The COVID pandemic resulted in an increased level of unoccupied care home beds across Essex. Since the end of the pandemic, we have seen an increase in the number of residential placements across Essex.
Market Context
Older People residential care is a service that supports an adult who requires short- or long-term care in a Care Quality Commission (CQC) registered residential care home. The type of services that can be provided in a registered residential care home are:
- Short- or long-term residential care.
- Short- or long-term specialist care, i.e. dementia, complex behaviours.
- Respite residential care.
Essex County Council have several different contracts with our providers in Essex. Our core contract is the Integrated Residential and Nursing Care Framework known as the IRN Framework. Essex County Council will work with our IRN Framework providers to block purchase beds when required to support specific capacity and demand needs for Adult Social Care.
Market Rating
The current overall Market Quality is good. There is currently an oversupply of registered residential care homes in the market. There is a need to work with the market to ensure care home provision meets future demand and need, including an increase in nursing care provision and supporting adults with more complex needs later in life.
| Market Quality | Market Supply | ECC Demand |
|---|---|---|
| Good | Good | Stable |
 |
 |
 |
| ECC Ambition | Market Workforce | Market Maturity |
| Decrease Supply | Low | Mature |
 |
 |
 |
ECC rating of the market, assessed on 31st March 2024.
- Since COVID there has been a 9% reduction in ECC funded care home placements in Older People Residential and Nursing Care Homes.
- 60 residential and nursing care homes have less than 80% occupancy.
- ECC has committed to review placement prices on an annual basis. Please see the Older People Residential and Nursing uplift page
| Essex Market | |
| No. Homes | 214 |
| No. Beds | 7,782 |
| % Homes CQC rated Good or Outstanding | 75% |
| Total Occupied Beds (including ECC funded) | 6,776 |
| Occupancy % | 87% |
| Occupancy % for ECC funded Adults | 34% |
| Market Entrants since 1.April 2023 | 2 |
| Market Exits since 1.April 2023 | 0 |
(Note: The above data set covers both Older People Residential and Nursing care. The market has been segmented based on the main specialism supported by the home)
| Essex Adult Social Care Market (ECC Funded) | |
| Spend | £131 Million |
| No. Contracted Homes | 155 |
| % Contracted Homes CQC rated Good or Outstanding | 70% |
| No. Adults funded by ECC receiving residential care | 2,973 |
| % ECC funded residential care placements CQC rated Good or Outstanding | 71% |
| Contract Utilisation | 76% |
| Average Length of Stay (Years) | 2 Years 3 months |
| Essex Adult Social Care Market - Sourcing | |
| Average Contracted Rate per week | £741.83 |
| Average Spot Rate per week | £1,148.24 |
| Contracted Placements per month | 127 |
| Spot Placements per month | 48 |
| % Admissions into residential care CQC rated Good or Outstanding | 70% |
| Average placements ended per month | 117 |
(Note: this includes homes that are also registered as Residential with Nursing)
The information shown in the table(s) above is correct as of 30th September 2024.
Information in the above table for sourcing is based on activity between 30th June 2024 and 30th September 2024.
Overall, prior to COVID 19 there was a gradual decrease in the number of placements made by ECC into residential care homes across Essex. Post COVID 19 the number of ECC placements increased and have now stabilised. This is in alignment with our strategic direction to keep adults at home with their families in the community for as long as possible.
The length of stay in domiciliary care is increasing, and there is pressure to secure additional nursing provision across Essex. Our expectation is that when adults require a residential placement it is likely the adult’s needs will be more complex and for a shorter period of time later in life. There is an ambition that whenever someone is placed in a care home, it is in a home that has a good or outstanding CQC rating.
Prior to COVID-19 the average occupancy levels in residential homes were approximately 92%. This decreased down to below 80% in some residential homes during COVID-19. These occupancy levels started increasing in 2023 and are currently at 86%.
There are several risks that will need to be managed over the next 18 months, these include:
- There could be an increase in homes exiting the market due to an increase in costs.
- The NHS may increase demand for residential placements from hospital driving up longer term costs for Adult Social Care.
- ECC does not currently pay Cost of Care Rates (25% for Residential Care).
Our current area of focus is:
- The current IRN Framework expires in 2025, we are currently reviewing our approach to IRN Framework provision from April 2025.
- Review the success of the Recovery to Home service for short-term placements and whether the 9 block contracts should continue beyond November 2024.
- Work with residential care homes to be able to meet the needs of adults with more complex needs later in life, including the possibility of shaping some residential homes into nursing homes.
- A more integrated approach with the NHS for residential placements may help keep costs down for placements that have come from hospital.