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Domiciliary Care - UK - September 2015

“People in need of care services tend to prefer to receive help in their own homes to maintain a sense of independence and reduce disruption to daily activities, such as visits from friends or family, which may not be as achievable in a different care setting. With the UK’s ageing population trend expected to continue indefinitely, care providers have increasing opportunities to seek out the ever-increasing number of users, with a rising number not able to access state-funded care, and provide them with a suitable home care service. The more widespread uptake of companies and employees contributing to pension funds is expected to see the next generation of older people have assets that surpass the means-tested threshold for access to state-funded social care. This means that more people will ‘self-fund’ the care services they need - providing another potential avenue for care providers to explore. The actual development of the domiciliary care industry will be determined by whether it can adapt and provide suitable services for all prospective care users with different levels of needs, particularly the ever-increasing number of elderly people.”

–    Lewis Cone, B2B Analyst

This reports covers the following issues:

  • What are the key determinants driving the domiciliary care industry?
  • How has the financial environment affected the industry?
  • How have UK governments influenced and shaped the development of home care in each respective country?
  • Are there any major regional differences in the UK when it comes to the provision of domiciliary care services?
  • What are the key issues the industry needs to address to be able to fully benefit from any favourable market conditions and future trends?
  • What does the future hold for the UK’s domiciliary care industry?

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Table of contents

  1. Executive Summary

      • Market Size
        • Figure 1: UK Market for Domiciliary Care, 2010/11-2014/15, (£ Million)
        • Figure 2: Segmentation of the UK Market Domiciliary Care, by Type of Purchaser, 2010/11-2014/15, (£ Million)
      • Market Trends
        • Figure 3: UK Population Projections, by Age Group, 2015-2040, (Million People)
        • Figure 4: Number of Contact Hours of Home Care Provided in the UK, by Sector, 2010/11-2014/15, (Million hours)
        • Figure 5: Local Authority Domiciliary Care Expenditure for All Adults, by Age Category, 2009/10-2013/14 (£ Million)
      • Regional Analysis
        • Figure 6: Number of Domiciliary Care Service Users per 10,000 adults, by Region, 2009/10-2013/14, (No. Of Clients per 10,000 adults)
      • Market Factors
        • Demographic trends will offer potential growth development for domiciliary care providers
          • Plans to introduce a national living wage in 2016 will have a mixed impact
            • The postponement of the introduction of a cap on social care costs until 2020 has somewhat dampened the impact of the Care Act
              • The minimum eligibility threshold offers a route for private providers to expand their presence in the market
                • Companies
                  • Forecast
                    • Growth in the domiciliary care market is anticipated to slow to 2017 before returning to 4% growth by 2020.
                      • Figure 7: Forecast UK Market for Domiciliary Care, 2015/16-2019/20, (£ Million at 2015 prices)
                    • Informal care expected to continue to reduce the burden placed on formal care providers in the light of a growing number of care users with intensive care needs
                      • Figure 8: Forecast Segmentation of the UK Market for Domiciliary Care, by Type, 2015/16-2019/20, (£ Million at 2015)
                    • What We Think
                      • Key Insights
                        • Is the trend towards independent sector provision expected to continue?
                          • How have the public sector expenditure cuts affected the provision of care services?
                            • Are care fees currently set at an equilibrium rate? Is regional disparity also apparent?
                              • How has new legislation affected the home care market?
                                • Can technology and innovative methods reduce the financial and resource burden currently placed on domiciliary care providers?
                                • Introduction

                                    • Definitions
                                    • Methodology

                                        • Abbreviations
                                          • Market Positioning
                                          • UK Economy

                                            • Key points
                                              • Overview
                                                • Figure 9: UK GDP, 2004-2015, (% Quarterly Growth and GDP in £ billion)
                                                • Figure 10: Quarters after GDP Peak, 1979, 1990 and 2008, (Number of Quarters and GDP as % of Pre-Downturn Peak)
                                              • Inflation
                                                • Interest rates
                                                  • House prices
                                                    • Consumer spending
                                                      • Manufacturing
                                                        • Business investment
                                                          • Figure 11: UK GFCF 2003-15, (£ million)
                                                        • Imports
                                                          • Exports
                                                          • Market Factors

