Adult social care in Isle of Wight

The Isle of Wight is one of the most distinctive adult social care markets in England.

Its population is smaller than most unitary authorities, but it is older, more geographically isolated and more dependent on local self-sufficiency than comparable mainland areas.

The final 2025–28 Pharmaceutical Needs Assessment estimates the Island's 2025 population at just under 143,500.

By 2030, that is forecast to increase to around 146,675.

The headline population growth is modest.

The age profile is not.

By 2030, around 30.5% of residents are projected to be aged 65 or over, with 15.8% aged at least 75 and 4.9% aged 85 or above. The number aged 85 and over is forecast to grow by 13.9% between 2025 and 2030, making the age profile far more significant for care demand than the Island's modest overall population increase.

That creates a very different demand profile from a younger urban authority.

This is likely to increase support needs related to dementia, frailty, sensory impairment, multiple long-term conditions, nursing, complex physical disability, family caring, hospital discharge and end-of-life care. The effect will differ by service and individual need.

But current market evidence does not support a simple conclusion that the Isle of Wight needs more of every type of care.

The 2024–26 Market Position Statement explicitly says the Island has historically had a relative overprovision of adult residential care.

The strategic direction is not simply to add residential beds. The council is seeking more Extra Care, supported living, flexible homecare, technology-enabled support, short-term step-up and step-down services, respite and specialist complex provision. These should be assessed against the existing supply of conventional residential care.

The Care Quality Commission's June 2026 local-authority assessment reinforces that picture.

CQC rated the council Requires Improvement at 62%, one percentage point below the threshold for Good.

It found sufficient care and support overall, but also identified waits, gaps in alternative accommodation, a continuing high rate of older people entering residential care and limited on-Island capacity for some mental-health needs.

For a prospective provider, the central question is therefore not whether the Island needs care.

It is whether the proposed service helps the Island move from traditional residential models toward more flexible, local and specialist support.

Isle of Wight at a glance

143,500

Residents estimated in 2025, just under

146,675

Population forecast by 2030

30.5%

Residents aged 65 and over by 2030

15.8%

Residents aged 75 and over by 2030

4.9%

Residents aged 85 and over by 2030

104

CQC-regulated adult social care services, 2024/25

65

Residential regulated services

39

Non-residential regulated services

5,700

Adult social care posts

5,300

Filled posts

450

Vacancies

8.2%

Estimated workforce vacancy rate

28.4%

Estimated staff turnover

3,115

People on long-term support, 2024/25

880

People on short-term support

909

Residential beds for older people, across 36 homes

457

Nursing beds for older people, across 10 homes

237

Beds in 18 other homes or supported-living settings

31

CQC-registered domiciliary-care agencies

9,405

Weekly council homecare hours, July 2024

1. Aged 65 and over

   30.5%

2. Aged 75 and over

   15.8%

3. Aged 85 and over

   4.9%

These age bands overlap. Someone aged 85 and over is also counted in the 65 and over and 75 and over shares.

These figures come from different datasets and reference periods. They should not be treated as one live operational snapshot. Together they show a relatively small but intensive care market with a very high level of older-person demand.

The Island's age profile is the defining market factor

The Isle of Wight is older than England overall.

The PNA records 15.3% of residents aged 75 and over, compared with 9.2% nationally.

15.3%

Isle of Wight

against

9.2%

England

Around 2,500 residents are aged 90 and over.

The Island also has a smaller working-age population proportion than England.

This has two major consequences.

A high proportion of older residents increases demand for medicines, primary care, homecare, dementia and nursing services, rehabilitation and care technology. At the same time, a comparatively smaller working-age population limits the pool of people available to deliver those services. Demand and workforce supply are therefore linked rather than separate planning questions.

The second is workforce pressure.

A relatively smaller working-age population has to support a disproportionately large older population.

Ageing will increase complexity more than total population

The Isle of Wight's total population is not projected to grow dramatically.

The need for care can still increase substantially.

Ageing is associated with frailty, dementia, falls, sensory loss, multiple conditions and greater dependency. Even if the population grows only slowly, more people living to advanced ages can increase the intensity of support required. The market should therefore be assessed through age-related needs rather than total resident numbers.

The commercial care market should therefore be read through the age structure rather than the total population number.

