CCN and Rural Services Network - The State of Care in County and Rural Areas

This report, produced by the County Councils Network (CCN) and the Rural Services Network, sets out a detailed assessment of the pressures facing adult social care in county and rural areas, highlighting demographic challenges, rising demand, higher delivery costs and significant funding shortfalls.

The report finds that county areas experience disproportionately high levels of service requests, particularly from older adults, due to their older-than-average populations and extensive geographic coverage.

Despite this growing demand, funding has not kept pace with need, leading to high eligibility thresholds and a proportion of unfulfilled care requests.

This analysis reveals that reforms such as the cap on care and new rights for self-funders will add substantial administrative and financial pressures, especially where self-funders form the majority of service users.

Home care and community provision also cost significantly more in sparsely populated areas, further intensifying financial strain. The report concludes that without major structural reforms, long-term funding certainty and tailored national policy, county and rural care markets risk further destabilisation, leaving councils unable to meet growing demand.

Key data findings from the report include:

• County and rural councils receive 49% of all national service requests.
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• 75% of requests in these areas come from adults aged 65+.
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• 58% of requests result in no formal service due to limited resources.
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• A £761m annual care home fee gap exists between public and self‑funder rates.
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• Home care costs are up to 18% higher than in metropolitan areas.

Recommendations to government include:

• Increase funding to address rising costs and unmet need before reforms take effect.
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• Fully assess and fund new duties relating to self‑funders.
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• Legally protect a share of the Health and Social Care Levy for social care.
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• Improve workforce recruitment and retention in rural areas.
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• Ensure fair national funding distribution recognising rural service costs.
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• Support the transition from residential to domiciliary and mixed‑model care.