This page provides an overview of social care in Medway Towns, 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 Medway Towns. 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 disability rate in Medway is 18.4 %, a little above the England average of 17.6 %. This fits with the area’s higher deprivation score (mean decile 4.9 against 5.9 nationally). Poor health and disability often track economic hardship, so the excess is plausible.
In 2024, 3 595 working-age adults asked the council for care or support. When set against the 2023 mid-year population (286 800), this is about 1 254 requests per 100 000 residents, slightly higher than the national mean of 1 143. A larger flow of requests may reflect the higher disability rate, but it can also signal that informal support networks are weaker in a mainly urban, more deprived setting.
The same year 1 465 working-age adults were being supported. This is roughly 511 per 100 000 people, just under the England mean of 533. Medway therefore converts a smaller share of requests into ongoing packages than the typical council (about 41 % of requests, compared with 47 % if national per-capita rates applied). The gap hints at possible unmet need or longer waiting times between assessment and service start.
Medway places more people in residential settings (73 per 100 000 versus 61 nationally), yet slightly fewer in nursing homes (12 versus 14). Community support shows a mixed picture. Direct-payment only packages are lower than average (115 versus 122), and part direct payment is markedly lower (33 versus 48). By contrast, council-managed personal budgets in the community are a little higher (277 versus 267). The pattern suggests the authority relies more on services it arranges itself and less on fully personalised, cash-held options. This may stem from market limits or a wish to shield users from financial risk, but it can also restrict flexibility for disabled residents who want to organise their own care.
Small 2025 samples show that requests for advice on assessments, care plans, charging and direct payments all sit below national per-capita levels, while enquiries about legal issues and complaints are slightly higher (1.05 versus 0.68 per 100 000). Lower information-seeking could mean residents are not aware of their rights; the higher legal query rate hints that some who do engage feel dissatisfied with decisions.
Medway’s population is modest (about 287 000) but dense for an area outside major conurbations (1 444 people/km²). Only one tenth of residents live in rural zones. Urban settings often raise demand for statutory services because families are more mobile and informal care can fragment.
The council faces a double pressure: a disability rate above average and higher demand for assessments, yet a slightly below-average rate of active support. Extra effort may be needed to shorten the journey from first contact to service delivery and to expand community-based options that residents can manage themselves. Improving advice services could prevent routine queries from escalating into legal challenges. Targeted investment in preventative and personalised support is likely to help close the current gap between expressed need and care received.
✨ ✅ ❌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
Between 2019 and 2023 the share of residents aged 65 plus in Medway rose from 16.3 per cent to 16.6 per cent. This rise is small, yet because the whole population also grew, the number of older people increased by about 2,000, from roughly 45,500 to 47,500. The local rate remains lower than the national figure, which stayed around 18.5-18.9 per cent. Medway therefore keeps a younger age structure than most of England, but ageing is still steady and slightly faster than overall growth.
Medway is largely urban, with only 10 per cent of land classed as rural and a density of 1,444 people per km². It is also more deprived than England on average, scoring 4.9 on the deprivation decile scale compared with 5.9 nationally, and it shows wide variation between neighbourhoods. A younger working population, attracted by relatively affordable housing and good links to London, helps keep the proportion of older people down. Even so, the gradual rise in the older group reflects longer life expectancy and some inward migration of retirees.
Service data for 2025 give clues about how older residents engage with adult social care. Requests for help with charging (15 cases, 5.23 per 100,000) sit close to the national rate, showing that many households still need advice on paying for care. Requests linked to assessments, care plans and carers are all lower than England, each at around half the national level. In contrast, legal issues and complaints are higher, at 1.05 per 100,000 compared with 0.68 nationally.
The low use of assessment and planning support may mean that needs are not being identified early, possibly because services are stretched or families rely on informal care. This fits with a deprived, working-age community that may delay calling for formal help. The higher rate of complaints suggests that when people do enter the system they sometimes meet barriers or confusion, particularly around charging rules.
Although Medway has fewer older people per head than England, the absolute number is rising and the pace of growth is faster than the overall population. Coupled with pockets of high deprivation, this points to a future increase in complex needs. The current pattern of low uptake of assessments hints at hidden demand that could surface later as urgent cases, placing sudden pressure on hospitals and care homes.