                                                            • Key points
                                                              • Demographic and Health
                                                                • Social
                                                                  • Economic
                                                                    • Residential care home trends
                                                                      • Other factors
                                                                        • Legislation
                                                                          • Community Care Act
                                                                            • Care Standards Act
                                                                              • Regulation and Inspection Bill (Wales)
                                                                                • The Care Act 2014 and Better Care Fund
                                                                                  • Market Oversight
                                                                                    • Care Certificate
                                                                                      • Pensions Act
                                                                                        • The Carers’ Strategy
                                                                                          • Other legislation
                                                                                          • Market Size and Trends

                                                                                            • Key points
                                                                                              • Market Size
                                                                                                  • Figure 12: UK Market for Domiciliary Care, 2010/11-2014/15, (£ Million)
                                                                                                  • Figure 13: UK Market for Domiciliary Care, 2010/11-2014/15, (£ Million)
                                                                                                  • Figure 14: UK Commercial Market for Domiciliary Care, 2010/11-2014/15, (£ Million)
                                                                                                  • Figure 15: UK Commercial Market for Domiciliary Care, 2010/11-2014/15, (£ Million)
                                                                                                • Market Segmentation
                                                                                                    • Figure 16: Segmentation of the UK Domiciliary Care Market, by Type of Purchaser, 2010/112014/15, (£ Million)
                                                                                                    • Figure 17: Segmentation of the UK Domiciliary Care Market, by Type of Purchaser, 2010/11-2014/15, (£ Million)
                                                                                                  • Local Authority Expenditure
                                                                                                    • Older people (65+)
                                                                                                      • Figure 18: Segmentation of Local Authority Expenditure on Domiciliary Care for Older People (65+) in the UK, by Type, 2009/10-2013/14 (£ Million)
                                                                                                      • Figure 19: Segmentation of Local Authority Expenditure on Domiciliary Care for Older People (65+) in the UK, by Type, 2009/10-2013/14, (£ Million)
                                                                                                    • Adults aged 18-64
                                                                                                      • Figure 20: Segmentation of Local Authority Expenditure on Domiciliary Care for Adults aged 18-64 in the UK, by Client Type, 2009/10-2013/14, (£ Million)
                                                                                                      • Figure 21: Segmentation of Local Authority Expenditure on Domiciliary Care for Adults aged 18-64 in the UK, by Client Type, 2009/10-2013/14, (£ Million)
                                                                                                      • Figure 22: Segmentation of UK Local Authority Expenditure on Domiciliary Care, All Adults, by Client Type, 2009/10-2013/14, (%)
                                                                                                      • Figure 23: Segmentation of UK Local Authority Expenditure on Domiciliary Care, all adults, by Client Type, 2009/10 and 2013/14, (%)
                                                                                                      • Figure 24: Number of Contact Hours of Home Care Provided in the UK, by Sector and Country, 2010/11-2014/15, (Million hours)
                                                                                                      • Figure 25: Number of Contact Hours of Home Care Provided in the UK, by Sector, 2010/11-2014/15, (Million Hours)
                                                                                                      • Figure 26: Number of Domiciliary Care Service Users, by Region, 2009/10-2013/14, (Thousands)
                                                                                                      • Figure 27: Number of Domiciliary Care Service Users per 10,000 adults, by Region, 2009/10-2013/14, (No. Of Clients per 10,000 adults)
                                                                                                      • Figure 28: Number of Domiciliary Care Service Users per 10,000 adults, by Region, 2009/10 and 2013/14, (No. of Clients per 10,000 adults).
                                                                                                      • Figure 29: Local Authority Expenditure, All Adults, by Region, 2009/10-2013/14, (£ Million)
                                                                                                      • Figure 30: Local Authority Domiciliary Care Expenditure for All Adults, by Age Category, 2009/10-2013/14, (£ Million)
                                                                                                      • Figure 31: Local Authority Expenditure, Older People (65+), by Region, 2009/10-2013/14, (£ Million)
                                                                                                      • Figure 32: Local Authority Expenditure, Older People (65+), 2009/10 and 2013/14, (£ Million)
                                                                                                      • Figure 33: Local Authority Expenditure, Adults (18-64) with Physical or Sensory Disabilities, by Region, 200910-2013/14, (£ Million)
                                                                                                      • Figure 34: Local Authority Expenditure, Adults (18-64) with Learning Disabilities, by Region, 2009/10-2013/14, (£ Million)
                                                                                                      • Figure 35: Local Authority Expenditure, Adults (18-64) with Mental Health Needs, by Region, 2009/10-2013/14, (£ Million)
                                                                                                      • Figure 36: Local Authority Expenditure, All Adults (18-64), by Region, 2009/10-2013/14, (£ Million)
                                                                                                    • NHS Expenditure
                                                                                                      • Figure 37: Segmentation of NHS Expenditure on Social Care Community Services, by Country, 2010/11-2014/15, (£ Million)
                                                                                                      • Figure 38: Segmentation of NHS Expenditure on Social Care Community Services, by Country, 2010/11 and 2014/15, (% of Total)
                                                                                                    • High Tech Domiciliary Care
                                                                                                      • Private Expenditure
                                                                                                          • Figure 39: Segmentation of Private Expenditure on Domiciliary Care in the UK, by Type, 2010/11-2014/15, (£ Million)
                                                                                                          • Figure 40: Segmentation of Private Expenditure on Domiciliary Care in the UK, by Type, 2009/10-2013/14, (£ Million)
                                                                                                          • Figure 41: Estimated size of self-funded home care market, by client type, 2013/14, (in units, hours, million hours and £ Million)
                                                                                                        • Informal Care
                                                                                                          • Figure 42: Informal Carers by Relationship to Person Receiving Care in England, 2011/12-2013/2014, (% of Informal Carers)
                                                                                                          • Figure 43: The UK Market for Informal Domiciliary Care, 2010/11 - 2014/15, (£ Billion and Hours)
                                                                                                          • Figure 44: UK Market for Informal Domiciliary Care, 2010/11-2014/15, (£ Billion and billion hours)
                                                                                                        • Market Trends
                                                                                                          • Figure 45: UK Population Projections, by Age Group, 20152040, (Million people)
                                                                                                          • Figure 46: Estimated and projected age structure of the United Kingdom population, by Sex, mid-2015 and mid-2040, (Thousands)
                                                                                                      • Regional Analysis

