Domiciliary Care Services | Provider Hub

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 12% in weekly domiciliary care hours being delivered in the 12 months up to March 2026 compared to the 12 months up to March 2025. Furthermore, there has been a growth of 11% in new care packages commissioned over the same period. 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. Since the start of Jan 2026, all new demand is being met by providers on our Live at Home framework.

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 commenced in November 2025 and has a term of six years. The framework covers a number of service types - personal care, 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. 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. 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 supporting care planning and service delivery (using electronic rostering, electronic homecare monitoring (EHM), digital social care records (DSCR) and electronic medications administration records). All framework providers are contractually required to use an Electronic Homecare Management system to manage care visits as a minimum.

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, to build stronger relationships with a manageable number of suppliers, whilst also maintaining a wide supplier base with a range of provider types (including SMEs and micro suppliers) to ensure sufficient supply. The current framework has approximately 390 suppliers, including 36 tier 1 suppliers. The ambition is to increase the proportion of work placed with the tier 1 framework providers.

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:

As part of the new contract there will be programme of service development. The programme includes a range of initiatives including the opportunity for some pilot projects with tier 1 suppliers to explore new ways of working.

The service development programme includes:

Exploring the commissioning of flexible care packages so that the provider is empowered to work flexibly with the adult to deliver the types of care and outcomes that are important to the adult;
Understanding the potential for Trusted Reviewers to support with the Council’s reviews of adults needs;
Building connections with providers and local health and social care services to support with ongoing service delivery and recognition of decline and escalation processes:
Maximising day opportunities offers, and access, for those in receipt of domiciliary care.
Improving the interfaces with intermediate care services, including hospital discharge processes and package restarts.

In addition to this, the Council is working with framework suppliers to explore and encourage the use of digital solutions and care technology to support adults to main independence as well as to achieve efficiencies through technical solutions to automate sourcing for this market.

While this work will be directly undertaken with tier 1 providers, some elements of the service development plans (where changes are made to pathways and processes) will have benefits for the wider care market.

Last updated: 01/04/2026

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