Cost of Living Support

Essex County Council - Provider Hub
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Market Context

Older People Residential Care is a service that supports an Adult who requires short or long term care in a specific setting outside of the Adult's home. The type of services that can be provided in a residential setting 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 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. Covid has impacted the speed of which we can develop and shape this market.

Market Quality Market Supply ECC Demand
Good Good Stable
Market Quality = Good Market Supply = Good ECC Demand = Stable
ECC Ambition Market Workforce Market Maturity
Decrease Supply Low Mature
ECC Ambition = Decrease Supply Market Workforce = Low Market Maturity = Mature

ECC rating of the market, assessed on the 01 October 2022

The COVID pandemic has resulted in an increased level of unoccupied care home beds across Essex. There has been an increase in the number of providers and homes joining the Integrated Residential and Nursing (IRN) Framework, assisting ECC to secure placements in good or outstanding CQC rated homes.

  • Since COVID there has been a 13% reduction in ECC funded care home placements in Older People Residential and Nursing Care Homes.
  • 44 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 208
No. Beds 10,206
% Homes CQC rated Good or Outstanding 78%
Total Occupied Beds (including ECC funded) 8,066
Occupancy % 79%
Occupancy % for ECC funded Adults 34%
Market Entrants since 1.April 2022 1
Market Exits since 1.April 2022 0

(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 Funder)
2022-23 Forecasted Spend £201 Million
No. Contracted Homes 149
% Contracted Homes CQC rated Good or Outstanding 74%
No. Adults funded by ECC receiving residential care 3,050
% ECC funded residential care placements CQC rated Good or Outstanding 76%
Contract Utilisation 77%
Average Length of Stay (Years) 2 years

(Note: this includes homes that are also registered as residential with Nursing)

Essex Adult Social Care Market - Sourcing
Average Contracted Rate per week £631.84
Average Spot Rate per week £909.50
Contracted Placements per month 87
Spot Placements per month 18
% Admissions into residential care CQC rated Good or Outstanding 76%
Average placements ended per month 101

(Note: this includes homes that are also registered as residential with Nursing)

The information shown in the table(s) above is correct as of 31.July 2022

Information in the above table for sourcing is based on activity between 1st April 2022 and 31st July 2022

Overall, prior to COVID 19 there was a gradual decrease in the number of placements made by ECC into residential care homes across Essex. This is in alignment with our strategic direction to keep adults at home with their families in their 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. 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.

The current COVID impact highlighted is:

Prior to COVID our average occupancy levels were approximately 92%. This has decreased down to 80% in some residential homes due to COVID. Without financial support there is an assumption that some areas of the market will struggle to remain open. Interim measures in place include:

  • The residential market is able to apply for grant funding
  • Block provision has been secured for a period of time with some providers that are on the IRN Framework and have a good or outstanding CQC rating.
  • Providers are joining the IRN framework to receive ECC benefits i.e. mini competitions and other opportunities as they arise.
  • Residential placements are increasingly being used for intermediate care placements for short term provision.

There are several risks that will need to be managed over the next 18 months, these include:

  • Further waves of COVID could impact our carer workforce providing care..
  • It is to be expected that there could be an increase in homes exiting the market if unable to increase occupancy and retain financial security with less demand in the market for residential placements.
  • The NHS may increase demand for residential placements from hospital driving up longer term costs for Adult Social Care.
  • Long COVID could bring people into Social Care a lot earlier for 55 plus.
  • ECC does not currently pay Cost of Care Rates (30% for Residential Care)

Our current area of focus is:

  • A review of residential homes is required to ascertain future provision requirements. ECC will need to play an active role in shaping our future residential provision.
  • There is a possibility of shaping some residential homes into nursing homes or providing intermediate care provision moving forward, potentially using either block contract mechanisms or other incentives.
  • A decision will need to be made as to whether or not longer-term funding will be required to keep any key residential homes in the market.
  • A more integrated approach with the NHS for residential placements may help keep costs down for placements that have come from hospital.
  • A review of our financial pricing matrixes for the IRN Framework.
Last updated: 14/10/2022