Adult Social Care in West Sussex: Capacity, Demand and the Market Outlook

West Sussex is one of the larger adult social care markets in the South East.

It combines a substantial and ageing population with affluent commuter areas, older coastal communities, rural settlements and pockets of significant deprivation. It also has a large established independent care sector and an unusually important private-pay market.

Those characteristics create considerable underlying demand for adult social care.

They do not mean that West Sussex simply needs more of every type of care service.

Recent evidence from West Sussex County Council and the Care Quality Commission points to a more selective picture. Mainstream provision is extensive, while some of the clearest gaps concern people with complex and multiple needs, younger people living with dementia, emergency respite and people with progressive conditions.

At the same time, the county's strategic direction is increasingly focused on prevention, independence and supporting people to remain at home for longer.

For anyone considering starting or expanding a care service in West Sussex, the important question is therefore not simply whether demand exists.

It is which parts of a very large care market still have unmet need, and whether a new provider can meet that need sustainably.

West Sussex at a glance

923,200

Projected population, 2026

221,900

Residents aged 65 and over, 2026 projection

11,210

People on long-term support, 2023/24

120+

Approved homecare providers, August 2025 framework

35%

Share of wider care market purchased by the council

Good

CQC overall Care Act rating, August 2025

A large and ageing population

West Sussex has a substantially older population profile than England as a whole.

ONS projections used in the county's 2025 Pharmaceutical Needs Assessment put the population at approximately 917,400 in 2025, rising to a projected 923,200 in 2026.

Within that 2026 projection, around 221,900 people are aged 65 or over, meaning roughly one in four residents is within that age group. By 2028, the 65-plus population is projected to reach approximately 231,900.

923,200

Projected population, 2026

with

221,900

Aged 65 and over in that projection

The ageing trend is expected to continue.

West Sussex's JSNA describes the county as having an older age structure than both the South East and England and projects particularly rapid growth among adults aged 70 and over. It estimates that more than 30% of the county's population could be aged 65 or over by 2039.

1. Roughly 1 in 4West Sussex, 2026 projection
2. More than 30%Projected by 2039

This creates a strong long-term demand base for care and support.

But West Sussex is not demographically uniform.

Older populations are particularly concentrated in parts of the coastal strip, including communities around Littlehampton, Worthing, Bognor Regis, Selsey and Chichester. The county also contains substantial rural areas, while places such as Horsham and Mid Sussex have stronger commuter characteristics and Crawley has a different population profile from much of coastal West Sussex.

CQC's 2025 assessment specifically highlighted these geographical differences, including pockets of deprivation in coastal areas and Crawley despite West Sussex being comparatively affluent overall.

That matters when assessing care demand.

A county-wide population figure can conceal very different local markets. Neighbouring East Sussex and Brighton & Hove show how different South East markets can look at authority level.

Adult social care is already operating at considerable scale

West Sussex already supports a large number of people through formal adult social care.

CQC reported that approximately 11,210 people were receiving long-term adult social care support and around 1,330 people were receiving short-term support in 2023/24.

Adult social care expenditure was approximately £333.3 million in that year, exceeding the council's original budget by more than £30 million.

11,210

People receiving long-term support, 2023/24

1,330

People receiving short-term support, 2023/24

£333.3m

Adult social care expenditure, 2023/24

There is also extensive independent provision.

The council's 2023-25 commissioning strategy recorded 221 care homes containing 7,831 beds within its then-existing contractual framework. It also reported 78 supported-living providers, approximately 164 supported-living schemes and 91 commissioned homecare providers under the previous homecare framework.

221

Care homes in the then contractual framework

7,831

Beds in those homes

164

Supported-living schemes, approximate

91

Commissioned homecare providers under the previous framework

Historic figures. They show market scale, not today's provider counts.

Those figures are historical and should not be treated as current provider counts in 2026.

They are useful for demonstrating the scale and maturity of the market.

The homecare market has subsequently been recommissioned. West Sussex's newer Care and Support at Home Framework had more than 120 approved providers by August 2025, including several new services.

This is therefore not a market characterised by an absence of providers.

New entrants are joining an already substantial care economy.

West Sussex also has a large self-funder market

One of the most important features of West Sussex is the role played by people purchasing their own care.

CQC's 2025 assessment described the county as having a high proportion of self-funders.

West Sussex County Council has separately stated that it purchases only around 35% of the wider care market, with much of the remainder purchased by people funding their own care.

This changes the commercial dynamics.

In some local-authority areas, understanding council commissioning is central to understanding almost the entire adult social care market.

That is less true in West Sussex.

Local-authority commissioning remains extremely important, particularly for people with complex needs and working-age adults, but private purchasing power also has a significant influence on capacity, pricing and provider behaviour.

A prospective provider therefore needs to distinguish between the commissioned market and the private-pay market rather than assuming they behave in the same way.

This is particularly relevant to care homes and homecare, where private customers may compete with publicly funded purchasers for available capacity.

Mainstream capacity exists, but specialist gaps remain

CQC rated West Sussex County Council's overall delivery of its Care Act responsibilities Good in August 2025.

