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Market Context

Domiciliary care is a range of services that are put in place to support an adult to remain in their home. The professional, known as a carer, will provide support and complete tasks that aid an adult to remain independent and safe. The type of tasks can vary from personal care, administering medications, or supporting the adult with activities. Their primary role is to maintain the adult's quality of life and support them to meet their outcomes.

Domiciliary care can be provided on a short-term or long-term basis. It is commissioned mainly from the Live at Home framework. Where care cannot be sourced from framework providers, a spot purchase contractual arrangement is used.

Market Rating

The current overall Market Quality is good, and past issues with market capacity and workforce have been addressed. Essex continues to see an increase in demand which has had some impact on the speed of market development.

Market Quality Market Supply ECC Demand
Good Good Stable/High
ECC Ambition Market Workforce Market Maturity
Manage Supply Stable/High Evolving

ECC rating of the market, assessed on the 31st March 2025

Demand for domiciliary care has been increasing year on year, with an overall growth of 4.5% in weekly domiciliary care hours commissioned in the 12 months up to March 2025. Market supply has increased significantly, partially due to a number of care providers obtaining overseas workers sponsorship licences. This has enabled providers to recruit care workers from overseas and build their capacity. On the whole, demand is being met by providers on our Live at Home framework, with currently 92% of new provision being commissioned with framework providers. Whilst market capacity across the county is currently good overall, there are pockets where there is less framework provision and work is commissioned through spot purchasing arrangements. This is typically linked to areas where there is more travel time between care visits, often in rural areas. Areas where an increase in framework provision is needed are: Colchester (Mersea & Pyefleet, Marks Tey & Layer, Rural North); Tendring (Arlseford & Elmstead); and Maldon (Southminster).

Overall, quality in the home care market is good - 89% of packages commissioned overall in the last year are with providers who are rated Good or Outstanding by the CQC.

The current Live at Home (domiciliary care) framework that commenced in August 2021 is due to expire in August 2025. There is provision to extend the framework for an up to 6 months. Currently there is a tender opportunity for the replacement contract which will reflect the current contractual model:
The current framework covers a number of service types - personal care, carers’ support, carers’ break, night awake, night sleep and 24-hour live-in care services.  It is structured as a two-tier framework, with a specific set of quality criteria that providers must satisfy in order to be eligible for inclusion on tier 1 (this includes holding a Care Quality Commission rating of at least Good overall. There are ranked lists for each service type in each of the 12 Essex districts. Care packages are offered in order of the highest ranked tier 1 provider, then if no tier 1 provider will accept the package it is offered to tier 2, and then to the spot market. Providers on the framework have had the opportunity to select rates from a price matrix, with rates for new packages being refreshed on an annual basis. For spot purchased care, providers select their own prices.

The majority of commissioned providers are using digital technology to manage care provision. However, the extent to which this is used varies - some providers are using technology to manage all aspects of their business including the management of staff as well to support care planning and delivery (using electronic rostering, electronic homecare monitoring (EHM), digital social care records (DSCR) and electronic medications administration records). Framework providers are contractually required to use an EHM system (if they deliver care to 10 or more  adults). The Council is currently developing a proof-of-concept system to collate Electronic Home Care data from framework providers to improve the oversight and risk management of commissioned care delivery.

Essex Market (This is whole market)  
No. Providers 411
Total No. Adults Receiving Domiciliary Care 15,513
% Providers CQC rated Good or Outstanding 65%
No.Providers onboarded to work with the Council since 1st April 2023 39
No. Providers exiting the market since 1st April 2023 22
Essex Adult Social Care Market - funded  
Spend £165.9 Million
No. Providers on the Live at Home Framework 104
% Providers on the Live at Home Framework CQC rated Good or Outstanding 90%
No. Adults funded by ECC  6,877
Commissioned Hours per week funded by ECC 128,277.00
% ECC funded placements CQC rated Good or Outstanding 86%
Framework Utilisation 67%

The information shown in the table(s) above is correct as of 31st March 2025.

Information in the above table for sourcing is based on activity between 31st December 2024 and 31st March 2025

The Council has a strategic ambition to drive up quality in the market. Also to develop a partnership approach, working collaboratively with key strategic providers, to align with future alliance working work, whilst maintaining a wide supplier base with a range of suppliers including SMEs and micro suppliers. To achieve this, the Council is working to increase the proportion of work placed with framework providers, in particular with tier 1 providers, and reduce the volume of placements made with the spot market.

As part of the new contract there will be pilots to explore new ways of working with contracted domiciliary providers including a programme to test right-sizing, outcomes orientated, enabling practice for domiciliary care provision, also delegated reviewer and possibly delegated assessment pilots. In addition to this, the Council is investigating technical solutions to automate sourcing and flow for this market.

The market has recovered from some of the effects of COVID-19, with workforce recruitment and retention being good.

Key risks that will need to be managed over the next two years include:

  • An increase in care packages being handed back/supplier failures in both the spot provider market and from framework providers positioned lower down the ranked lists, as a greater proportion of work is picked up by framework providers, particularly those positioned higher up on ranked lists
  • Inflationary pressures
  • Impact of Local Government Reform

Our current area of focus is:

  • The tender for the replacement Live at Home framework
  • The workforce, training and retention strategy - critical to ensure the increased capacity is sustained
Last updated: 01/04/2025
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