Background
Adult social care services in England encompass a range of support designed to assist individuals over 18 years old with personal care and daily activities, particularly those facing illness, disability, or age-related challenges. These services include personal care (e.g. help with dressing and washing) and broader support to take part in social activities or employment. Unlike the NHS, social care is not universally free. Access to publicly funded adult social care services is means-tested by local authorities, with support primarily available to those with significant needs and limited financial resources. Usually, individuals with assets exceeding £23,250 are typically required to fund their own care.
The adult social care sector in England faces significant challenges. Despite numerous inquiries and reviews over the past three decades, comprehensive reform has been lacking, leading to deep systemic issues. Approximately 400,000 individuals are awaiting assessments for their social care needs, indicating substantial delays in service provision. Local authorities are experiencing budgetary pressures, often resulting in overspending, while the workforce contends with over 100,000 vacant positions, highlighting severe staffing shortages. For more information, visit this October 2024 briefing on the state of social care in England and the future possible actions.
The number of requests for access to adult social care services received by local authorities from all new individuals who are not in receipt of long-term support increased from around 1.8 million in 2015/16 to about 2.0 million in 2024/25. 2022/23 was the first time the requests for support from new individuals received by local authorities surpassed 2.0 million.
In 2024/25, 65% (1.3 million) of requests for support were received from new individuals aged 65 years and over who are not in receipt of long-term support, and 32% (around 665,000) were from those aged 18 to 64 years. This compares with 72% (1.3 million) and 28% (around 500,000) respectively in 2015/16.
There are several outcomes for new individuals not in receipt of long-term support who request access to adult social care services from local authorities, which fall under different categories: short-term care (including short-term care to maximise independence — ST-Max), long-term care, directed to universal services or signposting, and no support provided.
For people aged 18 to 64 in 2024/25, 8% received short-term care compared with 23% for people aged 65 and over. For those aged 65 and over, the percentage rose from 20% in 2015/16 (data not shown) which could indicate a shift in care provision patterns toward short-term care.
In 2024/25, long-term care was 4% for those aged 18 to 64 and 8% for those aged 65 and over. The percentage of requests that resulted in no support being provided constitutes one of the bigger categories for both age groups: 29% for 18- to 64-year-olds and 28% for 65-year-olds. It is important to note that an individual can receive more than one type of support, but they can only be recorded against one of the support categories. For more information, see the ‘About this data’ section.
The proportion of individuals in receipt of adult social care support who have said that they were satisfied with their care and support has slightly increased from 65% in 2017/18 to 65.4% in 2023/24.
Since 2017/18, a slightly higher proportion of men in receipt of adult social care support have reported that they are satisfied with their care and support than their female counterparts. In 2023/24, 66% of men in receipt of adult social care support reported that they were satisfied with their care and support compared with 65% for their female counterparts.
Since 2017/18, a higher proportion of individuals aged 18 to 64 in receipt of adult social care support have reported that they were satisfied with their care and support than individuals aged 65 or over. In 2023/24, 69% individuals aged 18 to 64 in receipt of adult social care support reported that they were satisfied with their care and support compared with 63% those aged 65 or over.
Due to the Covid-19 pandemic, data for the 2020/21 survey is missing from this time series. See the ‘About this data’ section for more information.
We know that for people with a learning disability, appropriate accommodation has a strong impact on their safety and overall quality of life, while also reducing social exclusion. However, many people with a learning disability do not have a choice about where they live or who they live with.
The proportion of adults aged 18–64 in England who received long-term support during the year for a learning disability and lived in their own home or with their family, increased from 74% in 2014/15 to 82% in 2023/24, the highest it has been in the last 12 years.
Between 2020/21 and 2021/22, the number of adults with a learning disability who were living in their own home or with their family decreased slightly from 104,624 to 104,430, despite the proportion increasing from 78% to 79%. This is because the number of adults who received long-term support for a learning disability during the year decreased from 133,658 to 132,450 in the same period. In 2023/24, both the number of adults with a learning disability who were living in their own home or with their family and the number of adults who received long-term support during the year for a learning disability increased (to 110,371 and 135,176 respectively).
The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. As part of its regulatory requirement, the CQC conducts inspections on social care services at location-level against 5 categories: safe, effective, caring, responsive to people’s needs and well-led. These adult social care services can be rated as ‘inadequate’, ‘requires improvement’, ‘good’ or ‘outstanding’. More information can be found in the ‘About this data’ section.
The 2025 data use the single assessment framework that was introduced in 2024, therefore direct comparisons with previous years is not possible (for more information, please see the ‘About this data’ section). In 2025, the majority (67%) of adult social care services were rated as ‘good’ and only 2.1% of adult social care services were rated as ‘outstanding’. The proportion of social care services requiring improvement was 26.4%, and 4.1% were deemed ‘inadequate’.
