Adult social care in Oxfordshire

Oxfordshire is a large, relatively affluent adult social care market with a strong existing provider base and a clear strategic preference for supporting people to remain independent in their own homes and communities.

That makes the county a poor example of a market where demographic growth can be translated directly into a general shortage of care.

Oxfordshire County Council says overall capacity in its homecare and care-home markets is good. The Care Quality Commission reached a similar conclusion in its September 2025 local-authority assessment: most homecare and care-home referrals were sourced quickly, while the more persistent delays related to supported living, specialist housing and people with complex needs.

The distinction is commercially important.

Oxfordshire's market problem is not simply the number of providers.

It is whether available provision can meet the needs of people who require specialist support, whether that provision is in the right part of the county, and whether housing, workforce and commissioning arrangements allow people to remain local.

In July 2024, Oxfordshire reported 270 people placed outside the county. CQC found that the majority of those placements reflected an inability to identify a local provider able to meet specialist requirements, particularly for people under 65 and people with learning disabilities or autism.

During 2026, Oxfordshire continued to commission additional complex-needs supported living and described specialist accommodation as a critical part of its local offer.

For a prospective provider, that is a much stronger market signal than population growth alone.

Oxfordshire at a glance

These figures come from different datasets and reference periods. They should not be treated as one live operational snapshot. Together they describe a large and generally well-supplied market with selective specialist gaps.

750,230

Residents in the ONS mid-2023 estimate used by the 2025 Pharmaceutical Needs Assessment

4.9%

Population projected to increase by approximately between 2025 and 2030

335

CQC-regulated adult social care services in 2024/25

141 / 194

Non-residential regulated services

20,500

Adult social care posts in 2024/25

1,500

Vacant adult social care posts

8.0%

Estimated workforce vacancy rate

30.6%

Estimated staff turnover rate

89.1%

Of social care providers rated Good or Outstanding in February 2025

1,082

Extra-care units across 20 schemes in the CQC evidence base

270

People placed outside Oxfordshire in July 2024

32,180

Homecare hours per week commissioned in June 2024

115

Providers on the Live Well at Home framework in the 2024 self-assessment

Good

CQC rating for Oxfordshire County Council's Care Act responsibilities, published September 2025

Oxfordshire's population is growing

The 2025 Pharmaceutical Needs Assessment used an ONS mid-2023 population estimate of 750,230.

The same assessment projects the population to increase by around 37,000 people between 2025 and 2030, approximately 4.9%.

Growth will not be evenly distributed.

That growth is spread across Oxford City, Cherwell, South Oxfordshire, the Vale of White Horse and West Oxfordshire. The county combines a dense urban centre with market towns, new housing developments and extensive rural communities. A single county-wide growth estimate therefore masks several quite different local markets.

The county contains a dense urban centre, large market towns, expanding housing developments and extensive rural areas.

That creates several different care markets inside one county boundary.

More residents can increase demand for homecare, residential and nursing care, supported living, extra care and respite. It can also bring greater need for community support, unpaid-carer services, occupational therapy and home adaptations. How that demand translates into purchased care will depend on age, locality, eligibility and the support already available.

But Oxfordshire's strategy is designed to prevent that growth translating directly into higher institutional-care use.

The Oxfordshire Way is built around independence

Oxfordshire's adult social care strategy is organised around what the council calls the Oxfordshire Way.

The central principle is to support people to live well and independently within their communities for as long as possible.

The approach combines strengths-based assessment and reablement with homecare, extra care, community support, direct payments and small community enterprises. Technology may also help people manage at home. The underlying objective is to meet support needs earlier and in less restrictive settings where appropriate, rather than default to residential placement.

The result is visible in performance.

Oxfordshire has reduced the rate at which older people enter permanent residential care and supports more people at home.

In 2023/24, 453 people aged 65 and over were permanently admitted to a care home. The rate was below the national average and among the stronger local-authority performers.

This means providers should not assume that an ageing population will create proportional growth in conventional residential-care demand.

Overall homecare capacity is good

Oxfordshire has spent several years building homecare capacity.

The council's self-assessment recorded 115 providers working through the Live Well at Home framework for reablement and domiciliary care.

In June 2024, the council was purchasing 32,180 hours of homecare each week.

32,180

Homecare hours purchased per week, June 2024

+6.8%

Increase on the previous year

That was 6.8% higher than a year earlier.

