This page provides an overview of social care in Liverpool, 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 Liverpool. Understanding the types of care available can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people receiving personal care may indicate a need for more support with daily living activities, while a high number of people receiving respite care may suggest a need for additional support for carers.
ASCFR and SALT Data Tables 2023-24 Sheet T34
The age-standardised rate of disability in Liverpool is 23.8 %. The England rate is 17.6 %. In a city of about 504,000 people, this means roughly one in four residents lives with a disability. High deprivation (average decile 2.8 versus the national 5.9) and a history of heavy industry are likely to raise long-term illness in the local population. The city is also very dense, with 4,346 people per km², which can make daily life harder for people with mobility problems.
In 2024, 5,415 working-age adults asked the council for care or support. This equals 1,075 requests per 100,000 residents. The national figure is 1,143 per 100,000. Liverpool therefore sees slightly fewer formal requests than the country as a whole, even though its disability rate is higher. Some residents may not know how to seek help, or they may rely on family networks instead. The pattern in 2025 requests for advice (for example on charging or safeguarding) is also modest. Most categories sit below or close to the England average. Again, this hints at possible unmet need rather than low demand.
Despite the lower request rate, 3,175 working-age adults were actually receiving council-funded care in 2024. This is 630 people per 100,000, around 18 % above the national mean of 533. Liverpool therefore converts a higher share of requests into ongoing support, or it keeps people in services for longer. A high level of social deprivation can drive complex needs that require continuing help.
Patterns of provision differ from the England picture. Community packages managed by the council are the dominant model, at 381 per 100,000 versus a national 267. Part-direct payments are also common (145 per 100,000 versus 48). In contrast, fully self-managed direct-payment cases are much lower (29 versus 122), and community support commissioned only by the council without a personal budget is rare (15 versus 58). Nursing home rates (28 versus 14) are double the average, while standard residential placements (32 versus 61) are about half.
This mix suggests the authority prefers to keep people at home with a managed personal budget rather than rely on residential care. The higher nursing figure shows that when institutional care is needed, needs tend to be complex. Lower take-up of pure direct payments may reflect limited confidence or capacity among residents to handle personal funds, especially in deprived areas.
The city faces a double challenge: a large, dense and deprived population creates above-average disability, yet formal requests for help are not as high as expected. Outreach and information work could bring hidden demand into view. At the same time, the care system is already supporting more working-age adults than the national norm, with a clear focus on community-based packages. Sustaining this approach will require a strong home-care workforce and effective personal budget management.
Given the high rate of complex nursing placements, investment in early intervention and rehabilitation could lower future institutional demand. Finally, low use of self-directed payments may merit targeted training for service users, so that more people feel able to shape their own support.
✨ ✅ ❌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
In 2023 around 15.3 % of Liverpool residents were aged 65 or over. This share has stayed almost flat since 2019, moving only between 15.2 % and 15.4 %. The national figure is higher at about 18 – 19 %, so Liverpool has a younger age mix. Population growth is steady, rising from 485 000 to 504 000 in five years, and the city is very dense, with 4 346 people per square kilometre. Liverpool is also one of the most deprived places in England, with an average Index of Multiple Deprivation decile of 2.8. These facts mean many people reach later life with poorer health, even though the area has fewer older residents overall.
In 2024 the council logged 8 755 requests for support from residents aged 65 +. This equals 1 738 requests per 100 000 people, well below the England rate of 2 438. The lower rate partly reflects the younger population. It may also hint at hidden need: people in deprived areas sometimes delay asking for help or find it hard to reach services.
Despite fewer requests, 5 900 older residents were actually getting long-term care. That is 1 171 per 100 000, higher than the national average of 1 003. Once someone comes forward, Liverpool appears more likely to provide ongoing support. This fits a city with high deprivation, where older citizens often have complex illness at an earlier age.
Per 100 000 people, nursing home use (140) and residential care use (261) are slightly above national levels. Community support shows a mixed picture. Direct payment only packages are low (16 vs 55 nationally), but mixed packages that add a direct payment to council-managed help are high (120 vs 22). Pure council-commissioned community support is very low (4 vs 137). This suggests Liverpool prefers to place control with the person, either through a direct payment or a personal budget that they help manage. The pattern may also reflect the city’s dense housing, where care workers can reach many homes quickly, making mixed community models practical.