                                                                                                        • Key points
                                                                                                          • England
                                                                                                            • North East
                                                                                                              • Figure 47: Analysis of Households Receiving Home Help and Home Care in the North East of England, by Authority, 2009/10-2013/14, (Number of service users per 10,000 adults)
                                                                                                              • Figure 48: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the North East of England, by Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 49: Analysis of Intensity of Local Authority Domiciliary Care Services in the North East of England, by Authority, 2013/14, (% of People Receiving Home Care)
                                                                                                            • North West
                                                                                                              • Figure 50: Analysis of Households Receiving Home Help and Home Care in the North West of England, by Authority, 2009/10-2013/14, (Number of Service Users per 10,000 Adults)
                                                                                                              • Figure 51: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the North West of England, by Authority, 2009/10-2013/14, (£ 000)
                                                                                                              • Figure 52: Analysis of Intensity of Local Authority Domiciliary Care Services in the North West of England, by Authority, 2013/14, (% of Clients Receiving Home Care)
                                                                                                            • Yorkshire and the Humber
                                                                                                              • Figure 53: Analysis of Households Receiving Home Help and Home Care in Yorkshire and The Humber, by Authority, 2009/10-2013/14, (Number of Service Users per 10,000 Adults)
                                                                                                              • Figure 54: Analysis of Local Authority Domiciliary Care Expenditure on Older People in Yorkshire and The Humber, by Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 55: Analysis of Intensity of Local Authority Domiciliary Care Services in Yorkshire and The Humber, by Authority, 2013/14, (% of Clients Receiving Home Care)
                                                                                                            • East Midlands
                                                                                                              • Figure 56: Analysis of Households Receiving Home Help and Home Care in the East Midlands, by Authority, 2009/10-2013/14, (Number of Service Users per 10,000 Adults)
                                                                                                              • Figure 57: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the East Midlands by Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 58: Analysis of Intensity of Local Authority Domiciliary Care Services in the East Midlands, by Authority, 2013/14, (% of Clients Receiving Home Care)
                                                                                                            • West Midlands
                                                                                                              • Figure 59: Analysis of Households Receiving Home Help and Home Care in the West Midlands, by Authority, 2009/10-2013/14, (Number of People Receiving Care per 10,000 Adults)
                                                                                                              • Figure 60: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the West Midlands, by Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 61: Analysis of Intensity of Local Authority Domiciliary Care Services in the West Midlands, by Authority, 2013/14, (% of Clients Receiving Home Care)
                                                                                                            • South West
                                                                                                              • Figure 62: Analysis of Adults Receiving Home Help and Home Care in the South West of England, by Authority, 2009/10-2013/14, (Number of People Receiving Care per 10,000 Adults)
                                                                                                              • Figure 63: Analysis of Local Authority Domiciliary Care Expenditure on Older People in South West England, by Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 64: Analysis of Intensity of Local Authority Domiciliary Care Services in the South West of England, by Authority, 2013/14, (% of Clients Receiving Home Care)
                                                                                                            • East of England
                                                                                                              • Figure 65: Analysis of Households Receiving Home Help and Home Care in the East of England, by Authority, 2009/10-2013/14, (Number of People Receiving Care per 10,000 Adults)
