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Residential Care for the Elderly - UK - October 2019

“The lack of long-term funding plans and the outlining of potential solutions to problems in the wider social care industry will only lead to doubts over the provision of care to those already in the system and those who may need it in future.”
– Lewis Cone, Senior B2B Analyst

This report looks at the following areas:

  • Despite numerous consultations and government pledges, adult social care still faces significant challenges
  • Limited funding and debt-ridden operators leading to uncertainty for both current and future residents

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Table of contents

  1. Overview

    • What you need to know
      • Covered in this Report
      • Executive Summary

          • The market
            • Record market value reached but growth continues to slow
              • Figure 1: UK residential care market, by value, 2015-19, (£ million)
            • Old age support ratio continues to decline with dependency on the rise
              • Figure 2: Old age support ratio, 2019-44, (ratio)
            • Market value to rise by 7% to 2024
              • Figure 3: Forecast UK residential care market value, 2020/21-2024/25, (£ million at 2019 prices)
            • Companies and brands
              • The consumer
                • Almost half place performance rating as most important factor behind care home choice
                  • Figure 4: Residential care home choice factors, by any importance, April 2019, (% of respondents)
                • What we think
                • Issues and Insights

                  • Despite numerous consultations and government pledges, adult social care still faces significant challenges
                    • The facts
                      • The implications
                        • Limited funding and debt-ridden operators leading to uncertainty for both current and future residents
                          • The facts
                            • The implications
                            • The Market – What You Need to Know

                              • Record market value reached but growth continues to slow
                                • Market value to rise by 7% to 2024
                                • Market Size

                                  • Record market value reached but growth continues to slow
                                      • Figure 5: UK residential care market, by value, 2015-19, (£ million)
                                    • Number of homes continues to decline…
                                        • Figure 6: UK residential care market, by number of registered care homes, 2015-19, (units)
                                        • Figure 7: UK residential care market, by number of registered places, 2015-19, (000)
                                      • …with the average number of places rising per home
                                          • Figure 8: Average number of places, revenue per care home and revenue per place, UK, 2015-19, (average number of places, revenue in £000)
                                      • Market Segmentation

                                          • Accommodation type
                                              • Figure 9: Segmentation of the UK residential care market, by type of accommodation, 2015-19, (number of homes, sheltered housing in 000 units)
                                            • Care purchaser
                                              • Figure 10: Segmentation of the UK residential care market, by type of purchaser, 2015-19, (£ million)
                                            • Provider type
                                              • Figure 11: Segmentation of the UK residential care market, by type of provider, 2015-19, (£ million)
                                            • Local authority expenditure
                                              • Figure 12: Segmentation of local authority-commissioned residential and nursing care expenditure, by provider and client type, 2015-19, (£ million)
                                              • Figure 13: Segmentation of local authority-commissioned residential and nursing care expenditure, by provider and service type, 2015-19, (£ million)
                                            • Older people (65+) expenditure
                                              • Figure 14: Segmentation of local authority expenditure on residential care services for older people (65+), by service type, 2015-19, (£ million)
                                            • Adults aged 18-64 expenditure
                                              • Figure 15: Segmentation of local authority expenditure on residential care services for adults aged 18-64, by service type, 2015-19, (£ million)
                                            • NHS care expenditure
                                                • Figure 16: Segmentation of NHS expenditure on residential and nursing care, by provider type, 2015-19, (£ million)
                                              • Private care purchasers
                                                  • Figure 17: Private expenditure on residential and nursing care, 2015-19, (£ million and % market share)
                                                • Sheltered housing
                                                    • Figure 18: The development of sheltered housing in the UK, 2015-19, (000 units and % change)
                                                  • Extra care housing
                                                  • Market Forecast

                                                    • Market value to rise by 7% to 2024
                                                        • Figure 19: Forecast segmentation of the UK residential and nursing care market, by type of purchaser, 2020-24, (£ million)
                                                      • New software launched that aims to improve care home record keeping
                                                      • Market Trends

                                                        • Old age support ratio continues to decline with dependency on the rise
                                                            • Figure 20: UK population projections, by age group, 2018-43, (000 people)
                                                          • Rise in people living with dementia represents one of the biggest challenges to health and social care
                                                            • Staff turnover and vacancy rates remain high despite slight improvement in average wages
                                                                • Figure 21: Annual workforce turnover rates in the adult residential care sector, England, 2016-17, by employee position, (%)
                                                                • Figure 22: Average annual pay in the adult residential care sector, England, 2016-17, by employee position, (£)
                                                              • Home care accounts for majority of social care’s delays in transfer of care from NHS hospitals, but residential and nursing care figures remain high
                                                                • Occupancy rates reach 13-year high…
                                                                  • …but standards continue to fall
                                                                  • Market Drivers

                                                                    • Declining proportion of the UK population receiving the state pension creates need for operating model changes
                                                                      • New cross-party group launched to tackle care crisis whilst green paper is delayed
                                                                        • Implications of Brexit
                                                                        • Legislation

                                                                          • Care Standards Act
                                                                            • Regulation and Inspection of Social Care (Wales) Act
                                                                              • The Carers (Scotland) Act
                                                                                • The Care Act 2014 and Better Care Fund
                                                                                  • CQC and Market Oversight
                                                                                    • Pensions Act
                                                                                      • Other legislation
                                                                                      • Companies and Brands – What You Need to Know

                                                                                        • Many providers seek refinancing deals to fund expansions
                                                                                          • Hallmark Care Home starts own construction to build homes
                                                                                          • Industry Structure