CQC's assessment found that 54% of homecare referrals were sourced within 48 hours and a further 23% within three to five days; the median wait in July 2024 was three days. Those figures suggest a comparatively responsive mainstream market, although they do not establish that every specialist package or rural location is equally well served.

• 54%Within 48 hours
• 23%Within three to five days

These figures do not support a general county-wide shortage of standard homecare.

They do show a large and active market.

Homecare complexity is more important than headline capacity

CQC identified a different problem within homecare.

Finding provision for people with mental-health needs was more difficult.

Oxfordshire was planning to add additional providers able to support people with forensic needs alongside mental-health needs.

The gaps reported in the wider local-authority assessment affected people living with serious mental illness or psychosis, acquired brain injury, poor physical health, long-term conditions, addictions or dual diagnoses. These overlapping needs call for specific workforce skills and reliable coordination with health services, rather than more undifferentiated homecare hours.

That changes the market-entry question.

The strongest homecare opportunity may be specialist capability rather than another general provider.

The Live Well at Home framework remains central

Oxfordshire's current Live Well at Home framework covers reablement, long-term homecare and extra-care housing.

The framework was extended first to March 2027 and, in September 2026, Oxfordshire approved a further extension to 31 March 2028 while reviewing the future commissioning model.

The planned replacement Staying Well at Home procurement was delayed following local government reorganisation decisions.

For providers, this matters.

The commissioning landscape is in transition.

An operator relying on council-funded packages needs to establish the current framework route, the status of replacement procurement, any proposed geographic zoning and the effects of local government reorganisation. The timetable for arrangements after 2028 also matters to investment decisions. CQC registration does not itself secure access to commissioned work.

Registration with CQC and access to commissioned demand are separate issues.

Care-home capacity is also broadly adequate

Oxfordshire's CQC evidence says overall care-home capacity is adequate.

In July 2024, 48% of care-home placements were sourced within 48 hours and another 24% within three to five days. This is consistent with the council's wider description of adequate overall capacity, although it still leaves room for gaps in specific locations or care categories.

1. Of care-home placements were sourced within 48 hours

   48%

2. Within three to five days

   24%

The council's 2025 public reporting also said it had sufficient care-home places overall.

Again, this does not support a simple county-wide shortage narrative.

But the distribution of capacity is uneven.

Geography creates local care-home gaps

CQC found that some parts of Oxfordshire had little or no care-home provision, especially rural areas.

Other parts had more capacity than local demand required.

This means county-wide bed numbers can conceal local access problems.

A vacancy elsewhere in the county can leave a person far from family, community relationships, their GP and familiar services. For prospective care-home operators, a genuinely useful local placement may therefore be more valuable than adding beds to an area with ample existing supply.

For prospective providers, locality can therefore matter more than the total number of beds in the county.

The quality profile is comparatively strong

Oxfordshire reported that 89.1% of social care providers were rated Good or Outstanding as of February 2025.

That compared favourably with the England figure cited by the council.

A mature, high-quality market raises the competitive standard for new entrants.

Registration is not differentiation.

A new provider needs to compete through specialist capability, strong leadership, continuity, a convenient location and demonstrable outcomes. Residents and families will also assess their experience of the service. Registration establishes permission to operate but is not, on its own, a reason for someone to choose the provider.

Council fee levels are relatively high

The 2025/26 ceiling thresholds included £1,145.10 a week for residential care and £1,249.20 for specialist residential care. Nursing rates were £1,228.68 and £1,332.78 respectively for standard and specialist provision, excluding funded nursing care. The published homecare threshold was £30.26 an hour. These figures provide context for business planning, not guaranteed contract prices for every placement.

The council has also described itself as one of the higher-paying authorities in the South East for residential and nursing care and among the highest for homecare.

Although useful for planning, the rates do not guarantee financial viability.

Oxfordshire has high housing and labour costs, and specialist services can require significantly higher staffing intensity.

Supported living is where the market picture changes

Supported living is one of Oxfordshire's clearest areas of pressure.

CQC reported much longer sourcing times than for homecare or care homes.

In July 2024, only 33% of supported-living referrals were sourced within six weeks, although 67% were sourced within three months. Those timescales contrast sharply with mainstream homecare and suggest that matching specialist needs to the right support and accommodation is the more difficult part of the market.

