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

East Sussex has one of the oldest population profiles in England, a substantial existing care market and very different supply-and-demand conditions depending on the type of care being provided.

For anyone considering starting, buying or expanding an adult social care service in the county, the headline demographic story is only the beginning. Residential care, nursing care, home care, supported living and specialist provision are not moving in the same direction, and county-wide capacity figures can conceal important differences in affordability, geography and complexity of need.

This report brings together East Sussex County Council's Spring 2026 Market Position Statement, local demographic projections and current market data to show where demand is growing, where capacity already exists and where the strongest pressure appears to be concentrated.

East Sussex at a glance

563,100

Population, approximate

26.6%

Population aged 65 and over

4%

Population aged 85 and over, around

167

Registered care homes

6,700

Care-home beds, approximate

5,300+

People living in those homes

10,925

People receiving long-term support, 2024/25

2,700–2,800

Council-supported home-care users

37,000

Home-care hours commissioned each week, approximate

19,000

Adult social care workforce, approximate

1,400

Vacant adult social care posts, approximate

69,241

Unpaid carers, approximate

East Sussex County Council expects the population to reach around 584,400 by 2031. The overall increase matters, but the age profile matters more. Between 2026 and 2031, the number of residents aged 65–84 is projected to increase by 11.1%, while the 85+ population is projected to increase by 28.5%.

1. Aged 65 to 84

   +11.1%

2. Aged 85 and over

   +28.5%

The county's total population is expected to reach about 584,400 by 2031.

That creates a strong underlying demand signal. It does not, however, mean that every part of the care market needs more general capacity.

An unusually old population is increasing underlying demand

People aged 65 and over already represent 26.6% of the East Sussex population, compared with 18.7% nationally. Around 4% of residents are aged 85 or over.

The position also differs considerably within the county. Rother has one of the highest proportions of residents aged 85+ in England, while Wealden is expected to experience particularly strong growth in the oldest age groups.

Age is only one part of the demand picture. Around 51,665 people aged 65+ were estimated to be living with a limiting long-term illness in 2025, rising to more than 57,000 by 2030. The number of older people living with dementia is projected to reach around 13,059 by 2030.

The number of people receiving long-term support from East Sussex Adult Social Care and Health reached 10,925 in 2024/25. That was 20.6% higher than in 2021/22. Among people aged 65 and over, the increase was 23.7%.

1. All people receiving long-term support

   +20.6%

2. Aged 65 and over

   +23.7%

10,925 people received long-term support in 2024/25.

So the broad direction is clear: more people are likely to require support, and a growing proportion will have multiple or complex needs.

Prevention and reablement are changing the shape of demand

Growing need does not automatically translate into proportional growth in long-term residential care.

East Sussex's commissioning direction is to support people to remain independent and living at home or in their communities for as long as possible. In 2024/25, 74.6% of people aged 65+ who entered reablement or rehabilitation after hospital discharge were still at home 12 weeks later, compared with 60.7% nationally.

That matters to the market because successful prevention and reablement can delay or avoid some long-term care placements. At the same time, people who eventually move into residential or nursing care may do so later and with higher levels of need.

This helps explain an important feature of East Sussex: overall demand is rising, but the strongest pressure is increasingly concentrated in complexity, nursing, dementia and specialist provision rather than simply in the total number of beds or providers.

Unpaid carers are also part of this capacity system. East Sussex estimates that around 69,241 people provide unpaid care, roughly one in ten residents. Pressure on informal care can therefore affect demand for respite, emergency support, home care and longer-term services.

Residential and nursing care: capacity exists, but it is not evenly matched to demand

As of March 2026, East Sussex had 167 registered care homes providing around 6,700 beds and supporting just over 5,300 people.

At county level, the Council describes total care-home bed supply as broadly sufficient. But the headline number hides a substantial difference between residential and nursing provision.

1. Nursing dementia

   93% occupied, 7% vacant

2. General nursing

   92% occupied, 8% vacant

3. Residential dementia

   81% occupied, 19% vacant

4. General residential

   80% occupied, 20% vacant

That points to a much tighter nursing market than general residential care.

