Starting an Adult Social Care Service in West Sussex: What the Market Evidence Shows

Starting a care service in West Sussex can look commercially attractive for obvious reasons.

It has a population of more than 900,000 people, a comparatively old age profile, significant projected growth among older age groups and a large existing care economy.

It also has a substantial private-pay market.

But none of those factors automatically means that a new care service will succeed.

West Sussex already has extensive residential, nursing, homecare and supported-living provision. More than 120 providers were approved onto the county's current Care and Support at Home Framework, while the care-home market is large and mature.

The stronger market signals concern more specific needs.

CQC's 2025 assessment identified gaps affecting people with complex and multiple needs, younger people living with dementia, people with progressive conditions and those requiring emergency respite.

At the same time, West Sussex County Council's 2026 strategy is explicitly focused on early support, independence and helping people remain at home for longer.

For anyone considering starting a care service in West Sussex, the first question should therefore not be:

Is there demand for care?

There clearly is.

The more useful question is:

Is there accessible demand for the particular service I intend to build?

See the adult social care market report and key challenges report for the wider local picture.

Start with the client group, not the registration

One of the most important decisions is defining exactly who the service is intended to support.

A broad description such as "older people", "adults with complex needs" or "supported living" is usually not enough to establish a credible market position.

Different groups can require substantially different:

• Staffing models
• Competencies
• Property
• Equipment
• Management experience
• Commissioning relationships
• Pricing

For example, a supported-living service for people with mild learning disabilities is very different from one designed around people with autism and behaviours that challenge.

A residential home supporting relatively independent older people operates in a different market from dementia nursing provision.

A homecare agency providing conventional personal care is different from a service able to support complex double-handed packages or people with progressive neurological conditions.

This matters particularly in West Sussex because the clearest identified shortages are not simply shortages of generic capacity.

CQC found that the authority understood there were gaps around complex and multiple needs, younger-onset dementia, progressive conditions and emergency respite.

If a proposed business intends to respond to one of those gaps, it needs to demonstrate how its model is actually capable of doing so.

Do not treat West Sussex as one single care market

West Sussex is geographically large and internally diverse.

Its coastal towns, rural communities, market towns and more urban areas do not behave identically.

For a homecare provider, this can materially affect viability.

A branch serving a dense area may be able to organise efficient care rounds with relatively short journeys between customers.

A provider covering dispersed rural communities may face substantially greater:

• Travel time
• Mileage
• Gaps between visits
• Staffing inefficiency
• Recruitment difficulty

That affects how much of a care worker's paid time can actually be converted into chargeable care.

• Dense coastal rounds, for example around Worthing
• Rural Chichester or Horsham districts with longer travel
• Crawley and inland towns with different catchments
• Supported living where locality must match family and clinical links

The same principle applies to other services.

A supported-living vacancy in one part of the county may be unsuitable for somebody whose family, employment, healthcare or community connections are elsewhere.

A care home can compete within a very different catchment depending on whether it is located in Worthing, Chichester, Horsham, Crawley or one of the county's smaller communities.

For that reason, a county-wide demand figure should be treated as the beginning of the analysis, not the conclusion.

Decide whether you are building for the commissioned or private-pay market

West Sussex has a particularly important self-funder market.

CQC's assessment describes the county as having a high proportion of people who fund or arrange their own care.

West Sussex County Council has previously stated that it purchases only around 35% of the wider market.

• 35%Purchased by West Sussex County Council

That means a prospective provider needs to make an early decision about where revenue is expected to come from.

The possible routes can include:

• Local authority commissioned care
• NHS-funded care
• Direct payments
• Private-pay customers
• Mixed funding

Each behaves differently.

A provider reliant on council-funded work needs to understand frameworks, package allocation, fee structures and procurement.

A provider targeting self-funders needs to understand customer acquisition, local competition, willingness to pay and how prospective customers choose services.

A model designed for both needs to be realistic about the tension between them.

Private-pay customers may support higher prices, but they also require investment in marketing and reputation.

