This page provides an overview of social care in Middlesbrough, 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.
IMD 2019 for the Lower Tier Local Authorities: Middlesbrough
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.
IMD 2019 for the Lower Tier Local Authorities: Middlesbrough
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 Middlesbrough. 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 Middlesbrough is 21.9 per cent, well above the England figure of 17.6 per cent. This difference is unlikely to be a counting error; it reflects local living conditions. Middlesbrough is one of the most deprived authorities in the country, with an average Index of Multiple Deprivation decile of 3.4 compared with the national 5.9. Deprivation is linked to poorer health, fewer job opportunities and riskier working environments, all of which raise the likelihood of long-term illness or impairment. Population density is also high, at 2 671 residents per square kilometre, which can limit access to green space and increase exposure to pollution. These factors help explain why a larger share of residents report a disability.
In 2024 the council recorded 2 015 requests for formal care from adults aged 18–64. That is 1 320 requests per 100 000 residents, around 15 per cent higher than the England average of 1 143. Middlesbrough’s population is growing, from 142 000 in 2019 to almost 153 000 in 2023, yet demand remains ahead of the national curve. A high disability rate among working-age people means that the council is dealing with a younger mix of care users, which often requires specialist employment, training and mental-health support rather than only traditional home care.
The gap between requests and services delivered is modest: 1 365 working-age adults receive support, a rate of 894 per 100 000 population. This is 1.7 times the England benchmark of 533. The breakdown sheds more light on the type of help required.
Nursing placements stand at 26 per 100 000, almost double the national norm, signalling a group with complex clinical needs. Residential placements reach 154 per 100 000, again more than twice the England average, which may point to limited accessible housing in the community. Community-based packages are also common. Direct-payment-only users (177 per 100 000) and part direct-payment users (131 per 100 000) both sit far above national rates, suggesting that the council has embraced personalisation. While this empowers users, it also requires strong brokerage and safeguarding arrangements to ensure quality.
In 2025 the council logged only two formal requests in each of the four advice and safeguarding categories measured. Scaled to population, the rate is 1.31 per 100 000, almost identical to national averages. These tiny numbers should be interpreted with caution; they may reflect recording practice more than true demand. Nevertheless, they hint that most contact is filtered earlier in the customer journey, or that residents are unsure how to seek formal reviews.
A young but highly disabled population, coupled with deep deprivation, means pressure on adult social care budgets will stay high. High use of direct payments shows that local teams already work in a person-centred way, yet the above-average use of nursing and residential care indicates gaps in supported housing and community health services. Investment in accessible housing, early vocational rehabilitation and integrated health-care teams could curb future demand for institutional care. Because disability is linked to socio-economic factors, any wider plan to improve employment, air quality and neighbourhood safety is likely to reduce both the prevalence of disability and the volume of care requests over time.
✨ ✅ ❌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
Middlesbrough has a young age structure compared with England. Between 2019 and 2023 the share of residents who are older people stayed close to 16.7 per cent, while the national average hovered around 18.6 per cent. During the same period the total population rose from 142,000 to 153,000. As a result, the absolute number of older residents has grown, yet they still make up a smaller slice of the whole community than is normal across the country. This difference is important when judging service use, because need is linked both to head-count and to the mix of ages.
In 2024 there were 2,795 requests for social-care help from people aged 65 plus. That works out at 1,831 requests for every 100,000 residents, well below the England figure of 2,438. Two main explanations are possible. First, fewer older people live in the town, so demand is naturally lower. Second, people may be asking for help less often than in other places, perhaps because they do not know the system, choose to rely on family, or face barriers linked to deprivation. Middlesbrough sits in the third most deprived decile on average, and high deprivation can limit awareness of entitlements.
Although the request rate is low, the number of older people who do receive council-funded care is high. In 2024, 2,205 people were supported, equal to 1,444 per 100,000 residents. The national rate is only 1,003. The gap suggests that once Middlesbrough residents make contact, they are more likely to meet the eligibility threshold or to move quickly on to a service. One reason may be that poorer health, linked to deprivation and dense urban living, means needs are more severe when they surface.
The pattern of provision is distinctive. Nursing-home use is low at 88 per 100,000, compared with 122 nationally, hinting that the town either has limited nursing supply or tries to delay very high-cost placements. Residential-home use, by contrast, is more than double the England rate (563 versus 250). Community services are also taken up more often than average, especially council-managed personal budgets (701 versus 508). This mix shows a strong reliance on traditional residential settings combined with a healthy use of home-based support. The skew toward residential care could reflect local market history, lower property costs that make homes viable, or family circumstances that reduce the ability to care at home.
Small numbers sought help with care planning, charging, information, or safeguarding in 2025. At about 1.3 cases per 100,000, the rates are in line with or below national levels. While the figures are tiny, they add to the picture of limited early contact with the system.
Middlesbrough faces an unusual combination: a fairly young overall population, high deprivation, and a heavy draw on formal services once older people enter the system. Keeping demand sustainable may mean investing in prevention and in advice services that reach people earlier. The high use of residential beds raises cost pressures and suggests a need to expand community-based alternatives, especially nursing-at-home options, so that frailer residents can stay outside institutional settings for longer. Planning must also account for population growth; even if the proportion of older people remains lower than average, their numbers are rising each year and will add to the borough’s budget challenge.
