This page provides an overview of social care in Merton, 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 Merton. 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
Only 14.1 % of Merton residents describe themselves as disabled once age is taken into account, compared with 17.6 % across England. Merton is a young, relatively affluent and very urban borough. It therefore has a lower prevalence of long-term illness, and its dense public transport network may make everyday activities easier for some people with moderate impairments.
Despite the smaller disabled population, requests for support from working-age adults are high. In 2024 the council logged 2,850 requests, equal to 1,324 per 100,000 residents aged 18-64. The national rate is 1,143. Living costs in an outer-London borough, limited informal care in small flats and greater visibility of services may all encourage people to approach the council earlier.
Only 780 working-age adults went on to receive a long-term package, 362 per 100,000, well below the England figure of 533. This gap between high demand and low supply hints at strict eligibility, pressure on budgets or a reliance on short-term or informal solutions. The conversion rate from request to service (27 %) is much lower than the national average of roughly 47 %.
Where services are arranged, Merton leans slightly towards institutional care:
Nursing care stands at 16.3 per 100,000, just above the England average of 13.8. Residential placements are slightly lower (53.4 versus 60.6). Community-based support is markedly lower: direct payments only 67.4 versus 122.2 nationally, part direct payment 30.2 versus 47.9, and council-managed personal budgets 192.8 versus 266.7. These figures suggest obstacles to arranging flexible, home-based help, whether because of limited accessible housing, workforce shortages, or people’s difficulty in managing a direct payment in a high-cost labour market.
Small but telling 2025 data on advocacy shows that requests for help with funding disputes (9.8 per 100,000) are almost double the national norm (5.7), and information-seeking requests are also higher. Residents appear to struggle with charging rules and eligibility, reinforcing the impression of a tight local threshold.
Merton’s population has stayed stable at about 215,000, yet its density (5,722 people per km²) is over twice the England average. Deprivation is relatively low (mean decile 6.9), so fewer people qualify on financial grounds. However, urban living can mask isolation and mental ill-health, driving demand among working-age adults even in a prosperous area.
High demand alongside low service receipt points to potential unmet need. Improving the first contact service, clarifying charging and widening access to community-based options could narrow the gap. Given the borough’s compact geography, expanding direct payments and personal assistants may be feasible if brokerage and payroll support are strengthened. Finally, monitoring the conversion rate from requests to packages should become a routine performance measure to ensure disabled residents receive timely, appropriate 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
The share of residents aged 65 years and over is rising in Merton, moving from 12.3 per cent in 2019 to 13.1 per cent in 2023. The national share has stayed near 18.7 per cent, so the borough still has a smaller older population than most of England. Merton is very dense, with 5,722 usual residents per square kilometre compared with 2,469 nationally, and it has below-average deprivation. These factors usually go with younger, working-age communities, and this is reflected in the figures.
In 2024 the council logged 3,785 requests for long-term care from people aged 65 plus. This equals 1,759 requests per 100,000 older residents, well below the England rate of 2,438. A lower rate is expected when the older population itself is smaller, yet the gap is wide enough to raise two possible readings. First, healthier and better-resourced older people may be coping for longer without formal help. Second, some need could be hidden if families, volunteers or private agencies are filling the space before residents approach the council.
At the same time 1,435 older people were receiving council-funded long-term support in 2024. This is 667 per 100,000, against a national figure of 1,003. Service mix gives more detail. Nursing home use in Merton, 118 per 100,000, matches the national pattern (122), but residential home use is very low at 79 per 100,000 compared with 250 in England. Community-based personal budgets, at 390 per 100,000, also sit below the norm of 508. High property costs limit the supply of local care-home beds, while good transport and compact geography make it easier to deliver care at home. This may explain the lean towards nursing placements for people with the highest needs, and the lighter touch elsewhere.
The 2025 data on older residents asking for help shows mixed signals. Requests linked to assessments and funding disputes are lower than average, suggesting processes may be clear. Queries about charging and general information are higher, pointing to concern over the cost of care. The raw numbers are small – the highest count is 21 – yet they hint that residents are cost-aware and pro-active in seeking guidance.
Merton’s ageing trend is gentle but steady. Even if the proportion of older people stays below the national level, absolute numbers will grow because the total population is stable. Demand for support is therefore likely to rise, especially if informal care becomes harder to sustain. Lower residential-care use places ongoing weight on community services, so investment in home care, reablement and voluntary networks will be vital. Clear financial information should remain a priority, given the interest in charging. Finally, the borough’s relative affluence and urban layout provide opportunities for preventative work, such as accessible leisure, digital inclusion and age-friendly transport, to help residents stay independent for longer.
