This page provides an overview of social care in Southwark, 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 Southwark. 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 Southwark stands at 17.6 per cent. This is the same as the national average, so the borough is not unusual in the share of residents who report a long-term condition or serious difficulty. Southwark’s population is young and dense (over 10,000 residents per square kilometre), yet the disability rate mirrors England. This hints that poorer health linked to deprivation is balancing out the health advantages that often come with youth.
In 2024 the council logged 710 new requests for social care from working-age adults. This is 225 requests per 100,000 residents, only one fifth of the England mean (1,143 per 100,000). For an inner-city area with above-average deprivation this low flow is striking. It could mean that people do not know how to ask for help, or that informal support in families and communities is shouldering more of the burden. High housing costs might also push some disabled residents to seek support outside the borough.
Despite the modest number of new requests, 1,495 working-age adults were already getting long-term care in 2024. This equals 474 people per 100,000, close to the England mean of 533. The gap between a low intake and an average caseload suggests that once residents enter the system they stay for some time. Services therefore need to focus on sustained, not short-term, support.
Only 50 clients live in nursing homes (16 per 100,000), a little above the national rate. Residential care is used less (40 per 100,000 versus 61 nationally). Most support is delivered in the community. Almost 298 people per 100,000 hold a council-managed personal budget, above the England mean of 267, while direct payment use is below average. Residents may prefer the council to organise care, or may find managing money hard. Offering extra help with budgeting could raise take-up of direct payments and widen choice.
In 2025 only 42 working-age adults asked the council for specialist advice. Rates for assessments, care plans, information and safeguarding are slightly above national levels, while charging and mental capacity queries are lower. The numbers are tiny, yet they point to two things. First, residents seem more concerned about understanding their plan or staying safe than about fees. Second, low mental-capacity queries may hide unmet need among people who struggle to speak up. Targeted outreach to advocacy groups could close this gap.
Southwark combines high density with above-average deprivation. Disability rates match England, but formal requests for help are scarce. The council may wish to:
• Strengthen front-door information so that disabled adults know how to ask for support.
• Work with local health services to spot hidden need early, before crises arise.
• Invest in advice on managing direct payments, giving residents more control.
• Monitor safeguarding and mental-capacity work closely, as small changes in numbers can signal big shifts in risk.
Keeping these points in view will help Southwark shape responsive, long-lasting services for its disabled population.
✨ ✅ ❌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
Southwark is still a young borough. In 2019 only 8.0% of residents were aged 65 or over; by 2023 the share had edged up to 8.8%. Nationally the proportion hovered near 18.7% throughout the same period. The steady rise in Southwark therefore reflects a genuine ageing trend, even if the borough remains far below the English average. This pattern is shaped by long-standing inward migration of working-age adults, high housing costs that encourage older owners to relocate, and the very dense urban fabric (10 659 residents per km² in 2021, more than four times the national figure). The increase, modest in percentage terms, still translates into roughly 2 000 extra older people between 2019 and 2023 because the total population also grew.
In 2024 the council recorded 1 345 requests for support from residents aged 65+. This equals 426 requests per 100 000 people over 65, far below the England mean of 2 438. A smaller older cohort explains some of the gap, yet the per-capita rate is also low. Possible reasons include stronger informal family networks, difficulties in navigating the care system, or unmet need masked by high deprivation (mean index decile 4.0 versus 5.9 nationally). The borough may wish to test whether awareness and access are equally low across all neighbourhoods, because deprivation spreads unevenly here (decile standard deviation 2.0).
At the same time 2 560 older residents were receiving council-funded long-term care, equating to 811 per 100 000—again under the national mean of 1 003. The mix of services is telling. Nursing care (101 per 100 000) and residential care (87) both sit well below England levels, while community support arranged and managed by the council is notably higher at 578 per 100 000 (national 508). Direct payment-only packages are fewer than average, suggesting that, although the borough supports staying at home, it does so mainly through council-commissioned services rather than cash payments. Dense housing and short travel distances can make home-care rounds more efficient, so the current balance probably reflects both user preference and practical service design.
Early-help contacts logged for 2025 are small in absolute terms—fewer than 12 cases in any single category—but the per-capita rates for assessments (2.2 per 100 000) and care-plan queries (1.6) sit slightly above national norms. This may indicate that residents who do approach the council expect more personalised guidance, or that frontline staff record these interactions carefully. Legal issues, mental capacity, and safeguarding queries are close to national averages, hinting at broadly typical levels of complexity.
