This State of the Nation report looks at the extent to which social care advice demand and provision has changed due to the COVID-19 health crisis as well as ongoing chronic underfunding in the social care sector. Access Social Care have worked with Mencap, Age UK, Carers UK and Independent Age for over a year on analysing the key challenges facing people who need social care and their families. Our findings indicate sharp and alarming rises in demand in many areas. The rate of growth is extremely concerning, particularly against the backdrop of known and imminent cost efficiency targets within some adult social care budgets from 2021/22 onwards.