Small numbers from 2025 show less than one enquiry per 100 000 about legal issues, mental capacity or safeguarding, and about six enquiries for charging. These rates are close to or below national norms. The figures are tiny, so clear trends are hard to read, yet they support the idea that many citizens do not seek help early.
Liverpool’s older population is smaller than average but lives with higher deprivation. This combination keeps overall demand modest while pushing up the share who move straight into formal care. The city’s preference for personal budgets aligns with national policy and gives clients control, yet the very low use of council-commissioned community support could leave gaps for people who find self-management hard.
As the population grows and ages, requests for help are likely to rise. High density makes home care efficient, but poverty and poor housing can raise care needs and complicate delivery. Continued investment in early advice, outreach in deprived wards and flexible home-based support will help delay or reduce moves into residential settings. Close monitoring is vital so that hidden need does not grow while headline request rates look stable.
✨ ✅ ❌When government support falls short, unpaid carers step in to provide care. However, many struggle with burnout, financial pressure, lack of social contact, and a lack of support. This section explores the number of unpaid carers, their increasing workload, and what forms of support are available.
Carers play a vital role in supporting vulnerable adults, often stepping in to provide care when professional services are unavailable or insufficient. The percentage of carers receiving direct payments highlights financial empowerment, the number of carers accessing services reflects local authority outreach, and the number turning to charities underscores unmet needs. Together, these data points reveal systemic strengths and weaknesses: low direct payment uptake may push carers toward charities, while effective services can reduce dependence on charitable support. Understanding these metrics enables targeted interventions to ensure carers receive the recognition and resources they deserve.
Unpaid carers play a crucial role in supporting vulnerable adults, often stepping in to provide care when professional services are unavailable or insufficient. Understanding the number of unpaid carers in a local authority can be complicated. On the one hand, a relatively high proportion might be indicative of not enough being done by the local authority, and/or a strong community. On the other hand, a relatively lower number can mean good service provision, lower need, lower availability to look after family, or a problem with reporting.
Still, understanding the number of unpaid carers is a baseline number that must be considered.
NOMIS NM_2213_1
These values are widely considered to be an underestimate. See this report from Carers UK for more information.
August 2021 - Patient with dementia who lives in a shared lives setting. Carer had been requesting respite from the council since September 2020. Croydon Social Prescriber helped with a referral to the local authority in March 2021. Assessment conducted, with the promise they would come back with support, which did not happen. 25 August, social prescriber used the chatbot to find the right legal wording for the situation. The email was sent at 4.52pm that day. At 5.12pm the council contacted the carer to discuss the respite. This was the impact of one letter, addressed to a senior team.
This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!
Social contact is important for carers’ well-being, as it can help reduce feelings of isolation and loneliness. Understanding the level of social contact that carers have can help local authorities identify areas where additional support and resources may be needed. For example, a low level of social contact may indicate a need for more social activities or support groups for carers, while a high level of social contact may suggest that carers have a strong support network.
Survey of Adult Carers in England (SACE) - question 11
The type of support available to carers can vary significantly, impacting their ability to provide care effectively. Understanding the types of support available can help identify areas where additional resources may be needed. For example, a high number of carers receiving respite care may indicate a need for more support with caregiving responsibilities, while a low number of carers receiving financial support may suggest a need for additional financial assistance.
ASCFR/SALT Sheet T47
Access to information is crucial for carers to navigate the social care system effectively. Understanding how easy it is for carers to get information can help local authorities identify areas where additional support and resources may be needed. For example, a high number of carers finding it difficult to get information may indicate a need for improved communication and support services, while a low number of carers finding it difficult to get information may suggest that existing services are effective.
Would you like social care information? Try our Chatbot!
Survey of Adult Carers in England (SACE) - question 17
Note: these values are a work in progress… expect these numbers to go up
Access Social Care and other Helplines help people with information, advice, and support related to social care. Understanding the types of calls received by carers can highlight areas where additional support and resources may be needed. For example, a high number of calls related to financial support may indicate a need for more financial assistance for carers, while a high number of calls related to respite care may suggest a need for additional support with caregiving responsibilities.
It is important to note that, just as in the previous section, low numbers of requests might indicate that people don’t know where to get help, don’t feel they can get (or deserve) help, or other outreach problems. This is particularly important because we often work with people where the role of a carer is not recognised, or where the carer themselves does not recognise their role.
