This page provides an overview of social care in Hillingdon, 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: Hillingdon
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: Hillingdon
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 Hillingdon. 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
An age-standardised disability rate of 14.7 percent places Hillingdon well below the national average of 17.6 percent. Part of the gap is likely to come from local demography. Hillingdon’s population has grown from 305,641 in 2019 to 319,018 in 2023 and is younger than many areas, so fewer residents have long-term limiting conditions. Urban districts with large migrant communities often report lower self-declared disability, and only three percent of the borough is rural, reducing the share of older, village populations that normally report higher disability.
In 2024, 2,370 working-age adults (18–64) asked the council for social care. This equals 742.9 requests per 100,000 residents, far below the England rate of 1,143.5. A lower disability prevalence explains some of the difference, yet it may not be the only reason. A busy labour market, better family support networks, or limited awareness of eligibility can all dampen demand. The borough’s average deprivation score (decile 5.9) is close to the national mean, so financial barriers are unlikely to be the main cause. Monitoring unmet need, especially among new arrivals and private renters, remains important.
Hillingdon supports 1,490 working-age adults, or 467.1 per 100,000, again slightly under the national figure of 532.7. Use of each care setting paints a mixed picture:
Residential care holds 155 clients (48.6 per 100,000) and nursing 40 clients (12.5 per 100,000). Residential use sits modestly below the England benchmark of 60.6, while nursing is close to the average of 13.8. The figures suggest the council is containing high-cost placements, possibly through early re-ablement or better housing options.
Most support is delivered in the community. Direct payments run entirely by the client reach 175 people (54.9 per 100,000), under half the national rate of 122.2. In contrast, 990 people (310.3 per 100,000) receive a council-managed personal budget, well above the England mean of 266.7. The pattern hints at a cautious local market: clients receive personalised funding but rely on the authority to organise services, maybe because the independent provider base is thin or residents prefer the reassurance of council brokerage.
Early help can prevent crisis, yet 2025 records show only 30 formal requests for advice on assessments, care plans, charging or safeguarding. Rates per 100,000 range from 0.3 to 4.1, very close to or below national levels. Low volumes could mean needs are met informally, but they could also signal limited promotion of advocacy routes, especially for disabled people with communication barriers.
The combination of a growing, urban population and a comparatively small recorded disabled cohort offers both opportunity and challenge. Lower demand keeps budget pressure down, but it may also hide latent need. High use of council-managed personal budgets shows residents value personalised care yet still want hands-on support with coordination. Strengthening the home-care market and promoting direct payments could widen choice.
Given steady population growth and proximity to Heathrow, inward migration is likely to continue. The council may need to invest in outreach, translated materials and community navigators to ensure that newcomers with disabilities understand their rights and know how to ask for help. Regular review of waiting lists and complaints data will help test whether the low request rate reflects satisfaction or unmet need.
Overall, Hillingdon performs moderately well on disability support, but vigilance is required to make sure that a headline “lower than average” disability rate does not mask residents who still need tailored, timely care.
✨ ✅ ❌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
Hillingdon is growing fast, from about 306,000 people in 2019 to more than 319,000 in 2023. At the same time only one person in eight is aged 65 plus, while across England it is nearly one in five. This lower share of older residents fits with the borough’s young, mobile airport economy and its very high population density of 2,644 people per square kilometre. Deprivation is close to the national average, but some neighbourhoods are richer and some poorer, which may shape how and where older people seek support.
In 2024 the council recorded 5,230 requests for care from residents aged 65 plus, equal to 1,639 requests for every 100,000 people. The national rate is 2,438 per 100,000. The gap is larger than the difference in the size of the older population alone, so two things may be happening. First, many older people may still be in good health and do not yet need formal help. Second, some people could be relying on family or private services and therefore do not appear in council data. The small number of contacts about charging, legal issues, or safeguarding in 2025 supports the idea that many residents manage without heavy council involvement.
In 2024, 2,460 older residents received long-term council-funded care, a rate of 771 per 100,000. England shows 1,003 per 100,000. Hillingdon therefore supports a smaller share of its older people. Where care is given, it is mainly in the community. Direct payments, part-direct payments, and council-managed community budgets together reach about 558 per 100,000, almost matching the national picture. Nursing home use is very low at 119 per 100,000 compared with 122 nationally, and residential home use is much lower at 89 per 100,000 against 250. This pattern fits an urban area with good transport and family networks, where people can stay at home longer and where land for new care homes is costly.
The share of older residents rose slightly between 2019 and 2021, then edged down again in 2022 and 2023. Because the total population keeps rising, the absolute number of older people is still increasing, but more slowly than in many shire areas. Demand for both requests and packages of care is therefore likely to rise, yet growth may be steadier than in places with a much older age profile.