About this data
Adult Social Care Activity and Finance Report
Requests for support and what happens next
This indicator uses data from the of the Short and Long Term (SALT) data return from the Adult Social Care Activity and Finance Report on requests for support and their outcomes. It focuses on the number of requests for support received by local authorities from ‘new clients’, which are defined as individuals not currently in receipt of long-term support at the time of the request. The data includes only those requests for which an outcome, also referred to as a sequel, was determined within the reporting period. This means the dataset may include requests received in a previous year if their outcomes were finalised during the current year.
The outcomes of requests for support are categorized into three primary areas: short-term care to maximize independence (ST-Max), long-term care, and other support. We have grouped the outcomes in the following manner:
- Short-term care includes:
- Short Term Care: to maximise independence
- Short Term Care: other short term
- Long Term Care includes:
- Long Term Care: Nursing
- Long Term Care: Residential
- Long Term Care: Community
- Long Term Care: Prison
- No Further Action includes:
- No further action: Deceased
- No further action: Moved to another LA
- No further action: Outcome stated and not found
- No further action: Referral to NHS services or NHS funded social care or end of life care
- No further action: Self-funded client (inc. 12wk disregard)
- No further action: Service ended as planned
- No Support includes:
- Services not provided
- Information and advice or signposting
- Admitted to hospital
- Unknown
Each request can only be recorded under one sequel, determined using a top-to-bottom hierarchy that prioritises which outcome to record when multiple sequels apply. Requests for support are defined as inquiries or applications for access to adult social care services and can be initiated by clients or on their behalf.
For more information, please visit Adult Social Care Activity and Finance Report, England, 2024-25
Adult Social Care Outcomes Framework
Satisfaction of care and support
This indicator uses data from outcome measure 3A of NHS Digital's Adult Social Care Outcomes Framework (ASCOF). The measure shows the proportion of all adults (aged 18–64) in receipt of social care services who said they were satisfied with their care and support, reported in percentages.
Assistance in completing the questionnaire was categorised as help from a care worker, someone in the same household, or someone outside the household. The largest group (28.3%) received help from someone outside their household, up from 26.6% in 2021/22. Those reporting no help dropped slightly to 23.2% from 23.6% in 2021/22. Therefore, caution should be applied when interpreting this question on satisfaction of care and support as only a minority of respondents completed it alone.
Due to the impact of Covid-19, the 2020/21 ASCS survey was voluntary and only 18 Councils with Adult Social Services Responsibilities (CASSRs) participated. Consequently, England, Regional, and Council Type outcomes were not calculated, and only the average of the 18 CASSRs was provided for comparison. Data from 2021/22 can be compared with earlier years but not to 2020/21. Data from 2020/21 is not reported in this indicator.
Data for this indicator is collected from each local authority. In 2020/21 Hackney Council did not submit their data because of a cyber-attack. To ensure 2020/21 data is comparable with previous years, NHS Digital calculated the aggregate totals using 2019/20 data from Hackney Council. In 2023/24, the Isles of Scilly, City of London and Hackney do not have ASCOF outcome scores for this measure. Further details can be found in the Adult Social Care Activity and Finance data quality report.
For more information, please see the Adult social care outcomes framework: handbook of definitions.
Residence
This indicator uses data from outcome measure 1G of NHS Digital's Adult Social Care Outcomes Framework (ASCOF). The measure shows the proportion of all adults (aged 18–64) whose primary support reason is learning disability support, who are ‘known to the council’, and who are recorded as living in their own home or with their family.
The definition of individuals ‘known to the council’ is that they are adults of working age with a primary support reason of learning disability support who have received long-term support during the year.
‘Living on their own or with their family’ is intended to describe arrangements where the individual has security of tenure in their usual accommodation – for instance, because they own the residence or are part of a household whose head holds such security.
Prior to 2014/15, all adults with learning disabilities who were known to the council were included. In 2014/15 the eligible population was changed to include only those clients who have received a long-term service in the reporting year and have a primary support reason of learning disability support.
Data for this indicator is collected from each local authority. In 2020/21 Hackney Council did not submit their data because of a cyber-attack. To ensure 2020/21 data is comparable with previous years, NHS Digital calculated the aggregate totals using 2019/20 data from Hackney Council. Further details can be found in the Adult Social Care Activity and Finance data quality report.
For more information, please see the Adult social care outcomes framework: handbook of definitions.
CQC ratings
This measure uses data from inspection ratings of adult social care services conducted by the Care Quality Commission (CQC). The frequency of the inspections depends on the information they receive and the information they collect. Ratings are based on five key questions: whether services are safe, effective, caring, responsive to needs, and well-led. The ratings— ‘inadequate,’ ‘requires improvement,’ ‘good,’ and ‘outstanding’—are reported for all active services as of 1 August, 2025, with ‘insufficient evidence to rate’ included separately.
The newer single assessment framework introduced in January 2024 is still in its early implementation phase. Comparative analysis with previous years will not be possible due to this transition.
For more information, please visit The state of health care and adult social care in England 2024/25 – Appendix (CQC ratings chart)