                                                                                                              • Figure 66: Analysis of Local Authority Domiciliary Care Expenditure on Older People in East of England, by Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 67: Analysis of Intensity of Local Authority Domiciliary Care Services in East of England, by Authority, 2013/14, (% of Clients Receiving Home Care)
                                                                                                            • London
                                                                                                              • Figure 68: Analysis of Households Receiving Home Help and Home Care in London, by Authority, 2009/10-2013/14, (Number of People Receiving Care per 10,000 Adults)
                                                                                                              • Figure 69: Analysis of Local Authority Domiciliary Care Expenditure on Older People in London, by Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 70: Analysis of Intensity of Local Authority Domiciliary Care Services in London, by Authority, 2013/14, (% of Clients Receiving Home Care)
                                                                                                            • South East
                                                                                                              • Figure 71: Analysis of Households Receiving Home Help and Home Care in the South East of England, by Authority, 2009/10-2013/14, (Number of People Receiving Care per 10,000 Adults)
                                                                                                              • Figure 72: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the South East of England, by Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 73: Analysis of Intensity of Local Authority Domiciliary Care Services in the South East of England, by Authority, 2013/14, (% of Clients Receiving Home Care)
                                                                                                            • Scotland
                                                                                                              • Figure 74: Domiciliary Care Clients in Scotland, by Client Type and Authority, 2013/14, (Number of Clients)
                                                                                                              • Figure 75: Domiciliary Care Clients in Scotland, by Client Type and Authority, 2014/15, (Number of Clients)
                                                                                                              • Figure 76: Distribution of Home Care Hours per week in Scotland, 2013/14, by Time Band and District, (% of Clients)
                                                                                                              • Figure 77: Distribution of Home Care Hours per week in Scotland, 2014/15, by Time Band and District, (% of Clients)
                                                                                                            • Wales
                                                                                                              • Figure 78: Number of Domiciliary Care Clients Aged 65+ in Wales, 2009/10-2013/14, by Local Authority, (Number of Clients)
                                                                                                              • Figure 79: Number of Domiciliary Care Clients Aged 18-64 in Wales, 2009/10-2013/14, by Local Authority, (Number of Clients)
                                                                                                              • Figure 80: Local Authority Domiciliary Care Expenditure in Wales, by Local Authority, 2009/10-2013/14, (£000)
                                                                                                              • Figure 81: Hours of Home Care Provided in Wales, by Local Authority, 2009/10-2013/14, (000 Hours)
                                                                                                              • Figure 82: Percentage of Home Care Hours Contracted to the Independent Sector, by Local Authority, 2009/10-2013/14 (% of Home Care Hours)
                                                                                                            • Northern Ireland
                                                                                                              • Figure 83: Number of Clients Receiving Domiciliary Care in Northern Ireland, by Sector and HSC trust, 2013/14, (Number of Clients during Survey Week)
                                                                                                              • Figure 84: Number of Clients Receiving Domiciliary Care in Northern Ireland, by Sector and HSC trust, 2014/15, (Number of Clients during Survey Week)
                                                                                                              • Figure 85: Number of Home Care Hours Provided per Week, by Sector and HSC Trust, 2013/14, (Number of Hours Provided during Survey Week)
                                                                                                              • Figure 86: Number of Home Care Hours Provided per Week, by Sector and HSC Trust, 2014/15, (Number of Hours Provided during Survey Week)
                                                                                                          • Industry Structure

