aged 65 plus, equal to 1,941 per 100,000 residents. National demand is higher at 2,438 per 100,000. Lower demand can point to better health, strong family networks or a tendency to pay privately. It may also mean that some need is hidden if residents do not approach the council until a crisis.
Altogether 9,480 older residents were in long-term care arranged by the council. This is 780 per 100,000, well below the England figure of 1,003 per 100,000. The pattern across care types helps explain the gap. Nursing home use is 100 per 100,000 against 122 nationally, and residential home use is 173 against 250. Community support paints a mixed picture. Direct payment only is slightly higher than average, while council-managed personal budgets and commissioned community services are far lower. Wealthier residents may favour buying services themselves, so they choose a direct payment or go entirely outside the council system.
Lower institutional care use can signal better health and effective prevention, but it can also reflect high self-funding. If many self-funders later fall back on the council when funds run down, demand could rise sharply. The steady growth in the older population means the number of users could climb even if the per-capita rate stays low.
Only small numbers asked for help with assessments, charging issues or safeguarding. Rates sit well below national levels. Good on-line information and a proactive voluntary sector may meet need earlier. Still, very low figures risk masking unmet need, especially for people with limited digital skills.
Hertfordshire enjoys relative affluence and slightly younger age-structure, yet both population growth and ageing are clear. Current demand is manageable, but the council should plan for a larger pool of older residents who may switch from private to public funding. Investment in prevention, clear advice and flexible community support can help keep institutional demand low. Monitoring self-funding trends and the point at which people approach the council will be vital for sound financial planning.
✨ ✅ ❌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.
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.
NOMIS NM_2213_1
These values are widely considered to be an underestimate. See this report from Carers UK for more information.
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!
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.
Survey of Adult Carers in England (SACE) - question 11
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.
ASCFR/SALT Sheet T47
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!
Survey of Adult Carers in England (SACE) - question 17
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.
Access Social Care casework, AccessAva data, and helpline partner submissions
In 2021 there were about 92 800 unpaid carers in Hertfordshire. This figure comes from a rate of 7 726 carers for every 100 000 residents and a mid-year population of just over 1.2 million. The county therefore has a slightly smaller share of carers than the England average of 8 204 per 100 000. A lower rate can hint at a younger age profile, better general health, or wider use of formal care services. Hertfordshire’s relative affluence – most districts sit in deprivation decile 6 or above – may also mean that some people can purchase care privately, reducing the need for family members to step in.
By 2024, 30.4 % of carers said they had as much social contact as they wanted, just ahead of the national average of 29.3 %. Good transport links, dense settlement (730 residents per km²) and a strong voluntary sector are likely to help carers stay connected. Information also appears easier to find locally: 64.2 % judged it “easy” to obtain service information, five percentage points above the England figure. This suggests that sign-posting through libraries, GP surgeries and the county’s digital offer is working well.
Despite positive user feedback, most formal support is provided at a lower rate than seen nationally. In 2024 the council arranged 113 direct payments per 100 000 carers, compared with 150 per 100 000 in England. Part direct payments and managed personal budgets show a still wider gap. Purely commissioned carer services were not recorded at all, while advice and sign-posting were offered to 186 carers per 100 000, barely half the national level. The only area that exceeds the benchmark is respite or other help delivered to the cared-for person (74 per 100 000 versus 70 nationally). In other words, Hertfordshire is more likely to support the person with care needs than to fund the carer directly.
Lower use of funded support may reflect choice rather than shortage. Affluent households might prefer informal help or self-funded solutions, and a mixed urban-rural geography allows family networks to live nearby. That said, fewer recorded services can also mask unmet need: carers who cope alone may only reach out when they are already exhausted. The single recorded “critical” carer event in 2025 (0.08 per 100 000 against an England rate of 0.75) hints at good prevention, but it could equally point to under-reporting.
Hertfordshire’s carers report slightly better contact and information than their peers elsewhere, yet they receive less direct financial or practical help from the council. With the county’s population growing by around 20 000 a year, demand is likely to rise. If present patterns continue, a growing number of carers may choose or be forced to manage without state support. Targeted outreach in pockets of deprivation, broader promotion of personal budgets and continued investment in respite services could spread benefits more evenly and prevent crisis situations.
