This page provides an overview of social care in Sandwell, 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 Sandwell. Understanding the types of care available can help local authorities identify areas where additional support and resources may be needed. For example, a high number of people receiving personal care may indicate a need for more support with daily living activities, while a high number of people receiving respite care may suggest a need for additional support for carers.
ASCFR and SALT Data Tables 2023-24 Sheet T34
About one in five Sandwell residents say they are disabled when age is taken into account (20 %). The England rate is nearer one in six (17.6 %). Higher disability is common in places with low income, and Sandwell sits in the second most deprived decile on average. Poor housing, harder jobs and long-term illness are therefore likely to push disability levels up.
In 2024, 5,160 working-age adults asked the council for social care. This equals 1,485 requests for every 100,000 residents, well above the national rate of 1,143. The figure fits the higher disability level and also reflects the borough’s dense, fully urban setting, where people often know how to find council help. Strong demand can also arise because informal carers are stretched; Sandwell’s low incomes may limit private care options, leading residents to look first to the council.
Although many people ask for help, fewer end up with an ongoing service. Only 1,550 adults aged 18–64 were receiving long-term care in 2024. That is 446 per 100,000 people, below the England average of 533. The gap between high demand and lower receipt hints that needs are being filtered out at assessment, waiting for care, or met in other ways such as family support or short-term re-ablement.
Nursing placements stand at 24 per 100,000, almost double the national rate of 14. This suggests that when Sandwell does fund care, cases are often complex, requiring skilled staff and clinical input. Residential placements are a little below average (50 versus 61 per 100,000), showing some restraint on permanent moves into care homes.
Most service users stay in the community, yet the pattern differs from England. Direct payment only packages are low at 83 per 100,000 compared with 122 nationally, and mixed packages that combine a direct payment with commissioned care are also lower. By contrast, council-managed personal budgets are on par with England. The figures point to a cautious use of direct payments, possibly because residents feel less confident managing their own support or because providers accept council-run budgets more readily. In an area of high deprivation, many people may prefer the predictability of council-arranged services over handling cash themselves.
Small numbers asked for help with care planning, charging or safeguarding in 2025 (around 1.4 per 100,000 for most categories, matching national levels). While these data are limited, they hint that information and advice pathways function normally despite the heavy caseload elsewhere.
Sandwell has a large disabled population and strong demand for help, yet fewer adults receive long-term support than in similar areas. The council may need to check assessment thresholds, waiting times and the balance between short-term and ongoing care. Expanding community-based options, especially direct payments with good peer support, could give disabled adults more control and relieve pressure on nursing beds. High poverty levels mean any new offer must stay affordable and easy to use. Extra investment in preventive services, welfare advice and carer support could also reduce the flow of repeat requests. In short, matching high demand with the right mix of services is now critical for Sandwell.
✨ ✅ ❌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
Sandwell is a growing and very urban place. The population rose from 340,198 in 2019 to 347,551 in 2023. Density is high at almost 4,000 people per square kilometre, well above the England figure of 2,469. Only 14.6 % of residents are aged 65 or over, while England stands nearer 18.5 %. The share of older people has stayed almost flat in Sandwell since 2019, but it has edged up nationally. Sandwell is also one of the more deprived areas in the country, with a mean deprivation decile of 2.8 compared with the England mean of 5.9. Early ill-health linked to deprivation can increase the need for care even when the older population is small.
In 2024 there were 8,505 requests for care from residents aged 65+. This equals 2,447 requests per 100,000 people, slightly above the national rate of 2,438. Put another way, a smaller pool of older residents is making a similar, and in fact slightly higher, number of requests than the average area. High deprivation and long-term health conditions may help explain this pressure on the front door of adult social care.
Of those who asked for help, 3,275 people were receiving long-term services. That is 942 per 100,000 residents—about 6 % below the England rate of 1,003. The gap between the high rate of requests and the lower rate of ongoing packages could point to careful gate-keeping, tight budgets, or unmet need. It may also show effective short-term or informal support that prevents some requests turning into long-term care.
The pattern of services is different from England. Nursing home support stands at 181 per 100,000, noticeably above the national 122. Residential care is lower at 171 per 100,000 against 250 nationally. Community support delivered through a council-managed personal budget is slightly higher than average, while direct-payment-only packages are a little below. The high nursing figure suggests many people enter services with complex needs. The lower residential figure may show a policy preference for home-based care or reflect a limited local supply of residential beds.
Small numbers asked for help with care plans, charging, and similar issues in 2025. Rates for these advice requests sit close to national levels. This hints that older residents know where to find basic information, but the very low raw numbers (for example, only three legal or complaint queries) deserve closer look to ensure voices are heard.
Sandwell’s younger age profile gives short-term relief to funding pressures linked to demography. Yet deprivation is driving an early and complex demand pattern. Front-line staff face request rates that match richer areas with many more older people. A higher share of nursing care packages signals costly, high-need cases that can quickly absorb budgets. Community support is being used well, but the drop-off between requests and ongoing care hints at potential unmet need.