Targeted outreach in the most deprived neighbourhoods, clear information on charging, and stronger advocacy could help older residents enter the system earlier and reduce complaints. Planning should also allow for the expected rise of about 500 more older residents each year, ensuring that housing, transport and community services adapt before needs become acute.
Medway remains a relatively young, urban area, yet its older population is growing both in size and complexity. Proactive, equitable services now will prevent higher costs and dissatisfaction later.
✨ ✅ ❌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
Only 28 percent of unpaid carers in Medway Towns say they have as much social contact as they would like. The England average is 29.3 percent. The gap is small, but it matters. Medway Towns is a largely urban area with 1,444 people per square kilometre, yet many carers still feel apart from their community. Higher deprivation (mean decile 4.9, below the national 5.9) may limit money for travel, leisure or digital access, making it harder to meet friends or join support groups. More effort to run low-cost, local activities could lift this score.
Just 55.6 percent of carers feel it is easy to find information about services, compared with 59.3 percent across England. When carers cannot find clear advice, they may lose trust or miss help they are entitled to. In an area where population has risen to about 287,000, small shortfalls in signposting can leave many people unsupported. Simple language, single contact points and active outreach in poorer neighbourhoods could narrow this gap.
For several types of direct support—such as direct payments, managed personal budgets or council-commissioned breaks—the local data are recorded as “not available.” One figure is reported: 0.35 packages per 100,000 people in 2025 for a category labelled “Carers UT1,” against a national rate of 0.75. Even allowing for Medway’s smaller population, the number is low. This may mean local services are under-used, are hard to access, or are not being captured in returns. Any of these would fit with carers’ difficulty in finding information.
Low social contact, limited information and very few recorded support packages point to one story: unpaid carers in Medway Towns are doing much of the work on their own. Deprivation can add money worries, while a dense but fractured urban setting can make neighbourhood networks weak. If carers become isolated, the cared-for person may also suffer, leading to more pressure on GP surgeries, hospitals and emergency care.
The council and local NHS need to raise the profile of carers’ services. Better data collection should show the true scale of help already given and reveal gaps. Outreach should focus on deprived wards, where need is usually higher. Community centres, libraries and GP practices can host drop-in advice points. Small grants or travel vouchers could encourage carers to join peer groups, widening social contact. Finally, clear online and printed guides—written in plain English and shared through schools, pharmacies and faith groups—can make it easier for carers to find what they need.
Medway Towns has a growing and relatively young population, so the demand for unpaid care may keep rising as parents of children with disabilities and adults supporting older relatives come forward. Acting now to improve contact, information and formal support will help carers stay healthy and continue their vital role.
✨ ✅ ❌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
Almost one in three care providers inspected in 2024 were rated “requires improvement” or “inadequate” (32.5 %). Nationally the share is closer to one in six (16.8 %). This gap suggests that many older and disabled people in Medway are not receiving the standard of help they should expect. Lower quality can stem from heavy workloads, lack of experienced staff, and the need to support residents with complex needs linked to higher deprivation. Medway’s average deprivation decile is 4.9, below the England mean of 5.9, and the spread of deprivation is wider than average. Providers therefore face a mix of affluent and very deprived neighbourhoods, making it hard to run a uniform, high-quality service.
Staff turnover in 2023/24 was 26.7 %, almost identical to the England figure. Although this is not above the national level, it still means that more than one quarter of the workforce changes each year, disrupting continuity of care and increasing training costs. Three quarters of providers (72.4 %) say that keeping staff has become more challenging, a slightly higher share than in England (68.1 %). Recruiting new staff is even harder: 82.9 % report greater difficulty, compared with 79.8 % nationally. Interestingly, the recorded vacancy rate is 6.8 %, below the national 8.4 %. Taken together, the numbers hint that posts are eventually filled, yet often by new or inexperienced workers who then leave. Frequent handovers can lower inspection ratings, even when headline vacancy figures look healthy.
Medway’s population has grown steadily from 279,900 in 2021 to 286,800 in 2023, an increase of about 2.5 %. The area is largely urban; only 10 % of residents live in rural wards, far below the national 34 %. Density is 1,444 people per km², lower than the England mean of 2,468, but services are concentrated in a tight urban corridor. A rising, mostly town-based population puts day-to-day demand close to care homes and home-care agencies, so providers cannot rely on rural scarcity to explain workforce gaps. Instead, competition with retail, logistics, and the NHS for local workers is likely driving the high churn.
