Starting an Adult Social Care Service in East Sussex: What the Market Data Shows

East Sussex has an ageing population and growing demand for adult social care. But that does not mean every type of new care service is equally needed.

The county already has a substantial care market, and the position differs considerably between residential care, nursing care, home care, supported living and specialist provision.

For anyone considering starting a care service in East Sussex, the more useful question is therefore not simply "Is demand growing?"

It is: what type of care is needed, where is it needed, and how does that compare with the provision already available?

East Sussex at a glance

East Sussex County Council describes the county as experiencing some of the most pronounced demographic pressures in the country. Demand for long-term support is growing, but its latest Market Position Statement also makes clear that some parts of the market already have sufficient or excess capacity.

Population growth creates demand, but it does not identify the opportunity

East Sussex has a significantly older population than England overall.

Around 26.6% of residents are aged 65 or over, and the older population is projected to continue growing. Rother already has one of the highest proportions of residents aged 85+ in England.

The number of people receiving long-term support from Adult Social Care and Health reached 10,925 in 2024/25. That represents growth of 20.6% since 2021/22, rising to 23.7% among people aged 65+.

On its own, this appears attractive to a prospective care provider.

But population growth is only a demand indicator. It does not tell us:

• whether existing providers already have spare capacity;
• whether the demand is residential, nursing, home care or supported living;
• whether commissioners want additional providers;
• whether people can afford the proposed service;
• or whether a service can recruit the workforce required to deliver it.

That distinction is particularly important in East Sussex.

Demand indicators

• 26.6%Residents aged 65 and over
• +20.6%Long-term support, 2021/22 to 2024/25
• +23.7%Long-term support, people aged 65+

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The same growth sits against very different capacity in each part of the market.

Capacity indicators

• 80%General residential occupancy
• 92–93%Nursing occupancy
• Home-care capacity exceeds council demand
• Sufficient general supported living in parts of the market

Decide who will pay before interpreting the demand

The same care need can create very different commercial opportunities depending on who is expected to fund the service.

In older people's residential and nursing care, more than half of occupied beds in East Sussex are used by people who are not funded by Adult Social Care and Health. This includes self-funders, NHS Continuing Healthcare placements and people funded by other local authorities.

That means a provider cannot treat the Council's commissioning position as a complete description of the market. A service designed mainly for private-pay residents may face a different demand and pricing environment from one relying on local-authority placements.

The reverse is also true.

East Sussex continues to identify demand for affordable nursing and dementia provision, but it explicitly links that demand to services able to operate within or close to local-authority fee structures. Published 2026/27 weekly rates are approximately £1,129.73 for general nursing and £1,163.12 for dementia nursing, inclusive of applicable contributions and NHS-funded nursing care.

So before using any demand statistic as evidence for a business case, a prospective provider should be clear about:

• who is expected to buy the service;
• whether demand is commissioned, NHS-funded or privately funded;
• the price that market can realistically sustain;
• and whether the proposed operating model still works at that price.

Demand without a viable payer is not a viable market.

Starting a residential care home

East Sussex has a large established care-home market.

As of March 2026, the county had 167 registered care homes providing around 6,700 beds, with just over 5,300 people occupying them.

At county level, the Council says overall care-home bed supply broadly meets demand.

General residential occupancy is around 80%, while residential dementia occupancy is approximately 81%.

That means a prospective residential provider should be cautious about interpreting an ageing population as evidence that East Sussex simply needs more general residential beds.

• 80%General residential
• 81%Residential dementia
• 92%General nursing
• 93%Nursing dementia

Approximate averages, East Sussex County Council, Market Position Statement, Spring 2026.

There may still be viable propositions within the residential market. Location, property quality, pricing, client group, specialism and the balance between private and publicly funded residents can all materially change the position.

But the headline evidence does not indicate a general county-wide shortage of ordinary residential capacity.

Starting a nursing home

Nursing care presents a materially different picture.

General nursing occupancy is approximately 92%, while nursing dementia occupancy is around 93%.