However, the specific quality statement covering care provision, integration and continuity received a score of 2 rather than 3.

One reason was that not every type of care was equally easy to source.

CQC identified awareness within the authority of gaps affecting:

1. 01

   Complex and multiple needs

   People whose support requires combinations of health, social care and behavioural provision.

2. 02

   Younger people with dementia

   Working-age adults whose dementia-related needs are harder to place locally.

3. 03

   Emergency respite

   Short-notice breaks for carers when planned provision is unavailable.

4. 04

   Progressive conditions

   People whose needs intensify over time and outstrip generalist capacity.

This is an important distinction.

West Sussex can have thousands of care-home beds, more than 120 providers on a homecare framework and extensive supported-living provision while still experiencing shortages.

The problem is not necessarily the absolute number of providers.

It is whether available providers have the skills, staffing model, property, registration and commercial ability to accept a particular person.

That distinction becomes increasingly important as the complexity of need rises.

Care homes: a major market shaped heavily by ageing and self-funding

West Sussex has a sizeable residential and nursing care market.

The demographic case for continuing demand is strong.

More than 220,000 residents are projected to be aged 65 or over during 2026, and the older population is expected to continue growing faster than the population as a whole.

West Sussex also contains established private-pay care-home markets, particularly in more affluent parts of the county.

But neither fact means that every new care-home development has an obvious route to occupancy.

The county's current strategy places substantial emphasis on supporting people to remain at home for longer, with residential and nursing care positioned as part of a wider spectrum that also includes homecare, supported housing, extra care, technology and community support.

As people enter residential care later, those who do enter may increasingly have higher acuity or more complex needs.

That changes what useful capacity looks like.

Demand for ordinary residential care cannot automatically be inferred from growth in the older population. The more valuable analysis is whether sufficient provision exists for people who can no longer be supported safely through lower-intensity alternatives.

The CQC findings around complexity, progressive conditions and younger-onset dementia suggest that parts of this higher-acuity market deserve particular attention.

Homecare: substantial demand and substantial competition

The size and geography of West Sussex create an obvious long-term role for domiciliary care.

Supporting people to remain in their own homes is central to the county's 2026 adult social care strategy, and demographic ageing is likely to increase the number of people requiring some level of support at home.

But homecare is also one of the clearest examples of why population demand does not automatically equal a gap for new providers.

The county's 2024 Care and Support at Home Framework contains more than 120 approved providers.

Under the framework, packages are allocated primarily according to the provider's ability to meet the person's needs, followed by the lowest hourly cost based on the provider's submitted standard or enhanced rates.

120+

Approved providers on the Care and Support at Home Framework, August 2025

2 steps

Allocation by ability to meet need, then lowest submitted rate

This creates a significant competitive environment for businesses dependent on council-funded packages.

A newly registered domiciliary care agency should therefore not assume that obtaining registration automatically creates access to meaningful commissioned volume.

It needs to understand how packages are allocated, whether the framework is open to new entrants, what rates can realistically be achieved and whether the business can build sufficient geographical density to operate efficiently.

The private-pay market creates another route to demand, but that introduces its own customer-acquisition and pricing considerations.

Geography matters more in West Sussex than a county-wide figure suggests

West Sussex covers a very different geography from neighbouring Brighton & Hove.

More than half of the county's land area is protected countryside, alongside substantial coastal communities and inland towns.

• Coastal strip: Littlehampton, Worthing, Bognor Regis, Selsey, Chichester
• Commuter and inland: Horsham, Mid Sussex
• Distinct urban profile: Crawley
• Rural villages across Chichester and Horsham districts

For care delivered in people's homes, this matters commercially.

A provider operating around Worthing or Crawley can face a very different routing problem from one serving villages across parts of Chichester or Horsham districts.

Travel time between visits, recruitment catchments and the density of care packages can materially change how many productive hours a care worker can deliver during a shift.

County-wide demand figures can therefore be misleading for homecare.

A profitable domiciliary care market is usually built at a much smaller geographical level.

The same principle applies to supported living and specialist accommodation.

A vacancy may exist somewhere in West Sussex but still be unsuitable because it places somebody too far from family, community connections, employment, education or clinical support.

Locality matters.

Supported living remains strategically important

West Sussex has a substantial supported-living sector.

The 2023-25 commissioning strategy recorded approximately 164 supported-living schemes, with commissioned support covering hundreds of people with learning disabilities, mental-health conditions and physical or sensory impairments.

But the authority's strategic direction suggests that supported accommodation will remain important.

The council wants to develop a wider range of accommodation options for working-age adults, expand extra care and enable more people with learning disabilities and mental-health needs to live independently.

Its current 2026 strategy continues to identify supported housing, extra care and other independence-focused models as central parts of the market it needs to sustain.

This does not establish a general shortage of supported living.

The opportunity is more specific.

West Sussex's evidence points toward the need for services capable of supporting higher complexity while maintaining independence within the community.

That may require different staffing, accommodation and management arrangements from a conventional lower-support scheme.

Lifelong disability and autism create a distinct market

Working-age adult provision is particularly important in West Sussex.

