Fresh analysis reveals a growing gap between need and provision in social care – and a post code lottery that families can’t afford to ignore.
Few decisions made in later life carry as much weight as where you choose to live. Most of us think about the lifestyle we want. The activities available, the kind of community we want to live in, the proximity to family and friends. But one crucial issue is often overlooked: will you be able to access care and support if you need it?
New analysis by leading care platform Elder, drawing on the government’s annual Adult Social Care Activity Report, shows that a significant number of older people who approach their council for help do not receive social care. The picture is slightly worse in rural areas and in some regions, markedly so.
Nationally, 38.5% of people aged 65 and over who asked their local authority for support did not receive any council-facilitated care. In rural areas, the figure was slightly higher at 39.8%, compared with 37.4% in urban areas.
While the rural/urban difference is modest at a national level, Elder’s analysis shows that outcomes vary dramatically between councils. The key message is that unmet need is not confined to one type of place. While rural residents face additional challenges, access to care varies widely between local authorities.
In Hertfordshire, 64.5% of people over 65 who requested social care did not receive it. Meanwhile, in the more urban St Helens, six in 10 older people did not receive council-arranged care. In County Durham, the figure was closer to one in 10.
Commenting on the findings, Pete, founder and CEO of Elder, said: ““The differences we are seeing between local authorities show just how important it is for families to plan ahead. Leaving care decisions until a crisis can limit a person’s options. Having open conversations early, looking into what support exists in your local area, and exploring alternatives such as home-based care can make a real difference. Access to care varies depending on where someone lives, so taking the time to research and get advice can help families make confident, informed choices for their loved ones.”
In other words, this is not simply a countryside problem. Nor is city living a guarantee of support. Access to care depends heavily on where you live and what authority you fall under.
Why rural areas are facing particular pressure
Rural England is ageing faster than urban areas. Around 9.7 million people live in rural England and more than one in four are aged 65 or over, compared with fewer than one in five in towns and cities.
Delivering care in those areas can be harder. Longer travel distances, workforce shortages and shrinking home-care capacity all make traditional models of care harder to sustain. Local authorities are also under intense financial strain, limiting their ability to respond flexibly to rising demand.
But urban living does not guarantee easy access to care either. Higher population density can stretch services, leaving older people in cities facing long waits or limited options too. The variation between councils shows that location alone does not determine outcomes.
This is why our first Prepare to Care question is where do you want to live? Decisions need to be grounded in realism rather than assumption. Whether you are considering a village, suburb or town centre, it is worth asking:
- What care services operate locally and how consistently are they delivered?
- How stretched is the local authority and what are typical outcomes for people who request care?
- Are there home care or live-in care providers covering the area reliably?
- How dependent would you be on driving and what would change if that stopped?
Prepare to Care, before a crisis hits
Elder’s analysis does not suggest that rural living is a mistake, or that urban living guarantees security. What it shows is that access to care is uneven everywhere – and that relying on assumptions can leave people exposed.
Preparing to care means recognising that where your loved ones live, the care they may need, and how that care is provided are all connected. Having these conversations early gives older people and families more choice, more control and greater peace of mind.
Age Space exists to help families navigate these decisions with trusted information, practical guidance and tools that support better outcomes in later life.