Commissioned packages may provide a more organised referral route, but the provider may have less control over pricing.

Homecare is a large market, but entry is not automatically easy

Homecare aligns closely with West Sussex's strategic direction.

The county's 2026 Adult Social Care Strategy places supporting people to remain at home for longer among its central priorities.

That creates strong long-term demand for services delivered in people's homes.

But the existing provider market is substantial.

West Sussex's current Care and Support at Home Framework has more than 120 approved providers.

Packages are allocated first according to a provider's ability to meet the person's needs and then according to the lowest hourly cost submitted by capable providers.

That has an obvious implication.

Simply obtaining CQC registration does not guarantee access to sufficient council-funded packages.

If the business case assumes that local-authority work will begin immediately after registration, that assumption needs to be tested before money is committed.

Specialist homecare may present a different opportunity

The market may look different where a homecare provider can safely support more complex needs.

West Sussex wants to help people remain at home for longer.

That can mean people receiving homecare at greater levels of acuity than might historically have been possible.

For some providers, that may involve:

• neurological conditions
• complex physical disability
• dementia
• end-of-life care
• intensive double-handed packages
• behavioural support
• clinically supported care.

The commercial opportunity can be stronger because fewer providers may be able or willing to accept the work.

But the cost base can also increase substantially.

Specialist training, higher pay, longer calls, additional supervision and increased management complexity can quickly absorb a higher hourly rate.

A specialist model therefore needs to be financially modelled as a specialist service, not simply as ordinary domiciliary care with a higher selling price.

Residential care needs a more precise business case than population ageing

West Sussex has a large older population.

That provides a strong underlying demand base for care homes.

But it would be a mistake to build a residential-care business case entirely around the number of people aged 65 or over.

The county is actively trying to delay or prevent unnecessary admission into long-term institutional care.

Its current strategy prioritises early intervention and helping people remain independent at home.

Its reablement programme illustrates the potential effect.

In the year to August 2026, more than 2,600 people received reablement support, and 76% of those completing the programme required no ongoing care afterwards.

2,600+

People receiving reablement in a year

with

76%

Of completers who required no further ongoing care

That means genuine episodes of care need do not always convert into permanent care-home or homecare demand.

People who eventually do enter residential or nursing provision may therefore increasingly do so later and with greater levels of dependency.

That creates a different market.

The more relevant question may be whether there is sufficient capacity for higher-acuity care, rather than whether there are enough ordinary residential beds in aggregate.

The care-home commissioning market is changing

Anyone planning a new care home should also pay attention to the current commissioning timetable.

West Sussex County Council is preparing to replace its existing residential and nursing care-home framework, which is due to end in 2027.

The authority is consulting residents, families and providers while designing the replacement arrangements.

This is relevant for a new entrant.

A financial model built around existing framework arrangements may not reflect the system under which care is purchased after 2027.

Potential changes could affect:

• Contracting routes
• Quality requirements
• Pricing arrangements
• Service specifications
• Access to commissioned placements

A new care-home operator therefore needs to understand not only today's market but the commissioning environment it is likely to enter once the service is operational.

Private-pay care can be attractive, but affordability still matters

The strength of the West Sussex self-funder market can make private-pay care attractive.

But high care costs create their own limitations.

In September 2026, West Sussex County Council published indicative South East self-funded care costs of approximately:

£1,450

Residential care per week

£1,695

Nursing care per week

£460

14 hours of homecare per week

£1,200

Live-in care per week

Illustrative regional averages, not fixed West Sussex prices.

These are illustrative regional averages, not fixed West Sussex prices.

They nevertheless demonstrate the size of the financial commitment.

A provider needs to understand both sides of the equation.

Can the business charge enough to cover its costs?

And is there a sufficiently large local customer group willing and able to pay that price?

Affluent demographics help, but they do not eliminate price sensitivity.

Supported living needs a clearly defined commissioning case

Supported living aligns closely with West Sussex's preference for independence and community-based support.

That does not mean supported living in general is undersupplied.

The proposition needs to go deeper.

