This page provides an overview of social care in Sunderland, along with key metrics that could affect social care. Understanding these metrics is important because they help contextualise the challenges with social care provision in each local authority. These statistics are important to keep in mind when reviewing the other pages.
Why are these metrics important? Population size and density can affect the demand for social care services. For example, if a local authority has a high population (relative to other areas), it may need to allocate more resources to meet care needs. Similarly, areas with high population density may require more care services due to the increased number of people living in close proximity. Inversely, areas with a low population density may have fewer care needs, but residents may face challenges accessing services due to the distance between them. Lastly, people in rural areas might live further away from services, which can impact their ability to access care, or make it more expensive to provide.
Understanding these metrics can help local authorities plan and allocate resources effectively.
Deprivation decile is a measure of the level of deprivation in a local authority. It is calculated by ranking areas in England from 1 (most deprived) to 10 (least deprived) based on factors such as income, employment, education, and health. A higher decile indicates lower levels of deprivation, while a lower decile suggests higher levels of deprivation. Understanding deprivation levels can help local authorities identify areas that may require additional support and resources to address social care needs.
IMD 2019 for the Lower Tier Local Authorities: Sunderland
Deprivation rank is a measure of the relative deprivation of a local authority compared to other areas in England. It is calculated by ranking areas from 1 (most deprived) to 32,844 (least deprived) Lower Layer Super Output Areas (LSOA), which can be thought of as “small areas”. This rank is based on factors such as income, employment, education, and health. A lower rank indicates higher levels of deprivation, while a higher rank suggests lower levels of deprivation. Understanding deprivation ranks can help local authorities identify areas that may require additional support and resources to address social care needs.
IMD 2019 for the Lower Tier Local Authorities: Sunderland
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 Sunderland. 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 23.1 % of Sunderland residents are disabled, compared with the England rate of 17.6 %. The city therefore supports a much larger share of disabled citizens than the country as a whole. Sunderland is also one of the more deprived localities in England (average Index of Multiple Deprivation decile 3.8 versus 5.9 nationally). Long-term ill-health and disability often track deprivation, so high need is not unexpected. Population growth has been modest, rising from 274,000 in 2019 to 281,000 in 2023, so the high proportion is unlikely to be driven by sudden inward migration; it more probably reflects local health patterns.
In 2024 there were 3,955 requests for care from working-age adults. This equals 1,407 requests per 100,000 residents, markedly above the national figure of 1,143. The gap shows that local services face heavier front-door demand, again consistent with higher disability and deprivation.
Only 1,365 working-age adults were in an ongoing care package, or 486 per 100,000 people. The England rate is 533 per 100,000. In other words, Sunderland processes more requests but ends up supporting slightly fewer people than average. The difference may point to tighter eligibility, successful sign-posting to universal or preventative services, or unmet need that remains after assessment.
Patterns of provision give further clues. Nursing placements stand at 23 per 100,000, nearly double the national rate of 14. This suggests that those who do qualify often have complex needs requiring clinical oversight. Residential placements are lower (44 per 100,000 against 61 nationally), and direct-payment community support is also lower (84 versus 122). By contrast, council-managed community packages are common, at 313 per 100,000, above the England level of 267. The city therefore leans towards in-house managed support rather than user-controlled budgets.
The profile can reflect both choice and capacity. High nursing use may result from poorer physical health linked to socio-economic factors. Lower residential figures may be policy driven, aiming to sustain people at home. Direct payments demand confidence and informal networks; these are sometimes weaker in deprived urban settings, which could explain their relative scarcity.
Requests for help with care planning, charging queries, information, and safeguarding in 2025 are small in absolute terms (between one and eleven cases) and sit close to national per-capita rates. They have little weight on overall demand but act as early signals. The numbers show that residents do seek advice, so keeping accessible information channels open remains important.
Sunderland’s above-average disability prevalence and high request rate create sustained pressure on assessment teams. Yet the city delivers long-term care to a slightly smaller share of its population than England overall. Commissioners may wish to test whether current eligibility thresholds, re-ablement, or alternative community offers fully meet local need.