✨ ✅ ❌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 Merton had about 6,451 unpaid carers for every 100,000 residents. When this rate is applied to the mid-year population of 215,426 it suggests roughly 14,000 people give unpaid care. The England rate is higher, at 8,204 carers per 100,000. A smaller share of residents therefore report caring roles in Merton than in many parts of the country. Merton is younger, more urban and a little less deprived than the national average. These factors may lower the need for family care, but they can also hide carers who do not see themselves as such. Identifying “hidden carers” may still be a local challenge.
Only 25.9 % of Merton carers said they have as much social contact as they would like, compared with 29.3 % across England. Living in a dense urban area does not always protect people from isolation; busy streets do not guarantee close networks. Carers often juggle work, family and care duties, which can limit time for friends or community groups. The lower score hints at unmet emotional support needs, even though the borough is relatively affluent.
Sixty-five per cent of carers feel it is easy to find information about services, comfortably above the national figure of 59.3 %. This suggests the council and voluntary sector have effective sign-posting, websites or helplines. Good information alone, however, does not remove practical or financial barriers to taking up support.
Direct payments to carers stand at about 135 per 100,000 people, below the England rate of 150. Provision limited to information or advice is also lower than average, at 274 per 100,000 against 339 nationally. The most striking gap is in respite or other aid delivered to the cared-for person: 26 per 100,000 in Merton, well under the national rate of 70. At the same time the borough records more carers receiving no direct support (163 per 100,000 versus 130). Taken together, the data point to a support offer that is lighter-touch and less likely to include a break from caring duties.
Merton’s healthier, less deprived and highly urban population may create lower formal demand, yet it can also mask pressure on individual families. Housing costs and lack of spare rooms in dense areas can make overnight respite hard to arrange. Cultural factors in a diverse borough may further shape willingness to seek formal help. The higher score on information suggests awareness campaigns work, but service capacity or eligibility rules may still limit take-up.
Improving social contact should be a priority. Community hubs, peer groups and flexible day services could offer relief without large capital spend. Expanding short-break and respite options would address the area where Merton lags most. Finally, continued outreach to “hidden” carers could raise identification rates and ensure people know about the help that is already available.
✨ ✅ ❌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
Merton has 46 community-based adult social care services and 36 residential homes. The local population is about 215,000. This means there are roughly 21 community services and 17 residential homes for every 100,000 people.
The national picture looks different. Across England the average council area holds 64 community services and 91 residential homes, but the average population is much larger (about 377,000). When set against population size, England offers around 17 community services and 24 residential homes per 100,000 people. In other words, Merton gives residents better access to community support than most areas, yet offers fewer care-home beds. The strong community offer may suit an urban borough where travel distances are short and many older people prefer to stay at home. The low residential supply, however, could limit choice for people with high care needs, especially if demand rises.
Only 8.5 % of local services are rated “needs improvement” or “inadequate”, one-half of the England rate of 16.8 %. This suggests that the smaller set of providers is, on the whole, working well. Good inspection results may be linked to the borough’s lower deprivation: average deprivation falls in decile 7, compared with decile 6 nationally. Less deprivation can mean more self-funding users, steadier income for providers and more scope to invest in quality.
Workforce stability is mixed. Turnover in 2023/24 stands at 19 %, almost identical to the England figure. Yet the vacancy rate is 11 %, above the national 8.4 %. A tight housing market and high living costs in South London may make it hard to fill posts even when people stay longer once hired.
Managers still describe staffing as a concern. Fifty-six percent say retaining staff is “more” or “much more” challenging; nationally the figure is 68 %. Sixty-eight percent find recruiting staff harder; the England share is 80 %. So providers struggle, but a little less than elsewhere. Easy transport links and a young, dense labour pool might soften the problem, though competition with better-paid sectors remains fierce.
The high community-service rate gives older people options near their homes and helps keep care closer to family support. Good quality scores show that staffing strain has not yet hurt service standards. Even so, the elevated vacancy rate hints at pressure that could grow. If posts stay empty, the borough risks longer waiting times or higher use of costly agency staff, both of which can erode quality.
For now, residents benefit from a wide range of community care and above-average quality. The council may wish to:
• Monitor residential capacity so that people with complex needs are not forced to move out-of-area.
• Support providers in recruiting locally, for example through links with colleges or travel-cost help, to bring the vacancy rate down.
• Keep encouraging quality improvement, as good ratings appear to draw and keep staff.
• Use the borough’s low deprivation and dense transport network to pilot home-care tech or neighbourhood care teams, reducing pressure on limited residential beds.
Keeping an eye on workforce gaps while preserving the strong community offer will be key to meeting future demand as the population ages.
✨ ✅ ❌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.