Southwark’s older population is growing from a low base, while its social care contact and uptake rates remain below national norms. The borough already relies heavily on community-based support, an approach that fits its dense urban setting and the wish of many residents to remain at home. As the cohort expands, pressures will rise first in home-care commissioning, followed later by nursing and residential demand. Low request rates could signal good health or, equally, hidden need; targeted outreach in more deprived neighbourhoods would clarify this. Planned investment should therefore combine extra capacity in domiciliary care with work to improve awareness of entitlements, ensuring the borough is ready for a steadily ageing yet still mobile population.
✨ ✅ ❌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 about 18,800 Southwark residents looked after a friend or relative without pay. This equals 6,135 carers for every 100,000 people, well below the England rate of 8,204 per 100,000. The borough’s population is young, mobile and tightly packed. Fewer older households and easier access to paid services can reduce the need for family care. Some carers may also be “hidden”: long work hours and low incomes can stop people from seeing themselves as carers or from completing surveys.
Even so, 31.1 % of carers say they have as much social contact as they would like, slightly above the national figure of 29.3 %. Busy streets, good public transport and many community venues make it easier to stay in touch. Formal help is a different story. In 2024, 235 carers per 100,000 residents—about 740 people—received no direct support from the council, almost twice the England average of 130 per 100,000. Data for other support types are missing, but the high “no support” figure suggests that many carers are coping alone.
Only 37.9 % of carers feel it is easy to find information about services, far below the national rate of 59.3 %. Southwark is one of the most deprived and most densely populated areas in England, with many languages spoken. Standard online or paper guides may not reach all groups. Poor sign-posting can explain both the low recorded carer rate and the high share without support.
The picture is mixed: fewer carers are recorded, and social contact is relatively good, yet many carers lack help and struggle to navigate services. The rising population since 2021 is likely to add demand. The council may wish to:
• Expand outreach through GP surgeries, schools and employers to identify hidden carers.
• Offer clear, multi-language information in places people already visit, such as libraries and markets.
• Make the route to a carer’s assessment faster and simpler, so fewer carers stay in the “no support” group.
• Use Southwark’s dense urban layout by creating small local hubs where carers can drop in for advice or a short break.
These steps could lift the proportion who find information easily, reduce unmet need and ensure that carers, who save the public purse both time and money, receive the backing they deserve.
✨ ✅ ❌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
In 2024 Southwark had 32 community-based adult social care services and 15 residential care homes. With a mid-2023 population of about 315,500 people, this works out at roughly 10.1 community services and 4.8 residential homes per 100,000 residents. Converting the national averages to the same scale gives around 16.9 and 24.1 providers per 100,000 respectively. Southwark therefore offers far fewer registered services for its size than is typical across England.
The borough’s very high density (10,659 residents per km²) can help providers reach clients quickly, yet it also means demand is concentrated. Combined with above-average deprivation—the local deprivation score sits in decile four compared with the national mean of nearly six—many residents are likely to need affordable or publicly funded care. Fewer providers per head may therefore translate into longer waiting times, reduced choice and higher caseloads for each service.
Just over 23 per cent of inspected services in Southwark were rated “Requires Improvement” or “Inadequate”, higher than the national figure of 16.8 per cent. Limited market capacity can make it hard for commissioners to shift people away from weaker providers, so lower supply may be feeding into poorer quality. Dense urban housing and complex deprivation-related needs can also stretch providers, affecting regulatory outcomes.
Staff turnover in 2023/24 stood at 19.0 per cent, almost identical to the England average, and the vacancy rate was 8.6 per cent versus 8.4 per cent nationally. Despite broadly similar headline numbers, London’s high living costs can make these vacancies harder to fill quickly. Encouragingly, only 68 per cent of Southwark employers described recruitment as “more” or “much more” challenging, compared with 79.8 per cent across England, and 56 per cent reported growing difficulty in retention against a national 68.1 per cent. Proximity to good transport links and a diverse labour pool may be softening pressure, yet vacancies remain high enough to threaten service continuity if demand rises.
The combination of a small provider base, above-average deprivation and high density suggests that existing services are likely running near capacity. Limited room for new care homes in a built-up borough, together with expensive property prices, may be constraining market growth. Community-based support dominates the offer, but even that sits well below national supply levels. These gaps can push informal carers and the NHS to absorb unmet need, particularly when quality issues deter placements.
Workforce data paints a mixed picture. On paper, turnover and vacancies match national norms, and recruitment pressures are reported as slightly lighter. However, because Southwark starts with fewer staff per resident, every lost worker affects more clients. Sustaining quality will therefore depend on retaining skilled staff and supporting providers to expand capacity.
Commissioners may need to encourage new entrants or support existing services to scale up—through premises grants, block contracts that underwrite risk, or shared workforce initiatives across neighbouring boroughs. Strengthening quality oversight is equally important; with nearly one in four services rated below “Good”, targeted improvement plans and peer learning could have a swift impact. Finally, given high deprivation, ensuring that fee rates keep pace with London costs will be vital to attract providers and stabilise staffing.