Planning should therefore balance investment in prevention—health promotion, housing, and community support—with enough high-acuity capacity. Given the borough’s density and zero rural hinterland, neighbourhood services can be delivered efficiently, but they must be easy to access for residents in deprived wards. Targeted outreach, clear advice pathways, and strong links with health partners will help make sure that older people who need help receive it at the right time and in the right setting.
✨ ✅ ❌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 Sandwell had about 29,600 unpaid carers. This figure comes from a rate of 8,656 carers for every 100,000 residents, set against 8,204 for England as a whole. The borough therefore relies a little more on family and friends than most places. A high population density and a low average deprivation score (decile 2.8 compared with the national 5.9) help to explain this. In crowded, deprived urban areas relatives often live near each other and formal services can be harder to reach, so informal caring grows.
Only one carer in three (32.8 %) says they already have as much social contact as they want. Although this is slightly better than the England average of 29.3 %, it still means two out of three carers feel lonely or cut off. Sandwell’s tight-knit communities may soften the impact of caring, yet long hours and limited money continue to restrict time for friends and leisure.
Half of local carers (50.4 %) feel it is easy to find information about support. The national picture is higher, at 59.3 %. This gap suggests that signposting is a weak link in the local system. In a borough where far more people are deprived and where English may not be everyone’s first language, clear advice in simple formats and community languages becomes vital. Improving this could also help carers who are not yet known to services.
Sandwell records 190 carers per 100,000 residents—around 650 people—who receive a direct payment. The national rate is 150 per 100,000. Direct payments allow carers to arrange help that fits their own life, so the high take-up points to a flexible council offer and carers who feel able to manage funds.
Only 24 carers per 100,000 (about 80 people) are classed as receiving no direct support, far fewer than the national 130. This is encouraging: most Sandwell carers do get some help once they contact the council.
However, support delivered through respite for the cared-for person stands at 30 per 100,000 (roughly 100 carers), less than half of the England norm of 70. Fewer breaks can raise stress and reduce the chance of paid work or study. The data also show no recorded services for part direct payments or council-managed budgets; this may signal gaps in recording or in the range of offers.
Sandwell’s carers are numerous and more likely to receive direct payments than elsewhere, yet many still feel lonely and have trouble finding guidance. Increasing the supply of short-term breaks and improving information channels—especially in deprived and multilingual neighbourhoods—could make a clear difference. Given the area’s high density and low rural share, community centres, libraries and GP surgeries provide accessible hubs for advice sessions. Targeted investment here could protect carers’ well-being and, in turn, sustain the informal support on which the local health and care system depends.
✨ ✅ ❌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
Sandwell has 65 community-based adult social care services and 81 residential care services. With a 2023 population of about 348,000, this equals roughly 18.7 community services and 23.3 residential services for every 100,000 residents. Nationally the rates are near 16.9 and 24.1. Sandwell therefore offers a little more community provision than the country as a whole but slightly less residential capacity. The pattern fits an urban area that is trying to support people at home and in the community rather than in care homes.
Just under three in ten local providers (28.8 percent) are rated “requires improvement” or “inadequate”, while the England figure is 16.8 percent. This gap of twelve percentage points signals a clear quality challenge. High density, very low average deprivation decile (2.8 compared with the national 5.9) and a growing population can all place extra pressure on services. Providers may be caring for people with more complex needs, and this can make it harder to meet Care Quality Commission standards without extra support.
The annual turnover rate in 2023/24 stands at 26.7 percent and is almost identical to the regional average. Vacancy sits at 8.2 percent, a little better than the 8.4 percent benchmark. At first sight these numbers look steady, yet 70.3 percent of employers say it is more or much more difficult to keep staff, and 81.4 percent say the same about recruiting. Both figures sit two percentage points above the Midlands norm. This hints that providers are working hard to hold vacancy and turnover down, but they must spend more effort and money on repeated recruitment. Over time this strain can pull resources away from training and quality improvement, which may help explain the high share of weaker inspection grades.
Sandwell’s extra community capacity is positive because people often prefer support at home. However, residential supply is slightly below average, so any sudden rise in demand could create pressure. High deprivation levels can also lead to earlier ill-health, creating complex care packages that test both community and residential services.
Quality concerns appear most acute in residential settings, where staff ratios and skill mix are central. Persistent recruitment and retention problems make it harder to run stable teams, and high density means that competition for the same labour pool is sharp. Without action, there is a risk that the number of “requires improvement” ratings stays high or rises.
Commissioners may wish to target improvement support towards the homes and agencies that are struggling. This could include shared training, stronger clinical input and incentive schemes that reward good inspection outcomes. At the same time, workforce plans need to focus on local recruitment pipelines, for example links with colleges and schemes that help unemployed residents into care roles. Given the borough’s deprivation profile, pay, travel and career progression matter if providers are to compete with retail and hospitality.