Hillingdon can focus on early-help and preventative work that keeps people independent, because the proportion of very old and frail residents is still modest. Investment in home adaptations, falls prevention, and carer support should bring good returns. Lower use of residential care suggests that when placements are needed they may be hard to find locally; securing enough high-quality nursing beds will remain a risk area. Finally, as the airport economy attracts younger workers, future budgets must balance the needs of a growing but still relatively small older group against pressures from children’s and working-age services.
✨ ✅ ❌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 about 7,363 residents in every 100,000 described themselves as unpaid carers. Applied to Hillingdon’s 2021 population of 305,107, this equates to roughly 22,500 people. The local rate is around ten per cent lower than the England average of 8,204 per 100,000. A slightly younger, highly urban population may partly explain the difference: fewer older residents means fewer frailty-related caring roles, while good transport links and a wide pool of formal services can offset the need for family care. Cultural factors may also play a part, as some communities do not readily identify with the term “carer”, so their contribution remains hidden.
Only 22.3 per cent of Hillingdon carers say they have as much social contact as they would like, compared with 29.3 per cent nationally. In practice four out of five local carers feel isolated. High housing density—2,644 residents per square kilometre—does not guarantee connection; busy traffic, shift work linked to Heathrow, and lingering effects of the pandemic make it hard to leave home or attend groups.
Access to information is another weak spot. Just 49.2 per cent find it easy to obtain advice or guidance, well below the England figure of 59.3 per cent. Because Hillingdon’s average deprivation score sits close to the national norm, the shortfall points more to the way services are promoted and organised than to poverty itself. When carers cannot navigate the system they are more likely to reach crisis point, increasing unplanned demand for social care and hospital services.
Direct payments reach 53 per 100,000 residents, barely one third of the national rate. Part direct payments are rarer still at 9 per 100,000. No cases were recorded for council-managed personal budgets or council-commissioned support delivered solely to the carer, even though such options are common elsewhere. Episodes of information, advice or sign-posting stand at 89 per 100,000, roughly a quarter of the national level. These figures suggest that carers’ assessments either happen less often or lead to lighter, lower-cost offers.
Conversely, respite or other support provided to the cared-for person reaches 78 per 100,000, slightly above the England mean. Hillingdon therefore leans towards helping the cared-for individual rather than empowering the carer through personalised packages. While respite is valuable, it cannot replace the flexibility and control that a direct payment can give.
The borough’s population has grown by almost five per cent since 2021 and is projected to keep rising. Even if the caring rate stays below average, the absolute number of unpaid carers will increase, intensifying pressure on local services. Low levels of social contact and poor access to information point to unmet need that could escalate into higher health and social care costs.
Strengthening outreach, simplifying the assessment pathway, expanding the use of direct payments, and rebuilding community-based peer groups would all help carers feel less isolated and better informed. Regular monitoring of carer outcomes will be essential to judge whether these steps improve experience and prevent crisis demand.
✨ ✅ ❌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
Hillingdon has 53 community-based adult social care services and 44 residential care services. When the latest population figure of 319,018 is used, this equals about 16.6 community providers and 13.8 residential providers for every 100,000 residents. The average council in England shows almost the same rate of community providers (around 16.9 per 100,000) but a far higher rate of residential providers (about 24.1 per 100,000). In simple words, Hillingdon offers a normal level of support in people’s homes yet a smaller stock of care homes. The borough’s high population density and low share of rural land (only 3 %) may make short-travel, home-based services easier to run, so the market could be choosing community care over bricks-and-mortar homes.
Only 12.4 % of Hillingdon providers are rated ‘Needs improvement’ or ‘Inadequate’, compared with 16.8 % across England. This better-than-average picture suggests that the tighter residential market has not led to poorer quality. It may also reflect effective local commissioning and support from the council’s quality team.
The annual staff turnover rate is 19.0 %, almost identical to the London average. A similar pattern is seen in the share of managers who say it is ‘more’ or ‘much more’ difficult to keep staff: 56 % in Hillingdon, against 68 % across London. These figures point to a labour market that is still stretched, yet slightly less pressured than elsewhere in the capital. Possible reasons include good transport links to Heathrow and central London, which widen the pool of potential recruits.
Even so, the vacancy rate stands at 12.3 %, well above the England mean of 8.4 %. Employers also report that 68 % find recruiting harder, though this is lower than the London benchmark of 79.8 %. Put together, the data suggest that new posts are being created to match a growing, ageing population, but providers are struggling to fill them quickly.
The borough’s population has risen by about 4 % since 2019, faster than the national trend. Density is higher than the England norm, and deprivation sits very close to the national average. This mix often leads to complex need: urban areas bring higher numbers of older people living alone, and median deprivation can hide local pockets of poverty. As demand builds, the limited stock of residential beds could push more people toward home care or out-of-area placements, unless capacity grows.
Maintaining quality while expanding capacity is now the core challenge. Short-term action could focus on:
• Supporting providers to convert empty high-street units into extra community hubs, taking advantage of dense housing and short travel distances.
• Deepening links with local colleges and Heathrow employers to ease recruitment, especially for night and weekend shifts.