A prospective provider should identify:

• the intended client group
• the level of support
• whether the need is already being met locally
• the likely referral route
• how housing will be secured
• how care and accommodation will be separated
• the fee level required
• what happens if occupancy develops slowly.

This is particularly important because the strongest evidence in West Sussex concerns people with more complex needs.

Those services may need more intensive staffing, enhanced training or specially adapted accommodation.

The result can be a high-cost supported-living model.

If the commissioning route and expected fee are not understood before the property is secured, the business can carry significant exposure.

Supported living is also a regulatory structure, not just a label

The regulatory distinction between supported living and residential care is important.

CQC states that registration depends on the nature of the regulated activity being carried out.

Where personal care is provided in a supported-living setting, Personal care is generally the relevant regulated activity.

By contrast, where accommodation and nursing or personal care are provided together as a single package, the activity can fall within Accommodation for persons who require nursing or personal care.

The legal relationship between accommodation and care therefore matters.

A business should not choose the phrase "supported living" because it sounds commercially attractive and then attempt to design the housing arrangements around that label.

The model needs to genuinely satisfy the relevant regulatory structure.

Respite requires careful commercial modelling

Emergency respite is one of the specific areas where CQC found a gap in West Sussex.

That may look like an obvious opportunity.

But respite can be operationally difficult.

Demand may be irregular.

A provider may need to maintain:

• spare capacity
• appropriately trained staff
• flexible admission arrangements
• accommodation suitable for different needs.

Emergency placements can also involve people with complex support requirements.

The need may therefore be very real without automatically producing consistently high utilisation.

A respite business case needs to establish how unused capacity will be funded and whether commissioners are willing to support the model required to keep that capacity available.

Understand the CQC registration scope before applying

Once the service model is clear, the provider needs to establish whether CQC registration is required and which regulated activities apply.

CQC's scope guidance, updated in August 2026, makes clear that registration is determined by the regulated activities being provided, rather than simply the name given to the service.

For a domiciliary care agency providing personal care, the relevant regulated activity will commonly be Personal care.

Supported-living services providing personal care are also generally registered for Personal care.

A care home supplying accommodation together with personal or nursing care as a single package will normally require registration for Accommodation for persons who require nursing or personal care.

The location being registered also matters.

CQC's current guidance states that a homecare or supported-living location is generally the premises from which regulated activity delivered in people's homes is organised or managed.

Getting this wrong at the beginning can create problems later.

The step-by-step CQC registration guide sets out the process; this report is about whether the local market supports the service you intend to register.

CQC expects the service to be ready, not theoretical

CQC's registration guidance was updated in August 2026.

It states that providers should apply only when everything required to begin providing the service is in place, including the necessary locations and staff.

The regulator describes its registration assessment as rigorous and expects applicants to demonstrate how they will provide safe, effective, caring, responsive and well-led services.

For new homecare agencies, CQC currently requires additional supporting documents including:

• a business plan and financial forecast
• evidence of legal occupancy
• service-user guides
• a staff training plan.

This reinforces an important sequencing point.

Registration should not be used as the stage at which the provider begins deciding whether the business itself is viable.

That work should already have been done.

Workforce planning needs to happen before launch

A care service without enough suitable workers does not have meaningful capacity.

This is particularly relevant in West Sussex because the geographic and specialist elements of the market can make workforce planning more difficult.

A homecare provider needs to consider where workers live in relation to customers.

A nursing service needs access to registered nurses.

A specialist learning-disability or autism service may require specific competencies and experience.

A complex-care provider may need additional clinical oversight.

The workforce plan should include more than an assumed hourly wage.

It should account for:

• recruitment cost
• employer National Insurance
• pension
• holiday
• training
• sickness
• supervision
• travel
• non-contact time
• management overhead.

A model can appear profitable when calculated on chargeable hours alone and become loss-making once the full cost of employing the workforce is included.

The property should follow the service model

For care homes and supported living, property selection can become one of the largest sources of risk.

A property should be assessed against the needs of the intended client group.