Overall, Hertfordshire appears to be a comparatively good place to be a carer, but its large population means that even a small shortfall in support can affect many thousands of residents. Ongoing monitoring of service take-up and satisfaction will be key to keeping informal care sustainable.
✨ ✅ ❌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.
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.
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.
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.
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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.
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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
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
Workforce_survey_data_tables, Tab 6_2
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.
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
Workforce_survey_data_tables, Tab 6_2
Hertfordshire has a large population, now a little over 1.2 million. It therefore needs more care organisations than a typical council. In 2024 there are 215 community-based adult social care services and 228 residential services. The national average council records only 64 and 91, so Hertfordshire looks very busy at first sight. Yet when the figures are set against population the gap almost disappears. The county has about 17.7 community services and 18.8 residential homes for every 100,000 residents, while the average area has roughly 16.9 and 24.1. In short, Hertfordshire offers a broad community market, but its residential supply is a little thinner for the number of people who live there. This may push some users towards home-care, or to placements outside the county, if beds become scarce.
Just under one care provider in five (18.4 per cent) is rated “requires improvement” or “inadequate”, a touch higher than the 16.8 per cent seen nationally. The slightly weaker result is notable because Hertfordshire is, on the whole, less deprived than England. Most local neighbourhoods sit in deciles 6 to 8, so poor social conditions are unlikely to be the main driver of lower ratings. Instead, the reason may lie in workforce strain or in the rapid expansion of the market, where newer services have not yet reached steady quality.
Turnover sits at 23.9 per cent, almost identical to the England figure. The vacancy rate, however, is lower at 6.4 per cent against 8.4 per cent. This suggests that posts can usually be filled, helped by the county’s good transport links and proximity to London’s wider labour pool. Even so, managers still say recruitment and retention are hard. More than four in five providers call recruitment “more” or “much more” challenging than a year ago, and seven in ten say the same for retention. The message is clear: while posts are filled in the end, it is taking longer and costing more effort.
The combination of average turnover, lower vacancies, but high perceived difficulty hints at churn rather than long-term shortages. Frequent replacement of staff can unsettle care teams, reduce continuity for residents and, in turn, limit inspection scores. The slightly higher share of lower-rated services may therefore reflect the human cost of ongoing staff movement rather than a simple lack of heads.
With population still growing by around 10,000 people each year, the county will soon need additional care capacity. Expanding residential provision should be a priority, otherwise the gap with national bed density will widen. At the same time commissioners may want to invest in workforce stability schemes—such as career pathways, affordable housing offers or travel support—to reduce churn and lift service quality. Because deprivation is low, the council could explore employer levies or targeted fees to fund such schemes without adding undue strain on local taxpayers.
✨ ✅ ❌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.
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.
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.
Discharge-Ready-Date-monthly-data-webfile-November-2024, Tab UTLA Acceptable
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.
Discharge-Ready-Date-monthly-data-webfile-November-2024, Tab UTLA Acceptable
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.
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.
Coming soon!
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.
Personal Social Services Adult Social Care Survey, question 1
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!
Personal Social Services Adult Social Care Survey, question 13
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.
The Care Quality Commission gives Hertfordshire an overall score of 78 for 2024/25. This is well above the England mean of 64.7 and is classed as “Good”. It shows that most services work well and that local leaders act on problems.
Fast and safe discharge from hospital is a key sign of quality. In November 2024, 89.2 % of Hertfordshire patients left hospital in the right way, matching the national rate of 89 %. Only 15.1 % of discharges were delayed, against 12.3 % for England. While still higher than the mean, the gap is small and may reflect Hertfordshire’s big and growing population (1.22 million in 2023) rather than poor practice. The average delay per person was 0.45 days, shorter than the national 0.7 days, so most people who do face a delay do not wait long.