✨ ✅ ❌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 around 12,500 Middlesbrough residents described themselves as unpaid carers. This works out at 8,708 carers for every 100,000 people, slightly above the England rate of 8,204. The town’s higher figure sits alongside persistent deprivation (mean Index of Multiple Deprivation decile 3.4 compared with the national 5.9) and a densely populated, largely urban setting. Poor health and disability need are usually more common in deprived places, so a larger share of the local population is likely to rely on family or friends for day-to-day help. The total population has also risen by roughly 10,500 since 2019; even if the per-capita rate stayed the same, simple growth would add several hundred new carers each year.
In 2024 one-third (33.7 %) of carers said they enjoyed as much social contact as they wished, better than the national result of 29.3 %. Although this is a positive gap, it still leaves two carers in three feeling lonely or cut off. Middlesbrough’s compact geography – 2,671 residents per square kilometre – may make it easier to keep in touch with friends and services, but high deprivation can limit spare time and money for social activities. The relatively good score therefore suggests that local voluntary groups and community hubs are helping, yet demand for wider befriending and short-break options remains clear.
About two-thirds (66.7 %) of carers felt it was easy to obtain information about support, ahead of the England average of 59.3 %. In part, this may reflect the council’s decision to concentrate assistance in a smaller number of accessible centres and to promote digital channels. Stronger sign-posting is important because carers with good knowledge of services are more likely to look after their own health and to keep caring roles sustainable.
Middlesbrough leans heavily towards direct, personalised help. Roughly 450 carers (295 per 100,000) receive a direct payment, almost double the national rate. A further 130 benefit from a local-authority managed personal budget (85 per 100,000, again above average). Around 210 carers obtain respite arranged for the cared-for person (138 per 100,000 versus 70 nationally).
Conversely, only about 235 carers (154 per 100,000) were recorded as receiving purely information or universal services, less than half the national rate, and the count logged as receiving no direct support at all is also below average (135 people, 88 per 100,000). These patterns suggest that assessments are translating into tangible, often cash-based packages rather than sign-posting alone. While this reduces the proportion left without help, the lower use of universal services could mean some carers miss out on light-touch, preventative offers that delay the need for higher-cost support.
Middlesbrough’s carers picture is broadly positive: identification of carers is strong, and most indicators of experience sit above the England benchmark. However, the town’s rising population and entrenched deprivation will continue to generate high caring demand. Maintaining adequate direct payments and respite will therefore stretch budgets unless more emphasis is placed on early, low-cost interventions such as peer networks or digital advice. At the same time, only one in three carers feels fully connected socially, underlining the need for community-based activities that fit limited income and time. Balancing personalised support with a wider, inclusive offer should help carers stay well and keep loved ones at home for longer.
✨ ✅ ❌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
Middlesbrough has twenty-two community-based adult social care services and forty-four residential services. The raw totals are below the England means of 63.8 and 91, yet the picture changes when population size is considered. With about 152,650 residents in 2023, the town holds roughly 14.4 community services and 28.8 residential services for every 100,000 people. Nationally the equivalent figures are about 16.9 and 24.1. In other words, residential provision is slightly richer per head than the average, while community provision sits a little below it. The balance hints at an offer that leans towards bed-based care, which suits some users but can limit choice for people who wish to stay at home.
Only 7.6 % of local services are rated “requires improvement” or “inadequate”, less than half the national rate of 16.8 %. This suggests that oversight, leadership and day-to-day practice are strong. High quality may also reflect the town’s compact geography; inspectors and commissioners can visit providers quickly, and managers often know each other, helping good practice spread.
Workforce stability is mixed. The turnover rate stands at 24.3 %, almost identical to the England figure, so staff do not leave more often than elsewhere. Vacancies are low at 3.7 % against the national 8.4 %, meaning posts are largely filled. Yet 70.5 % of services say that keeping staff has become more difficult and 82.5 % say the same about recruitment, both slightly above national sentiment. Providers may be covering gaps by overtime or agency work, holding vacancies down for now but feeling pressure for the future.
The town is densely populated, with 2,671 residents per square kilometre compared with 2,468 for England. High density usually makes home-care travel times shorter and tends to support community services, yet deprivation changes the picture. Middlesbrough’s average deprivation decile is 3.4, far below the national 5.9, and inequality is wider than average. Higher poverty is linked to earlier ill-health, so demand for support is likely to be high even while income to purchase extras is low. An urban setting with very little rural area (0.3 %) also means there is relatively little private domestic space for informal care, which can push demand towards formal services.
Good quality scores and low vacancy levels are clear strengths. However, a modest supply of community-based services risks limiting options for people who prefer to receive care at home, especially as the population has grown by about 7 % since 2019 and is likely to keep rising. Strong residential supply may absorb some pressure, but it is often more costly and less aligned with the national policy aim of supporting people to live independently for longer.
