This page provides an overview of social care in Sefton, 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 Sefton. 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 share of residents who report a disability is 20.7 per cent. The England average is 17.6 per cent. Sefton therefore has about one sixth more disabled people than is typical. The borough is slightly poorer than average, with a mean deprivation decile of 4.8 compared with 5.9 nationally, and it has a growing but still mid-sized population of 283 000. Poorer areas often see worse health and earlier long-term illness, so local deprivation most likely adds to the high disability rate. A relatively older age profile also plays a part; older residents are more likely to be disabled even after age-standardisation.
During 2024, 2 360 working-age adults asked the council for social-care support. This is 835 requests per 100 000 residents, well below the England figure of 1 143 per 100 000. Lower demand can mean that needs are met in other ways, but it can also point to barriers in access or to limited awareness of what the council offers. The picture should be read alongside the higher disability prevalence: if more people live with disability yet fewer seek help, some needs may be hidden.
Despite the modest number of requests, 1 830 adults aged 18–64 are in receipt of long-term support. That equals 647 people per 100 000, around 22 per cent above the national mean of 533. The conversion of requests into packages is therefore high, which suggests that once someone contacts the council their needs are judged substantial.
The care pattern is strongly community-based. Support managed by the council at home or in the community stands at 348 per 100 000, markedly above the England figure of 267. Nursing placements (34 per 100 000) and residential placements (62 per 100 000) are also above average, hinting at complex needs for a small but significant group. Direct-payment-only packages are low at 27 per 100 000 versus 48 per 100 000 nationally, so personal choice may be constrained or local culture may favour council-managed budgets.
In 2025 the council logged a small number of advice cases. Most categories sit close to, or below, the England per-capita mean, except for help with charging, which is almost double the national level (10.3 versus 5.7 per 100 000). A higher need for guidance on paying for care can reflect financial strain among service users or confusion about charging rules. Requests linked to safeguarding are low, yet this may show under-reporting rather than low risk.
Sefton hosts more disabled residents than average, shaped by relative deprivation and an ageing population. Fewer people come forward for help, but those who do are more likely to receive substantial support. The council leans on in-house or commissioned community services, while uptake of self-directed support is limited. Extra outreach, especially in poorer neighbourhoods, could uncover unmet need. Better information on direct payments and on how charging works may widen choice and reduce anxiety about costs. Given steady population growth and existing density, demand is unlikely to fall, so planning for sustainable community support should remain a priority.
✨ ✅ ❌Older People
Just like with Working Age people, knowing how many older people are requesting social care, how many people are recieving care and what percent of the population is 65+ helps understand need and social care provision at a top level.
Jamaican female, blind and in her 40s. She was in an emergency Bed & Breakfast with her Niece, who acts as her unofficial carer, she is unable to work but would like to go to University. She is receiving PIP but not the Daily Living Allowance which she applied for in June 2021. She is vulnerable and has a history of self harm so was assigned a rehab Support Worker. Vanessa supported her using the Chatbot to chase up her PIP Daily Living allowance application, after waiting for several months and they received a reply within a week but was awarded the lower rate.
Another Chatbot letter was sent to request an urgent assessment due to her vulnerability and this was action quickly by the LA. Vanessa also supported her to use the chatbot and ask the Social worker to be moved to a place that supports her needs and rights. As she was having to use a shared bathroom, toilet and kitchen in a place with drug/alcohol abusers and being blind with no carer, this left her vulnerable. The Chatbot was used again to raise this issue and after a few weeks she was successfully moved to a private property in another area.
This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!
As above, it is important to see what type of care older people are being provided because it can help explain where additional work is needed.
ASCFR and SALT Data Tables 2023-24 Sheet T34
Between 2019 and 2023 the share of Sefton residents who are aged 65 plus rose from 23.1 % to 23.6 %. England stayed around 18–19 %. The gap is large and getting wider. Sefton’s total population grew only slowly (about 1,800 extra people a year) and the borough already has fewer young adults than many places. These two factors make the age profile move upward.
Sefton is also more deprived than the national average (mean Index of Multiple Deprivation decile 4.8 against 5.9) and has pockets of very high and very low deprivation. This mix can increase health need and limit family resources for informal care. Although the area is urban (density 1,783/km²) it is less dense than most metropolitan areas, so services may still have to travel to reach clients.
There were 8,785 requests for support from people aged 65 plus, equal to 3,107 requests per 100,000 population. The England rate was 2,438. A higher request rate is expected in an older district, yet Sefton’s figure is still high even after adjusting for age. It hints at greater disability, weaker informal support, or good local awareness of how to ask for help.