                                                                                            • Industry development
                                                                                              • Use of electronic planning systems could boost occupancy rates
                                                                                                • M&As and other industry movements
                                                                                                  • Market share
                                                                                                    • Changes in the structure of the industry
                                                                                                      • Figure 23: Analysis of the changes in the structure of the ‘residential nursing care activities’ industry, 2015-19, (number of local units and businesses)
                                                                                                      • Figure 24: Analysis of the changes in the structure of the ‘residential care activities for the elderly and disabled’ industry, 2015-19, (number of local units and businesses)
                                                                                                      • Figure 25: Analysis of the changes in the structure of the hospital activities - medical nursing home activities industry, 2015-19, (number of outlets and businesses)
                                                                                                    • Structure by employment
                                                                                                      • Figure 26: Analysis of the employment structure of the residential nursing care activities industry, 2018-19, (number of outlets and outlet employment size)
                                                                                                      • Figure 27: Analysis of the employment structure of the residential care activities for the elderly and disabled industry, 2018-19, (number of outlets and outlet employment size)
                                                                                                      • Figure 28: Analysis of the employment structure of the hospital activities - medical nursing home activities industry, 2018-19, (number of outlets and outlet employment size)
                                                                                                    • Structure by turnover
                                                                                                      • Figure 29: Analysis of the financial structure of the residential nursing care activities industry, 2018-2019, (£ 000 and % of total turnover)
                                                                                                      • Figure 30: Analysis of the financial structure of the residential care activities for the elderly and disabled industry, 2018-19, (£ 000 and % of total turnover)
                                                                                                      • Figure 31: Analysis of the financial structure of the hospital activities - medical nursing home activities industry, 2018-19, (£ 000 and % of total turnover)
                                                                                                  • Competitive Strategies

                                                                                                    • Many providers seek refinancing deals to fund expansions
                                                                                                      • Providers look to extra care schemes and dementia offerings to meet growing demand for these specific care needs
                                                                                                        • Hallmark Care Home starts own construction company to build homes
                                                                                                        • Company Profiles

                                                                                                          • Abbeyfield Society
                                                                                                            • Recent company activity
                                                                                                              • Financial information
                                                                                                                • Figure 32: Financial analysis of Abbeyfield Society, 2015-19, (£ million)
                                                                                                              • Barchester Healthcare
                                                                                                                • Recent company activity
                                                                                                                  • Financial information
                                                                                                                    • Figure 33: Financial analysis of Barchester Healthcare, 2014-18, (£000)
                                                                                                                  • Four Seasons Healthcare
                                                                                                                    • Recent company activity
                                                                                                                      • Financial information
                                                                                                                        • Figure 34: Financial analysis of Four Seasons Health Care, 2014-18, (£ million)
                                                                                                                      • HC-One
                                                                                                                        • Recent company activity
                                                                                                                          • Financial information
                                                                                                                            • Figure 35: Financial analysis of HC-One, 2014-18, (£ million)
                                                                                                                          • Housing 21 (formerly Housing & Care 21)
                                                                                                                            • Recent company activity
                                                                                                                              • Financial information
                                                                                                                                • Figure 36: Financial analysis of Housing 21, 2015-19, (£ million)
                                                                                                                              • Sanctuary Care
                                                                                                                                • Recent company activity
                                                                                                                                  • Financial information
                                                                                                                                    • Figure 37: Financial analysis of Sanctuary Care, 2014-18, (£ million)
                                                                                                                                • The Consumer – What You Need to Know

                                                                                                                                  • Government and personal savings expected to fund long-term care
                                                                                                                                    • Almost half cite performance rating as most important factor behind care home choice
                                                                                                                                      • 71% would prefer to have care at their own or a family member’s home than in a residential care home
                                                                                                                                        • Resident consideration key before service changes are made, with homes also in need of extra funding
                                                                                                                                        • Care Payment

                                                                                                                                          • Government and personal savings expected to fund long-term care
                                                                                                                                            • Figure 38: Long-term care payment method, April 2019, (% of respondents)
                                                                                                                                        • Choosing a Care Home

                                                                                                                                          • Almost half cite performance rating of care home as most important factor behind care home choice
                                                                                                                                            • Figure 39: Residential care home choice factors, by rank of importance, April 2019, (% of respondents)
                                                                                                                                        • Care Home Opinion

                                                                                                                                          • Nearly three-quarters believe that CCTV camera installation would stop negative treatment of residents
                                                                                                                                            • Figure 40: Residential care home opinion, April 2019, (% of respondents)
                                                                                                                                          • Women are more open to the use of CCTV in homes, whilst also carrying greater guilt should a family member move into a home
                                                                                                                                            • Figure 41: Residential care home opinion, by gender, April 2019, (% of respondents)
                                                                                                                                        • Care Home Issues

                                                                                                                                          • Resident consideration key before service changes are made, with homes also in need of extra funding
                                                                                                                                            • Figure 42: Residential care home Issues, by gender, April 2019, (% of respondents)
                                                                                                                                        • Appendix – Data Sources, Abbreviations and Supporting Information

                                                                                                                                            • Abbreviations
                                                                                                                                              • Methodology
                                                                                                                                              • Further Sources and Contacts

                                                                                                                                                • Trade associations
                                                                                                                                                  • Trade magazines
                                                                                                                                                    • Trade events

                                                                                                                                                    Residential Care for the Elderly - UK - October 2019

                                                                                                                                                    £1,495.00 (Excl.Tax)