Key facts and figures about adult social care

What is social care? How many people deliver social care? How much does social care cost individuals and the state?

Our press and public affairs team, library service and policy experts deal with hundreds of enquiries every year. Below are our answers to some key questions that have been frequently or recently posed to us. If you’ve got a question, get in touch with us.

These figures focus on adult social care in England and mostly use 2023/24 data as the most recent figures available due to the time lag of some data reporting. It mainly draws from the Adult social care activity and finance report and the Skills for Care The state of the adult social care sector and workforce in England report.

What...?

What is adult social care?

Adult social care covers a wide range of activities that help people who are older or living with disability or physical or mental illness to live independently and stay well and safe. It can include ‘personal care’, such as support for washing, dressing and getting out of bed in the morning, as well as wider support to help people stay active and engaged in their communities. Social care includes support in people’s own homes (home care or domiciliary care); support in day centres; care provided by residential homes and nursing homes (care homes); reablement services to help people regain independence; the provision of aids and adaptations for people’s homes; information and advice; and support for family carers.

Social care is often broken down into two broad categories of ‘short-term care’ and ‘long-term care’. Short-term care refers to a care package that is time limited, usually with the intention of maximising the independence of the individual using the care service and eliminating their need for ongoing support. Long-term services are provided on an ongoing basis and range from high-intensity services such as nursing care to lower-intensity community support. Both long-term and short-term care are arranged by a local authority and could be described as ‘formal’ care.

Find out more about the basics of adult social care in England in our series of video explainers.

Who...?

Who is eligible for publicly funded adult social care in England?

Although some services, such as advice and information, are available to anyone, most publicly funded social care in England is only available to people with the highest needs and lowest assets. People with assets worth more than £23,250 are normally not eligible. (For residential care, this figure includes the value of their property, if they have one.) People are usually expected to contribute towards the cost of publicly funded services from their income.

Who provides adult social care in England?

Local authorities are responsible for assessing people’s needs and, if individuals are eligible, funding their care. However, most social care services are delivered by independent sector home care and residential care providers, which are mainly for-profit companies but also include some voluntary sector organisations. Many people will also have this care organised and purchased by their local authority, though many people with disabilities employ individuals directly (‘personal assistants’) to provide their care and support, using a ‘direct payment’ from their local authority.

How much...?

How much does the government spend on social care?

In England, each local authority decides what it will spend on social care – there is no national government budget (though some of the amount local authorities have available to spend comes from grant funding that they receive from central government to spend on social care). In 2023/24, the total expenditure on adult social care by local authorities was £32 billion, up £4.6 billion compared with 2010/11. However, as a result of Covid-19, some expenditure in 2020/21 and 2021/22 went on support for the social care sector rather than individuals’ care, so totals are not comparable with previous years.

Local authorities spent similar proportion of money on long-term support for working-age adults (£10.4 billion) and older people (£11.0 billion) in 2023/24. For working-age adults, nearly two-thirds of money was spent on community-based care, whereas for older adults, nearly two-thirds was spent on care homes.

What is the cost of receiving adult social care?

In 2023/24, the average cost of a local authority-funded care home place for someone aged over 65 was £951 a week. For working-age adults, the cost was £1,540 a week. In 2023/24, local authorities paid, on average, £22.03 an hour to commission externally provided home care services.

There are no precise figures on spending for people who fund their own care, though it is estimated that self-funders pay around 40% more for their care in care homes and around £3 more per hour for home care than publicly funded clients. 

How much does social care cost and how many people will have to spend more than £100,000?

The lifetime costs of adult social care for older people vary considerably according to the level of their need. In 2010, the Dilnot Commission estimated that 50% of people aged 65 and over will spend up to £20,000 on care costs. The Department of Health and Social Care estimates that one in seven people will face costs of more than £100,000. However, it is very difficult to predict which individuals will have the greatest needs (for example, those who will develop dementia) so costs are very hard to prepare for.

How much do individuals spend on social care?

The National Audit Office cites an estimate from industry experts Laing Buisson that £8.3 billion is spent on privately purchased social care.

Many people who receive publicly funded social care are also expected to contribute towards it from their income. In 2023/4, a total of £4.1 billion was spent on these fees and charges.

How many...?

How many people work in social care in England?

There are 1.7 million filled posts in the social care sector in England, with around 1.59 million people working in adult social care (a similar size workforce to the NHS). This includes approximately 905,000 care workers, 82,000 senior care workers and 34,000 registered nurses. Most social care staff are employed by small and medium-sized private providers (of which there are around 18,500 in total). There are also approximately 123,000 roles directly employed by individual users of care services.

How many people who request social care actually get it?

In 2023/24, local authorities received over two million requests for support from new clients – 658,000 from working-age adults and 1.43 million from older people. 

In 2023/24, 859,000 people (559,000 older people and 300,000 working-age adults) received publicly funded long-term social care, primarily in residential/nursing homes or in their own homes. In addition, there were 252,000 episodes of short-term care provided.

Overall, around 42% of requests for support result in some form of service. A further 27% receive advice or signposting, and 31% receive nothing.

As such, there is significant unmet need for social care. Nuffield Trust estimated that fewer than half of older people with care needs were receiving support (including support from unpaid carers). Long-running cuts to local authority budgets have meant that funding has failed to keep pace with demographic pressures. Currently, nearly one-third of requests for local government funding result in no support. Unmet need puts pressure on the five million self-identified unpaid carers in England and Wales to provide support for their families and friends, and demand is unlikely to be met without significant funding increases.

Are people happy with the quality of care they receive?

In 2023/24, 65.4% of users of publicly funded social services said they were extremely satisfied or very satisfied with the services they received. These numbers have increased slightly from 64.7% in 2014/15. There are no figures about the satisfaction levels of people who pay for their own care.

Why...?

Why is the cost of social care rising and how much is it forecast to rise in the future?

The rising cost of social care is driven by two main factors: increasing demand for services, and the increasing costs of providing those services.

The number of people who need social care has risen over recent years, though this has not always been reflected in the number of people using care services. In 2023/24, 2.1 million people requested support from their council – an increase of 15% since 2015/16.

This rate of increase has been driven, in part, by demographic trends. People are living longer with multiple or complex needs and therefore might require short-term or long-term social care. This trend is set to continue.

However, demand for social care is not driven exclusively by an ageing population; the prevalence of disability among working-age adults has increased over recent years. The most recent data shows that the prevalence of disability among working-age adults is 23% – up from 15% in 2010/11. The same figure for older adults has remained fairly static over the same period.

As well as increasing demand, the unit cost of providing care services is also going up, driven mainly by workforce costs. Care workers, who make up the majority of the workforce, have benefited from the introduction of the National Living Wage: since 2015/16, median care worker pay has increased by 17% in real terms. However, pay in other sectors has been increasing more quickly. In 2023/24, average care workers pay was £0.67 per hour less than newly employed health care assistants in the NHS, though £0.09 higher than cleaners and £0.40 higher than kitchen and catering assistants.