Starting a care service in Hampshire

Hampshire is one of the largest adult social care markets in England.

That scale can make it look like an obvious place to start a care business.

The county has more than 1.45 million residents, a large older population, more than 20,000 people receiving long-term adult social care support and a provider market spread across 11 districts.

But Hampshire's current evidence is unusually useful because it shows where providers should be cautious as well as where opportunity exists.

The June 2025 Independent Living at Home Market Position Statement says the standard homecare market has become overcrowded.

The Younger Adults Market Position Statement says learning-disability residential care has significant ongoing oversupply.

The Residential and Nursing Market Position Statement says the council is not forecasting a near-term increase in placement numbers.

The county is nevertheless expanding affordable Extra Care, specialist supported accommodation, complex homecare, dementia capability, physical-disability services and mental-health housing. These are much more precise opportunities than the overall size of the social-care market suggests.

The critical question is which specific service gap the provider intends to address, in which Hampshire district, through which purchasing route, and whether it can recruit and retain enough suitable staff.

Start with the service model, not the registration

CQC registration is important.

It should not be the first commercial decision.

Before applying, define the client group and service type, relevant district or commissioning zone, payer, referral and procurement routes, property needs, workforce, achievable fee and existing competition. Those decisions determine what service is viable and what CQC application is actually required.

Hampshire already has hundreds of regulated services.

A provider needs a reason to be selected.

Decide which Hampshire market you are entering

Potential services include standard or complex homecare, live-in support, residential or nursing care, dementia provision, Extra Care, supported living, specialist learning-disability, physical-disability or mental-health services, respite and day opportunities. These models have very different sources of demand.

The economics, workforce, property, regulatory scope and referral mechanisms vary substantially. A broad decision to enter 'adult social care' is therefore not a sufficient business model.

The service category needs to be precise before registration begins.

Generic homecare is a high-caution entry

Hampshire's current Independent Living at Home MPS says the market has become overcrowded.

Providers have reported difficulty obtaining enough packages from the council, NHS and private customers to maintain viable operations. This is a stronger warning against a generic domiciliary-care launch than national forecasts of growing demand are evidence in its favour.

That is strong negative evidence for a generic domiciliary-care start-up.

A large homecare market does not automatically mean a shortage

Hampshire delivers more than four million hours of homecare each year.

The council expects the number of older people using care at home to grow.

But a provider still needs enough work in the specific zone it intends to serve.

County-wide demand is not enough.

Check the exact homecare zone

CCSH divides Hampshire into 15 geographic zones, which can differ in provider density, availability of packages, travel costs and workforce supply. A business case should reflect the zone in which care would actually be delivered, rather than assume uniform county-wide conditions.

A provider should analyse the actual zone rather than market itself across the whole county.

CCSH access matters

Since 28 April 2025, all new council-funded domiciliary care has been purchased through Community Care and Support Hampshire.

The Community Care and Support Hampshire purchasing arrangements cover eligible older adults and people with physical disabilities, learning disabilities or mental-health needs. Providers need a current route into these contracts; CQC registration and market access are separate matters.

CCSH does not guarantee packages

Even after being accepted onto CCSH, providers are not guaranteed work.

The contract is designed around competitive package allocation and geographic zones.

That makes the business case especially important.

A provider should not register on the assumption that a framework place automatically creates revenue.

Complex homecare has a stronger case

The current homecare market may be crowded overall, but Hampshire expects increasing complexity.

More specialist propositions may relate to hospital discharge, dementia, high-dependency physical care, learning disabilities, mental-health needs, overnight packages or live-in support. Each demands more capable staffing and governance than conventional personal care, which partly explains why suitable capacity may be harder to find.

These services require more capability.

That is part of why the opportunity exists.

Rural homecare can be more attractive commercially only if density works

Some Hampshire communities are harder to serve because of geography.

That can create local opportunity.

It can also create weak economics.

A rural service needs realistic assumptions about travel, mileage, where staff live, package density, gaps between calls and cancellations. An underserved locality can still be unprofitable if too much paid time is spent travelling rather than providing commissioned care.

A rural shortage does not automatically mean a profitable market.

Reablement changes the homecare model

Hampshire wants providers to work in a strengths-based way.

The aim is to help people regain or maintain independence.

Reablement seeks to maintain or restore independence through proportionate care, equipment, appropriate technology and family or community support. A provider depending on packages remaining at their initial intensity may therefore be poorly aligned with commissioning expectations.

A provider that relies entirely on preserving high weekly hours may be poorly aligned with the council's direction.

Technology should be built into the operating model

Hampshire has extensive experience of technology-enabled care.

Technology can contribute to independence, risk management, communication and better use of staff time. It should be chosen as part of a safe care pathway and tested for actual value, rather than introduced as an isolated product.