People’s own views give a more direct picture. In 2024, 65.2 % of respondents said they were satisfied with the help they get. This is slightly above the England mean of 64.7 %. A second survey from NatCen shows 57 % dissatisfaction. The difference between the two sources may point to uneven quality between service types or areas. Hertfordshire is less deprived than average (mean Index of Multiple Deprivation decile about 7 versus 5.9 for England), so expectations may be higher, making the NatCen result a useful warning sign.
Finding information is also part of quality. In 2024, 68.8 % of service users said it was easy to find what they needed, just above the mean of 68.2 %. Good digital tools and a mainly urban setting, with 70 % of residents in towns, may help here.
The Local Government and Social Care Ombudsman received 2.80 cases per 100,000 people in 2024, compared with 4.45 nationally. Only 2.22 cases per 100,000 reached a decision, again below the England mean of 4.12. When adjusted for Hertfordshire’s large population, the county sees far fewer complaints. This supports the positive CQC rating and suggests that issues are often solved early.
Hertfordshire’s population has risen by about 2 % since 2019. Density is 730 residents per km², lower than the England mean of 2,469, yet the county has small pockets of deep rurality. Managing services across mixed urban and rural areas can stretch staff and transport. Lower deprivation may ease some pressures, but growth and an ageing population will still raise future demand.
The county delivers good quality now. Delays are short, users can find information, and formal complaints are rare. Slightly higher delayed discharge rates and mixed satisfaction scores show room for fine-tuning, especially in areas that feel service is not meeting their rising expectations. Continued investment in community teams and clear communication, backed by the county’s relative affluence, should help keep quality high while demand grows.
✨ ✅ ❌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.
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.
ASCFR/SALT Sheet T3
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.
ASCFR/SALT Sheet T3
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.
ASCFR/SALT Sheet T3
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.
ASCFR/SALT Sheet T3
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.
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.
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The county spends about £578 million on adult social care. After taking income into account, the net cost to the council is roughly £505 million. Because Hertfordshire has more than 1.2 million residents, this works out at £47,556 for every 100,000 people. The figure is large in cash terms but only fractionally below the England average of £47,758 per 100,000.
Net spending per head is a little higher than the national rate (£41,581 versus £40,472). This shows that, once other funding streams are removed, the council puts slightly more of its own money into care than the average council. The county therefore appears to shield services, at least in part, from the wider pressure on municipal budgets.
Service users in Hertfordshire contribute about £73 million, or £5,976 per 100,000 residents. This is well below the national norm of £7,286. In an area that is, on the whole, affluent, many older people arrange and pay for help privately rather than through the council. Their payments never enter local authority accounts, so recorded “client contributions” look low even though overall spending on care in the county may be high.
NHS transfers stand at only £39 million, equating to £3,214 per 100,000 people. The average authority receives more than twice this amount (£7,878). Limited joint funding may stem from weaker integration programmes or from the fact that local health partners face other cost pressures. The result is that Hertfordshire must rely more on its own resources.
Hertfordshire’s population is large and growing steadily, rising by around 2 per cent between 2019 and 2023. Density is 730 residents per square kilometre, which is lower than the England mean shown here, yet the county is mainly urban, with small pockets of countryside. Urban areas tend to generate more referrals because services are easier to reach, while scattered rural settlements can be costlier to serve. The mix of settlement types therefore adds complexity and may raise unit costs in some districts.
Most local neighbourhoods sit in the sixth to eighth decile for deprivation, so hardship is less common than in many parts of England. Lower deprivation often means fewer people qualify for fully funded care. This, again, aligns with the lower level of recorded client income and with the likelihood that a higher share of need is met in the private market.
Hertfordshire’s gross spending per head is almost on a par with the national figure, yet the county receives far less external income. Maintaining current service levels will therefore depend on its willingness to keep prioritising social care within the council budget. Closer work with the NHS could unlock fresh money, reduce delayed discharges and spread risk.
The county’s size means that even small changes in demand or policy can add or remove tens of millions of pounds. Careful monitoring of the older population and of migration into the county will be essential. If more people with complex needs start to seek council support, Hertfordshire may need to revisit charging policies, strengthen prevention, or press for greater national funding clarity so that local spending plans remain sustainable.
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