Adult social care in Portsmouth

Portsmouth is a compact adult social care market with a relatively young population, low geographic barriers compared with rural authorities, and an unusually clear distinction between the parts of the market that are currently oversupplied and the parts where the council wants additional capacity.

The city's latest Adult Social Care Market Position Statement, published in October 2025 and covering 2025 to 2027, is particularly useful because it does not describe a general shortage of care.

Instead, it identifies a market in transition.

Standard domiciliary care supply currently exceeds demand. Portsmouth had 62 providers on its Dynamic Purchasing System, of which 47 were active, and the council closed the system to new providers because most referrals were receiving multiple offers of care.

At the same time, the city expects need to increase significantly as the population ages and becomes more complex.

The number of people aged 65 and over is projected to increase substantially over the next two decades, while the number aged 80 and over is expected to increase even faster. Portsmouth also wants more people to remain independent at home, through reablement, technology, extra care, supported living and community-based support.

That means future demand is unlikely to be distributed evenly across the market.

The clearest opportunities are not in ordinary homecare but in affordable extra-care housing, nursing and higher-dependency residential provision, and specialist supported living for people with learning disabilities or mental-health needs. Specialist respite and community opportunities are also relevant. Across these settings, a provider may need to support dementia, neurodivergence, behaviours that challenge or multiple long-term conditions, so the commercial case depends on the precise service being offered.

For a prospective provider, Portsmouth is therefore a market where precision matters.

Portsmouth at a glance

These figures come from different datasets and reference periods. They should not be treated as one live operational snapshot. Together, however, they show the structure of the market clearly.

214,300

Residents in the ONS mid-2024 estimate

31,300

Residents aged 65 and over in 2022

18%

Projected growth in the 65-plus population by 2032

26%

Projected growth in the 80-plus population by 2032

84

CQC-regulated adult social care services in 2024/25

34 / 50

Residential and non-residential regulated services

5,000

Adult social care posts in 2024/25

200

Vacant posts

4.1%

Estimated vacancy rate

17.8%

Estimated workforce turnover

1,034

People receiving commissioned domiciliary care in January 2025

21,155

Domiciliary-care hours commissioned per week

243

Extra-care units across four schemes

211

Extra-care units subject to council nomination rights

23

Residential care homes with 507 registered beds

9

Nursing homes with 461 registered beds

272

People with learning disabilities living in supported living

55

People with learning disabilities supported outside the city

Portsmouth is ageing from a relatively young starting point

Portsmouth has a younger age profile than many neighbouring areas.

Its universities, naval and port economy, and large working-age population all contribute to that.

But the direction of travel is clear.

Between 2022 and 2032, the council projects roughly 18% growth among residents aged 65 and over and 26% growth among those aged 80 and over. By 2047, the increases are expected to be around 30% and 72% respectively. Growth among the oldest residents is especially important because care needs tend to become more complex with age.

• 18%Aged 65 and over
• 26%Aged 80 and over

This is important because care demand is concentrated disproportionately in the oldest age groups.

The number of people aged 80 and over matters more to the care market than total population growth alone.

That demographic change can bring more dementia, frailty, falls, mobility difficulties and multiple long-term conditions, alongside greater demand for nursing and end-of-life care. It does not follow that these needs will all be met through permanent care-home places.

But the council's strategic response is not to route all of that additional need into care homes.

The strategic direction is independence first

Portsmouth's Adult Social Care Strategy 2024–27 is built around helping people live fulfilling lives at home wherever possible.

The council's strategy emphasises prevention and strengths-based practice, supported by reablement, technology-enabled care, direct payments, community services and flexible housing with care. The intention is to support independence wherever it is appropriate, rather than meet rising need principally through residential admissions.

This changes how demographic growth should be interpreted.

An ageing population does not automatically mean proportional growth in general residential care.

Some people will remain at home longer.

Others may move into extra care rather than residential care.

People who ultimately require a care home may therefore enter later and with more complex needs.

That pushes future demand toward higher capability rather than simply higher volume.

Domiciliary care is currently oversupplied

This is one of the clearest messages in Portsmouth's current Market Position Statement.

The domiciliary-care Dynamic Purchasing System comprised 62 providers, of which 47 were active. The council describes supply as exceeding demand, with most referrals attracting multiple provider responses. New entrants should distinguish existing purchasing volume from an actual shortage.

62

Providers

and

47

Active providers

As a result, the DPS was closed to new providers.

This is a significant warning for anyone planning a standard domiciliary-care agency in Portsmouth.

There is care demand.

But there is not currently a general shortage of providers.

Portsmouth commissions a substantial volume of homecare

Oversupply does not mean the homecare market is small.

