This page provides an overview of social care in Islington, 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.
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.
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 Islington. 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 proportion of disabled people in Islington is 20.4 %, compared with the England average of 17.6 %. With a mid-2023 population near 221,000, this means roughly 45,000 local residents live with a disability. The borough is one of the most densely populated in the country (14,575 people per km²) and has high deprivation (average decile 3.6). Poverty and poor health often go together, so a higher disability rate is consistent with the local social profile.
In 2024 the council logged 2,255 requests for social care from working-age adults. This equals 1,022 requests per 100,000 residents, slightly below the national rate of 1,143. A younger population mix and the ready availability of voluntary or community help may mean some needs are met before a formal approach is made. It may also point to people who are eligible but unaware of their rights, a possibility in an area where deprivation and language barriers are common.
Once a request is made, the chance of getting a service is high. During 2024, 1,350 working-age adults received ongoing council-funded care—612 per 100,000 residents, well above the national figure of 533. The data suggest that local assessment teams are willing to approve care packages, and that the urban setting allows efficient delivery, helping budgets stretch further.
Care is mainly community-based. Only 45 people (20 per 100,000) are in nursing homes and 150 (68 per 100,000) in other residential units, but 1,160 people receive support at home. Direct payments alone cover 370 people and part direct payments another 155, both above national rates. A further 635 clients use council-managed personal budgets. The strong use of personalised and home-based care fits local policy goals of independence and reflects the limited space for traditional care homes in a dense inner-city borough.
Small numbers of disabled adults seek specialist help: in 2025 there were six requests about assessments, eight about charging, four about information, and three about safeguarding. Rates per 100,000 sit close to national norms, suggesting that most questions are answered within mainstream teams, yet a steady trickle still require targeted advice.
The higher disability rate and persistent deprivation mean that underlying need is unlikely to fall. While the council appears effective at converting requests into support, the lower request rate hints at unmet or hidden need, especially among groups who face language, cultural or digital barriers. Strengthening outreach in deprived estates, ensuring clear information in multiple formats and sustaining the personal-assistant workforce will be important. Rising housing costs could make it harder for care workers to live locally, so commissioners may need to review pay, travel and training support to keep the current community-centred model viable.
✨ ✅ ❌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
Islington has very few older residents. Between 2019 and 2023 the share of people aged 65 plus rose only a little, from 9.0 per cent to 9.5 per cent. The England figure stayed near 18–19 per cent, so Islington still has only about half as many older people as most areas. The total population stayed close to 220,000 and the borough remains one of the most crowded places in the country, with almost 14,600 residents per square kilometre. High housing costs, a large student and young adult population, and early movement out of the borough after retirement all help to keep the older share low. At the same time Islington is more deprived than average (mean deprivation decile 3.6 against 5.9 for England), which is linked to poorer health at earlier ages.
In 2024 there were 3,570 requests for social care from people aged 65 plus. This equals 1,618 requests per 100,000 residents, well below the national rate of 2,438. Some of that gap is caused by the smaller older population, yet even after allowing for age structure the figure hints that either needs are being met informally, people do not come forward, or access routes feel harder to use.
Islington supported 1,960 older residents with a long-term care package, or 889 per 100,000 residents. The England rate is 1,003, so coverage is modestly lower. The mix of services tells a more detailed story. Nursing home use is high for the size of the borough (154 per 100,000 versus 122 nationally). This suggests that the smaller group of older residents contains a higher share of people with very complex health problems, possibly linked to lifelong deprivation. By contrast, standard residential care is low (129 versus 250 nationally), pointing to limited local bed supply or a choice to keep people at home when possible. Community support funded and managed by the council is common (544 versus 508), while direct-payment options are less used. Taken together, the figures show a strong emphasis on intensive medical care for the frailest group and on council-managed help for those staying in their own homes.
More recent counts of advice and information requests add another layer. Older residents ask for assessment help (2.7 per 100,000) and safeguarding advice (1.4) slightly more often than the England average. They seek guidance on charging, information, or legal matters less often. This pattern may mean that people only approach the council when needs feel urgent or when safety is at risk, while more routine questions are solved through family, voluntary bodies, or online sources.
Because few people grow old in Islington, total demand for older-person services is limited, yet the needs that do appear can be severe. High nursing-home use and above-average safeguarding contact suggest significant frailty and risk among a small group. Maintaining enough nursing beds and skilled community nurses is therefore vital. At the same time, the borough could widen take-up of lower-level community and direct-payment support, which may delay or prevent moves into costly nursing care. Clear access routes and outreach in deprived neighbourhoods may help residents seek help earlier. As the proportion of older people is inching upwards, even a slow rise will add to workload in a densely populated, resource-tight borough. Careful planning now can match future demand to staffing and budget limits.
✨ ✅ ❌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
The 2021 Census–based estimate suggests about 6,839 unpaid carers per 100,000 residents in Islington. Applying this rate to the borough’s 217,050 people gives roughly 14,800 carers. The national rate is higher at 8,204 per 100,000, so around 3,000 fewer Islington residents are identified as carers than we would expect if the borough followed the England pattern. A younger population profile and a large share of single adults in inner-London housing may mean fewer people take on long-term caring roles. Equally, caring may be under-recorded when households are mobile or when residents do not see themselves as carers.