Island geography changes the commissioning problem

The Isle of Wight cannot rely on neighbouring local-authority capacity in the same way as a mainland area.

A placement or service on the mainland can require ferry journeys for relatives, professionals and staff, while creating practical difficulties for commissioners coordinating care. The Market Position Statement therefore places particular emphasis on sufficient on-Island capacity, especially where specialist needs cannot readily be met locally.

The Market Position Statement explicitly says the Island needs a level of self-sufficiency that mainland authorities may not.

The council's aim is to avoid off-Island care unless it is genuinely necessary.

This makes local specialist capacity particularly important.

The council wants less reliance on traditional residential care

Historically, the Isle of Wight has used residential care at a relatively high rate.

The Market Position Statement describes a historical relative overprovision.

CQC's June 2026 assessment still found a higher proportion of people aged 65 and over moving into permanent residential or nursing care than the England average.

This is not the direction commissioners want to preserve.

The Island is trying to build alternatives.

Older-person residential supply is already substantial

The 2024–26 Market Position Statement records 36 residential care homes for older people, offering 909 registered beds. Two are council-operated, providing residential reablement alongside 12 respite beds. This established capacity is an important reason to investigate the suitability of beds rather than assume a general shortage.

36

Residential care homes for older people

909

Registered beds

2

Homes operated by the council

12

Respite beds in those council homes

Two of those homes are operated by the council.

They also provide residential reablement and 12 respite beds.

The number of council-funded older people in permanent residential care remained broadly stable through the period covered by the MPS.

Around 20 people per month were moving into residential care.

That supports the conclusion that the market is substantial but not simply short of standard residential capacity.

Nursing capacity is smaller and more specialist

The Market Position Statement identifies 10 nursing homes for older people, with 457 registered beds. Council-funded placements were relatively stable in the 2024 evidence, although the needs of people entering nursing care are likely to become more complex as the older population grows.

• 909Residential beds, 36 homes
• 457Nursing beds, 10 homes

Council-funded nursing placements were relatively stable in the 2024 data.

But future need is likely to become more complex as the older population grows.

The Island's commissioning message is therefore not simply "more nursing beds".

It is more capability for people whose needs cannot be safely met in standard settings.

Complex dementia, acquired brain injury and bariatric care are explicit priorities

The Market Position Statement specifically encourages providers to develop residential and nursing provision for people with complex needs.

The council specifically identifies dementia, acquired brain injury and bariatric support as areas for specialist residential and nursing development. These needs require particular environments, competencies and clinical input, making them a more meaningful market signal than a generic call for more older-person beds.

This is a stronger signal than general older-person residential demand.

The same principle applies to homecare.

A provider with genuine complex-care capability may address a real gap even where the Island has substantial overall capacity.

Dementia will be one of the largest demand pressures

The Island's older population means dementia prevalence is expected to rise.

The council says more services will be needed to respond.

The council expects additional need for specialist dementia residential care, dementia nursing, suitable domiciliary provision and dementia-friendly Extra Care. Future demand is therefore likely to spread across several different models rather than concentrate exclusively in care homes.

That creates demand across several service models rather than only care homes.

Homecare capacity has expanded significantly

The current MPS records 31 CQC-registered domiciliary-care agencies.

Through its three prime providers, provision rose from 332 homecare packages and 5,151 weekly hours in November 2022 to 554 packages and 9,405 weekly hours in July 2024. That increase reflects a substantial shift in commissioned support toward people's homes.

5,151

November 2022

to

9,405

July 2024

Homecare is not uniformly easy to source

CQC's 2026 assessment adds important operational context.

CQC reported that 107 people were waiting for homecare to begin because of capacity issues during the three months to November 2025. Where the wait exceeded two weeks, the average was 34 days. Some people were not yet ready to leave hospital, so these figures need careful interpretation; they nevertheless show that delivery capacity is not uniformly responsive.

107

People waiting for homecare to begin

and

34 days

Average wait where it exceeded two weeks

The data included some people who were not yet ready for discharge, so it is not a pure measure of provider shortage.

Even so, it shows that overall provider numbers do not guarantee immediate capacity.

The prime-provider model affects market access

The council's main domiciliary-care contract is a 10-year prime-provider model.

There are three prime providers covering localities.

