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People who need adult social care

In England, local authorities are responsible for co-funding care services for individuals who have social care needs and insufficient financial means to meet the cost themselves. The rising demand and increasing cost of providing adult social care at a time of prolonged fiscal austerity presents a major challenge for public services across the country. Herefordshire faces specific challenges with the delivery of Adult Social Care services in the face of an ageing population in a dispersed rural setting.

In the face of increasing demand, the council has set out its commissioning intentions from 2020 onwards in the Herefordshire Market Position Statement 2020-2025. Herefordshire Council’s approach is to focus services upon those in greatest need, recognise personal abilities, fully utilise community assets and networks and preventative strategies to enable people to live independently for as long as possible.

Unpaid carers are one of Herefordshire’s most valuable assets and play a crucial role within the county’s health and social care sector. The approach in adult social care builds upon the strength of individuals and what they can do themselves, with the support of family, friends, their wider community and from commissioned services.

The supply of people into the care sector is at crisis point nationally. Employers are also finding it harder to keep existing staff. The situation is no different in Herefordshire, particularly in the home care service. Supply shortages within the workforce became critical during the pandemic as agency staff became unavailable.

Over 2,000 adults are supported by Adult Social Care (ASC) services as long-term clients, at any one time, in Herefordshire. Around half of clients are frail and/or disabled people aged 65 and over; followed by learning disabled, disabled and/or long term conditions aged under 65 and those with dementia, each accounting for around a quarter of all clients.

Residential & nursing care homes

Residential homes offer 24-hour care and support to ensure an individual’s personal needs are met. Nursing homes are similar to residential homes but are able to provide more specialist care for medical conditions by trained nurses.

The council currently supports around 750 people to meet their assessed eligible social care needs in a care home.

Home care

Home care is a range of services that help individuals live at home and remain independent for longer. Care workers can provide a range of support and assist with essential tasks such as washing and dressing, preparing and eating food and using the toilet. Herefordshire Council commissions just under 10,000 hours of home care per week from providers to support around 700 customers at any one time.

Despite the county’s ageing population, adult social care has managed to reduce the demand for home care services in recent years, through the introduction of a strengths based approach to assessment, improvements in the information and advice service and the introduction of the Home First Service.


Given Herefordshire’s relative levels of wealth and ageing demographic, it is likely that there are a considerable number of people who self-fund their personal care needs. There is only limited support available to self-funders to help them make appropriate care choices, but if they exhaust their own resources they are likely to need local authority funded care.

Although the council provides advice regarding care choices to all who want it, not all choose to seek such advice and it is currently difficult to establish the size of this cohort, or what proportion of self-funders eventually go on to need local authority funded care. The council is undertaking work to map and understand self-funder demand and choices more fully and whether they have the information needed to make informed decisions.

More information

For the latest published Adult Social Care performance data go to 'useful links'.