Technology should therefore be considered at service-design stage rather than added later.

Extra Care deserves serious attention

Extra Care is one of Hampshire's strongest strategic growth areas.

The county currently reports 974 apartments across 21 schemes.

Its overall ambition is around 1,500 units.

974

Apartments now

and

1,500

Overall ambition

The 2024 demand study identified around 64% additional affordable need by 2043.

• 64%More homes

This is a much stronger market signal than general care-home growth.

Extra Care is not a conventional start-up

The entry barriers are high.

A development requires suitable land, planning, finance, housing and landlord expertise, a developer or registered-housing partner and a viable care commissioning arrangement. It is often more realistic for a specialist care provider to collaborate with housing organisations than to lead every aspect independently.

A care provider may need to partner rather than build independently.

Prioritise the identified Extra Care districts

Hampshire identifies Fareham, Havant, East Hampshire and Basingstoke and Deane as areas with especially strong future Extra Care demand. These signals should inform initial site and partner research, while scheme-level feasibility still needs verification.

1. Fareham
2. Havant
3. East Hampshire
4. Basingstoke and Deane

That should influence where a developer investigates first.

The county-wide growth figure should not be used to justify a scheme in a weaker locality.

Extra Care needs to support greater complexity

Hampshire wants residents to remain in schemes for longer.

Future schemes may need to support dementia, frailty, sensory impairment, autism and higher-intensity personal care, allowing people to remain in their homes as needs change. Conventional low-support retirement housing would not meet that requirement on its own.

A low-support retirement model is not equivalent to Hampshire's Extra Care ambition.

Generic care-home development should be approached cautiously

Hampshire's Residential and Nursing MPS does not forecast an increase in council placement volumes over the next few years.

The council already purchases around 1,600 to 1,900 new placements annually.

That creates a substantial market.

But it does not create evidence for indiscriminate expansion.

Dementia has a stronger care-home case

Hampshire expects dementia prevalence to rise significantly.

The council explicitly wants providers able to support more people with dementia.

A prospective operator should assess whether the local need concerns dementia residential care, dementia nursing, complex care or higher-dependency provision. These are different clinical and staffing models; a general dementia label does not establish which additional beds would be useful.

Use current Hampshire fee bands

Hampshire publishes needs profiles and price bands.

Published rate structures distinguish standard residential, enhanced residential, enhanced nursing and complex residential or nursing provision. The most complex band can reach approximately £1,445 a week, subject to the relevant nursing-care funding arrangements. These are planning references, not guaranteed income for every resident.

The complex rate can reach up to around £1,445 per week, with nursing Funded Nursing Care treated separately.

These are important commercial reference points.

They should not be treated as automatic rates.

Build the care-home model from realistic occupancy

The residential MPS says occupancy remains a challenge for some providers.

The self-funder market has not fully recovered to its pre-2020 position.

The financial model must remain viable at conservative occupancy, with a realistic mix of publicly and privately funded residents and the fees genuinely attainable from each. A development that only works at full occupancy leaves little resilience for normal admission and void fluctuations.

A model that only works when full is fragile.

Learning-disability residential care is a weak generic entry case

Hampshire is explicit that the wider learning-disability residential and nursing market is oversupplied.

The county council funds 613 placements against around 1,230 beds across the wider Hampshire market.

1. Beds in the wider market

   1,230

2. Placements funded by Hampshire

   613

It is not planning substantial generic residential expansion.

That should materially affect a start-up decision.

Specialist learning-disability residential provision may still have a case

The oversupply is not uniform.

Although ordinary learning-disability residential provision is described as oversupplied, the council can still struggle to source emergency placements, crisis services and highly complex support. A specialist entrant needs direct evidence of which group commissioners cannot place safely.

A specialist service can therefore have a stronger case.

Supported living has much stronger strategic alignment

Hampshire already commissions supported living for around 1,100 people with learning disabilities.

It wants further growth.

The long-term strategy is to reduce dependence on residential care and increase supported accommodation.

That is a much clearer market direction.

Supported living should start with the person, not the property

Do not acquire a house and then look for referrals.

Start with:

1. client group
2. commissioner demand
3. staffing model
4. environmental requirements
5. property.

This is especially important where support needs are complex.

HADSOM is central to supported accommodation market access

Hampshire uses its accommodation and support procurement model for many supported-living opportunities.

Organisations considering supported accommodation for people with learning disabilities, autism, physical disabilities or mental-health needs must understand the relevant Hampshire accommodation-and-support procurement arrangements. An available property and CQC registration do not independently secure placements.

Physical-disability provision has a narrower specialist opportunity

Hampshire funds 126 residential and 92 nursing placements for physical disability.

The council is particularly interested in alternatives for younger adults who may currently live in older-person services.