Access Social Care casework, AccessAva data, and helpline partner submissions
In 2021 there are about 9,108 unpaid carers for every 100,000 Liverpool residents. With a mid-2021 population of roughly 485,000 people, this gives an estimate of 44,000 local carers. The England rate is 8,204 per 100,000, so Liverpool has around 11 % more unpaid carers than the average area. The city is densely populated and ranks high for deprivation. Both factors are linked with poor health and disability, so more relatives and friends may step in to give unpaid help.
Direct support paid straight to carers is common. Liverpool records 176 direct payments per 100,000 people, a little above the England figure of 150. Even more striking is the use of council-managed personal budgets: 243 per 100,000, almost four times the national norm of 66. These budgets let the council arrange services on the carer’s behalf and may suit people who feel unsure about managing cash.
Other forms of help are less frequent. Support that is only council-commissioned shows at 48 per 100,000, well below the England figure of 102. Offers restricted to information, advice or signposting stand at 289 per 100,000, slightly under the national 339. Fewer carers receive no direct support at all (47 per 100,000 versus 130 nationally), suggesting the council makes contact with most carers and gives at least some form of help. However, respite delivered to the cared-for person, which lets carers take a break, is low at 43 per 100,000 compared with 70 across England. This gap matters because breaks are vital for carer health.
Only 22.3 % of Liverpool carers say they have as much social contact as they would like, while 29.3 % do so nationally. A further signal of strain is that just 47.3 % find it easy to get information about services, against 59.3 % in England. These answers point to loneliness and frustration despite the relatively high level of financial and practical support. Dense urban living does not, in this case, appear to ease isolation.
The city’s high carer rate and low satisfaction scores suggest demand is heavy and complex. Direct payments and managed budgets are well used, yet many carers still feel cut off and poorly informed. Service planners may wish to:
• Expand respite offers so carers can rest.
• Strengthen community groups and peer networks to raise social contact.
• Improve digital and face-to-face advice, especially in lower income wards where health literacy may be low.
Addressing these gaps could protect the well-being of Liverpool’s large carer population, reduce future stress-related illness and support the wider health and care system.
✨ ✅ ❌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
Liverpool has 71 community-based adult social care services and 80 residential care services. On a simple count the city sits above the national average for community support but below it for residential homes. When population size is taken into account the picture changes. With about 504,000 residents in 2023, the city holds roughly 14 community services and 16 residential homes for every 100,000 people. The national ratios are around 17 and 24 per 100,000. Liverpool therefore offers fewer care outlets per head than most areas. Rapid population growth since 2019 and the city’s very high density mean that each provider looks after more potential users than the English norm. This can stretch staff time and make it harder for families to find a place close to home.
Just over one-quarter of Liverpool providers (27.2 %) are rated “requires improvement” or “inadequate”, compared with 16.8 % across England. A higher share of low grades can signal older buildings, tight budgets, or pressure on managers to fill vacancies quickly. In Liverpool the challenge is likely worsened by deprivation. The city sits in the second most deprived decile on average, far below the national mid-point. Services in deprived neighbourhoods often face higher demand, more complex needs and lower private fee income, all factors linked with weaker inspection outcomes.
Staff turnover stands at 25.4 %, almost identical to the North West figure. However 69.5 % of employers say keeping staff is now “more” or “much more” difficult, and 81.3 % report the same for recruiting. Even so, the recorded vacancy rate is 6.7 %, lower than the regional average of 8.4 %. A large urban labour pool may help fill posts faster, but many workers move on after a short period. Pay that competes with entry-level retail, shift work and the emotional load of caring can all drive churn. Repeated recruitment cycles consume management time and can unsettle residents.
Liverpool is completely urban and among the most densely populated places in England. High density can support community care because services are close together, yet it also means traffic, parking and housing shortages, which complicate home visits and raise overhead costs. Deprivation deepens the challenge: people in poorer areas tend to develop ill health earlier and rely more on publicly funded care. Lower provider numbers per head, mixed with rising need, increase the risk of waiting lists or of people staying in hospital longer than necessary.
Improving quality should be a priority. Targeted support for under-performing homes, coupled with incentives to adopt stronger governance, could lift inspection results. Workforce stability is equally pressing. Career-long training paths, closer links with local colleges and fair pay could reduce exit rates. Finally, commissioners may wish to encourage new entrants, especially specialist residential units, to bring local capacity closer to national norms. This would spread demand more evenly, ease staff workload and give residents greater choice.
✨ ✅ ❌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.