The longer-term capacity trend reinforces the distinction. Since 2014, East Sussex has experienced a net loss of 477 older people's nursing beds, and no new nursing beds have opened since 2021. Recent additions to capacity have been more concentrated in residential provision or services aimed at self-funders.

477

Net loss of older people’s nursing beds since 2014

and

0

New nursing beds opened since 2021

East Sussex therefore does not have a simple shortage of care-home beds. It has a more specific mismatch between the type of capacity available and the type of capacity increasingly required.

Who pays for care changes how capacity should be interpreted

A vacant bed is not necessarily available to the person who needs it.

More than half of occupied older people's care-home beds in East Sussex are used by people who are not funded by Adult Social Care and Health. This includes self-funders, people funded through NHS Continuing Healthcare and people supported by other local authorities.

That matters because price can turn theoretical capacity into inaccessible capacity.

The Council explicitly identifies continuing demand for affordable nursing and dementia care. For the purposes of its Market Position Statement, affordable provision means services able to operate sustainably within, or close to, the Council's fee structure.

Published 2026/27 weekly rates include approximately £1,129.73 for general nursing and £1,163.12 for dementia nursing, inclusive of the applicable individual contribution and NHS-funded nursing care.

£1,129.73

General nursing, per week, 2026/27

£1,163.12

Dementia nursing, per week, 2026/27

The Council also says that there remains a mismatch between much of the new provision entering the older people's care market and local-authority affordability.

For a provider, this creates two quite different commercial questions: whether there is demand for the service, and whether the intended payer can sustain the price required to deliver it.

Market consolidation is changing the provider landscape

East Sussex also reports increasing corporate acquisition and consolidation within residential and nursing care.

Consolidation can bring investment and operational scale, but the Council is monitoring its effect on market diversity, local responsiveness, quality and continuity of care.

This is relevant to prospective entrants because the competitive environment is not defined simply by the number of registered homes. Ownership structure, scale, purchasing power, fee mix and the ability to invest in nursing or complex-care capacity can all affect how individual services compete.

It also reinforces the importance of looking below county totals when assessing a proposed service.

Home care presents a very different market

Demand for care at home remains substantial.

East Sussex County Council supports approximately 2,700–2,800 people with home-care packages at any one time and commissions around 37,000 hours of care each week. Annual expenditure is approximately £50 million.

The average home-care package is around 12.9 hours per week.

2,700–2,800

People supported with home care at any one time

37,000

Hours commissioned each week, approximate

12.9

Average package hours per week, approximate

£50m

Annual council spend on home care, approximate

However, the Council's current assessment is that existing home-care capacity is more than sufficient to meet its Adult Social Care demand.

Five lead providers account for approximately 55% of the Council's home-care requirement. Around a quarter of providers on the approved list have left the market during the current contract period, yet the Council reports that there have been no home-care waiting lists anywhere in the county during that period.

This is an important distinction. East Sussex has a large home-care market, but a large market is not the same as an undersupplied market.

The Council expects modest demand growth over the next five years, including from people who fund their own care. Opportunities may therefore exist by locality, client group, funding model or specialism, but the evidence does not support a simple county-wide case for additional general home-care capacity.

Quality is also comparatively strong. As at April 2026, no East Sussex home-care services were rated Inadequate by CQC, 6% were rated Requires Improvement and 94% were rated Good or Outstanding.

Supported living and specialist care: the opportunity is increasingly specific

Supported living is the Council's preferred accommodation-with-support model for many working-age adults with learning disabilities where it can safely and effectively meet individual need.

East Sussex has seen growth in newly established supported-living services and has recently tendered for a new supported-living contract. As a result, the Council says it currently has sufficient supported accommodation for adults with higher levels of learning-disability need and is not seeking additional standard capacity over the immediate period.

But that does not mean the market is closed.

The Council continues to identify specific needs, including respite, short-term and emergency provision. It also has a targeted opportunity planned for two supported-living services supporting up to 20 people from spring 2028.

Specialist residential and nursing care is another distinct market. East Sussex has 53 specialist providers operating across 106 establishments, supporting adults with learning disabilities and/or autism, mental health needs and working-age adults with multiple or complex needs.

