This page provides an overview of social care in Lewisham, 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 Lewisham. 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
About 17.6 % of Lewisham residents are disabled after age-standardisation, exactly matching the England figure. The borough, however, is very different from the average place: it is smaller than the typical upper-tier authority (≈299,000 people) yet more than three times as dense (8,551 residents per km²) and markedly more deprived (mean Index of Multiple Deprivation decile 3.8 compared with 5.9). High density limits family housing and access to informal care, while higher deprivation often brings poorer health. Together these factors tend to raise demand for publicly funded support even when disability prevalence itself is only average.
In 2024 the council received 6,755 requests for help from working-age adults. This is 2,261 requests per 100,000 residents, almost twice the England mean of 1,143. The figure signals heavy front-door workload and suggests that disabled residents rely strongly on the local authority rather than on private or family solutions. Urban living costs, lower carer availability and tighter benefit margins may all push people to seek formal help sooner.
Only 1,665 people (557 per 100,000) moved on to long-term care, a rate only slightly above the national 533. Roughly one in four requests therefore results in ongoing services. This wide gap can indicate effective signposting and short-term reablement, but it can also point to high eligibility thresholds and possible unmet need, especially where deprivation is high.
Lewisham places proportionally more disabled adults in institutional settings. Nursing care stands at 35 per 100,000 versus 14 nationally, and residential care at 80 versus 61. That implies a client group with more complex or unstable conditions, perhaps linked to multi-morbidity associated with deprivation.
Community support shows a mixed picture. Direct-payment-only packages (121 per 100,000) are close to the England norm (122), but council-managed personal budgets are far less common (127 versus 267). At the same time, reliance on council-commissioned support without a personal budget is over twice the national average (134 versus 58). Personalisation therefore lags: many residents still receive traditional block-contracted home-care hours rather than directing their own support. Expanding direct payments and individual service funds could promote independence and ease pressure on costly residential beds.
Numbers for 2025 early-help contacts are small, yet the rate of safeguarding requests (2.34 per 100,000) is almost double the England figure (1.21). This could reflect good local vigilance, but it may also point to greater exposure to abuse and neglect in crowded, deprived neighbourhoods. Assessment, care-plan and information-seeking contacts sit close to national averages, suggesting reasonable access routes, though low volumes hint that recording practices might under-capture activity.
Lewisham’s share of disabled residents is ordinary, but the borough faces extraordinary demand. High deprivation and density appear to drive people towards statutory services sooner and to push a larger proportion into institutional care. The council may wish to:
• Invest in prevention and reablement to curb the high inflow of requests.
• Promote personal budgets and direct payments to shift support from residential to community settings.
• Maintain strong safeguarding capacity, given elevated referral rates.
• Work with housing, employment and welfare agencies to tackle the social factors that intensify care needs.
Without such measures the gap between demand and supply could widen, risking greater unmet need among 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
Lewisham is a dense inner-London borough with no rural areas and a high level of deprivation. The total population has slipped from about 306,000 in 2019 to 299,000 in 2023, yet the share of residents aged 65 and over has inched up each year. The proportion moved from 9.2 per cent in 2019 to 10.1 per cent in 2023. Although this is still only a little over half of the national average (18.5 per cent), it shows that Lewisham’s population is ageing even while the overall head-count falls. Around 30,000 older people now live in the borough, meaning service demand will almost certainly grow.
In 2024 the council logged 6,830 requests for adult social care from people aged 65 plus. This equals 2,287 requests per 100,000 older residents, slightly below the England figure of 2,438. A younger age profile explains part of the gap, yet lower request rates can also point to barriers such as limited awareness of help, complex application processes or cultural expectations of family care. Given the borough’s high deprivation score, earlier onset of ill-health is likely, so the modest request rate may mask unmet need.
Lewisham supports 2,760 older residents, or 924 per 100,000. Again this is below the national average of 1,003 per 100,000. Fewer people in care than expected from the request figure suggests a tighter eligibility threshold or a push towards informal support.
Patterns inside the total give important clues:
• Nursing home placements stand at 139 per 100,000, a little above the England mean (122). This hints that, once accepted, clients often have high or complex needs.
• Residential care is low at 100 per 100,000 versus 250 nationally, showing a policy preference to avoid permanent placement where possible.
• Community services paint a mixed picture. Direct payments only (55 per 100,000) match the national rate, yet part direct payments are four times higher than average (95 versus 22). Meanwhile council-commissioned support only is almost three times the England rate (362 versus 137), whereas council-managed personal budgets are far lower (172 versus 508). Together these figures suggest Lewisham leans heavily on home-based, council-arranged packages and has not embedded fully personalised, budget-holder models.
Early 2025 data show very few older residents sought help with assessments, finance or safeguarding. Rates hover around one or two persons per 100,000, broadly close to national figures. Numbers are too small for firm conclusions, yet they reinforce the picture of limited formal engagement with the care system.