Southwark’s care market is compact and stretched. The borough must balance its dense, deprived context with proactive measures to widen provision, lift quality and secure a resilient workforce if it is to meet future demand.
✨ ✅ ❌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.
Southwark is a dense, fully urban borough with about 316 000 residents and more than 10 600 people per square kilometre. Average deprivation sits in decile 4, so need is likely to be higher than in the country as a whole. These factors create strong pressure on adult social care, but also give scope for close links between hospitals, community teams and voluntary groups.
Almost every hospital discharge in November 2024 (99.7 %) came from a trust that the Care Quality Commission lists as acceptable. Nationally the figure is 89 %. This suggests effective commissioning and good joint planning with local acute providers. Only 11.2 % of discharges were delayed, a little lower than the England average of 12.3 %. However, when a delay happens it lasts longer: the mean delay is 0.95 days compared with 0.7 days nationally. In a crowded, deprived inner-city area it is often harder to secure home care or supported housing quickly, so the longer tail is understandable. Tackling the small number of long delays could free capacity without major structural change.
Satisfaction with care and support is a concern. In the 2024 survey only 53.8 % of respondents said they were satisfied, well below the England average of 64.7 %. An independent NatCen study also records 57 % dissatisfaction, hinting that negative views are widespread. The proportion of service users who feel it is easy to find information is 57.9 %, again lower than the national 68.2 %. High population turnover, many languages and complex service pathways in a big city can make navigation harder. Poor sign-posting may also dampen satisfaction even when the care itself is safe.
The Local Government and Social Care Ombudsman received around nine adult social care complaints in 2024 (2.85 per 100 000 people), and made decisions on about ten cases (3.17 per 100 000). Both rates sit below national figures of 4.45 and 4.12. This could point to strong early resolution, but could equally mean that some residents are unsure how to take a grievance forward. Low awareness would fit with the finding that information is hard to find.
The discharge data show that frontline processes are working well at the health-social care interface. Once people leave hospital, though, their ongoing experience is less positive. In an area with high deprivation, good clinical pathways alone do not guarantee that care feels responsive or that information is clear. Lower complaint rates may mask unmet need rather than confirm all is well.
Keeping the strong discharge partnership while focusing on communication and advice could raise satisfaction without large new investment. Simplified online guides, community language support and visible feedback routes may help residents use the system confidently. Reducing the small number of very long delays would also ease hospital pressure and improve user perception.
Overall, Southwark shows solid operational performance but must now turn this into a better lived experience for people who rely on adult social care.
✨ ✅ ❌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 the year 2024 Southwark spent about £39,837 for every 100,000 residents on social care before income is taken off (gross total expenditure). The England mean was £47,758. This is around 17 percent lower. After income is removed the borough spent about £35,795 per 100,000 people, while the national figure was £40,472. When we apply these rates to the local population of roughly 315,500 people, the gross bill is near £126 million and the net bill is close to £113 million.
Spending is therefore modest when we take account of head-count. That is notable because Southwark is both very urban and quite deprived. The borough has more than 10,600 people per square kilometre, four times the England average. At the same time its mean deprivation decile is 4.0 on the ten-point scale, so need for support is likely to be above the national picture. Lower spend may point to tight budgets, short care packages or demand that is still unmet rather than to low need.
Residents in Southwark put in around £4,042 per 100,000 people through client contributions, only a little over half the England mean of £7,286. In cash terms that is nearly £13 million locally against an England-level expectation of about £23 million. The gap makes sense because more households in Southwark have low income and do not meet the charging threshold. The council therefore has fewer private fees to recycle into services and must rely more on public money.
The picture is different for health partners. NHS bodies gave about £8,011 per 100,000 people, which is slightly above the England mean of £7,878. The local NHS contribution is about £25 million in total. This suggests that joint work with the Integrated Care Board is active and may be helping to fill some of the funding gap left by lower client income.
High density can create both savings and extra cost. Travel time between clients is short, yet land and labour are expensive. Southwark’s lower spend may show good efficiency, but it may also show pressure on services:
• Deprivation raises the chance that people need help earlier in life, especially with mental health or long-term illness.
• A young and mobile population can hide pockets of older or disabled residents who still require intensive support.
• Limited local charging income means the council has less room to grow supply when demand rises.
The borough’s population has grown slowly since the pandemic and is expected to keep rising. If funding does not keep pace, the present spending gap could widen and put strain on carers, staff and hospitals. Clear signals from central government on the real cost of care, plus continued strong links with the NHS, will be vital so that money follows need and residents receive the help they are entitled to.
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