It is estimated that two thirds of people with dementia live in their own home and it is estimated that £2 billion is spent on home care. Adult social care and support helps people with dementia to feel supported to live their life as they want to.

Adult social care is delivered by thousands of different provider organisations, and there is often little information about how well care processes recommended by NICE are being carried out nationally. As a result, we have used survey results to look at outcomes for people using care and support services. Surveys carried out by the Alzheimer’s Society suggest that 60% of people using home care and 70% of people who live in care homes live with some form of dementia.

Home care allows people to remain in their own home, by receiving visits from home care workers to help with daily routines such as personal care, shopping, and preparing meals. It also allows people to have control over their care and support whilst staying close to what is familiar.

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43% of people who need support with memory and cognition said they were extremely or very satisfied with the care and support they received from adult social services

People's experience of care and support

Our guideline and quality standard on people’s experience using adult social care services aim to help people understand what care they should expect and improve their experience by supporting them to make decisions about their care and support. We recommend that people’s preferences and needs should be the basis on which to provide care and support to live an independent life.

Less than half (43%) of people who need support with memory and cognition said they were extremely or very satisfied with the care and support they received from adult social services in 2018/19. This is according to NHS Digital's Personal Social Services Adult Social Care Survey in England, which asked around 3,100 people who require support with memory and cognition what they thought about the local authority funded or managed care and support they received.

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Our guidance on dementia recommends that people’s care and support is reviewed. Healthwatch published why it’s important to review the care of people with dementia in 2019 and found that less than 45% of people with dementia using social care services had a planned local authority care review in the previous year.

People's control over their daily life

In the people’s experience in adult social care services guideline, we recommend that people should be provided with support to express their views, preferences, and aspirations in relation to their care and support. A person’s right to make their own decisions should be respected and they should be actively involved in all decisions that affect them.

Although most people who need support with memory and cognition said they were satisfied overall, only 21% of the survey respondents said they have as much control over their daily life as they want. When people were asked about having control over their lives and how they spend their time, the survey results varied depending on the setting where care and support was delivered. Adult social care is provided in 3 main settings: residential care homes, nursing care homes and in the community. People using nursing care or community services were less likely to give a positive answer to these questions.

People using community services live at home; this includes homes such as supported living, care housing, home care and sheltered housing. Residential homes provide accommodation and personal care, such as help with washing, dressing, taking medicines and going to the toilet. Nursing homes also provide personal care but there will always be 1 or more qualified nurses on duty to provide nursing care.

The proportion of people with memory or cognition problems who report that they're able to spend their time as they want, doing things they value or enjoy, differs by care setting