The double-sized share of poorly rated providers points to an urgent need for support. Stable staffing is the first priority: measures such as career-long training, mentoring, and links with local colleges could lift retention while making recruitment easier. Given the higher deprivation, extra funding for complex care and clear pathways into social work or nursing would help raise quality. Population growth, though moderate, underlines the value of planning now—expanding home-care capacity and supporting small providers before demand outpaces supply. Finally, regular feedback between inspectors, commissioners, and providers could target common shortcomings and reduce the current 32.5 % shortfall in acceptable standards.
✨ ✅ ❌Historically, hospital delays have been due in large part, to the inability to discharge patients into social care. We no longer have DTOC data, but we can still look at the number of hospital delays and the number of facilities requiring improvement.
CQC, as the regulator of health and social care services in England, is beginning to rate Local Authorities on their social care provision. Understanding the CQC rating of a local authority should be used as the most official evaluation of service care provision. For example, a low rating may indicate a need for improved service delivery, while a high rating may suggest that existing services are effective.
Hospital delays can have a significant impact on patient care and outcomes, and are in large part the result of not having invested sufficiently in social care. Understanding the number of hospital delays in a local authority can be a sympthom of a poorly working social care sector. For example, a high number of hospital delays may indicate a need for improved discharge planning and coordination, not enough places to discharge people to, lack of sufficient staff to assess patients, or a lack of care providers.
Discharge-Ready-Date-monthly-data-webfile-November-2024, Tab UTLA Acceptable
This metric illustrates how long patients are delayed in hospital before being discharged. Higher average delays mean that patients are spending more time in hospital than necessary, which can lead to increased costs, reduced bed availability, and poorer patient outcomes. This also means that the beds are not available for people that might desperately need them for life-saving procedures.
Discharge-Ready-Date-monthly-data-webfile-November-2024, Tab UTLA Acceptable
Delayed Transfer of Care (DTOC) refers to the time between a patient being declared medically fit for discharge and actually leaving the hospital. Understanding the number of DTOCs in a local authority can help identify precisely where the social care system is failing.
Unfortunately, this dataset is no longer being generated.
Reablement is a short-term service that helps people regain independence and confidence after a period of illness or injury. Understanding the number of people receiving reablement services can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people receiving reablement services may indicate a need for more support with daily living activities, while a low number of people receiving reablement services may suggest that existing services are effective.
Coming soon!
Service user satisfaction is a key indicator of the quality of social care services. Understanding service user satisfaction can help local authorities identify areas where additional support and resources may be needed. For example, a low level of service user satisfaction may indicate a need for improved service delivery, while a high level of service user satisfaction may suggest that existing services are effective.
It is important to note that the people surveyed are already receiving service care. Notably absent are all the people that are not yet lucky enough to be receiving care.
Personal Social Services Adult Social Care Survey, question 1
Access to information is crucial for people using social care services to navigate the system effectively. Understanding how easy it is for people to get information can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people finding it difficult to get information may indicate a need for improved communication and support services, while a low number of people finding it difficult to get information may suggest that existing services are effective.
Would you like social care information? Try our Chatbot!
Personal Social Services Adult Social Care Survey, question 13
An ombudsman is a person who has been appointed to look into complaints about companies and organisations. The number of cases received and decided by the Ombudsman is important because it provides insight into the volume of complaints about a local authority’s social care services and how effectively these complaints are being addressed. The number of cases received indicates the level of dissatisfaction or systemic issues within a council’s care provision, while the number of cases decided shows how efficiently the Ombudsman is processing and resolving complaints. A large gap between the two may suggest delays in complaint handling, leaving individuals waiting.
It is important to note that contacting the Ombudsman is widely considered a last resort, often discouraged, and sometimes penalised.
The Care Quality Commission has given Medway a score of 59 for 2024/25. England as a whole stands at 64.7. The rating “Requires Improvement” tells us that most core standards are not yet met. This gap of almost six points is important, yet not huge. It suggests that many services work, but consistency is weak. Extra support may be needed in areas where risks are highest, such as timely hospital discharge and clear public information.
