Adult Social Care in Brighton & Hove: Complexity, Capacity and the Market Outlook

Brighton & Hove is a relatively compact adult social care market with a distinctive demographic profile.

It has a younger population than most of the South East, a substantial existing care market and comparatively good availability of mainstream residential and domiciliary care. That makes the local opportunity more nuanced than simply identifying an ageing population and assuming that more general care provision is required.

The stronger signals sit elsewhere.

Brighton & Hove City Council has identified pressure around complex care, nursing, dementia, respite and specialist services. More recent evidence from the Care Quality Commission also found that people with more complex needs can have limited local options, while ordinary residential care and non-specialist homecare are comparatively easy to source.

For anyone considering starting or expanding a care service in Brighton & Hove, the type of provision matters at least as much as the overall level of demand.

Brighton & Hove at a glance

283,870

Estimated population, 2024

14%

Residents aged 65 and over

5,328

People on long-term adult social care, 2024/25

1,543

Beds for older people across residential and nursing provision

23%

Adults reporting a mental health difference or condition, 2025

14 days

Average referral to care in place, updated CQC evidence

Brighton & Hove had an estimated population of 283,870 in 2024.

Unlike many parts of the South East, it is not currently an especially old population. Around 14% of residents are aged 65 or over, compared with a larger proportion across both the South East and England. The city has a particularly large working-age and young-adult population. Neighbouring East Sussex has a much older county-wide profile, which helps show how different two nearby markets can look.

That can initially make Brighton & Hove appear less attractive as an adult social care market than neighbouring authorities with older populations.

The longer-term picture is different.

ONS projections used by Brighton & Hove City Council suggest that between 2022 and 2032 the number of residents aged 80 and over could increase by 31%, while the population aged 60 to 69 is projected to increase by 29%.

1. Aged 60 to 69

   +29%

2. Aged 80 and over

   +31%

By 2047, the number of people aged 80 and over is projected to be 79% higher than in 2022.

By 2047, the number of people aged 80 and over is projected to be 79% higher than in 2022.

So Brighton & Hove is starting from a younger demographic base, but significant ageing is still expected.

That distinction is important. Future demand is likely to grow, but it does not automatically follow that every type of care service faces the same opportunity today.

A substantial existing social care market

Adult social care is already supporting a significant number of people across the city.

Brighton & Hove City Council reported that 5,328 people received a long-term adult social care service during 2024/25. The council also reported 1,543 beds for older people across residential, dementia residential, physical nursing and dementia nursing provision.

5,328

People receiving long-term adult social care, 2024/25

1,543

Beds for older people across residential and nursing provision

The market covers considerably more than older people's care.

Current commissioning activity includes homecare, supported living, learning disability services, mental health provision, physical disability and acquired brain injury support, housing-related services and different forms of accommodation-based care.

During 2024/25 the council reported, among other developments:

1. 01

   Additional supported living provision for people with mental health needs.

2. 02

   12 adults with learning disabilities moving into supported living placements within the city.

3. 03

   Two new supported living services opening.

4. 04

   Additional provision for people with physical disabilities or acquired brain injury through a fully accessible supported living service.

This is therefore an established and relatively diverse market rather than an area where adult social care infrastructure is still developing from a low base.

Mainstream care is not the clearest supply gap

This is one of the most important differences between Brighton & Hove and some other local authority markets.

During its assessment of Brighton & Hove City Council, the CQC reported that staff considered non-specialist domiciliary care and residential care abundant and relatively easy to access.

The same evidence showed that the homecare market had improved substantially from an earlier period when around 120 people had reportedly been waiting for care.

For the three months to February 2025, the local authority reported average waits of approximately:

1. Nursing care

   23 days

2. Homecare

   25 days

3. Residential care

   28 days

4. Supported living

   54 days

Updated evidence subsequently supplied to CQC showed the average time between referral to brokerage and care being put in place had reduced to 14 days overall.

These figures do not mean that there is no demand for a new homecare agency or residential service.

They do mean that general demand should not be confused with an identified shortage.

A new provider offering broadly the same service as a well-established group of existing providers would still need to demonstrate where its customers will come from, what differentiates its offer and whether the local purchasing market can support another entrant.

The stronger signal is complexity

The position becomes considerably more interesting when the market is broken down by need.

Brighton & Hove's Market Sustainability Plan identified:

1. High-frailty and nursing care

   A shortage of provision for people with higher physical dependency and nursing needs.

2. Dementia provision

   A severe shortage of residential and nursing dementia provision.

3. Planned respite

   Insufficient long-term planned respite.

4. Under-65 specialist care

   Shortages of specialist care for people under 65.

5. Complex mental health

   Gaps relating to people with complex mental health needs.

The council said shortages in some areas had resulted in people being placed outside Brighton & Hove.

More recent CQC evidence points in the same direction.

CQC found that while people could generally access a range of local services, people with complex or compound needs had fewer choices locally. This included people whose needs arose from combinations of health conditions, disabilities or other support requirements.

The authority had responded by developing more specialist services. CQC recorded that 22 new supported living placements had been commissioned for people with mental health needs or substance misuse-related needs during the preceding year.

This gives the market a clearer shape.

The issue is not simply "Brighton needs more care".