The Council purchases approximately half of the places in this specialist residential and nursing market, making commissioning priorities particularly important.

53

Specialist providers

106

Establishments

About half

Specialist residential and nursing places bought by the Council

The signal is therefore increasingly about specificity: the client group, complexity, locality and commissioning gap matter more than the broad label attached to the service.

Geography still changes the market

East Sussex should not be treated as one uniform care market.

Care-home provision is more concentrated in the east of the county and in urban areas. The Council says this can restrict choice and access for people living in northern and western East Sussex.

The population profile also varies. Rother has an unusually old population; Hastings experiences materially poorer health outcomes and lower life expectancy than some other parts of the county; Wealden has higher life expectancy and a different demographic profile.

• Lewes
• WealdenHigher life expectancy and strong growth in the oldest age groups
• RotherAn unusually old population
• Eastbourne
• HastingsMaterially poorer health outcomes and lower life expectancy

English Channel

Care-home provision is more concentrated in the east and in urban areas. Districts are shown in their rough positions, not to scale.

These differences can affect demand, workforce availability, travel time, private-pay potential and access to existing services.

For home care in particular, operating economics can change significantly with geography because travel time and workforce density affect how efficiently care hours can be delivered.

County-level data is therefore useful for direction, but not sufficient for a local investment decision.

Workforce may be as important as customer demand

Around 19,000 people worked in adult social care in East Sussex in 2024/25, with approximately 1,400 vacant posts.

The workforce required is projected to increase by 28% between 2023 and 2035.

The workforce itself is ageing. Around 29% of workers are aged over 55, and approximately 5,000 existing workers are expected to reach retirement age during the next decade.

International recruitment has also become more constrained. National changes introduced in July 2025 ended new overseas recruitment for care worker and senior care worker roles, including home care, with transitional arrangements for existing workers.

19,000

People working in adult social care, 2024/25

1,400

Vacant posts

29%

Workers aged over 55

+28%

Projected workforce growth by 2035 from 2023

For a prospective provider, this means demand cannot be separated from deliverability. A service can enter a market with genuine customer need and still fail to create viable capacity if it cannot recruit and retain the workforce required.

Quality and resilience are part of market capacity

Capacity is not just the number of beds, hours or providers.

East Sussex uses CQC outcomes, safeguarding information, placement activity and market-sustainability intelligence to assess provider risk.

Within older people's residential care, 80% of services were rated Good or Outstanding in the Council's Spring 2026 market information. For older people's nursing care, the figure was 78%. Working-age residential and nursing provision had a higher proportion, with 92% rated Good or Outstanding.

Older people’s residential

80% rated Good or Outstanding

Older people’s nursing

78% rated Good or Outstanding

Working-age residential and nursing

92% rated Good or Outstanding

These figures suggest that much of the market is delivering acceptable or strong quality, but they also show why new capacity is only useful if it is sustainable, appropriately staffed and able to meet the complexity of need commissioners and individuals are actually seeking.

Market resilience therefore depends on more than attracting new providers. It depends on retaining viable providers, maintaining quality and ensuring that capacity is in the right place, at the right price and for the right needs.

What does the East Sussex market actually show?

There is no single answer to whether East Sussex has "enough care".

The evidence points to several different markets.

1. Residential care

   Substantial existing capacity, with general residential occupancy at around 80%. New general capacity requires a more specific case around location, client group, quality, property or payer mix.

2. Nursing and dementia care

   The clearest area of pressure. Occupancy is above 90%, nursing beds have reduced over the long term and the Council continues to identify demand for affordable nursing, dementia and complex-care provision.

3. Home care

   Large and strategically important, but current capacity exceeds Council demand and there have been no waiting lists during the current contract period.

4. Supported living

   General additional capacity is not currently being sought in some parts of the market. Commissioning is increasingly targeted around specific gaps, respite, emergency support and particular future opportunities.

5. Specialist care

   Demand depends heavily on client group, complexity and commissioning need. The Council is an important purchaser, particularly in specialist residential and nursing care.

Across all of these markets, the long-term direction is towards greater complexity, more support in people's own homes and communities, and more selective commissioning rather than indiscriminate expansion.