Potential gaps include specialist short-term residential services, supported accommodation and complex homecare, particularly where younger people otherwise live in settings designed mainly for older residents. The offer needs to address that specific mismatch.

Physical-disability day services are not a growth signal

The council describes existing day provision as broadly sufficient.

A provider should treat that as negative market evidence.

Not every care-related service needs additional capacity.

Mental-health supported accommodation deserves closer attention

Hampshire commissions approximately 153 short-term beds and 215 long-term supported-accommodation packages. Its direction toward greater independence makes recovery-oriented housing a stronger line of enquiry than undifferentiated mental-health residential development.

The council wants to continue shifting people away from residential care where more independent models are appropriate.

That creates a credible supported-housing market.

Mental-health homecare is becoming more structured

Around 45% of mental-health homecare was still being spot purchased in the 2025 MPS.

Hampshire wants that proportion to fall.

Providers therefore need to understand framework access.

A business built around informal spot referrals may become less viable.

Ageing mental-health residents create a specialist crossover market

The average age of Hampshire's mental-health residential cohort is around 55.

Many people are older than that.

An ageing mental-health residential population may also require support with frailty and physical illness. Services able to combine mental-health expertise with appropriate older-person and clinical care could address a more specific need than conventional provision.

This creates a potentially valuable specialist crossover.

Decide who will pay

The funding route might involve Hampshire County Council, NHS Hampshire and Isle of Wight, direct-payment recipients, private self-funders or joint health and social-care arrangements. Each payer has different contracting and referral processes.

These are different markets.

The payer route should be known before the service is designed.

North-east Hampshire joined NHS Hampshire and Isle of Wight in 2026

On 1 April 2026, North East Hampshire transferred from the former NHS Frimley ICB into NHS Hampshire and Isle of Wight. The previous Frimley ICB no longer exists. This is important when identifying the responsible NHS commissioner for continuing healthcare, primary-care pathways or hospital discharge.

Legacy Frimley clinical policies may continue to apply during the transition, even though commissioning responsibilities have moved. Providers should verify the current local pathway and contractual arrangements rather than relying on the pre-April 2026 boundary. See NHS Hampshire and Isle of Wight's explanation of the change.

Workforce retention should be treated as a go/no-go issue

Hampshire has around 44,000 adult social care posts.

44,000

Adult social care posts

and

31.9%

Annual turnover

Skills for Care estimates a 31.9% turnover rate.

That is very high.

A provider should build the model around retention, not continuous replacement recruitment.

Specialist services require a stronger workforce plan

The clearest specialist opportunities may depend on nurses, autism and mental-health expertise, positive behaviour support and complex-care skills. A prospective provider should examine availability of these staff before making expensive property or registration commitments.

The provider should test the availability of those workers before registration.

International recruitment should not be the only strategy

National immigration rules have become less predictable.

Hampshire's workforce strategy reflects that.

Resilient recruitment planning should include local talent, staff retention, training, career progression, wellbeing and ethical recruitment. Relying solely on overseas recruitment exposes the service to changing immigration and sponsorship rules.

The registered manager should be identified early

A capable registered manager should influence service design, operating policies, staffing, clinical governance and the CQC application. The role cannot realistically be left as an administrative detail after the business model is fixed.

CQC scope needs to follow the actual service

Not every housing or support model requires the same registration.

For many homecare and supported-living services, Personal care is the relevant regulated activity.

But accommodation itself is not necessarily regulated by CQC.

Day opportunities may also fall outside registration depending on what is delivered.

The service model should determine scope.

A practical Hampshire market-entry test

Score the proposed service across six areas.

Before you commit heavily to premises, recruitment or registration, the Should I Start? Market Report can test your planned service in Hampshire against the same local demand, supply and commissioning evidence used in this analysis.

Which Hampshire services deserve the closest look?

Generic homecare

High caution.

The market is crowded.

Specialist or complex homecare

Stronger opportunity.

Rural homecare

Potentially attractive where package density can be made viable.

Extra Care

One of the strongest strategic development opportunities.

General residential and nursing care

Moderate caution in the near term.

Dementia and complex care

Stronger long-term signal.

Generic learning-disability residential care

Weak current signal because of oversupply.

Learning-disability supported living

Strong strategic direction.

Physical-disability supported accommodation

A smaller but credible specialist opportunity.

Mental-health supported accommodation

A substantial established market with further strategic relevance.

When should you move to CQC registration?

A credible plan identifies its client group, locality or commissioning zone, current market gap, payer, procurement and referral routes, achievable rates, workforce, registered manager, property, regulatory scope and working capital. Registration should implement that plan, not substitute for developing it.

If the business case now stands up and CQC registration is the next step, you can get a proposal comparing specially selected and verified CQC registration specialists and compare the support available for the application you intend to make.