It is closer to:

That is a much more useful starting point for someone deciding what type of service to develop.

Care homes: capacity exists, but it does not always match need

Brighton & Hove has historically described its general residential care offer as strong.

The problem is the match between available capacity and the needs of the people requiring placements.

The council's market sustainability work identified shortages particularly around high frailty, nursing, dementia nursing, functional mental health, planned respite and specialist care for younger adults.

This distinction matters commercially.

A market can simultaneously contain a substantial number of care-home beds and experience genuine shortages.

A vacant general residential bed is not necessarily capable of meeting the needs of somebody requiring dementia nursing, significant behavioural support, complex physical care or another specialist intervention.

For potential new care-home operators, therefore, simply measuring the number of beds already available in Brighton & Hove can be misleading.

Capability, registration, staffing model, environment and intended client group all influence whether capacity actually competes for the same demand.

There is another constraint.

Brighton & Hove is a dense urban authority with limited development space. The council has previously acknowledged that this reduces its ability to reshape the market simply through new large-scale care-home development.

That makes the property and development case particularly important for anyone considering new accommodation-based provision.

Homecare: a functioning market with future demographic demand

Homecare is an essential part of Brighton & Hove's adult social care system, but current evidence does not suggest a straightforward city-wide shortage of ordinary domiciliary care.

The council's earlier market sustainability work recorded 37 domiciliary care providers supporting approximately 2,000 people, with 22 providers holding local authority contracts at that point. Those figures are historic and should not be treated as a current provider count, but they illustrate that Brighton & Hove already had a developed homecare market.

37

Domiciliary care providers in earlier market sustainability work, historic

~2,000

People supported by those providers at that point, historic

22

Providers holding local authority contracts at that point, historic

CQC's later assessment is more useful for understanding the present direction of travel. It found mainstream domiciliary care relatively accessible rather than identifying it as one of the city's most significant capacity gaps.

There is still a long-term demand case.

The expected growth in older age groups, the emphasis on helping people remain independent and the pressure on accommodation-based provision all support continuing demand for care delivered at home.

But a new homecare provider should not rely on population ageing alone as evidence that there is room in the market.

The more important questions are likely to be:

Our guide to starting a domiciliary care agency covers registration and setup. Local market evidence still needs to sit alongside that for Brighton & Hove specifically.

Supported living: a more active area of development

Supported living is one of the more significant areas to watch.

Brighton & Hove has been actively increasing local supported living options across several client groups, including people with learning disabilities, mental health needs, physical disabilities and acquired brain injury.

At the same time, supported living recorded a longer average wait than homecare, residential or nursing care in the evidence supplied to CQC.

CQC also identified continuing gaps for people with more complex needs and noted that the authority's commissioning strategies sought to increase specialist supported accommodation.

This does not mean that any supported living service will automatically attract placements.

Supported living is particularly dependent on the interaction between:

• Identified commissioning need
• Intended client group
• Suitable housing
• Care and support intensity
• Local referral pathways
• Funding arrangements
• CQC-regulated activity where applicable

However, compared with generic provision, the evidence gives a clearer indication that appropriately targeted supported living remains part of the city's market-development direction.

Mental health and multiple needs are particularly relevant

Brighton & Hove also has characteristics that make working-age adult social care unusually important.

The city's 2025 population evidence estimated that 23% of adults reported a mental health difference or condition, while the council's broader needs evidence continues to identify neurodiversity, learning disabilities, multiple long-term conditions and multiple compound needs as significant areas of work.

Not everyone within these population groups requires regulated social care, so prevalence should never be converted directly into expected service demand.

It does, however, help explain why the city's commissioning priorities extend well beyond traditional older people's care.

Brighton & Hove has recently developed additional mental health supported living and accommodation-based support for people leaving mental health hospital, while CQC found that complex and compound needs remained an area where local choice could be limited.

For a specialist provider, understanding these pathways may be more valuable than simply analysing the city's overall population.

Demand is not the same as commercial opportunity

This distinction runs throughout the Brighton & Hove market.

There is clear adult social care demand.

There are also documented supply gaps.

But that does not mean every new service is commercially viable.

Local authority purchasing power, fee levels, staffing costs, property costs, private-pay demand and the availability of suitable referrals all affect whether an identified social-care need can support a sustainable business.

Brighton & Hove's own cost-of-care work has previously highlighted financial pressure across both homecare and residential services, while CQC's 2025 assessment recorded concerns from some providers about fees and the predictability of the authority's uplift process.

For someone starting a care service, the question is therefore not simply:

Is there demand in Brighton & Hove?

It is:

Is there sufficient demand for the specific service I intend to provide, from customers or commissioners able to purchase it at a sustainable price?

Those are very different questions.

What the evidence suggests

Brighton & Hove does not present as a market with a simple shortage of care across the board.

Its general residential and homecare markets are comparatively established. The city also has a younger population than neighbouring parts of the South East, despite substantial projected growth in its older age groups.

The more consistent market signals concern specialism and complexity.

For a prospective provider, that makes Brighton & Hove a market that needs to be analysed service by service, rather than treated as one single adult social care market.

A strong local proposition starts by identifying a defined need and then testing whether the commissioning, referral, workforce, property and financial conditions exist to meet it sustainably.