Prime providers are required to subcontract at least 30% of care requirements in their locality.

10 years

Prime-provider contract

3

Prime providers, one for each locality

30%

Minimum share each prime must subcontract

This is commercially important.

A new provider may not access council-funded packages directly in the same way as in authorities operating open spot markets.

The route to work may involve subcontracting.

CQC identified a two-tier fee concern

CQC found that subcontracted providers received fee uplifts through prime providers rather than directly from the council.

Partners said this had created a two-tier fee system.

Packages received directly from the council could be paid at a higher rate than subcontracted work.

For a new agency, this is a major commercial consideration.

The headline council rate may not be the effective provider rate.

Extra Care is a strategic development priority

The Isle of Wight wants to continue expanding Extra Care.

Independent Island Living aims to combine secure housing, suitable design, assistive technology, round-the-clock access to care, independence and community connection. The council sees this as an alternative to some traditional residential placements, not simply retirement accommodation.

The intended tenure mix includes affordable rent, private rent and ownership. That makes the housing and development model an important part of commissioning feasibility.

Extra Care is intended to reduce residential admissions

The strategic purpose is clear.

The Island wants more people to remain in housing-with-care rather than move prematurely into residential care.

CQC's 2026 assessment found a small waiting list for supported housing for older people such as Extra Care.

It also linked the Island's high older-person residential admission rate partly to a lack of suitable alternatives.

That makes Extra Care one of the clearest development opportunities.

Supported living is a major learning-disability gap

The Market Position Statement says the Island continues to benchmark highly for reliance on residential care for working-age adults.

Permanent admissions to residential care for adults aged 18 to 64 were around twice the national average in the evidence used by the MPS.

The council identifies insufficient supported living and community-based accommodation for people with learning disabilities. This has contributed to the Island's historic reliance on residential care and makes suitably designed community provision a clearer development opportunity than more generic residential places.

Demand for supported living is expected to rise

The council says many people with learning disabilities currently living with family, including ageing parents, are likely to seek their own supported-living accommodation.

That creates additional pressure on housing supply.

The strategy favours own-tenancy models, inclusion within local communities, sustainable schemes and appropriate assistive technology. It also seeks moves from intensive settings when these better support independence. Several new schemes opened during 2024 and 2025, demonstrating active development alongside remaining need.

1. 01NowMany adults with learning disabilities still live with family, including ageing parents
2. 02The directionOwn tenancies, local inclusion, sustainable schemes and assistive technology
3. 032024 and 2025Several new supported-living schemes opened, with need still remaining

CQC found that several new supported-living schemes opened in 2024 and 2025.

This shows active market development rather than only a future aspiration.

Mental-health capacity remains a specific gap

CQC found that the Island generally had minimal need to place people outside the local area.

But mental health was a notable exception.

Staff, partners and leaders all identified a lack of on-Island mental-health capacity that could lead to off-Island placements.

As of November 2025, 63 people were receiving mental-health support outside the Island, including 19 placed during the preceding year. Nineteen of the 63 were reported to have chosen an off-Island setting to be closer to family. The reasons behind other placements need closer analysis before being counted as unmet demand for a local provider.

63

People receiving mental-health support off Island

19

Placed during the preceding year

19

Of the 63 chose an off-Island setting to be closer to family

The remaining placements therefore deserve closer analysis.

Short-term and step-down care are explicit opportunities

The Market Position Statement encourages short-term residential and nursing care, step-up support to avoid unnecessary admission, step-down provision following hospital treatment, discharge-to-assess beds and reablement-focused services. These require responsiveness and coordination with health services rather than the occupancy model of a conventional long-term care home.

This is an important market signal.

The Island needs flexible temporary capacity as well as long-term services.

Respite is another explicit development area

The council calls for bed-based respite for adults with learning disabilities, older people, people living with dementia and those with mental-health needs. It is also interested in innovative options for people with more complex requirements, where a standard short break may not provide appropriate care.

It also specifically asks for innovative respite solutions for adults with more complex needs.

CQC's 2026 assessment found improved carers-break provision but also some waits.

A specialist respite provider may therefore solve a real system problem.

Reablement outcomes are reasonably strong

CQC found that reablement outcomes were similar to national averages.