Liverpool now has about 504,000 residents and the number has grown every year since 2019. The city is very dense, with over 4,300 people for every square kilometre, and it is one of the most deprived areas in England. These facts mean that health and care services face heavy and complex demand. Any change in service quality must be read against this busy background.
Almost 97 % of Liverpool patients go home from a hospital that the Care Quality Commission rates as “acceptable”. The England average is 89 %, so most local people are discharged from good-quality wards. Yet the journey home is not always smooth. In November 2024, 15 % of discharges were delayed, compared with 12.3 % nationally, and the average wait was 1.29 days, almost twice the England figure of 0.7 days. The result suggests that bottlenecks sit outside the ward itself, perhaps in community care or transport planning. High population density and low household income may slow the search for suitable home support or equipment, stretching the discharge team.
Survey data offer a more positive picture. About 70 % of adult social care users said they were satisfied with their support, five points above the national score. A different source reports 57 % dissatisfaction, but no England figure is supplied, so the local meaning is unclear. What we can say is that 72.5 % of users find it easy to get information on services, again beating the national average of 68.2 %. Clear information often leads to smoother care plans and may be a factor behind the high satisfaction rate.
In 2024 the Local Government and Social Care Ombudsman received 3.37 cases for every 100,000 Liverpool residents; England saw 4.45. The Ombudsman also decided 3.37 cases per 100,000 here, compared with 4.12 nationally. A lower complaint rate can signal better practice, but it can also point to barriers in making a complaint. Given Liverpool’s high deprivation, it is possible that some citizens lack time or confidence to start the process. The good scores on information access, however, imply that awareness of routes to complain is not a major issue.
Liverpool shows strong clinical quality inside hospital walls and service users generally feel supported. Communication appears clear, and formal complaints are few. The main weakness lies in the step between hospital and home. Extra social care staff, more home-care slots and closer links with housing services could help cut delay days. Because deprivation is deep and long-standing, demand is unlikely to ease soon. Any improvement plan should therefore focus on flow: timely assessment on the ward, quick equipment delivery, and early hand-over to community teams.
Quality has improved in several areas: safe discharges from good wards, higher satisfaction and better information. The city can build on these strong points. If leaders now target the discharge bottleneck, Liverpool could turn a mixed record into a consistently high one, even under the pressure of a growing, densely packed and deprived population.
✨ ✅ ❌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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For the year 2024 Liverpool spent about £255 million on adult social care before any income is taken off. This equals £50,634 for every 100,000 residents, around six per cent above the England average of £47,758. After client fees, NHS money and other income are removed, the net cost to the council was close to £226 million, or £44,902 per 100,000 people. The national figure is £40,472, so Liverpool’s net spending is roughly eleven per cent higher.
Residents paid about £29 million in client contributions, equal to £5,732 per 100,000 people. This is lower than the national rate of £7,286. In contrast, local NHS bodies put in an estimated £73 million, or £14,508 per 100,000 people, almost twice the England norm of £7,878.
Need is likely to be a main driver. Liverpool is one of the most deprived parts of England; its average deprivation decile is 2.8 compared with the national 5.9. Poor health tends to appear earlier in life in such areas, so more adults need help with daily living. At the same time, household incomes are usually lower, limiting what people can pay towards their own care. This fits with the low level of client contributions seen in the data.
The city is also very dense, with 4,346 residents per square kilometre, almost double the national figure. High density can raise demand for services linked to housing problems, substance misuse and rough sleeping. While travel costs between visits may be lower than in rural areas, the complexity of urban need can be greater, hence higher overall spending.
NHS contributions are strikingly high. This points to close joint working between the council and local health bodies, possibly through pooled budgets or integrated care teams. In areas with heavy ill-health, more care packages qualify for part funding from the NHS because needs are both social and medical. Without this support, the council’s net bill would be significantly larger.
Liverpool’s population has grown from 483,000 in 2020 to almost 504,000 in 2023. Each extra 1,000 residents adds demand for assessment, home care, equipment and day services. If per-capita spending stays flat, total costs will still rise simply because there are more people to serve.
Spending is already higher than average, yet local need indicators suggest it could be justified or even necessary. Low client income and strong NHS input mean the council carries a smaller share of the cost than gross figures imply, but this balance may not be secure if national rules on NHS funding change. The city therefore relies on continued partnership with health services and a funding formula that recognises deprivation.
Looking forward, Liverpool may need to focus on prevention and community support to curb future cost growth. Clear public information on budgets would also help residents understand how care is funded and why their own charges are set at current levels.
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