Of the older people asking for help, 3,780 received long-term services (1,337 per 100,000 compared with an England rate of 1,003). About 43 % of requests move on to ongoing care, slightly above the national picture. This suggests that many requests are made when needs are already substantial.
The pattern of care points to both high complexity and some openness to personalisation:
• Nursing home placements stand at 175 per 100,000, one-half higher than England’s 122. This often reflects frailty with medical needs.
• Residential care without nursing is 437 per 100,000, almost 75 % above the national rate. This may signal limited suitable housing or a shortage of intensive home-care hours.
• Community services managed by the council (654 per 100,000) are also above average, showing active home-based support.
• Direct-payment-only packages are close to the norm, but mixed packages that combine direct payments with commissioned hours are lower than average. Some citizens choose full delegation, yet fewer combine options, perhaps because the market for flexible home support is thin.
The next year saw small but telling volumes of advice activity. Enquiries on care plans (10.3 per 100,000) were almost double the national rate. Other categories sit near national levels. The pattern echoes the earlier finding: residents look for help at points where needs are complex and decisions are weighty.
Sefton’s ageing, partly deprived population drives a steady increase in demand. High use of nursing and residential beds implies pressure on placement budgets and on the local care-home market. At the same time, sizeable community caseloads and normal use of direct payments show that people will choose to stay at home when support is available.
To manage future growth, the council may need to widen modern housing with care, expand flexible home-care hours, and promote blended direct-payment models to delay or avoid institutional care. Close monitoring is vital: even a small annual rise in the older share of the population can add hundreds of new requests each year.
Sefton already cares for more older residents than most areas, and the trend is upward. A balanced offer that strengthens home support while ensuring quality in care homes will be key to sustainable, person-centred care.
✨ ✅ ❌When government support falls short, unpaid carers step in to provide care. However, many struggle with burnout, financial pressure, lack of social contact, and a lack of support. This section explores the number of unpaid carers, their increasing workload, and what forms of support are available.
Carers play a vital role in supporting vulnerable adults, often stepping in to provide care when professional services are unavailable or insufficient. The percentage of carers receiving direct payments highlights financial empowerment, the number of carers accessing services reflects local authority outreach, and the number turning to charities underscores unmet needs. Together, these data points reveal systemic strengths and weaknesses: low direct payment uptake may push carers toward charities, while effective services can reduce dependence on charitable support. Understanding these metrics enables targeted interventions to ensure carers receive the recognition and resources they deserve.
Unpaid carers play a crucial role in supporting vulnerable adults, often stepping in to provide care when professional services are unavailable or insufficient. Understanding the number of unpaid carers in a local authority can be complicated. On the one hand, a relatively high proportion might be indicative of not enough being done by the local authority, and/or a strong community. On the other hand, a relatively lower number can mean good service provision, lower need, lower availability to look after family, or a problem with reporting.
Still, understanding the number of unpaid carers is a baseline number that must be considered.
NOMIS NM_2213_1
These values are widely considered to be an underestimate. See this report from Carers UK for more information.
August 2021 - Patient with dementia who lives in a shared lives setting. Carer had been requesting respite from the council since September 2020. Croydon Social Prescriber helped with a referral to the local authority in March 2021. Assessment conducted, with the promise they would come back with support, which did not happen. 25 August, social prescriber used the chatbot to find the right legal wording for the situation. The email was sent at 4.52pm that day. At 5.12pm the council contacted the carer to discuss the respite. This was the impact of one letter, addressed to a senior team.
This case study is based on real data from Croydon. Have a story to tell? Let us know, and we might display it here!
Social contact is important for carers’ well-being, as it can help reduce feelings of isolation and loneliness. Understanding the level of social contact that carers have can help local authorities identify areas where additional support and resources may be needed. For example, a low level of social contact may indicate a need for more social activities or support groups for carers, while a high level of social contact may suggest that carers have a strong support network.
Survey of Adult Carers in England (SACE) - question 11
The type of support available to carers can vary significantly, impacting their ability to provide care effectively. Understanding the types of support available can help identify areas where additional resources may be needed. For example, a high number of carers receiving respite care may indicate a need for more support with caregiving responsibilities, while a low number of carers receiving financial support may suggest a need for additional financial assistance.
ASCFR/SALT Sheet T47
Access to information is crucial for carers to navigate the social care system effectively. Understanding how easy it is for carers to get information can help local authorities identify areas where additional support and resources may be needed. For example, a high number of carers finding it difficult to get information may indicate a need for improved communication and support services, while a low number of carers finding it difficult to get information may suggest that existing services are effective.