1. Of supported-living referrals were sourced within six weeks

   33%

2. Within three months

   67%

Availability can depend on the type of property required, the level of support, preferred location and the urgency of the case. Providers who can solve those practical constraints may offer more useful capacity than those adding generic supported-living vacancies.

This is a fundamentally different market signal from the strong overall capacity in standard homecare.

Out-of-county placements are a major indicator

Of the 270 placements outside Oxfordshire recorded by CQC, 104 were in neighbouring authorities and 166 were further afield. Fifty-nine had been made during the preceding 12 months. Their distribution is relevant to assessing whether people can access suitable local services.

104

In neighbouring authorities

and

166

In other areas

The majority were attributed to the lack of an Oxfordshire provider able to meet specialist requirements.

The problem was particularly evident among adults under 65, people with learning disabilities, autistic people and those with complex needs. Not every out-of-area placement is inappropriate, but where local providers cannot meet specialist requirements, there may be a clearly defined opportunity for suitable provision.

Out-of-area placement does not automatically mean the local market has failed.

Some people choose to live elsewhere or require a highly specialised national service.

But where the authority itself identifies local specialist capacity as the problem, the signal is stronger.

Complex-needs supported living is an active commissioning priority

Oxfordshire has continued to develop specialist supported-living capacity.

In June 2026, the council approved a new complex-needs supported-living contract through the Live Well Supported Services Framework.

The council described these developments as a critical part of the local offer.

The 2026 scrutiny evidence highlighted a shortage of specialist accommodation, fragmentation among providers and the need for better support for people with complex needs, including young adults. Reducing out-of-county placements remains part of the local objective. These are specific commissioning signals, but delivering against them requires demonstrable expertise.

That is one of the clearest opportunities for providers with genuine specialist capability.

Supported living is an expensive, high-complexity market

The 2026 scrutiny discussion put the supported independent living budget at around £56 million.

The reported average budget per service user was close to £86,000, although officers emphasised that many people have intensive and highly complex support needs.

£56m

Supported independent living budget, 2026 scrutiny

with

£86,000

Average budget per service user, reported

This is important.

Large expenditure does not imply high margins.

High expenditure often reflects intensive packages involving 24-hour staffing, waking-night support, behavioural expertise and highly individualised arrangements. Appropriate housing can also be costly or difficult to secure. The size of the budget is therefore not evidence of an easy or high-margin service.

A provider should not enter complex supported living simply because the commissioning spend is large.

Extra care is well established

Oxfordshire had 1,082 extra-care units across 20 schemes in CQC's evidence.

1,082

Extra-care units across 20 schemes

+9%

Increase in use over the previous year

Use of extra care increased by 9% over the previous year, and the council had commissioned additional capacity.

Extra care is strategically important because it provides an alternative to traditional residential care.

It allows people to retain their own accommodation while receiving care and support.

For developers and providers, the market is established rather than new.

The opportunity therefore depends on future scheme development, location, tenure and commissioning.

Community micro-enterprises broaden the market

Oxfordshire has also developed a large micro-enterprise sector.

The 2024 self-assessment reported 99 community micro-enterprises supporting 1,537 people and delivering more than 3,600 hours of support.

These organisations can provide smaller-scale, flexible community services.

They are part of the Oxfordshire Way because they expand alternatives to conventional provider models.

For a new care business, this creates another competitive dimension.

Not all demand will flow to large regulated agencies.

Working-age adult provision remains a clear gap

CQC found limited services for working-age adults outside education.

Day services and community engagement provision could have larger waiting lists.

The commissioning team was actively working with providers to improve availability.

This matters because adult social care demand is not only about older people.

Possible areas for further investigation include day opportunities, community inclusion, employment-related support, independent-living services and specialist outreach. Some of this provision may be outside CQC-regulated personal care, so the service model and regulatory scope need to be distinguished.

Some of these services may sit outside CQC-regulated personal care.

Mental health and dual diagnosis are specialist gaps

Identified gaps include support for people with severe and enduring mental illness, challenging behaviour, complex physical-health needs, addictions or dual diagnoses. These needs can make conventional housing and staffing models unsuitable. A provider would need to establish how its clinical partnerships and safeguarding arrangements would work in practice.