In summary, Sandwell has a reasonably large community care offer, a slightly tight residential market and a clear quality gap. Addressing workforce pressures and supporting continuous improvement should be top priorities if the borough is to give every resident safe, high-quality care close to home.
✨ ✅ ❌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.
Sandwell is a large, very dense and mostly urban borough. The population has risen from about 340,000 in 2019 to nearly 348,000 in 2023, while the land area has not changed. With almost 4,000 residents per square kilometre, services face heavy, close-packed demand. Deprivation is high: the mean Index of Multiple Deprivation decile is 2.8, far below the England figure of 5.9. These background facts shape both need and service experience.
Almost every Sandwell resident who leaves hospital (99.8 %) is discharged from a provider judged acceptable by the Care Quality Commission, well above the national figure of 89 %. This suggests strong relationships with local acute trusts and attentive contract management. Although the share of discharges that are delayed (12.2 %) is much the same as the England average (12.3 %), the average length of each delay is shorter: 0.49 days against 0.7 days. The pattern points to prompt problem-solving once a delay begins, even if the initial risk of delay is still present. Given high bed pressure in a deprived, urban area, cutting the time lost per delay is a meaningful gain for both hospitals and service users.
Satisfaction with care and support stands at 65.9 %, a touch higher than the England mean of 64.7 %. For an area with high socio-economic need, holding satisfaction above the national mark is encouraging and may reflect focused local investment, such as the new integrated care hubs. At the same time, an alternative survey by NatCen finds 57 % of respondents dissatisfied. The contrast hints at uneven experiences: formal service users report reasonable satisfaction, while the wider public, many of whom may be waiting for help, feel less content. Tackling access and waiting times could narrow this gap.
Finding information about services feels slightly easier in Sandwell than elsewhere (69.6 % versus 68.2 %). Digital signposting and well-used community facilities may help residents know where to go, an important asset in a fast-moving, densely populated place.
The Local Government and Social Care Ombudsman received 5.18 cases per 100,000 residents and decided 6.04 cases per 100,000, both higher than the England means of 4.45 and 4.12. A higher complaint rate can signal pressure points—perhaps linked to high volume and deprivation—but it can also show that residents feel able to speak up. The service should examine themes from decisions to see whether particular pathways, such as adult social care assessments, need improvement.
Sandwell shows positive signs in several quality markers: safe discharge routes, short delays, and slightly above-average satisfaction. These gains are noteworthy given the borough’s dense population and high deprivation. Yet higher complaint levels and mixed public opinion suggest that quality is not uniform. Continued work on early discharge planning, transparent communication, and swift response to complaints will be essential to move from good pockets of practice to consistently high standards across all services.
✨ ✅ ❌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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Sandwell spent about £146 million on adult social care in 2024. This equals £42,024 for every 100,000 residents. The England average is £47,758 per 100,000, so Sandwell spends roughly £5,700 less for the same number of people.
After taking off income the council receives, the net spend falls to about £126 million, or £36,234 per 100,000 residents. Again, this is lower than the national figure of £40,472. In short, Sandwell both raises and spends less money per person than most places in England.
Only £5,790 per 100,000 comes from client charges. This is 20 million in cash terms and is smaller than the national norm of £7,286 per 100,000. Low client income is not surprising. Sandwell is one of the most deprived areas in England (average Index of Multiple Deprivation decile 2.8 against England’s 5.9) and many residents simply cannot afford large care fees.
NHS money for joint care packages is also low: £5,696 per 100,000, or around £20 million. The England average is £7,878. Fewer health-funded placements may mean that the council shoulders a bigger share of the cost when people leave hospital or need nursing care. It may also signal weaker local partnership working or tight NHS budgets.
Sandwell’s population has risen steadily from 340,198 in 2019 to 347,551 in 2023. It is very densely settled—almost 4,000 residents per square kilometre—so services such as home care can be delivered with shorter travel times. This can lower unit costs and may partly explain the below-average spend.
High deprivation, however, tends to bring greater and more complex need at younger ages. People may live with poor health for longer and rely on publicly funded care rather than paying privately. The gap between Sandwell’s need and its lower spend suggests a risk of unmet demand, longer waiting times or shorter care packages.
The council covers only thirteen to fourteen per cent of its gross spend through client contributions, slightly below the national share. With low NHS income as well, Sandwell has limited external funding to offset costs. Unless grant funding rises, the council may have to continue strict eligibility rules or look for further efficiencies.
At the same time, the growing and deprived population points to rising future demand. Stronger joint commissioning with the NHS, better support for unpaid carers and investment in prevention could help balance the books while meeting need.
Sandwell spends less per resident on social care than the average English council even though local need is likely to be higher. Lower client and NHS income narrow its funding base, leaving the authority exposed to cost pressures. Careful financial planning and deeper partnership with health services will be essential to keep services safe and sustainable.
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