                                                                                                            • Key points
                                                                                                              • Industry Development
                                                                                                                  • Figure 87: Independent Sector Domiciliary Care Providers, 2015, (% of Total Independent Sector Market Share)
                                                                                                                  • Figure 88: Independent Sector Domiciliary Providers, 2015, (% of Total Independent Sector Market Share)
                                                                                                                  • Figure 89: Analysis of the Changes in the Structure of the ‘Other Human Health Activities’ Industry, 2010-2014, (Number of Local Units and Businesses)
                                                                                                                  • Figure 90: Analysis of the Changes in the Structure of the ‘Social Work Activities Without Accommodation for the Elderly and Disabled’ Industry, 2010-2014, (Number of Local Units and Businesses)
                                                                                                                • Structure by Employment
                                                                                                                  • Information on the structure of the industry by employment is drawn from VAT returns.
                                                                                                                    • Figure 91: Analysis of the Employment Structure of the ‘Other Human Health Activities’ Industry, 2013 and 2014, (Number of Local Units and Local Unit Employment Size)
                                                                                                                    • Figure 92: Analysis of the Employment Structure of the ‘Social Work Activities Without Accommodation for the Elderly and Disabled’ Industry, 2013 and 2014, (Number of Local Units and Local Unit Employment Size)
                                                                                                                  • Structure by Turnover
                                                                                                                    • Information on the structure of the industry by turnover is drawn from VAT returns.
                                                                                                                      • Figure 93: Analysis of the Financial Structure of the ‘Other Human Health Activities’ Industry, 2013 and 2014, (£ 000 and % of Total Turnover)
                                                                                                                      • Figure 94: Analysis of the Financial Structure of the ‘Social Work Activities Without Accommodation for the Elderly and Disabled’ Industry, 2013 and 2014, (£ 000 and % of Total Turnover)
                                                                                                                  • Company Profiles