In January 2025, 1,034 people were receiving council-commissioned domiciliary care, representing 21,155 hours a week. The average package was 17.9 hours. These figures show a substantial established market even though the council does not presently need additional generic provider capacity.

1,034

Clients receiving domiciliary care

and

21,155

Commissioned hours per week

The average package size was 17.9 hours.

Package sizes had been increasing, which the council linked to greater complexity among people leaving hospital and people remaining at home for longer.

This is a large market.

The issue for a new provider is competition and differentiation.

Homecare demand will rise over the longer term

Portsmouth expects the ageing population and the drive to keep people at home to increase total domiciliary-care demand.

The projection for care hours used by residents aged 65 and over rises from about 1.03 million in 2025 to 1.14 million in 2030, 1.24 million in 2035 and 1.30 million in 2040. These are forecasts rather than guaranteed commissioned volumes, and should not obscure current oversupply.

Those forecasts are not guaranteed purchasing volumes.

They show the direction of demand.

A market can therefore be oversupplied today and still require more capacity later.

Complexity matters more than standard volume

Portsmouth expects providers to support increasing numbers of people with dementia, behaviours that challenge, multiple long-term conditions and higher dependency. Delivering these packages requires different staffing and supervision from low-intensity personal care, even where both are described as domiciliary care.

That creates a distinction between standard domiciliary care and higher-complexity homecare.

A provider able to support people safely after hospital discharge, manage complex care plans and maintain continuity may have a stronger proposition than an agency competing for ordinary packages.

The domiciliary-care commissioning model is changing

Portsmouth began redesigning its domiciliary-care commissioning arrangements during 2025.

The council identified two connected pressures: an oversupplied market affecting provider viability and a fixed rate that was high relative to neighbouring authorities. Its November 2025 decision moved toward market-led pricing with safeguards and greater flexibility.

A November 2025 decision moved toward a market-led rate, with minimum and maximum parameters and stronger annual quality assessment through PAMMS.

The commissioning intention was also to support local providers and improve flexibility.

This is commercially important.

Applicants should confirm the current procurement arrangements, available rates and package-allocation process rather than rely on historic fixed-rate or Dynamic Purchasing System assumptions. Registration itself does not confer purchasing access.

The live procurement route should be checked before registration.

Extra care is one of Portsmouth's clearest structural opportunities

Portsmouth currently has four extra-care schemes.

The four existing schemes contain 243 apartments, with council nomination rights over 211. The absence of vacancies in those nominated apartments in September 2025 provides a more specific demand signal than a general claim that the older population is growing.

243

Units

and

211

Units where the council has nomination rights

In September 2025, there were no vacancies in those council-nomination units and a waiting list of 10 people across the schemes.

That is already a meaningful demand signal.

The longer-term projection is stronger.

Portsmouth forecasts a substantial extra-care shortfall

The model estimates demand for approximately 376 affordable extra-care units in 2025, increasing to 400 in 2030, 446 in 2035 and 504 in 2040. These estimates account for the city's unusually large sheltered-housing sector.

376

2025

400

2030

446

2035

504

2040

Against current council nomination capacity of 211 units, this implies a substantial gap.

The council's modelling then adds further demand from an intended shift away from residential care.

On that basis, the council equates future additional need to around three new 60-unit schemes between 2025 and 2030 and another two between 2030 and 2040. This is a potential housing-and-care development pipeline, not an unconditional guarantee of commissioning or scheme viability.

This is one of the most explicit development signals in any recent local-authority Market Position Statement.

Affordable extra care is the key phrase

The opportunity is not simply retirement development.

Portsmouth is specifically interested in affordable extra care.

Portsmouth is seeking engagement from registered housing providers, landlords, prospective site owners and development partners. The emphasis is affordable housing with appropriate care, so a premium retirement scheme without this component would not automatically address the identified shortage.

A premium retirement scheme without an affordable care component does not necessarily solve this need.

Extra care is intended to support higher needs

Portsmouth views extra care as a way to help people remain independent even as care needs increase.

The council also wants to develop rehabilitation capacity within extra-care settings so people can return home after hospital.

Future extra-care schemes may need to accommodate more intensive personal care, dementia, frailty, rehabilitation and rapid changes in support requirements. The buildings and staffing model therefore need to do more than offer conventional retirement accommodation.

Residential and nursing bed capacity is tighter

The 2025–27 Market Position Statement records 23 residential homes with 507 registered beds and nine nursing homes with 461 beds. Compared with neighbouring areas, Portsmouth has relatively limited capacity relative to population, making the suitability and use of existing beds important.

23

Residential care homes

507

Registered residential beds

9

Nursing homes

461

Registered nursing beds

The council says this represents fewer care-home beds per 1,000 population than neighbouring authorities.