Would you like social care information? Try our Chatbot!
Survey of Adult Carers in England (SACE) - question 17
Note: these values are a work in progress… expect these numbers to go up
Access Social Care and other Helplines help people with information, advice, and support related to social care. Understanding the types of calls received by carers can highlight areas where additional support and resources may be needed. For example, a high number of calls related to financial support may indicate a need for more financial assistance for carers, while a high number of calls related to respite care may suggest a need for additional support with caregiving responsibilities.
It is important to note that, just as in the previous section, low numbers of requests might indicate that people don’t know where to get help, don’t feel they can get (or deserve) help, or other outreach problems. This is particularly important because we often work with people where the role of a carer is not recognised, or where the carer themselves does not recognise their role.
Access Social Care casework, AccessAva data, and helpline partner submissions
In 2021 there were about 29,000 unpaid carers in Sefton. This is roughly 10,377 carers for every 100,000 residents, well above the England rate of 8,204. The area’s population is a little smaller than the national average but more deprived (mean deprivation decile 4.8 compared with 5.9). Higher deprivation often goes with poorer health and lower ability to buy in private care, so families may need to step in more often. The figures suggest that caring is a common part of life for many households.
Only 26.8 per cent of Sefton carers said they had as much social contact as they wanted in 2024, slightly below the England figure of 29.3 per cent. Social contact is important for mental health and resilience; this result hints at isolation. Carers also found it a little harder to get information about support: 55.3 per cent said it was easy, compared with 59.3 per cent nationally. Together, these answers point to a group that is larger than average, yet feels somewhat cut off from both peers and services.
Direct support through direct payments reached about 225 carers (80 per 100,000), only half of the national rate (150). In contrast, part direct payments were more common in Sefton (around 305 carers, 108 per 100,000) than across England (45). This pattern may reflect local policy that blends cash with commissioned services rather than offering a fully managed budget.
Fully commissioned support packages were rare, with roughly 55 carers (19 per 100,000) supported this way, against a national rate of 102. Services limited to information, advice or sign-posting reached around 505 carers (179 per 100,000), again below the England figure (339). Fewer carers received no direct support at all (150 people, 53 per 100,000) than the national benchmark (130), suggesting that most carers do encounter the council at some point, even if the help is light-touch.
Respite or other help delivered to the cared-for person was provided for roughly 175 carers (62 per 100,000), slightly under the national rate of 70 per 100,000. Given the higher prevalence of caring, the absolute number of respite breaks may be falling short of demand.
Sefton is urban but less dense than the average English authority. Smaller distances can favour service access, yet pockets of deprivation and health inequality (standard deviation of deprivation deciles 2.9, higher than average) may create mixed needs that are harder to meet uniformly. The higher share of carers, coupled with lower per-capita support, could stretch both formal and informal networks. Limited social contact and difficulties finding information hint at pressure on frontline advice teams or gaps in community infrastructure.
The council may wish to review the balance between part and full direct payments, as well as the capacity of advice services, to ensure carers receive help that matches their circumstances. Expanding peer support groups or digital information hubs could tackle isolation at modest cost. Finally, increasing access to respite, especially in the most deprived neighbourhoods, could protect carers’ health and enable them to continue in their role.
✨ ✅ ❌Care providers are essential for delivering social care services, including home care agencies and care homes. The quality of care they provide can vary significantly, impacting the well-being of service users. This section examines the number and types of care providers, their quality ratings, and some of the difficulties of maintaining high standards. Understanding these metrics is crucial for ensuring that vulnerable individuals receive high-quality care.
The number and types of care providers in a local authority can impact the availability and quality of social care services. Understanding the distribution of care providers directly influences people’s ability to get the care they need.
The Care Quality Commission (CQC) rates care providers based on their quality of care, safety, and effectiveness. Understanding the quality ratings of care providers can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers with low ratings may indicate a need for improved training and support, while a high number of care providers with high ratings may suggest that existing services are effective.
Framework rates are the agreed prices that local authorities pay care providers for social care services, such as home care and residential care. These rates are crucial because they determine the affordability, availability, and quality of care in a city. If rates are too low, providers may struggle to sustain services, leading to workforce shortages, poor care quality, and limited access for those relying on council-funded care.
Understanding framework rates helps assess whether local authorities are adequately funding social care, ensuring fair pay for care workers, and maintaining a sustainable care market that meets residents’ needs.