Lewisham’s older population is growing within a shrinking, deprived, high-density borough. Current demand is slightly below national averages, but indicators of high nursing need signal rising complexity. The reliance on council-commissioned home support, combined with low take-up of fully self-directed budgets, raises questions about choice and flexibility. To prepare for further ageing the borough may need to:
• widen outreach so more residents understand and access support early;
• strengthen community services that delay or prevent institutional care;
• expand the workforce, using the borough’s compact geography to maximise efficiency;
• promote personal budgets to give citizens greater control, while ensuring options are realistic for people with high needs.
Addressing these points now will help Lewisham manage future demand and reduce the risk of unmet need among its older residents.
✨ ✅ ❌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 Lewisham had about 20,000 unpaid carers. This equals 6,652 carers for every 100,000 residents. The national figure is higher at 8,204 per 100,000. Lewisham’s lower rate may reflect its young, mobile population and the fact that many carers in busy urban areas do not register with services. The borough is also more deprived than average, which can make caring harder to declare because people must balance work, rent and caring at the same time.
Social contact is a little better than in England as a whole. In 2024, 30.3 % of Lewisham carers said they had as much contact as they would like, compared with 29.3 % nationally. High population density (8,552 residents per km²) means friends, shops and buses are close by, which can help people meet others even when time is short.
The picture is less positive for information. Only 44.8 % felt it was easy to find out about support, well below the national figure of 59.3 %. The service map in a large city can be complex, and many carers speak English as a second language. Limited advice services—just 22 contacts per 100,000 people against an England rate of 339—suggest that not enough simple guidance reaches carers early.
Lewisham relies heavily on personal budgets managed by the council. About 174 carers per 100,000 receive a council-managed personal budget and 166 get a part direct payment, both far above national averages. Direct payments paid in full to the carer are rare at only 20 per 100,000 (around 60 people), while the England rate is 150. The pattern shows that the borough favours shared control rather than handing all the money to carers. This can give structure but may reduce flexibility, especially when caring needs change quickly.
Support delivered to the cared-for person, such as respite breaks, is also low at 23 per 100,000 compared with 70 nationally. Together with the small advice offer, this may leave some carers without the breathing space or know-how they need.
Only one safeguarding concern about a carer (0.33 per 100,000) was recorded in 2025, against 0.75 nationally. The number is tiny, so firm conclusions are hard, yet it might hint that issues are not being spotted early.
The headline is that Lewisham reports fewer carers than expected, yet those who are known receive fairly high levels of managed support. Deprivation and the cost of living press hard in the borough, so hidden carers may be coping alone. The low score on finding information and the very small advice service underline this risk.
Service planners may wish to invest in community outreach, translation and digital sign-posting to bring more carers into view. Expanding universal advice and offering more flexible direct payments could help carers tailor support to their own lives. Given the dense, diverse setting, even small changes can reach many people quickly. Identifying and backing hidden carers now will also ease later demand on health and social care budgets.
✨ ✅ ❌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
Lewisham has 51 community-based adult social care providers and 54 residential providers. The borough’s 2023 population is about 299,000. This gives roughly 17 community providers and 18 residential providers for every 100,000 residents. The national picture is close for community services (about 17 per 100,000) but higher for residential care (about 24 per 100,000). Lewisham’s very high population density and costly land can make new care homes hard to open. A smaller share of residential provision may also show a local choice to support people at home rather than in a care home.
Just over 19 percent of Lewisham providers are rated “needs improvement” or “inadequate”, compared with a national rate of 16.8 percent. Extra demand in a densely populated and relatively deprived borough can stretch services and make it harder to meet Care Quality Commission standards. Targeted support, such as coaching from well-performing providers or small grants for building upgrades, may help raise ratings.
The staff turnover rate is 19 percent, almost the same as the London average of 19 percent. However, only 56 percent of managers say that keeping staff is now “more” or “much more” difficult, well below the regional figure of 68 percent. The vacancy rate is 6.6 percent, compared with 8.4 percent for London, and fewer managers report major problems with recruitment (68 percent against 80 percent). These numbers suggest that Lewisham is coping slightly better than many London areas in filling and keeping posts. The large local labour market, good transport links and closeness to several colleges may give employers a wider pool of candidates. Lower housing costs than parts of inner London could also help staff remain in post.
A tight but fairly stable workforce may allow Lewisham to run more community services without a higher turnover. Yet quality issues remain. High caseloads, complex needs linked to deprivation, and limited space for modern care facilities could all affect inspection outcomes. Supporting staff with training in complex care, and spreading best practice from better-rated organisations, may lift overall quality.
The local population has fallen slightly since 2019, easing growth in demand, but deprivation remains higher than average. Residents are also concentrated in small areas, so home-care visits can be planned efficiently. This setting fits Lewisham’s present focus on community provision, but it means the borough must keep strong home-care teams and rapid response services, especially as fewer residential beds are available.
