Residential and nursing care

Data about the current market position for care homes as well as commissioning aspirations, intentions and opportunities for the future, to include the accommodation strategy for older people 2016-2026.

Market position statement

Current services 

Total expenditure on residential and nursing care is in excess of £100 million per annum, one of the most significant areas of spend for the council.

In April 2023, there were 163 care homes registered in Leicestershire, of which 27 were nursing care homes, and the Council contracts with the vast majority of them. 

Services are spread unevenly throughout the county with more services in areas such as Charnwood, Hinckley and Bosworth and fewer in the east of the county.   

In 2021 and 2022, the number of permanent residential placements grew from 1,510 residents in Leicestershire care homes in Feb 2021 to a peak of 1,672 (11% increase) in June 2022. Demand then fell back to 1,611 residents (4% reduction from the peak) in February 2023.

The national ‘capacity tracker’, which measures availability in all care homes across the county, indicates there are circa 4,800 beds in Leicestershire, and about 85% are occupied. However, not all unoccupied beds are available - the spare capacity in the market is typically about 550 to 600 beds, some 12% of the overall capacity.

There is a strong self-funder market in Leicestershire, which underpins a strong residential care sector. Capacity is good, but the challenge is the relative cost, as many beds are only available at a fee in excess of the band rates paid by the Council. This is particularly the case in relation to nursing placements.

As self-funder fee rates increase it is likely that more people will come to the Council for financial assistance due to depleted resources.  

Recent quality analysis, based on CQC ratings, indicates the quality of provision in care homes in Leicestershire is slightly below the national average with 76% of homes rated as good or outstanding, compared with 79% nationally. However, Leicestershire compares well with the East Midlands (71%) and Leicester, Leicestershire and Rutland [LLR] (74%).

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 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. 

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. 

The Council will continue to work constructively with providers to commission places, support quality and market development, and monitor sustainability.  
Working with the ICB and Leicester City Council, the County Council intends to develop the way nursing care placements are commissioned across the city and county. 

The challenge with the supply of nursing care, though known to the council, was highlighted in the Fair Cost of Care analysis and intensified in the last 12 months in the context of unprecedented inflationary pressures.

Engagement and dialogue with developers / care providers is welcomed in relation to increased capacity within the older peoples care home sector.

Market Sustainability Plan  

Page last updated in June 2023.