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Several providers are finding it increasingly difficult to stay in business, and sometimes several providers collapse at once. For example, when pay rises are approved without consultation and effective immediately, providers may not be able to afford to pay their staff. This can cause a chain-effect which leads to collapse in the market, and a lack of care for those who need it.
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Workforce turnover rate is a measure of the number of staff leaving a care provider over a specific period. High turnover rates can indicate issues with staff retention, such as low pay, poor working conditions, or lack of training and support. Understanding workforce turnover rates can help local authorities identify areas where additional support and resources may be needed to improve staff retention and ensure high-quality care services.
NOTE: This data series is based on regional data
Staff retention is crucial for maintaining high-quality care services. Understanding the challenges faced by care providers in retaining staff can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers struggling to retain staff may indicate a need for improved training and support, while a low number of care providers facing retention challenges may suggest that existing services are effective.
This dataset describes the results of a survey asking care providers about their challenges in retaining staff.
NOTE: This data series is based on regional data
Workforce_survey_data_tables, Tab 6_2
Vacancy rate is a measure of the number of unfilled positions within a care provider over a specific period. High vacancy rates can indicate issues with staff recruitment, such as low pay, poor working conditions, or lack of training and support. Understanding vacancy rates can help local authorities identify areas where additional support and resources may be needed to improve staff recruitment and ensure high-quality care services.
Recruiting staff is essential for maintaining high-quality care services, and for backfilling staff when they leave. Understanding the challenges faced by care providers in recruiting staff can help local authorities identify areas where additional support and resources may be needed. For example, a high number of care providers struggling to recruit staff may indicate a need for improved training and support, or can point to a systemic problem, such as low pay, poor working conditions, or not enough people interested in this job type.
Staff recruitment is important as it’s one of the areas that have levers to pull outside of social care, for example, by changing how many visas are awarded to social care workers.
NOTE: This data series is based on regional data
Workforce_survey_data_tables, Tab 6_2
Sefton has 44 community-based adult social care services. With a population of about 283,000, this is roughly 16 services for every 100,000 residents. The England mean is close to 17 per 100,000, so local access to care in the community is a little thinner than in many places. By contrast, Sefton records 118 residential care homes, or about 42 homes for every 100,000 people. Nationally the mean is only 24 per 100,000. In other words, the area offers far more beds in care homes than is usual, while having a slightly smaller pool of community options. This mix suggests a system that has long relied on residential provision, perhaps because of an older population profile or because housing and family support are less able to meet rising need at home.
About 17.3 % of Sefton providers are rated “needs improvement” or “inadequate”, a touch above the England average of 16.8 %. The difference is small, yet in a market with many residential places even a modest gap means a fair number of local beds sit below good standard. In an area with higher deprivation, and with pockets of very high and very low income, residents who must take what they can afford may feel this quality gap more sharply.
Staff turnover in the North West region stands at 25.4 %, and Sefton mirrors this rate. However, almost 11 % of posts in the borough are vacant, against a national figure of 8.4 %. Most providers (81 %) report that recruiting staff is now more or much more difficult, while 69 % say the same for keeping staff; both shares sit slightly above regional averages. Taken together, the figures point to a labour market that is tight and becoming tighter. Pay competition with retail and hospitality, the cost of commuting in a dense urban setting, and limited career pathways within a largely residential sector may all feed the problem.
Sefton is less rural than England as a whole, with only 12 % of land classed as rural. Population density is high at 1,783 people per square kilometre, yet below the national urban average. Mean deprivation lies in decile 4–5, so the borough is more deprived than the country overall, and variation between neighbourhoods is wide. Higher deprivation often links to poorer health and earlier frailty, which can drive demand for residential care. A strong supply of care home beds may therefore reflect genuine need, but it can also dampen investment in community services that keep people independent.
The current balance of provision meets demand for residential places, yet residents who wish to stay at home may find fewer choices. Workforce shortages threaten both sectors but will hit community services first if they cannot compete on pay. Improving quality in the bottom fifth of homes, expanding home-care capacity, and supporting providers to recruit locally should all be priorities. Given the borough’s mixed income base, targeted funding or fee uplifts in the most deprived wards could help ensure that higher need does not translate into lower quality.
✨ ✅ ❌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.
Sefton has about 283,000 people. This is smaller than the average English local authority. The borough is fairly crowded, with 1,783 residents for every square kilometre, yet it is less dense than the England mean. Only one in nine residents live in a rural setting. Deprivation is higher than the national norm; the mean Index of Multiple Deprivation decile is 4.8, while England stands at 5.9. Inequality is also wider, as shown by a larger spread of deprivation scores. These factors shape demand for health and care support and can press on discharge pathways, community services and information routes.