Occupancy is high, generally between 93% and 95%.

• 93%Lower end of the range
• 95%Upper end of the range

This creates a very different market position from domiciliary care.

Existing care-home buildings create limitations

Many Portsmouth care homes occupy converted Victorian properties.

Only a small proportion are purpose built.

Older converted buildings can have narrow corridors, limited accessible ground-floor space and difficulty accommodating larger equipment or bariatric care. These practical constraints can reduce the ability to offer high-dependency services even where a home has registered beds available.

This matters as resident acuity increases.

The existing number of beds may overstate the amount of capacity suitable for future complex need.

People are entering care homes later and with higher needs

Portsmouth's Market Position Statement says providers increasingly feel they are being asked to support greater complexity.

People are moving into care homes later.

Their stays can be shorter.

Homes are increasingly expected to support clinical tasks such as catheter care, insulin administration and PEG feeding. These requirements place greater demands on staff competence, clinical oversight and governance than a model designed around lower-dependency residents.

This raises workforce, training and governance requirements.

It also suggests future market demand will favour providers with stronger clinical capability.

Residential and nursing demand is projected to increase

Portsmouth's modelling shows additional future need in both residential and nursing care.

For nursing care, the council's indicative model rises from around 124 placements required in 2025 to 153 in 2030, 174 in 2035 and 185 in 2040. These projections support further investigation, but development plans still need a realistic assessment of current capacity, staffing and fees.

124

2025

153

2030

174

2035

185

2040

The council is interested in discussing new services, while acknowledging the economic difficulty of developing new residential and nursing schemes in the city.

This is a positive market signal.

It is not an uncomplicated one.

Land, property and build costs are significant constraints in a dense city.

Under-65 care-home demand creates another challenge

Most Portsmouth care homes are registered primarily for people aged 65 and over.

The council says more people under 65 are now requiring residential placements.

Some younger adults require residential care because of neurodivergence, complex physical disability, mental-health conditions, behaviours that challenge or substance and alcohol dependency. This is a specialist cohort rather than a conventional older-person residential market.

A provider may therefore find a stronger niche around complex working-age adults than general older-person residential care.

Learning-disability services are moving toward supported living

Portsmouth's preferred direction for adults with learning disabilities is supported living rather than residential care.

The current market includes 272 people with learning disabilities in supported living, 22 supported through Shared Lives and 34 in residential or nursing care. That mix illustrates the council's preference for community-based support, subject to individual suitability.

272

People in supported living

22

Supported by Shared Lives

34

In residential or nursing care

This shows that supported living is already the dominant accommodation model.

The future opportunity is therefore not simply to create another ordinary shared house.

Fifty-five people with learning disabilities are placed outside Portsmouth

The council says 55 people with learning disabilities are supported outside the city.

Out-of-city provision can reflect specialist requirements, legal circumstances or personal choice. The figure is nevertheless a useful starting point for exploring whether a defined group could be better supported through suitable local services.

But the figure is still a useful market signal.

The council wants more local provision where appropriate.

Supported-living design needs to balance independence and efficiency

Portsmouth favours housing that avoids institutionalisation while remaining viable to staff, offers people their own space and integrates with the surrounding community. The size and layout of a scheme should follow the client group's needs rather than the availability of a particular building.

This is a more specific commissioning proposition than generic supported living.

The property model matters as much as the support provider.

Short breaks are another area of pressure

Existing learning-disability respite is delivered through the council-run Russets service, a small independent residential offer, some Shared Lives arrangements and personal assistants providing support at home.

The council says these options are not suitable for everyone.

These options may not suit people with higher complexity, those needing a quieter environment or individuals whose support requirements are difficult to accommodate alongside other residents. That creates a more specific need than simply increasing the number of short-stay beds.

may require different respite models.

This creates an opportunity for genuinely specialist short-break provision.

Day opportunities are being redesigned

Portsmouth wants day services to become more outcome focused.

The council wants day opportunities to support employment, skills development, social enterprise, community participation and greater independence rather than rely only on attendance at buildings. These models may involve different funding and regulatory considerations from conventional care services.

For providers, this may create opportunity outside traditional regulated personal care.

Mental-health accommodation is shifting further toward supported living

Portsmouth has already moved significantly from residential mental-health care toward supported living.

The two existing supported-living contracts cover 63 people with mental-health needs across floating support, individual flats, shared houses and 24-hour staffed settings. The strategic direction is toward appropriate housing and recovery-based support rather than more generic residential placements.

The council wants to increase the proportion of people supported through these models.

There is limited specialist mental-health residential provision

Portsmouth currently commissions only a relatively small number of residential placements for people with mental-health needs.