Commissioners may wish to expand improvement plans for the one in five providers that do not yet meet good standards. At the same time, they should protect the conditions that are helping with recruitment and vacancies. Continued links with local colleges, affordable travel schemes and clear career routes can keep turnover stable. Finally, planners should monitor whether the current balance between community and residential care still meets need as the population ages; if demand for care homes rises, creative use of existing buildings or partnerships with neighbouring boroughs may be required.
✨ ✅ ❌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.
Lewisham sends almost all of its hospital patients to providers that meet national quality rules. The rate is 99.8 percent, well above the England figure of 89 percent. A good match between the council and its partner hospitals points to clear agreements and careful planning.
Only 9.4 percent of discharges are delayed, compared with 12.3 percent nationally. Average delay time is 0.69 days, almost the same as the England mean of 0.70 days. This is notable because Lewisham is a very dense urban area with 8,551 residents per km2 and higher than average deprivation. Pressure on hospital beds is usually greater in such places, yet the system is keeping delay low. Close teamwork between the council, the NHS and community services is likely helping people leave hospital on time, freeing beds and reducing cost.
Sixty-one percent of adult social care users say they are satisfied with their care, three points below the national rate of 64.7 percent. The gap is small but suggests there is room to improve day-to-day support. A separate survey by NatCen shows that 57 percent of residents express dissatisfaction. While the data sources differ, both point to mixed feelings among the public. High deprivation can raise expectations for help that services cannot always meet, and dense housing may limit the reach of neighbourhood support networks.
Seventy-four percent of service users feel it is easy to get information about help and support, five points above the England average. This strength may reflect the council’s investment in digital tools and face-to-face advice in a compact borough. Good signposting can reduce unmet need and avoid unnecessary contacts with GPs and hospitals.
In 2024 the Local Government and Social Care Ombudsman received 6.36 cases per 100,000 residents from Lewisham, compared with 4.45 nationally. Decisions were issued on 4.69 cases per 100,000, also above the England mean of 4.12. Higher complaint rates are common in urban, deprived areas where people are more likely to use public services and to challenge decisions. The figures may signal transparency rather than poor practice, but each case still consumes time and money.
The discharge pathway is strong and should be protected, especially as the population ages. Attention now needs to shift towards the quality of long-term support in the community. Targeted work in the most deprived neighbourhoods could lift satisfaction and cut the need for formal complaints. Given good performance on information, the council could use its channels to promote self-care and early help, easing demand further. Continued monitoring of complaint themes will show whether actions are having the right effect.
✨ ✅ ❌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 Lewisham spent about £37,100 for every 100,000 residents on adult social care before income is taken off. This is far below the England mean of nearly £47,800. If we apply the 2023 mid-year population estimate of 298,708, the gross bill is roughly £111 million. After client and NHS income are removed, the net out-turn is close to £96 million, equal to £32,400 per 100,000 people. National councils spend around £40,500 on the same basis, so Lewisham is spending about one fifth less than the norm.
The borough is small in area but very crowded, with 8,551 usual residents per square kilometre compared with an England average of only 2,469. At the same time it is relatively poor: the mean deprivation decile is 3.8 (1 = most deprived, 10 = least), while the national mean is 5.9. The local population has slipped from 306,000 in 2019 to just under 299,000 in 2023. A falling headcount eases some volume pressure, yet high density and deprivation tend to raise demand for care, because poorer residents are more likely to have ill-health and less able to purchase help privately.
The low spend per resident does not automatically mean the service is efficient; it may also point to unmet need. In a densely built and deprived area, staff often travel short distances but face higher living costs, and accommodation for supported housing is expensive. If money has not kept pace with these costs, staffing shortages, waiting lists or restrictive eligibility rules could emerge. The statement that “the government appears to know how much money is required for social care, and yet they are not making that known” hints at local concern that funding is below what is truly needed.
Lewisham raises about £4,700 per 100,000 people from client charges, versus a national mean of £7,300. Lower contributions can reflect a poorer user base with less ability to pay, tighter charging policies, or fewer people in state-funded residential care. NHS transfers stand at £4,100 per 100,000, only half the national figure of £7,900. Limited health funding may mean that joint discharge schemes, Continuing Healthcare or pooled budgets are smaller than elsewhere, leaving the council to cover costs from its own purse.
If need is rising faster than spend, the council may have to ration care or scale back prevention work, which in turn can increase hospital use. Strengthening partnership with the local NHS could unlock extra money for re-ablement, step-down beds and community nursing, easing pressure on both systems. Given the low level of client income, support for employment, benefits advice and carer respite could help citizens stay independent and limit later demand. Finally, transparent data on budget cuts would allow residents and elected members to judge whether current spending really matches local need and national expectations.
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