Only one-third of Islington carers (33.3 %) say they already have as much social contact as they would like, yet this is still better than the England figure of 29.3 %. Extreme population density—14,575 residents per square kilometre compared with the national 2,469—may make family, friends and voluntary groups physically closer and cheaper to reach, offsetting some isolation. However, the result still means two-thirds feel socially cut off, a concerning finding in a borough ranked among the most deprived in England.
Just under three in five carers (58.4 %) feel it is easy to find information about support; the national proportion is 59.3 %. The gap is small, but in a digital-rich, high-density area we might expect Islington to perform better. Feedback often points to fragmented service websites and frequent housing moves that disrupt contact with GPs and community centres. Streamlining online portals and ensuring advice is repeated through primary care and local employers could lift this figure.
Islington stands out for its use of direct payments. In 2024 about 290 carers per 100,000 residents—around 640 individuals—receive a direct payment, almost double the England rate of 150. Direct payments allow carers to design support around their own routines, a flexible approach that aligns with the borough’s diverse working-age population. By contrast, only 7 carers per 100,000 (fewer than 15 people) use a council-managed personal budget, far below the national 66, and similar numbers access respite arranged for the cared-for person. Offers limited to “information and advice” or “no direct support” also sit well below national levels. These patterns suggest that once a carer is known to the council, practitioners tend to move quickly to a cash budget and do less traditional commissioning. Lower take-up of respite may reflect tight urban housing, where moving the cared-for person to a residential setting is harder, or simply a lack of local placements.
The combination of fewer recorded carers, high deprivation and relatively positive social-contact scores paints a nuanced picture. Carers who come forward are given flexible resources, yet many more residents may be caring unseen without any help. Targeted identification in GP surgeries, pharmacies and housing associations could close this gap. Improving the clarity of advice might help newly identified carers choose between a direct payment and other forms of respite, broadening the offer beyond cash budgets alone. Finally, because density supports social contact, community organisations already embedded in estates could be funded to run peer-support groups, sustaining the relatively good social-contact performance while relieving pressure on formal services.
✨ ✅ ❌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
In 2024, Islington holds 31 community-based adult social care services and 16 residential homes. The borough’s population is about 221,000, so there are roughly 14 community services and 7 residential homes for every 100,000 residents. Across England the average councils have 18 community services and 25 residential homes per 100,000 people. Islington therefore offers a noticeably smaller formal supply, especially for residential care.
Space and land values help explain the gap. Islington is the most densely populated local authority in England, with nearly 14,600 residents per square kilometre, six times the national rate. Large care homes are hard to site in such a built-up area, and providers often face higher property costs. The borough is also relatively deprived: the average Index of Multiple Deprivation decile is 3.6 compared with 5.9 nationally. Higher deprivation can raise need but lower the proportion of older homeowners able to self-fund places, so the local market may be less attractive to commercial residential operators.
Only 8.5 percent of Islington’s registered providers are rated “requires improvement” or “inadequate”, about half of the 16.8 percent seen nationally. Fewer poorly rated services suggest effective local commissioning and support. Good quality may also be aided by the smaller number of providers, which can make oversight easier for the council.
Staff turnover in 2023/24 stands at 19.0 percent, virtually the same as the England benchmark. Vacancy rates are lower – 6.6 percent in Islington against 8.4 percent nationally – hinting that providers manage to fill posts more readily. Even so, two in three employers describe recruitment as “more” or “much more” challenging, though this is slightly better than the London average of 80 percent. Retention also feels difficult for more than half of managers, yet again the borough fares better than the regional picture. Urban transport links may widen the labour pool, while the high density of services allows staff to move between employers without leaving the area, easing vacancies but sustaining turnover.
The mix of fewer residential homes and more modest community provision suggests many residents rely on home-based support or on care homes outside the borough. Quality is strong, yet limited capacity could delay placements or raise travel distances for families. Lower vacancy levels and good inspection results point to committed providers, but persistent recruitment pressure risks future strain. Demand could rise further because deprivation is linked with earlier onset of care needs. To keep pace, commissioners may need to stimulate extra capacity, for example by helping smaller community providers expand or by encouraging new specialist housing schemes that fit dense urban sites.
Continued investment in community care seems essential, as land constraints make large new care homes unlikely. Support for workforce development – affordable housing, travel subsidies, career pathways – could help hold down turnover. Because quality is already above average, sustaining current support and quality monitoring remains important. Finally, close tracking of unmet need will be vital to ensure that residents who cannot find local residential places are not disadvantaged.
✨ ✅ ❌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.
Islington serves about 221,000 residents in barely six square miles. At 14,575 residents per square kilometre it is one of the most crowded boroughs in England, and the average neighbourhood sits in the third most deprived decile. High density and deprivation tend to create heavier, more complex demand for health and social care. These structural factors provide an important lens for judging current performance and areas for improvement.
