Residential care
When describing the residential market in Leicestershire it is important to distinguish between 3 very different types of care home:
- Residential care for older adults
- Residential care for working age adults
- Nursing care
Each type of care home operates in its own market segment, with its own market dynamics. By referring to information from the Care Quality Commission, the DHSC Capacity Tracker and the council’s commissioning activity, this statement will describe each market.
Market capacity
In June 2024, according to the CQC the following services were operating in Leicestershire:
| Market segment | Number of homes | Number of beds |
|---|---|---|
| Older adult care homes | 101 | 3,436 |
| Working age adult care homes | 31 | 291 |
| Nursing homes | 27 | 1,421 |
| 159 | 5,14 |
Compared with the position 3 years ago, June 2021, the older adult provision has increased from 93 homes with 3032 beds at that time, a growth in bed capacity of 13%. New homes tend to be larger and target the self-funder market which is strong in Leicestershire. Analysis from the ONS indicated that about half of older adult care home places are commissioned by self-funders.
On the other hand, working age adult capacity has declined from 48 homes with 463 beds, a very significant reduction of 37%. This decline corresponds with the county council’s strategy to make greater use of Supported Living accommodation for working age adults, there has been growth in that market with significant new capacity opening in 2023/24 and 2024/25. So, despite a sizable reduction in capacity, it is not a strategic aim to grow this provision.
Nursing care capacity, which is low compared with similar councils, has also reduced from 31 homes with 1,673 beds since June 2021, a reduction of 15% in bed capacity. This reduction is a cause for concern the council would support the development of new provision in this area. More information in relation to nursing care is set out in the Market Capacity Plan.
It should be noted that care home provision in Leicestershire is described here, but the council also commissions services from care homes in Leicester. So some of the challenges regarding capacity in relation to nursing care and working age adult provision are mitigated by making placements in city homes.
Also, there is a lag in updating this data, for example the council knows that some of the homes listed, including one of those judged to be inadequate are no longer trading. However, using the CQC registration data gives the most up to date and comprehensive overview of market capacity.
| Care home / vacancy type | Occupancy |
|---|---|
| General residential | 81% |
| Dementia residential | 84% |
| General nursing | 81% |
| Learning disability residential | 82% |
| Mental health residential | 81% |
| Dementia nursing | 89% |
| YPD - Young physically disabled | 85% |
| Mental health nursing | 98% |
| Community care | 50% |
| Transitional | 100% |
| Learning disability nursing | 100% |
| 83% |
It indicates pressures in nursing care in relation to mental health, learning disability and dementia care. It would appear with overall occupancy of 83% that vacancies equate to 17% of the capacity, but this is not the case. Typically less than 15%, circa 750 beds, are available across the county.
| Number of care homes |
Older adult care homes |
Working age adult care homes |
Nursing homes |
|
|---|---|---|---|---|
| Outstanding | 2 (75 beds) | 0 | 1 (60 beds) | 3 (135 beds) |
| Good | 73 (2,431 beds) | 24 (230 beds) | 20 (1,012) beds | 117 (3,673 beds) |
| Requires improvement | 20 (754 beds) | 7 (61 beds) | 5 (273 beds) | 32 (1,088 beds) |
| Inadequate | 2 (58 beds) | 0 | 0 | 2 (58 beds) |
| No judgement | 4 (118 beds) | 0 | 1 (76 beds) | 5 (194 beds) |
Of the 101 older adult care home 75 (74%) are good or outstanding, compared with 79% of working age adult homes and 77% nursing care homes. Overall, 120 (75%) of the 159 care homes are judged to be good or outstanding.
That overall proportion of 75% of homes with a good or outstanding judgment is comparable with the East Midlands region overall figure of 74%, but lower than the national average of 79%.
Council commissioning
During 2023/24, the council funded on average 2,413 people in care homes, with 355 of those people, some 15% placed in city care homes and 204, about 8%, supported in out of county homes. Therefore, 1854 people we supported in county care homes, approximately 36% of the market capacity overall. However, it can be seen that 23% of placements, almost 1 in 4, are made outside the county, most of them in city homes.
In terms of working age adults, on average 107 (24%) of the 447 placements made we in city homes and 73 (16%) were made in out of county homes, so only 60% of working age adult placements are made in the county. Those 267 placement represent a significant proportion (92%) of the market capacity.
Similarly with nursing care, the council commissioned 257 placements in 2023/24, but again some 48 (19%) of those placement were in city or out of county homes. So the council is commissioning a small proportion (15%) of the available capacity in the county. The issue here is not that there are too many nursing homes, rather that compared with other LAs, the commissioning of nursing placements is very low, work is ongoing with health to examine that issue. The council is seeking to increase nursing care capacity in Leicestershire.
The council reports its assessment of market capacity to the DHSC each year as part of the Market Improvement and Sustainability Fund arrangements. Though capacity is a challenge in nursing care, the general assessment is that there is sufficient capacity to meet the commissioning needs of the council, albeit drawing on provision in Leicester city.
Hospital discharge is a constant pressure, and a major driver is Home First, a policy developed in the context of Hospital discharge, and has included the development of a range of services in the community to support people to live independently in their own home.
However, there will always be a significant number of people who need to be supported in care homes and for many of them their route to that support will be via hospital discharge. The council works closely with health to support people coming back into the community following a hospital stay.
For more information about the residential care market in Leicestershire please see the latest version of the Market Sustainability Plan submitted to the DHSC in June 2024.
Commissioning aspirations, intentions and opportunities
As described in the accommodation strategy for older people 2016–2026:
most of the council’s longer term commissioning intentions are designed to prevent and reduce the need for residential care and promote the development of alternatives, such as supported living and extra care.
This approach drives the priorities in the council’s social care investment work, which focuses on the development of supported living and extra care services. More information can be found in the council’s social care investment plan:
and Private investment in supported living accommodation.
Engagement and dialogue with developers / care providers is welcomed in relation to increased capacity within the older adults’ care home market.
Page last updated: February 2025.