The heavy use of council-managed community support and nursing care suggests two priorities: first, continue investing in skilled home-care staff and care-co-ordination; second, work with health partners to manage complex cases that might otherwise move into high-cost nursing settings. Encouraging take-up of direct payments could widen choice, but would require targeted advice and peer support, especially in deprived neighbourhoods.
Given limited population growth, rising demand is likely to stem more from ill-health than demography. Tackling the root causes—poor housing, unemployment, and long-term health conditions—should therefore sit alongside traditional social care planning.
✨ ✅ ❌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 residents aged 65 + rose from 20.2 % to 20.9 %. England stayed around 18–19 %. Because total population only climbed from 274,000 to 281,000, the older group is growing faster than the city as a whole. Sunderland is already more deprived than average (mean Index of Multiple Deprivation decile 3.8 against 5.9 nationally) and almost entirely urban, so this ageing trend is likely to bring higher levels of long-term illness and disability than many places of similar size.
In 2024 older residents made 10,880 requests for adult social care. This equates to 3,871 requests per 100,000 people, about 60 % above the England rate of 2,438. The figure is strikingly high given that population density (1,995 persons/km²) is below the national urban average, so ease of access alone cannot explain demand. The combination of poor health linked to deprivation, legacy industrial disease, and limited informal support in an almost wholly urban area is a more plausible driver.
Of those asking for help, 3,635 older people were in receipt of a care package in 2024, equal to 1,293 per 100,000 residents: roughly one third of all requests ended with formal support. Provision is still 29 % above the national rate of 1,003 per 100,000, showing the council responds to high demand rather than simply signposting.
The pattern of support reveals further pressures. Residential placements stand at 1,475 people (525 per 100,000), more than double the national average of 250. Nursing placements are only slightly above average (130 vs 122 per 100,000), suggesting that many residents enter care homes for social rather than intensive medical reasons. Community services commissioned and managed by the council are also elevated at 610 per 100,000, yet uptake of direct payments is very low: 25 per 100,000 compared with 55 nationally, and part-direct payments are even scarcer. This reliance on council-managed care implies that personalisation has not taken root and families may feel less able, or less encouraged, to organise support themselves.
By 2025, recorded contacts for care-plan queries, charging issues, information seeking and safeguarding were very small (1–4 cases in each category) and broadly in line with national rates. Either the city now resolves most enquiries at first point of contact, or recording practices have changed. Given previous high demand, low figures need careful monitoring to ensure they do not conceal unmet need.
Sunderland is ageing faster than England while starting from a position of high deprivation. Requests for help and the proportion living in care homes are both far above average. Without stronger prevention—better housing, community health, falls services and carer support—the gap is likely to widen. Encouraging direct payments and other personalised options could ease residential demand and give families more control, but this will require confidence-building and practical brokerage. Finally, higher need per head strengthens the case for funding allocations that take deprivation-related ill-health as well as age into account, so that service levels can keep pace with a growing older 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 Sunderland had about 29,000 unpaid carers. This equals 10,648 carers for every 100,000 residents, well above the England figure of 8,204. A high level of ill health is common in places with greater poverty, and Sunderland sits in the third most deprived decile on average. More residents therefore need day-to-day help, and family and friends often provide it.
Only one carer in three (33.9%) feels they have enough social contact, yet this is still better than the national rate of 29.3%. Sunderland is a dense, mainly urban area, so shops, services, and relatives are near by. Short travel times may help carers see other people more often, even when they are busy. The finding is positive, but it also shows that two carers in three still feel lonely at least some of the time.
Most local carers (65.6%) say it is easy to get information about support, compared with 59.3% across England. This links to the very high use of “information, advice and universal services”: 669 cases per 100,000 residents, almost double the national rate. Clear signposting can prevent small problems from growing and may explain why satisfaction with information is strong.
