Local councils have improved their adult social care but they need to do more to achieve savings, a watchdog has said.
There were nine areas for improvement, the Audit Commission said in its Improving Value for Money in Adult Social Care briefing paper.
Better procurement and the use of community rather than residential care have been deployed by some authorities.
But councils need to "look more widely to deliver greater savings," it said.
In the report it said that as "demographic change and financial pressures combine to create tough times for adult social care", councils have looked at how to provide better, more efficient services.
The areas where they had acted were in procurement, prevention, back office, staffing, changing the balance of care, personalisation, partnership, assessment and care management, and charging.
The Audit Commission said no council addressed all nine areas, and only 20% addressed between six and eight categories.
It also said that there were few innovative examples, "with most approaches being tried and tested".
It said there was a need for "large-scale transformational changes" over the next couple of years, which could be difficult to achieve, but "the pace of change so far has been slow".
Andy McKeon, of the Audit Commission, said he was pleased councils were reacting to the pressures they face from an ageing population and because people with learning disabilities were living longer.
"But the pressures on councils are growing. Small, tried and tested improvements will help to make savings in the short-term and there are opportunities to do this.
"But councils also need to look more widely to deliver greater savings and make a real difference to people's lives in the longer term."