Some are outside the city.

The council says local specialist provision is limited.

But it also says overall residential capacity for highly complex mental-health need is currently sufficient and some providers experience voids.

That distinction matters.

The stronger opportunity is not simply another mental-health care home.

Mental-health supported housing has a clearer signal

Portsmouth's Market Position Statement gives unusually detailed requirements for future mental-health supported accommodation.

The council's accommodation brief points toward self-contained flats in a single block or small shared schemes for people requiring more support, with appropriate staff space, accessibility, safe layouts and separate step-down options. Sites should offer access to transport and ideally sit within PO1 to PO6, with schemes generally kept to around six units or subdivided where larger. These details help distinguish a credible proposal from speculative property-led development.

This is a very specific message to the market.

The care workforce is comparatively stable

Of around 5,000 adult social care posts identified for 2024/25, approximately 4,800 were filled and 200 vacant. The estimated vacancy and turnover rates were 4.1% and 17.8% respectively, relatively favourable compared with several other markets.

4,800

Filled

and

200

Vacant

The relatively favourable workforce indicators are a strength, although their relevance varies by specialism.

Workforce stability does not remove specialist recruitment risk

The headline workforce picture is positive.

But Portsmouth's clearest growth areas require specific capability.

Some of the strongest identified gaps depend on registered nurses, dementia expertise, positive behaviour support, autism knowledge, mental-health skills and complex-care competencies. Low overall vacancies do not establish that these workers can be recruited in sufficient numbers for a new scheme.

A 4.1% overall vacancy rate does not prove those specialist workers are easily available.

Portsmouth's compact geography is an operational advantage

Unlike rural authorities, Portsmouth is geographically small.

Most of the population lives within a compact urban area.

The city's density can support shorter travel times, tighter homecare rounds, closer supervision and flexible deployment of staff. Those advantages may also help explain why ordinary domiciliary provision has become so competitive.

That operational advantage partly explains why domiciliary supply has been able to expand strongly.

It also increases competition.

Deprivation affects the private-pay market

Portsmouth's Market Position Statement explicitly notes that deprivation means there are relatively few self-funders compared with more affluent neighbouring areas.

Deprivation and lower self-funding capacity in parts of the city affect assumptions about care-home fees, private domiciliary care and premium accommodation. A new operator needs to assess the relevant locality and payer rather than rely on the city's population density.

A high-end private model needs to be validated carefully.

The public and jointly funded markets are especially important in Portsmouth.

Neighbourhood health strengthens the community-care direction

Portsmouth was selected for the first wave of the National Neighbourhood Health Implementation Programme.

In September 2026, the Health and Wellbeing Board approved a Neighbourhood Health Strategic Plan for 2026–29 based around seven neighbourhood health areas.

The 2026–29 Neighbourhood Health Strategic Plan emphasises care closer to home, prevention, integrated provision and stronger support for people with complex long-term conditions. Providers that can work within these pathways may be better aligned with future commissioning than isolated capacity additions.

For social care providers, integration with neighbourhood health will become increasingly important.

What does the Portsmouth market actually show?

Portsmouth has substantial adult social care demand.

But it is highly uneven by service type.

Standard domiciliary care

Currently oversupplied. The previous DPS was closed to new providers because supply exceeded demand.

Complex homecare

A stronger longer-term opportunity as package sizes increase and more people remain at home with higher acuity.

Extra care

One of the clearest opportunities. Current council-nomination capacity is significantly below projected affordable demand.

General residential care

Demand is expected to rise, but the strongest case is not simply generic bed growth.

Nursing and higher-complexity care

A stronger signal because occupancy is high, the population is ageing and existing buildings are not always suited to complex need.

Learning-disability supported living

An established and strategically preferred model, with local capacity still needing development for some people.

Mental-health supported accommodation

A clear development priority with detailed housing requirements.

Specialist respite and day opportunities

Smaller but specific gaps where innovative providers may have a role.

If you are using this 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 in Portsmouth, including your service type, stage and intended customer group.

Questions to answer before starting a care service in Portsmouth

A prospective provider should be able to answer:

1. Which exact service category is being considered?
2. Is current supply already above demand?
3. Is the opportunity standard or specialist?
4. Which commissioning route applies?
5. Is the relevant framework or procurement route open?
6. Who will pay?
7. What local provider competition already exists?
8. Does the service depend on specialist housing?
9. Can it support higher-complexity needs?
10. What fee is realistically achievable?
11. Can the required specialist workforce be recruited?
12. Does the model support independence and reablement?
13. Can the service integrate with neighbourhood health?
14. What evidence would cause the provider not to proceed?

Those questions should be answered before significant investment in CQC registration, property or recruitment.

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.