East Sussex has also experienced a net loss of 477 older people's nursing beds since 2014, and the Council reports that no new nursing beds have opened since 2021.

92–93%

Average nursing occupancy

477

Net older people’s nursing beds lost since 2014

0

New nursing beds opened since 2021

Its current market message specifically identifies continuing demand for:

This is considerably stronger evidence of market pressure than the county-wide care-home figures alone would suggest.

However, there is an important qualification.

East Sussex is not simply seeking premium nursing capacity at any price. The Council explicitly refers to provision capable of operating within or close to local-authority fee structures.

For 2026/27, published Council weekly rates include approximately £1,129.73 for general nursing and £1,163.12 for dementia nursing, inclusive of applicable contributions and NHS-funded nursing care.

£1,129.73

General nursing, per week

£1,163.12

Dementia nursing, per week

For a proposed nursing home, demand therefore needs to be considered alongside the economics of actually delivering the service.

Starting a home-care agency

Home care provides perhaps the clearest example of why demographic demand should not be assessed in isolation.

East Sussex Adult Social Care and Health commissions approximately 37,000 hours of home care each week, supporting around 2,700–2,800 people at any one time. Annual Council spending is approximately £50 million.

That is clearly a substantial market.

However, the Council's current assessment is equally clear: existing home-care capacity is more than sufficient to meet its current demand.

Five lead providers currently account for around 55% of the Council's requirement, and approximately a quarter of providers on the approved list have left the market during the current contract period.

Despite that reduction, the Council reports that there have been no home-care waiting lists anywhere in East Sussex during the contract period.

• 55%Share of Council home-care requirement held by five lead providers
• 1 in 4Approved providers that have left during the contract period

Current capacity exceeds council demand. There have been no home-care waiting lists anywhere in East Sussex during the contract period.

That does not mean a new home-care agency cannot succeed.

Privately funded care, particular client groups, underserved localities or differentiated services may operate differently from the Council-commissioned market.

But it does mean that "the population is ageing" is not enough evidence to conclude that East Sussex needs another general home-care provider.

Starting a supported-living service

The position is similarly nuanced for supported living.

East Sussex has seen growth in newly established supported-living services and has recently tendered a new supported-living contract.

The Council currently says it has sufficient supported accommodation for adults with higher levels of learning-disability need and is not seeking additional standard capacity at this time.

That headline could make supported living appear closed to new provision, but the detail is more specific.

The Council continues to identify targeted requirements, including respite, short-term and emergency provision. It also has a planned targeted supported-living opportunity for two services supporting up to 20 people from spring 2028.

For prospective providers, this illustrates why simply counting supported-living services is unlikely to reveal whether there is a viable local opportunity.

The relevant question is increasingly what needs the service meets.

Specialist provision can behave differently again

East Sussex currently has 53 specialist providers operating across 106 establishments supporting groups including adults with learning disabilities, autism, mental health needs and working-age adults with complex needs.

The Council purchases approximately half of the places within the specialist residential and nursing market, making local commissioning intentions particularly important.

53

Specialist providers

106

Establishments

About half

Specialist residential and nursing places bought by the Council

Some general specialist markets are described as relatively stable. Others contain much more specific gaps.

For example, East Sussex has identified interest in provision supporting people with more complex mental-health needs, including people affected by drug and alcohol issues, autism and other multiple needs.

This is precisely where broad categories such as "mental health service" or "supported living" become too blunt to assess market potential properly.

Read the commissioning signal before committing heavily

East Sussex County Council's Market Position Statement is explicit about where it is interested in additional provision and where it is not.

The Council invites providers considering a new adult social care service to contact its Adult Social Care and Health Commissioning team with their plans. That is important because the commissioning position can differ sharply even within the same broad service category.

A county may have rising demand overall while the Council is not seeking additional general capacity in a particular market. Conversely, a smaller specialist gap can represent a much stronger commissioning signal.

Competitive opportunities over £25,000 are advertised through the Council's procurement arrangements, including the Proactis Supplier Network, and suppliers may also need to be registered on the Central Digital Platform for relevant tendering activity.