Almost all Medway patients (99.7 %) leave hospital from trusts that meet the national quality bar. This is better than the England rate of 89 %. Good clinical practice is therefore available at the point of discharge. However, 20.9 % of these discharges are delayed, against a national figure of 12.3 %. The average delay is 1.36 days, double the England mean of 0.7 days. These figures point to bottlenecks after the clinical team has agreed the patient can go home. Likely causes are shortages of home-care staff, limited step-down beds and slow equipment supply. Medway’s urban character (only 10 % rural) means that most people live close to hospital, so travel time is not the main issue. The area’s higher deprivation rating (mean decile 4.9 vs 5.9) hints that many households need extra social care or housing support before a safe discharge can take place, stretching community teams.
Only 61.8 % of service users say they are satisfied with their care and support; the England figure is 64.7 %. A separate national survey records 57 % of Medway respondents as dissatisfied, again pointing to mixed experiences. Information is another weak spot: 64 % find it easy to learn about services, compared with 68.2 % nationally. In a population of 287,000 people, this means roughly 103,000 residents may struggle to locate the right help. Unclear pathways feed back into the discharge problem: if families do not know how to arrange care promptly, beds stay blocked.
Medway’s population has grown by 2.5 % since 2019, a little faster than many similar councils. Density is 1,444 residents per square kilometre—dense enough to create demand pressure, yet not dense enough to guarantee the economies of scale seen in large cities. Deprivation is deeper and more uneven than the England norm. Such factors often correlate with higher need for social care, complex co-morbidities and lower ability to self-fund services. All place extra strain on local budgets and staffing.
No data are shown for Ombudsman complaints per 100,000 people. The England mean is 4.45. Without a local figure we cannot judge whether Medway’s lower satisfaction translates into formal complaints. Collecting and publishing this metric would close an information gap and help managers track progress.
The main message is that quality in Medway is uneven rather than poor overall. Clinical care looks sound, but the hand-over to community services is slow, and the public still finds the system hard to navigate. Given the modest but steady rise in population and the higher levels of deprivation, delays and dissatisfaction are unlikely to fall without extra action. Priorities should include expanding re-ablement and home-care capacity, improving real-time information for families, and targeting neighbourhoods where deprivation is deepest. If these points are addressed, the CQC score could move from “Requires Improvement” towards “Good” in the next cycle.
✨ ✅ ❌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 2024 the average council in England plans to spend about £47,758 for every 100,000 residents on gross adult social care. When the same calculation is done for net spend, the figure is £40,472. If Medway followed these national patterns its gross bill would be roughly £136.8 million and its net bill about £116.2 million, because the area now has around 286,800 people.
Client contributions and NHS transfers at national level add up to almost £15,200 per 100,000 people. Scaled to Medway, this would be close to £43 million of local income that can offset costs. In short, a council of Medway’s size would normally handle a total adult social care budget of about £160 million after all funding streams are included.
No spending data for Medway have been published for 2024. This absence matters. Social care is the second-largest item in most council budgets, so any hidden underspend or overspend will affect other public services. The note that “the government appears to know how much money is required for social care, and yet they are not making that known” underlines this worry. Without open figures it is hard for partners, care providers and residents to judge whether present resources match local need.
Several indicators point to above-average demand. The mean deprivation decile is 4.9, lower than the England mean of 5.9, showing that Medway is more deprived. Deprivation is linked with poorer health and earlier onset of disability, so adults may need care sooner and for longer. Density is high at 1,444 people per square kilometre and only one in ten residents live in a rural area. Urban settings tend to concentrate people who have complex social care requirements, for example those who are homeless or who have substance-misuse problems.
The population has also grown steadily, rising by about 7,000 in the last four years. Even if age structure stayed the same, this growth alone would add cost. If the older population is expanding faster than the total, pressure will be higher still.
If local spending is below the calculated £136–160 million range, services may be rationed. Signs can include longer waits for assessments, tighter eligibility rules and higher unmet need. Providers may struggle to recruit, further cutting capacity. Because NHS contributions fund reablement and intermediate care, any shortfall could lead to delayed hospital discharge, adding cost back into the health service.
A budget in line with or above the national benchmark would let Medway invest in home-based support, digital monitoring and community networks that delay or prevent admission to residential care. Given the relatively compact urban geography, outreach teams can reach many clients quickly, making prevention more cost-effective than in rural districts.
Medway’s social and demographic profile suggests higher than average demand for adult social care. Transparent, adequate funding is therefore essential. Until local spending figures are released, planners and residents cannot be sure that the resources available match the real level of need.
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