This is one of the strongest reasons some people are supported outside Oxfordshire.

For providers, the market signal is strong.

The operating requirements are equally demanding.

Physical disability and sensory impairment also need attention

CQC partners said provision could be improved for people with physical disability or sensory impairment.

Senior leaders also identified a lack of appropriate housing options for people with physical disabilities.

In some cases people had been placed considerable distances from Oxfordshire because suitable local accommodation was unavailable.

This is partly a care issue and partly a housing issue.

The provider cannot solve it through staffing alone.

Housing is a central constraint

Supported living depends on suitable property.

Oxfordshire's own guidance makes clear that people wanting a particular locality may need to wait longer because property availability varies.

Most supported-living properties are in or close to towns.

Suitable provision may need self-contained accommodation, accessibility adaptations, robust building design or proximity to established support networks. Property availability therefore limits the amount of specialist care capacity that can be created, even where workforce and commissioning demand are present.

Housing supply therefore determines how much specialist care capacity can actually be created.

Workforce is one of the largest risks

Skills for Care estimated approximately 20,500 adult social care posts in 2024/25, of which around 19,000 were filled and 1,500 vacant. The estimates give a sense of recruitment scale; the more persistent challenge is whether providers can retain people with the skills needed for increasingly complex support.

19,000

Filled

and

1,500

Vacant

The estimated vacancy rate was 8.0%, while turnover was substantially higher. At 30.6%, Oxfordshire's estimated turnover rate was materially above both the South East and England averages.

That creates a major commercial constraint.

A provider can find demand and still fail because it cannot maintain a stable team.

High turnover affects quality and continuity

Frequent departures increase recruitment, induction, training and supervision costs and absorb management time. They also disrupt continuity for people receiving care, can affect confidence in the service and place greater pressure on safeguarding and agency staffing. These consequences are especially serious where staff need detailed knowledge of an individual's risks and preferences.

For specialist services, losing experienced staff can be particularly damaging.

The strongest market opportunities in Oxfordshire are often also the ones requiring the most stable, skilled workforce.

Assessment performance has improved substantially

Oxfordshire had historically experienced long waits for Care Act assessments.

CQC reported that the number waiting fell by 66.9% between April 2021 and July 2024, and the council reported an 83.6% reduction by April 2025.

In January 2025, 286 people were waiting for an assessment, with a median wait of eight days and a longest recorded wait of 38 days. This illustrates improvement in access to assessments, although referral and placement timelines will continue to vary according to individual circumstances.

This is relevant because provider demand can be affected by the speed at which people move through assessment and support planning.

The improvement suggests a more efficient front end than historic data might imply.

Prevention affects future market composition

Oxfordshire is explicitly trying to reduce early or avoidable entry into care.

This is not simply a policy statement.

The approach has supported greater use of homecare, extra care, community services, direct payments and micro-enterprises. For care homes, that can moderate earlier admissions; for community-based providers, it can create new patterns of demand. The commercial effect will depend on what service is being offered and to whom.

For care-home providers, this creates substitution pressure.

For community providers, it creates opportunity.

The market is shifting in composition rather than simply growing.

What does the Oxfordshire market actually show?

Oxfordshire has substantial adult social care demand and a large provider market.

But it is not generally undersupplied.

Homecare

Overall supply is good and sourcing is usually fast. The stronger gaps concern mental health, forensic needs and other complex support.

Care homes

Overall capacity is adequate, but geography is uneven and some rural communities have limited local choice.

Supported living

One of the clearest pressure points. People can wait months, specialist accommodation is insufficient and complex needs drive out-of-county placements.

Extra care

A large and growing established market that supports the county's strategy of reducing residential-care admissions.

Complex needs

A major local development priority, including learning disability, autism, mental health, dual diagnosis and physical disability.

Working-age adults

Day and community provision has identifiable gaps.

Workforce

A major constraint, especially the high turnover rate.

The strongest proposition is therefore not "more care".

It is care that solves a specific complexity, housing or locality problem.

If you are still deciding whether the opportunity is strong enough for the service you have in mind, the Should I Start? Market Report can apply the same local evidence to your planned service in Oxfordshire, including your service type, stage and intended customer group.

Questions to answer before starting a care service in Oxfordshire

A prospective provider should be able to answer:

Those questions should be answered before significant investment.

If the local market case already looks strong 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.