For a new provider, the practical lesson is straightforward: registration should not be the first point at which the local market is tested.

Before committing heavily to premises, recruitment or consultancy costs, the provider should understand whether the intended service fits current commissioning priorities, whether an appropriate procurement route exists and whether there is realistic non-Council demand if commissioned work does not materialise.

Location within East Sussex also matters

A county-wide figure can conceal substantial differences between Hastings, Rother, Eastbourne, Lewes and Wealden.

Population profile, deprivation, health outcomes, existing provision and travel geography all vary across East Sussex.

For example, life expectancy is highest in Wealden and lowest in Hastings, while the age profile in Rother is particularly old.

Care-home provision is also not distributed evenly throughout the county.

• Lewes
• WealdenHighest life expectancy in the county
• RotherA particularly old age profile
• Eastbourne
• HastingsLowest life expectancy in the county

English Channel

Districts are shown in their rough positions, not to scale.

A service may therefore face very different conditions depending on the exact town or postcode in which it intends to operate.

Can the service actually recruit enough people?

Demand is only useful if a provider can create the capacity to meet it.

East Sussex had around 19,000 adult social care workers in post in 2024/25, alongside approximately 1,400 vacancies.

The workforce needed is projected to increase by 28% between 2023 and 2035. Around 29% of the current workforce is aged over 55, with approximately 5,000 workers expected to reach retirement age over the next decade.

1. 01In post, 2024/25Around 19,000 adult social care workers
2. 02VacantApproximately 1,400 posts
3. 03Aged over 55Around 29% of the workforce, with about 5,000 near retirement
4. 04Needed by 2035A workforce 28% larger than in 2023

For workforce-intensive services such as nursing and home care, the local labour market should therefore form part of the viability assessment from the beginning.

Prevention and reablement can reduce immediate demand for long-term care

East Sussex is deliberately trying to help people remain independent and at home for longer.

In 2024/25, 74.6% of people aged 65 and over who entered reablement or rehabilitation after hospital discharge were still at home 12 weeks later, compared with 60.7% nationally.

For a prospective provider, that matters because population ageing does not automatically convert into the same rate of growth in residential placements or long-term packages.

Successful prevention, reablement, technology-enabled care and support from unpaid carers can delay or reduce formal service use. At the same time, people who eventually need long-term care may enter the system later with more complex needs.

This is one reason the strongest East Sussex signals are often around complexity, nursing, dementia, respite and targeted specialist provision rather than simply "more care".

Test the proposition before committing capital

A useful East Sussex business case should be able to answer more than whether the population is ageing.

Before making major commitments, a prospective provider should be able to evidence:

• the precise client group and need being addressed;
• whether the demand is general or genuinely underserved;
• the exact locality and the provision already operating there;
• the intended payer and realistic fee level;
• whether the Council or NHS is actively commissioning the service;
• whether the service can recruit the workforce it requires;
• whether suitable premises are available, if premises are needed;
• how long utilisation or occupancy is likely to take to build;
• and what differentiates the service from existing capacity.

A strong registration application and a viable service are not the same thing. The registration process can establish whether the provider is ready to deliver a regulated activity; it does not establish that customers, commissioners or referrers will use the service once it opens.

So, should you start a care service in East Sussex?

The market data does not support one county-wide answer. Instead, it points towards a number of very different conditions.

1. General residential care

   Substantial existing capacity and materially lower occupancy than nursing provision.

2. Nursing and dementia care

   Tighter capacity, higher occupancy and explicit evidence of continuing demand, particularly for affordable provision capable of supporting complex needs.

3. Home care

   A large market, but existing capacity currently exceeds Council demand.

4. Supported living

   Sufficient general capacity in parts of the market, alongside specific targeted requirements.

5. Specialist services

   Opportunities depend heavily on the client group, type of need and commissioning priorities.

The most important conclusion is that service type and specialism matter more than the headline growth in the East Sussex population.