If recruitment becomes harder, maintaining current quality could prove challenging. Targeted training schemes, closer links with local colleges and flexible employment packages could help. Commissioners may also wish to encourage new community providers, perhaps through start-up grants or joint ventures, so care remains accessible, high quality and appropriately balanced between home and residential settings.
✨ ✅ ❌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.
Middlesbrough’s Care Quality Commission score is 62 for 2024/25. The England mean is 64.7. The rating “Requires Improvement” shows that, while many parts of the service work well, some key areas still fall short of national expectations.
Fast and safe discharge from hospital is a strong point. Almost 100 per cent of local people leave from an “acceptable” trust, well above the national figure of 89 per cent. Only 8.4 per cent of discharges are delayed, against 12.3 per cent for England. The average wait linked to each delay is 0.38 days, nearly half the national average of 0.7 days.
This success matters because Middlesbrough is a dense, urban borough with high deprivation. Quick discharge lowers the time people spend in expensive hospital beds and frees places for others. It also reduces the risk that frail patients lose strength while waiting to go home or to residential care.
Sixty-eight point eight per cent of survey respondents say they are satisfied with the care and support they receive, above the England mean of 64.7 per cent. A separate NatCen survey finds that 57 per cent are dissatisfied with social care. The two sources use different questions, yet both underline that many residents still feel worried about the quality or the cost of support. Helping citizens understand what the council can and cannot provide may narrow this gap.
Finding information is a little easier in Middlesbrough than elsewhere: 73 per cent of service users report that they can locate advice when needed, against 68.2 per cent nationally. This result may stem from the compact size of the borough and its heavy use of digital channels, but it also hints at responsive front-line teams.
The Local Government and Social Care Ombudsman received 1.31 complaints per 100,000 residents in 2024, compared with 4.45 for England. Only 0.66 per 100,000 reached a decision stage, far below the national rate of 4.12. The low level could point to better early resolution. It could also mean that some citizens do not know how to escalate concerns, especially in poorer neighbourhoods. The council should check that complaint pathways are clear for all groups.
The population has grown by more than 10,000 since 2019 and now sits at 152,650. Density is 2,671 people per square kilometre, higher than the England mean of 2,469. Middlesbrough is also one of the most deprived areas in the country, with an average Index of Multiple Deprivation decile of 3.4 compared with 5.9 nationally. High need, rapid growth and tight space create extra demand on home care, reablement and housing-related support.
Good discharge performance and low complaint rates suggest front-line practice is strong. Higher satisfaction and better access to information show that recent quality initiatives are reaching residents. Yet the overall CQC judgment of “Requires Improvement” signals gaps in workforce capacity, strategic planning, or safeguarding that the point-in-time metrics do not expose. Rising population and entrenched deprivation will increase pressure on budgets, so the council must keep streamlining hospital pathways while investing in community teams, prevention and clear communication. If progress continues at the current pace, Middlesbrough is well placed to reach at least “Good” at the next CQC review.
✨ ✅ ❌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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Middlesbrough spends about £54,710 for every 100,000 residents on adult social care. That works out at roughly £547 per resident, or close to £83.5 million in total for 2024. The national figure is nearer £478 per 100,000, about £70 lower per person. After taking income from clients and the NHS into account, net spending in the town is still around £457 per 100,000 people (£457 per resident, £69.8 million overall), again above the England average of £405 per 100,000.
People who use services contribute about £8,974 per 100,000 population (£90 per resident, £13.7 million). This is modestly higher than the England mean of £7,286. Higher client income often points to heavier use of chargeable services such as home care or day support. The NHS contribution is strikingly large: £19,700 per 100,000 people (£197 per resident, about £30 million) compared with a national norm of £7,878. This suggests strong partnership with local health commissioners, perhaps through joint packages for people leaving hospital or funded nursing care.
Middlesbrough’s need profile helps to explain the figures. The latest population count is 152,650, up by around 7 percent since 2019. Density stands at 2,671 people per km², higher than the England average of 2,469. High density often goes with greater demand for community-based support and higher unit costs for home care staff who spend more time in traffic and parking.
More important is deprivation. The borough’s mean deprivation decile is 3.4 whereas England sits at 5.9. Deep poverty raises the prevalence of disability, mental ill-health and substance misuse, all of which drive care packages. Low incomes also limit the number of people who can pay the full cost of care, so the council must step in more often.
Gross and net spending both exceed the national norm, yet the gap is not excessive when the town’s need profile is considered. Higher NHS funding is positive; it means costs are shared and hospital delays may be shorter. However, heavy reliance on NHS money could leave the council exposed if health budgets tighten.
The council still carries a net bill of nearly £70 million. Local comments note that data on budget cuts is not available and that government knows the true cost of care but does not publish it. If grants fall while need keeps rising, the authority may have to make difficult choices: raise council tax, tighten eligibility, or trim provider fees. Continuous joint planning with the NHS, alongside preventative work in deprived neighbourhoods, will be key to keeping services sustainable.
Spending levels show that Middlesbrough is responding to high social need and using national and health income streams well. The challenge is to keep this support in place as the population grows and ages while ensuring that funding keeps pace with demand.
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