The council has historically operated a dedicated Lifelong Services model covering people with learning disabilities, autism, physical or sensory impairments and acquired brain injuries.

Its earlier Market Position Statement identified an intention to reduce reliance on residential care and hospital settings while increasing supported-living and other community-based alternatives.

The 2023-25 commissioning strategy subsequently said that some of the markets facing the greatest pressure were those supporting people with lifelong conditions, including learning disabilities, autism and mental ill health.

It also highlighted increasingly complex needs and the cost of supporting people outside West Sussex.

These issues remain relevant when read alongside the later CQC assessment, which again identified complexity and multiple needs as areas where gaps existed.

For prospective providers, this creates a clearer signal than the generic proposition that West Sussex needs more care.

The stronger question is whether a service can support people whose needs are currently difficult to meet through existing local provision.

Respite is another identifiable pressure

Respite appears repeatedly in the evidence.

CQC found gaps in emergency respite provision and reported that some unpaid carers had been unable to meet other commitments because appropriate respite was not available.

The county has also been reviewing and recommissioning respite for people with lifelong disabilities and mental-health needs.

Respite is a useful example of a market where demand can be genuine but the commercial model still requires careful testing.

Provision may be intermittent rather than continuously occupied. Demand can vary between planned short breaks, emergency care and specialist respite for people with complex needs.

A provider therefore needs to understand not simply whether carers need breaks, but how that demand is funded, commissioned and converted into sustainable utilisation.

Extra care fits the county's direction of travel

West Sussex is also seeking alternatives between ordinary housing and residential care.

Extra care housing provides self-contained accommodation combined with access to care and support, often including 24-hour on-site support.

The council describes it as an alternative that can allow people with care needs to remain more independent than they might in conventional residential care.

Its commissioning strategy has also sought further development of extra care and other accommodation options for both older people and working-age adults.

This direction is consistent with the 2026 strategy's emphasis on helping people live at home for longer.

For developers and care providers, however, extra care is not simply another residential-care model.

Housing development, tenure, property economics, planning, care commissioning and the regulated activity being delivered all interact.

The opportunity therefore requires coordination between housing and care, rather than simply proving that West Sussex has an ageing population.

Prevention will influence future demand

West Sussex's 2026 Adult Social Care Strategy makes independence one of the central organising principles of the system.

The authority wants people to receive the right help earlier, draw more effectively on community and personal networks, and remain in their own homes for as long as possible.

CQC also found a strong local focus on prevention, including occupational therapy, equipment, adaptations and multidisciplinary support intended to reduce or delay the need for formal care.

• What prevention may restrain

  • Demand for some lower-intensity long-term commissioned care.

• What it may increase

  • Reablement and technology-enabled support
  • Supported housing and community services
  • Home-based care for people with more complex needs

The market is changing in composition as well as size.

For the care market, this matters.

An ageing population will increase underlying need, but the system is actively trying to prevent every increase in need from translating directly into long-term commissioned care.

Financial sustainability remains a major constraint

West Sussex has one of the clearest examples of the tension between rising care demand and affordability.

The council has warned publicly about the financial pressures facing the local care market.

It reported average provider fee increases of approximately 8%, 9% and 8% across three successive years but warned in early 2025 that additional employment costs created significant risks to providers and commissioners.

1. Year one

   ~8%

2. Year two

   ~9%

3. Year three

   ~8%

West Sussex County Council, early 2025.

The council also noted that because it purchases only around 35% of the overall market, providers have substantial exposure to private-pay customers and may choose where they allocate capacity.

The 2026 strategy continues to place financial sustainability among its guiding principles.

For a new provider, this reinforces a recurring principle.

An unmet social need is not automatically an economically sustainable market.

The achievable fee has to support the staffing, management, property, financing and compliance costs required to meet that need safely.

This can become especially difficult where the strongest shortages involve people with complex support requirements.

Workforce capacity is part of market capacity

West Sussex's current strategy explicitly describes the social care workforce as being under significant pressure.

It identifies an ageing workforce and the need to attract younger people into adult social care, while emphasising training, retention and sustainable employment across homecare, supported housing, extra care, residential and nursing care.

This affects how market gaps should be interpreted.

If commissioners have difficulty placing people with complex needs, the solution is not automatically another registered organisation.

A provider also needs enough suitably skilled people to deliver the required care.

Specialist support can involve higher staff ratios, additional clinical competency, behavioural-support expertise, waking-night provision or more intensive management.

The more specialised the market opportunity, the more important workforce viability becomes.

What does the evidence suggest?

West Sussex has a strong underlying adult social care demand base.

It has a large population, an older age structure, significant projected growth among older age groups and a substantial existing care economy.

But it is not an obviously undersupplied market in general terms.

The county is simultaneously trying to reduce or delay dependence on long-term formal care through prevention, reablement, supported housing, extra care, technology and stronger community support.

For prospective providers, that creates a market where specialism, location and purchasing route matter enormously.

A general statement that West Sussex has an ageing population is true.

It is not enough to establish that a particular care business should be started.