Portsmouth adult social care under pressure amid rising costs and demand

Portsmouth City Council has published reports detailing the performance of services in the year ending April 2025.

Adult social care provides support for people who need help with daily living due to age, disability, illness, or other circumstances. Services include residential and nursing care, safeguarding, day services, and meal provision.

Service Usage and Complaints

As of 14 April 2025, 6,556 people were using adult social care services in the city. During the financial year 2024/25, 59 statutory complaints were recorded – the same as the previous year. The main issues raised related to staff communication and inadequate service, with community social work being the primary area of concern.

Spending Levels

Key findings from the report highlight Portsmouth’s relatively low overall spend per adult, a higher reliance on residential care for older adults, and a significant proportion of unmet need.

The city’s gross spend per adult was £545.06, below both the national average (£592.34) and the regional average (£588.90). Including NHS and Better Care Fund contributions, the revised spend rose to £640.72, still below the national figure of £714.61. Portsmouth ranks 110th out of 152 councils for overall spending.

Spending has risen since 2020/21, particularly for adults aged 65 and over, with costs increasing from £1,067.87 to £1,370.12. Spend for adults aged 18–64 rose more modestly, from £186.62 to £222.46. Portsmouth ranks 34th nationally for spend per adult aged 65+, but 142nd for adults aged 18–64.

The council said the lower figure for younger adults reflects a “deliberate commissioning strategy focused on developing and expanding supported living options.”

Unmet Need

Requests for support have more than doubled, from 3,560 in 2020/21 to 9,265 in 2023/24. Despite this increase, 58 per cent of requests resulted in no services being provided – well above the national average of 29 per cent.

The council attributes this to the immediate and longer-term impacts of the Covid-19 pandemic, including delayed hospital discharges, reduced access to community support, and increased health vulnerabilities.

Residential Care

Portsmouth relies heavily on care homes. There were 722 admissions to residential and nursing care per 100,000 people aged 65+, compared with the national average of 560.

The council notes that the city’s population profile, including older adults living alone and higher levels of deprivation, increases demand for long-term care.

To reduce reliance on care homes, the council is investing in Extra Care housing and reablement services.

Direct Payments and Independent Living

The use of direct payments, cash payments that allow individuals to arrange their own support, remains among the lowest in the country. Just 7.9 per cent of people use them, compared to a national average of 25 per cent, ranking Portsmouth 150th out of 152 councils.

For adults with learning disabilities, national benchmarking showed 65.4 per cent living independently. The council said this figure underreports the true picture due to historic data issues, with internal monitoring suggesting closer to 80 per cent, nearer the national average of 81.8 per cent.

Care Costs

Care costs in Portsmouth remain high. The home care hourly rate is £22.32, above the national average of £21.36. Residential care for over-65s costs £965.59 per week (£930.28 nationally), while nursing care is £1,303.95 per week (£1,004.09 nationally).

The report notes that most Portsmouth care homes are converted dwellings with small numbers of beds, driving up unit costs. The council has introduced a brokerage system to stabilise rates. External funding contributes 13 per cent from the NHS and 7 per cent from the Better Care Fund, in line with national averages.

Improvement

The report concludes by identifying several areas for priority action: rising demand, high residential costs, low take-up of direct payments, and the need to expand community-based care solutions.