Direct payments, which give carers money to arrange help themselves, are rare in Sunderland (34 per 100,000) and far below the England rate of 150. Personal budgets managed by the council or mixed packages do not appear in the data. Instead, the city often offers respite or other services for the cared-for person (130 per 100,000, compared with 70 nationally) and provides no direct support to 144 per 100,000. The council also reaches many carers only through advice.
This pattern may reflect tight local budgets. Direct payments can cost more to set up and manage. By focusing on advice and on services aimed at the cared-for person, the council can reach many households quickly, but the help may feel less personal to carers.
Sunderland leans heavily on unpaid carers. Community links and good advice channels seem to soften the strain, yet limited use of direct payments means many carers cannot tailor support to their own needs. With a growing and ageing population, demand for care will rise further. Offering more flexible funding while keeping strong signposting could protect carers and delay costly residential or hospital care.
✨ ✅ ❌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
Sunderland has 40 community-based adult social care providers and 85 residential care homes. When set against a 2023 population of 281,000 people, this gives about 14 community services and 30 residential homes per 100,000 residents. Nationally the mix is roughly 17 and 24 per 100,000. Sunderland therefore offers a denser network of residential places but a thinner spread of community support. In an urban area with very little rural land (0.6 % rural, England 34.6 %), short travel distances make residential care easier to reach, which may explain the heavy focus on bed-based provision. At the same time the city’s lower number of community providers could signal fewer options for people who wish to stay at home, raising a risk of unmet demand for domiciliary help.
Only 0.8 % of local providers are rated “requires improvement” or “inadequate”, far below the England figure of 16.8 %. This striking gap suggests that the current market, while smaller on the community side, is maintaining good standards. High density and close proximity of services may support stronger peer learning and easier monitoring by commissioners and regulators.
The annual staff turnover rate stands at 24.3 %, on a par with the national average. Vacancies are lower than average (6.6 % versus 8.4 %), pointing to a relatively stable workforce. Nevertheless, four out of five providers still say that recruiting staff is becoming more difficult, and seven in ten report growing problems keeping staff. This apparent contradiction can arise when the labour market is tight but providers manage to fill posts only by extra effort and cost. Sunderland’s high deprivation (mean decile 3.8, England 5.9) may limit the pool of qualified applicants, while the wider regional economy competes for the same workers.
Sunderland’s population is smaller and poorer than the England average, yet more densely packed. Higher deprivation is often linked to greater health and care needs at younger ages. A stronger residential sector may therefore reflect demand from adults who develop complex needs earlier and cannot be supported safely at home. The low share of poorly rated services suggests that, despite financial pressure, quality has not been sacrificed. Maintaining this record will depend on tackling looming workforce issues before vacancy and turnover figures climb.
Commissioners may wish to grow the community provider market, giving residents more choice to receive care at home and easing future pressure on residential places. This could involve targeted grants or training support for new domiciliary businesses, especially in the most deprived neighbourhoods. At the same time, efforts to widen the recruitment pool—through apprenticeships, better transport links to workplaces, and promotion of care careers in local schools—could prevent today’s “challenge” sentiment from turning into concrete shortages.
Sunderland offers high-quality care services with strong residential capacity but a relatively light community footprint. Workforce metrics look stable for now, yet providers feel rising strain in hiring and keeping staff. Expanding home-based care and shoring up the labour supply would help the city meet future demand while preserving its current high standards.
✨ ✅ ❌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.
Almost all local people who leave hospital are now sent to a provider that meets Care Quality Commission standards. In November 2024, 99.8 percent of discharges were from “acceptable” trusts, well above the England figure of 89 percent. This shows strong partnership working between the council, the NHS and neighbouring hospitals.
Speed of discharge is a different story. Almost 16.8 percent of Sunderland discharges were delayed, compared with 12.3 percent nationally, and the average delay was about one day (0.99), versus 0.7 days in England. The higher delay rate may point to pressure on home-care packages, shortage of therapists, or limited family support. Sunderland’s small rural area (under 1 percent) means most residents live close to hospital, so travel is unlikely to be the reason. Deprivation is more plausible: with an average Index of Multiple Deprivation decile of 3.8 (England 5.9), many patients need extra social or housing support before they can leave safely, lengthening stays.