Almost all Sefton residents who leave hospital do so from a trust judged acceptable by the Care Quality Commission. The rate of 95 per cent is well above the England mean of 89 per cent and points to good-quality acute provision around the borough. However, one in five of those discharges is delayed. The 18.5 per cent delay rate is six percentage points higher than the national picture, and the average delay length is 1.4 days compared with 0.7 days across England. In a relatively deprived and urban area, the demand for social care packages, community nursing and suitable housing can be high, making it harder to free hospital beds quickly. The data suggest that while Sefton works well with its hospitals, it needs extra capacity in step-down and home-care services to keep patient flow moving.
Two out of three service users say they are satisfied with the care and support they receive (68.8 per cent). This is four percentage points above the national average and a positive sign, given the borough’s higher deprivation. People may value the personal care they receive once they are in the system. Yet only 67.1 per cent feel it is easy to find information about services, a shade below the England figure. Lower digital access in deprived areas, varied literacy levels and the complexity of mixed NHS and council offers may explain this gap. NatCen’s separate measure shows that 57 per cent report dissatisfaction, hinting at pockets of unmet need or rising expectations.
The Local Government and Social Care Ombudsman received about 4.2 complaints for every 100,000 residents, slightly below the national rate of 4.45. With Sefton’s population, this equals roughly 12 cases in 2024. Decisions issued also stand at 4.2 per 100,000, close to the England mean of 4.1. The modest volume suggests that people do not complain more often than elsewhere. Lower complaint rates can reflect good resolution at an early stage, but they may also signal barriers to advocacy, particularly in deprived communities.
Sefton already delivers care that most users value and maintains strong links with well-rated hospitals. The main challenge is speed of discharge. Investment in reablement teams, home-care recruitment and suitable housing adaptations could cut the current delays. Clearer, simpler information—especially in deprived neighbourhoods—could lift the “ease of finding information” score and help residents navigate services before problems escalate. Continual monitoring of complaints, with outreach in low-income areas, will ensure that every voice is heard and that the borough’s quality gains are shared by all citizens.
✨ ✅ ❌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 Sefton spent about £147 million on adult social care before any income was taken into account. This equals £52 ,172 for every 100,000 residents, around nine per cent above the England average of £47 ,758. After client and NHS income is netted off, the bill that the Council must meet falls to roughly £121 million, or £42 ,696 per 100,000 people, again a little higher than the national norm of £40 ,472. The population has risen only slowly, from 279,000 in 2021 to 283,000 in 2023, so most of the extra spend reflects policy choice or local need rather than growth in resident numbers.
Sefton collects more money from service users and from the NHS than the average authority. Client contributions stand at about £26.8 million, equal to £9 ,477 per 100,000 people compared with £7 ,286 nationally. NHS transfers add a further £28.3 million, or £9 ,952 per 100,000, again well above the England figure of £7 ,878. A higher local share from clients may show that a larger proportion of care is means-tested because of greater demand, higher fee levels, or a sizeable group with moderate assets. The strong NHS contribution hints at active partnership working, perhaps through pooled budgets or joint community services, which is common in areas trying to reduce hospital pressure.
Several background factors help to explain why per-capita spending is above average. Sefton is more deprived than the country as a whole; its mean deprivation decile is 4.8, while England sits at 5.9. Deprivation is linked to poorer health and earlier onset of long-term conditions, which raise the cost and complexity of care packages. The borough is also urban and compact, with only 12 per cent of land classed as rural. Urban density can make home-care delivery efficient, yet it often comes with higher caseloads and greater demand for mental-health and substance-misuse support.
The population density of 1,783 residents per square kilometre is lower than the England mean, but still high when set beside many northern authorities. The age profile is not given here, yet earlier Office for National Statistics releases show that coastal areas like Sefton tend to have more older people, who are the main users of social care. A growing but ageing population would push spending up even if the head-count changes only marginally.
Spending that sits modestly above national levels, coupled with higher client and NHS income, suggests that the Council is prioritising social care and has negotiated external funding well. However, the data note that information on budget cuts is missing, and local voices say that central government knows what is needed but has not shared it. If grants fall in future, Sefton may struggle to keep provision at its present level, especially as need linked to deprivation is unlikely to ease quickly.
Continued partnership with the NHS will therefore be crucial, both to protect community services and to avoid costly hospital stays. Monitoring of user outcomes and satisfaction will also help the Council judge whether the current spending mix is delivering the right balance between prevention and long-term support.
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