Ninety-nine per cent of Islington residents are discharged from an NHS trust judged acceptable by the Care Quality Commission, ten percentage points above the national average. This suggests that commissioners have secured capacity in better-rated hospitals and that the overall safety of discharge destinations is strong.
However, 15 per cent of hospital discharges are delayed, compared with 12 per cent across England. In a borough where many people live alone or in unsuitable housing, arranging packages of care or accessible accommodation can take longer than clinical teams expect. Encouragingly, once a delay occurs the mean length is 0.61 days, slightly shorter than the national 0.70 days, indicating that local discharge coordination teams can move quickly once the underlying barrier—often community care capacity—has been removed.
Only 58.6 per cent of adult social care users say they are satisfied with the help they receive, six points below the England average. A separate NatCen survey records 57 per cent dissatisfaction, reinforcing the picture of relatively poor user experience. Lower satisfaction is not inevitable in deprived areas, yet residents with complex needs and limited informal support are harder to please if packages are thinly stretched or delivered by a rotating workforce.
Interestingly, 68.4 per cent of people report that information about services is easy to find, almost identical to the national figure. Clear sign-posting therefore exists, but the services accessed may not consistently meet expectations. The disconnect implies that quality and reliability, rather than awareness, should be the focus of improvement work.
The Local Government and Social Care Ombudsman received 10.4 complaints per 100,000 residents in 2024 and decided on 10.0 per 100,000, both more than double the national rates. With a smaller population base, each complaint carries extra weight in per-capita terms. High volumes can indicate two things: first, people in Islington are informed and prepared to use formal routes, consistent with good information provision; second, frontline resolution may be faltering, pushing concerns upwards. Complaint themes should therefore be mined carefully for lessons.
Islington’s challenge is not primarily about access to regulated providers—the borough already secures high-quality hospital places and communicates well with the public. The data instead point to pressure points after discharge and within community-based adult social care, where user satisfaction lags and complaints accumulate. Dense living conditions and high deprivation mean that any gaps in homecare hours, therapy availability, or housing adaptations quickly translate into delayed transfers and negative feedback.
Priority actions could include strengthening reablement and domiciliary care capacity, investing in stable care teams, and using complaint analytics to target recurrent shortcomings. With average delay duration already low, reducing the proportion of discharges that become delayed would release hospital beds and improve the overall experience without large structural change.
Good provider quality and responsive discharge teams give Islington a solid foundation, but sustained improvement will depend on closing community care gaps that undermine satisfaction and drive high complaint rates in a densely populated, deprived borough.
✨ ✅ ❌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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Islington spends about £56,900 for every 100,000 residents on adult social care. With a 2023 mid-year population close to 221,000, this equals roughly £126 million in gross expenditure. The national picture is nearer £47,800 per 100,000, so local spending is around one-fifth higher.
Several local factors help explain the gap. Islington is small and intensely urban, holding almost 14,600 people per square kilometre—six times the English norm. Space pressures raise the unit cost of home care, supported housing, and staff travel. Deprivation also plays a part. The borough sits in decile 3–4 on the Index of Multiple Deprivation, well below the country’s average of nearly 6. Poorer health, overcrowded housing and limited informal support usually drive earlier and heavier reliance on formal social care. Together, density and deprivation create both higher demand and higher delivery costs.
After allowing for client and NHS income, net expenditure stands at about £51,000 per 100,000 people, or £112 million in cash terms. This is 26 percent above the English mean. The higher net figure shows that Islington is not simply recycling more outside income; it is adding extra local resource.
Client contributions are lower than average (about £6,000 per 100,000 versus £7,300 nationally). Lower charges stem from the borough’s income profile: more residents fall below means-test thresholds, so the council must meet a larger share of cost. By contrast, NHS contributions are markedly higher—about £12,400 per 100,000, fifty-plus percent above the norm. Strong joint-working with local health services and high prevalence of long-term conditions are likely reasons. NHS funds reduce direct council pressure, yet they still leave Islington spending heavily from its own budget.
The resident count has stayed close to 220,000 since 2019, with a small dip during the pandemic. Stable numbers do not mean stable need: tight housing and economic stress can move residents into frailty earlier. With almost no rural fringe, the borough lacks cheaper care home land, so home-based support stays prominent and costly. These structural features suggest that higher-than-average spending will persist even if the head-count remains flat.
A reliance on NHS money makes partnership working essential; any shift in integrated funding would leave a sizeable shortfall. Lower client income points to the importance of benefits maximisation and financial assessment support, helping residents contribute where possible and easing pressure on the local levy.
Given the absence of clear data on future budget reductions, planning should assume continued cost growth. High density and deprivation are slow to change, so the council may need to keep investing in preventive services—re-ablement, employment support, mental health outreach—to delay entry into long-term care and protect its budget.
In short, Islington’s social care spend is high because underlying need and delivery costs are high. The challenge is securing sustainable funding while improving outcomes in an area where both space and money are tight.
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