The adult social care survey in 2024 found that 67.9 percent of respondents were satisfied with their care and support, slightly higher than the England average of 64.7 percent. This suggests frontline teams give a service that feels personal and respectful, even in a high-demand setting. However, a separate NatCen study recorded a 57 percent dissatisfaction rate. The two figures come from different questions, yet the contrast hints at uneven experiences: people who do receive a package rate it well, while those who seek help but do not qualify report frustration.
In 2024, 68.9 percent of service users said it was easy to locate information about support, almost identical to the national level of 68.2 percent. Digital sign-posting and community hubs appear to be performing on par with other areas, but not yet delivering a step-change.
At 6.8 cases per 100,000 residents, Sunderland saw a higher volume of complaints both received and decided than England (4.5 and 4.1 respectively). The council’s population is smaller than the national average, so raw numbers stay modest, yet after standardisation the rate is still elevated. This may link to the earlier-noted discharge delays and unmet demand; people turn to the Ombudsman when local resolution fails.
Sunderland’s population has risen slowly, from 274,000 in 2019 to 281,000 in 2023, but remains below the England mean. Density is 1,995 residents per km², lower than the national 2,469, yet the city is almost entirely urban. High deprivation and a wider spread of poverty across neighbourhoods (standard deviation 2.54) increase the complexity of care needs. More people live alone, have long-term conditions and require wrap-around support, putting pressure on discharge pathways and complaints handling.
The council’s main strength is the quality of organisations it partners with; nearly every discharge meets CQC standards. The main risks lie in flow and follow-up: delays, higher complaint rates and mixed public sentiment point to stretched community capacity. Priorities for improvement could include expanding re-ablement teams, speeding up social care assessments, and giving clearer feedback channels to reduce escalated complaints. Targeted investment here should help the authority move from solid quality assurance to consistently timely, person-centred delivery.
✨ ✅ ❌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 Sunderland spends £58,066 for every 100,000 residents on social care before any income is taken into account. Using the 2023 population of 281,058, this equals roughly £163 million. After client charges and NHS money, net spending falls to about £130 million, or £46,407 per 100,000 residents. Both gross and net figures sit well above the England averages of £47,758 and £40,472. The city is therefore placing a larger share of its overall budget into social care than most councils.
Sunderland’s population is smaller than the typical English authority yet is almost wholly urban and ranks among the most deprived. The mean deprivation score is 3.8 compared with a national 5.9, and population density stands at 1,995 people per km². High deprivation is linked to poor health, earlier onset of disability and a greater need for long-term support. Higher per-person spend is therefore consistent with legitimate demand rather than simple overspend.
Residents contribute £11,659 per 100,000 people, around £33 million in cash terms, which is more than 60 % above the national rate. In a city with limited wealth this suggests that care packages are larger or last longer, pushing more clients above the means-test limit. By contrast NHS contributions are lower than average at £7,027 versus £7,878 per 100,000. The shortfall hints at limited joint funding for reablement, continuing healthcare or integrated community services. As a result, the council is carrying cost that might otherwise be shared with the health service.
Population growth has been modest—only about 6,800 extra residents since 2019—so the rise in spending is unlikely to be driven by numbers alone. Need is probably becoming more complex, reflecting enduring poverty, an ageing cohort in poor health and a housing stock that was not built with disability in mind. Sunderland’s compact geography makes home care travel efficient, yet intensive packages for people with multiple conditions can still push costs well above national norms.
Maintaining current spending appears essential if the council is to meet statutory duties and avoid hidden waiting lists. Three areas deserve attention. First, closer work with the Integrated Care Board could raise NHS contributions and reduce pressure on the council’s budget. Second, targeted prevention in the most deprived wards may slow the growth in high-cost care packages. Third, reviewing charging policies might ensure that client contributions remain fair while still supporting financial sustainability. National clarity on the true cost of social care, as local officers have requested, would help Sunderland plan with greater confidence.
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