That may include:

• accessibility
• room configuration
• communal space
• bathrooms
• outdoor space
• parking
• transport links
• fire safety
• staff facilities
• opportunities for adaptation.

A property suitable for one group may be fundamentally unsuitable for another.

The commercial temptation is often to find a building first and then determine what type of care can be operated from it.

The safer approach is the opposite.

Define the client group and operating model first.

Then identify a property capable of supporting it.

Do not assume registration creates referrals

CQC registration gives a provider legal permission to carry on specified regulated activities.

It does not create:

• customers
• framework access
• local authority referrals
• private-pay enquiries
• occupancy
• profitable utilisation.

This distinction is especially important in West Sussex because the existing market is already large.

A new provider needs a credible acquisition strategy.

For private-pay services, that may involve:

• local search
• directories
• professional referrals
• hospital discharge relationships
• community networks
• reputation and reviews
• partnerships.

For commissioned services, it may involve frameworks, brokerage systems, procurement and direct engagement with commissioning teams.

The route to demand should be understood before launch.

Build a realistic utilisation curve

Another common weakness is assuming that the business reaches target capacity quickly.

In practice, care businesses often incur substantial cost before utilisation becomes efficient.

A homecare agency may need management, office infrastructure, recruitment and compliance systems before it has enough chargeable hours.

A supported-living service can carry housing and staffing costs while waiting for placements.

A care home has significant fixed costs regardless of occupancy.

A realistic model should therefore include:

1. Launch
2. Initial referrals
3. Gradual utilisation
4. Break-even
5. Mature occupancy

It should also stress-test what happens if the ramp-up takes longer than expected.

This is particularly important where commissioners need time to approve a provider or where private customers make decisions gradually.

Test the market before committing heavily

The strongest evidence in West Sussex suggests a good underlying demand environment but a selective rather than universal opportunity.

Before committing heavily to premises, registration or recruitment, a prospective provider should try to establish evidence for five things.

1. Need

   Is there evidence that the intended client group is difficult to support locally?

2. Accessible demand

   Can a new provider actually receive that work through commissioning, direct payments or private pay?

3. Price

   What fee is realistically achievable once framework rules and local competition are understood?

4. Delivery

   Can the service recruit and retain the staff needed to deliver safely?

5. Utilisation

   Can enough referrals or customers be secured quickly enough to cover the cost base?

A weakness in any one of those areas can undermine the entire proposition.

What does the evidence suggest by service type?

The local evidence does not point equally strongly in every direction.

1. General homecare

   Strong long-term demand but more than 120 approved framework providers. Needs a clear geographical or service-level proposition.

2. Specialist homecare

   More attractive where the provider can meet higher-acuity needs other agencies struggle to accept, if costs are modelled honestly.

3. General residential care

   Ageing supports long-term demand, but independence and reablement mean demographics alone should not drive occupancy forecasts.

4. Nursing, complex dementia and specialist residential

   Complexity is a named pressure point in CQC evidence. Still validate current commissioning and fees before investment.

5. Supported living

   Strongest around defined client groups and more complex community-based support rather than generic new capacity.

6. Respite

   Identifiable gaps, especially emergencies, but flexible capacity economics need careful testing.

These are starting points for further research, not guarantees of viability.

West Sussex rewards precision

West Sussex is a large enough market that almost any care business can find statistics suggesting substantial demand.

That is not the difficult part.

The difficult part is identifying the part of that demand which is:

unmet, accessible, fundable and deliverable.

The county's demographics create a strong long-term requirement for adult social care.

Its current strategic direction also creates opportunities around independence, home-based support and more complex community provision.

But it is already a competitive market.

The strongest proposition is therefore unlikely to be:

"West Sussex has an ageing population, so I will start a care business."

It is more likely to be:

"This particular group of people in this part of West Sussex is difficult to support through existing provision. I understand who commissions or purchases that care, what they will pay, what staffing and infrastructure are required, and how my service will meet that need sustainably."

That is a much stronger basis on which to start the registration process.

CQC registration can give a provider permission to carry on regulated activity. It does not create demand, referrals or a viable business.