In 2024/25, 62.81% of people aged 65 or over who received reablement after hospital discharge remained in the community 12 weeks later. Among people receiving reablement who had not previously used services, 76.53% required no ongoing support afterwards. These results reinforce the independence-first approach and affect assumptions about long-term package demand.

• 62.81%Aged 65 or over still at home 12 weeks after hospital discharge
• 76.53%New users who needed no ongoing support afterwards

The two shares describe different groups. They are not parts of one whole.

This supports the Island's independence-first strategy.

It also means providers should not assume every short-term package becomes permanent care.

Equipment and occupational therapy remain pressured

CQC found significant waits for occupational-therapy assessment.

In November 2025, 530 people were waiting for an equipment assessment, with a median wait of 171 days. Although the position had improved on earlier figures, delays of that scale can limit independence and postpone effective community support.

530

People waiting

waiting

171 days

Median wait

This was improving from earlier data, but the backlog remained substantial.

The council has introduced measures including a mobile assessment van.

For the care market, delays in equipment can affect how safely people remain at home.

The workforce is a major constraint

Skills for Care estimated approximately 5,700 adult social care posts in 2024/25, around 5,300 of them filled and 450 vacant. The estimated vacancy rate was 8.2%, above the South East and England averages, while turnover reached 28.4%. The combination makes recruitment and retention a material risk for providers considering expansion.

5,700

Posts

5,300

Filled posts

450

Vacancies

8.2%

Vacancy rate, above the South East and England

28.4%

Staff turnover

The workforce is experienced but ageing

Workers had an average of 9.4 years of sector experience.

Around 70% had worked in adult social care for at least three years.

That is a strength.

But around 28% of the workforce was aged 55 and over.

Skills for Care estimates around 1,300 posts could reach retirement age over the next decade.

9.4 years

Average sector experience

70%

Worked in adult social care for at least three years

28%

Of the workforce aged 55 and over

1,300

Posts that could reach retirement age over the next decade

That creates a longer-term workforce risk.

Island labour-market constraints are structurally different

Mainland providers can draw staff from neighbouring authorities.

The Island's labour market is more contained.

Because the local labour market is relatively contained and ferry commuting is not a straightforward substitute for local staffing, providers need a strong focus on retention, training, career development and Island-based recruitment. This is particularly important for specialist care that depends on experienced teams.

Quality is mixed across the market

CQC found some care to be excellent and some poorer.

The council uses a structured quality framework across contracted services.

At the time of CQC's assessment, three providers had active suspensions.

This reinforces the point that the Island does not only need more capacity.

It needs reliable, high-quality capacity.

The local authority itself Requires Improvement

CQC's June 2026 assessment rated the council Requires Improvement, with an overall score of 62%. Areas needing attention included assessment of needs, support for healthier lives, equity, care provision and governance. This is a system-level assessment, distinct from the ratings of individual providers.

The assessment identified stronger practice in safeguarding, safe pathways, partnerships, and learning and innovation. The mixed picture suggests a council working through improvement priorities rather than a uniformly ineffective system.

For providers, that means the system is functioning but still undergoing improvement.

What does the Isle of Wight market actually show?

The Island has substantial adult social care demand.

But the strongest opportunities are not generic.

Standard residential care

Historically overprovided. The strategic direction is to reduce unnecessary reliance on residential care.

Complex residential and nursing care

A stronger market signal, particularly dementia, acquired brain injury and bariatric need.

Homecare

A growing market, but access is shaped by the prime-provider model and capacity is not uniformly available.

Extra Care

A strong strategic opportunity and part of the solution to high older-person residential admission rates.

Learning-disability supported living

One of the clearest current gaps.

Mental-health accommodation and support

A specific capacity problem that can still drive off-Island placements.

Short-term care and discharge support

An explicit commissioning priority.

Specialist respite

A clear development area for several client groups.

Workforce

A major constraint, with above-average vacancy and turnover.

If you are using this market evidence to decide whether a particular service is worth pursuing, the Should I Start? Market Report can apply the same local dataset to your planned service on the Isle of Wight, including your service type, stage and intended customer group.

Questions to answer before starting a care service on the Isle of Wight

A prospective provider should be able to answer:

If the local market case looks strong enough to proceed and you are moving towards CQC registration, you can get a proposal comparing specially selected and verified CQC registration specialists for the service you plan to register.