Merton moves almost all patients from local hospital trusts that the Care Quality Commission says are “acceptable”. At 99.3 per cent, this share is far above the England mean of 89 per cent. The figure suggests that the council works well with good-quality acute providers. Yet the flow out of hospital is not smooth. Sixteen per cent of discharges are delayed, compared with a national level of 12.3 per cent, and the average delay per person is 0.95 days against 0.7 days for England. In a borough of 215,000 people packed into only 35 km², hospital beds turn over fast, and even a short pause can block new admissions. Higher density may add extra strain on rehabilitation, re-ablement, and community nursing teams, making it harder to secure the home support needed for a timely discharge.
Only 58.9 per cent of survey respondents say they are satisfied with the care and support they receive, well below the England score of 64.7 per cent. More striking, just 56.7 per cent feel it is easy to find information about services, against 68.2 per cent nationally. These results point to a communication gap rather than solely to service quality. Merton is less deprived than the average area (mean Index of Multiple Deprivation decile 6.9 versus 5.9 for England). Residents may therefore expect quick, tailored answers and feel frustration when navigation is complex. The low rural share (0 per cent) means that digital channels could, in theory, reach most households, yet the data show that current sign-posting is not meeting the mark.
The Local Government and Social Care Ombudsman received 2.79 cases per 100,000 residents from Merton in 2024, compared with 4.45 nationally; decisions issued were 2.32 per 100,000 against 4.12. Fewer complaints may mean good early resolution of problems, but it can also signal that people do not know how to escalate concerns, which fits the wider picture of poor information. The absence of a published overall CQC local authority rating leaves an evidence gap on formal quality assurance.
Population numbers have held steady over the past five years, slipping by only one per cent, so rising demand is unlikely to be driven by growth alone. Instead, high density (5,722 residents per km², more than twice the England average) can lead to greater service turnover and pressure on domiciliary care staff who must travel through urban congestion. Deprivation is mixed; the standard deviation of the decile score (2.43) is slightly above the national norm, hinting at pockets of need within an otherwise better-off borough. This internal diversity may require more flexible commissioning to tackle both high and low need neighbourhoods.
Merton shows strength in the use of well-rated hospital trusts, but delayed transfers and low public satisfaction underline the need for better coordination after discharge and clearer guidance for service users. Targeted actions could include expanding re-ablement teams, investing in real-time discharge planning, and creating a single online and telephone advice hub. Addressing information gaps may also lift reported satisfaction and ensure that complaints reflect true service performance rather than lack of access to redress. Continued monitoring, once the CQC publishes its new local authority scores, will reveal whether these steps turn early promise into sustained quality gains.
✨ ✅ ❌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 the borough spent about £81.7 million on social care. This figure comes from a gross spend of £37,972 for every 100,000 residents and a mid-2023 population of 215,219. After taking client and NHS income into account, net spending fell to roughly £71.9 million, or £33,396 per 100,000 people.
Merton’s gross spend per head is 20 per cent below the national mean of £47,758 per 100,000. Net spend is 17 per cent below the England figure of £40,472. The gap is almost the same for money coming in. Client contributions are 37 per cent lower, and NHS contributions are 18 per cent lower than the respective national averages.
The borough is relatively affluent. Its average deprivation score sits in decile 7, above the England midpoint of decile 6. A wealthier population often needs less publicly funded care because more people can self-fund or because levels of disability linked to poverty are lower. The area is also very compact, with 5,722 residents per square kilometre—more than twice the national density. High density can reduce travel time for home-care staff and allow services to share buildings, holding costs down.
Merton’s population is smaller and, according to mid-year profiles, slightly younger than average. Fewer older residents mean fewer high-cost packages for frailty, residential care, or dementia. This too can push per-head spending below the England mean.
Client contributions total about £9.9 million, well below the national norm even after adjusting for population. This may point to fewer service users or to care plans that are less intensive. NHS contributions stand at roughly £13.9 million. The lower figure hints at fewer joint packages of care, or at local commissioning choices that keep health and social care funding streams more separate than in many places.
Lower spending is not automatically a problem; it can reflect lower need or better efficiency. Yet it can also hide unmet need. Merton’s wealth masks small pockets of deprivation, and its standard deviation on deprivation (2.43) is close to the England figure, so inequalities still exist. If people in less well-off wards cannot access help, demand may show later in expensive hospital stays or delayed discharges.
No data on recent budget cuts were available, but national pressures continue. If future grant levels tighten, Merton may find it harder to sustain preventive work that keeps needs low. The borough also draws less money from the NHS than many councils. Stronger integration could bring extra funds for rehabilitation, community nursing, and home adaptations. Finally, if population ageing speeds up, today’s lean budget may fail to cover rising care hours, forcing difficult choices or higher client charges.
Merton should keep tracking demand, especially in wards with higher deprivation scores. A fresh needs assessment, carried out with health partners, would show whether current low spending truly meets demand or whether silent gaps exist. Using its urban density, the council can continue to seek economies of scale, but it must balance this with fair access in every neighbourhood. Close monitoring now can prevent costlier interventions later and protect residents’ independence for longer.
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