                                                                                                                      • BUPA Home Healthcare
                                                                                                                          • Figure 95: Financial Analysis of BUPA Home Healthcare, 2010-14, (£ Million)
                                                                                                                        • Company Outlook
                                                                                                                        • Care UK

                                                                                                                            • Care UK has three core outsourcing operations:
                                                                                                                                • Figure 96: Financial Analysis of Care UK, 2010-14, (£ Million)
                                                                                                                                • Figure 97: Revenue breakdown of Care UK, by division, 2013-14, (£ Million)
                                                                                                                              • Company Outlook
                                                                                                                              • Chrysalis Community Care

                                                                                                                                  • Figure 98: Financial Analysis of Chrysalis Community Care Group, 2010-14, (£ 000)
                                                                                                                                • Company Outlook
                                                                                                                                • Housing and Care 21

                                                                                                                                      • Figure 99: Financial Analysis of Housing and Care 21 (formerly Housing 21), 2010-2014, (£ Million)
                                                                                                                                    • Company Outlook
                                                                                                                                    • Interserve Healthcare (formerly Advantage Healthcare)

                                                                                                                                          • Figure 100: Financial Analysis of Interserve, 2009-2013, (£ 000)
                                                                                                                                        • Company Outlook
                                                                                                                                        • Mears Group

                                                                                                                                              • Figure 101: Financial Analysis of Mears Group, 2010-14, (£ Million)
                                                                                                                                            • Company Outlook
                                                                                                                                            • MiHomecare

                                                                                                                                                  • Figure 102: Financial Analysis of MiHomecare, 2011-2015, (£ 000)
                                                                                                                                                  • Figure 103: Financial Analysis of Complete Care Holdings, 2010-2014, (£ 000)
                                                                                                                                                • Company Outlook
                                                                                                                                                • Newcross Healthcare Solutions

                                                                                                                                                      • Figure 104: Financial Analysis of Newcross Health Solutions, 2010-2014, (£ 000)
                                                                                                                                                    • Company Outlook
                                                                                                                                                    • Saga Group (Acromas Holdings)

                                                                                                                                                          • Figure 105: Financial Analysis of Acromas Holdings, 2010-2014, (£ Million)
                                                                                                                                                          • Figure 106: Financial Analysis of Allied Healthcare Group, 2008-13 (£ Million)
                                                                                                                                                        • Company Outlook
                                                                                                                                                        • Sevacare

                                                                                                                                                              • Figure 107: Financial Analysis of Sevacare , 2010-2014, (£ 000)
                                                                                                                                                            • Company Outlook
                                                                                                                                                              • Figure 108: Profiled Companies’ Combined Turnover, 2010-2014, (£ Million)
                                                                                                                                                            • Key points
                                                                                                                                                              • Market Size
                                                                                                                                                                  • Figure 109: Forecast UK Market for Domiciliary Care, 2015/16-2019/20, (£ Million at 2015 prices)
                                                                                                                                                                  • Figure 110: Forecast UK Market for Domiciliary Care, 2015/16-2019/20, (£ Million at 2015 prices)
                                                                                                                                                                  • Figure 111: Forecast UK Commercial Market for Domiciliary Care, 2015/16-2019/20, (£ Million at 2015 prices)
                                                                                                                                                                  • Figure 112: Forecast UK Commercial Market for Domiciliary Care, 2015/16-2019/20, (£ Million at 2015 prices)
                                                                                                                                                                • Market Segmentation
                                                                                                                                                                    • Figure 113: Forecast Segmentation of the UK Market for Domiciliary Care, by Type, 2015/16-2019/20, (£ Million at 2015 prices)
                                                                                                                                                                    • Figure 114: Forecast Segmentation of the UK Market for Domiciliary Care, by Type, 2015/16-2019/20, (£ Million at 2015 prices)
                                                                                                                                                                  • Service fee pressures force providers to consider market position
                                                                                                                                                                      • Figure 115: Average Hourly Price Paid for Domiciliary Care Services, by Region, 2015, (£ per Hour)
                                                                                                                                                                      • Figure 116: Average Hourly Price Paid for Domiciliary Care Services, by Region, 2015, (£ per Hour)
                                                                                                                                                                    • The ongoing dominance of the independent sector providing home care
                                                                                                                                                                      • The rise of the ‘self-funder’ market
                                                                                                                                                                        • Difficulties in expanding home care workforce numbers
                                                                                                                                                                          • Improving the efficiency of care technology use in homes
                                                                                                                                                                          • Further Sources and Contacts

                                                                                                                                                                            • Trade Associations and Organisations
                                                                                                                                                                              • Trade Magazines
                                                                                                                                                                                • Trade Exhibitions

                                                                                                                                                                                Companies Covered

                                                                                                                                                                                To learn more about the companies covered in this report please contact us.

                                                                                                                                                                                Domiciliary Care - UK - September 2015

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