• Using quality data to target help at the small minority of services rated below ‘Good’, ensuring that a larger market does not come at the cost of standards.
If these steps are taken, Hillingdon can keep its good performance on quality while closing the gap in residential provision and easing staffing gaps, ready for the next rise in demand.
✨ ✅ ❌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.
Hillingdon now holds a Care Quality Commission local authority score of 73. The England average is 64.7. This “Good” grade signals clear progress in the way adult social care is led and checked. The borough is urban and dense, with only three per cent of land classed as rural. Such places often face heavy, fast-changing demand. Getting a good rating in this setting hints at solid planning, quick decision-making and a workforce able to adapt.
Most people who leave hospital do so from a trust judged acceptable: 87.7 per cent, close to the national 89 per cent. More important is what happens next. Only 7.4 per cent of discharges are delayed, almost half the England rate of 12.3 per cent. The average length of any delay is 0.36 days against 0.7 nationally. A large, close-knit hospital and community network may help. The population grew by nearly five per cent between 2021 and 2023, yet flow has stayed smooth. This suggests that joint working between NHS wards, re-ablement teams and care providers is working and is preventing bed-blocking.
Despite strong operational signs, only 58.4 per cent of survey respondents say they are satisfied with the support they receive, six points below the England mean of 64.7 per cent. In a dense and diverse borough expectations can be high, and language or cultural fit may shape how people judge services. On a more positive note, seven in ten users find it easy to obtain information about help, slightly above the national figure. Good sign-posting may yet translate into higher satisfaction if waiting times and staff continuity also improve.
The Local Government and Social Care Ombudsman received 5.6 cases per 100,000 residents, compared with an England rate of 4.45. It decided 6.6 cases per 100,000, again above average. A higher complaint rate can indicate gaps in quality, but it can also show that residents are well informed and willing to speak up. The borough’s high literacy, strong community networks and easy access to online forms may all raise reporting. Nevertheless, each upheld complaint carries a cost and points to learning needs for frontline teams.
Low discharge delays and a good CQC result show that formal processes are robust. Yet lower satisfaction and more ombudsman activity hint at softer issues, such as how personal the care feels, staff turnover, or whether support plans match cultural and family structures in a highly mixed borough. Rising population density keeps pressure on domiciliary care rounds and day centres. While deprivation sits near the national middle, pockets of higher need exist, as shown by the slightly wider spread of deprivation scores. Unequal neighbourhoods may experience services very differently, feeding both discontent and complaints.
To keep quality improving, Hillingdon may wish to invest in staff continuity, cultural competency training and clearer follow-up after hospital. Extra attention to the neighbourhoods with the highest deprivation ranks could lift satisfaction and cut complaint numbers. The strong discharge record offers a firm base; extending the same joined-up approach to long-term community support can help turn operational success into deeper public trust.
✨ ✅ ❌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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In 2024 Hillingdon put roughly £118 million into adult social care. This is about £37.1 million for every 100,000 residents. The England average is £47.8 million, so local gross spend sits about 22 % below the norm.
After income is taken off, net spend stands near £99.9 million, or £31.3 million per 100,000 people. Again, this is around one quarter lower than the national rate of £40.5 million. Less money is therefore reaching front-line care once all funding flows are counted.
Client charges bring in about £18.3 million (£5.7 million per 100,000). Across England users contribute closer to £7.3 million per 100,000. Lower income from charges can point to fewer service users, smaller personal budgets, or a larger share of people who do not meet means-test limits.
NHS bodies add around £28.8 million (£9.0 million per 100,000). This is 14 % higher than the national rate of £7.9 million. Strong health-care support may help the council keep its own spend down, for example through joint re-ablement or discharge teams that are paid for by the local Integrated Care Board.
Hillingdon’s population has grown from 306,000 in 2019 to 319,000 in 2023, yet it remains younger than many areas. A smaller older-old group means fewer people who need high-cost care such as residential placements.
The borough is very dense (2,644 residents per km²) and only 3 % rural. Dense urban areas often deliver home care more cheaply because travel time is short and support workers are easier to recruit locally.
Mean deprivation ranks almost exactly on the England median. Need is therefore not as intense as in many northern or coastal councils, though a relatively high spread of deprivation scores hints at pockets of acute hardship. Local eligibility rules could be tight, keeping the number of care packages low and pushing down spend.
High NHS funding suggests close joint working, but it can also mask gaps in council budgets. If demand rises as the borough ages, Hillingdon may struggle to hold spending at today’s low level. A fifth of gross cost is already being met by the health sector; further shifts may be hard to secure.
Lower client income may signal unmet need among people who cannot pay privately. Monitoring waiting lists and carer stress will show whether low spend is due to true efficiency or hidden demand.
Population growth and an eventual rise in the over-85 group are likely. Without extra council funds, either NHS partners must give even more, or eligibility may tighten further. Transparent budget plans and regular joint reviews will be key to make sure residents continue to receive safe, timely care.
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