Starting a care service in Portsmouth

Portsmouth has enough adult social care demand to make the city look attractive to new providers.

Its population is ageing.

More people are being supported at home with higher levels of need.

Care-home occupancy is high.

Extra care has a waiting list.

Supported living remains central to the council's strategy for people with learning disabilities and mental-health needs.

But Portsmouth is also one of the clearest examples of why a provider should not move directly from "there is demand" to "I should register a service".

The latest Adult Social Care Market Position Statement says standard domiciliary-care supply exceeds demand.

The council closed its previous Dynamic Purchasing System to new providers because most referrals were receiving multiple offers.

Mental-health residential care also does not show a simple shortage: Portsmouth says current highly complex residential capacity is broadly sufficient and some providers experience voids.

The stronger opportunities are narrower.

The stronger areas for investigation are affordable extra care, higher-complexity homecare and nursing, modern care-home accommodation suited to higher needs, specialist supported living, mental-health housing, respite and more outcome-focused community provision. They are distinct markets, each with different requirements and routes to revenue.

For a prospective provider, the right question is therefore not whether Portsmouth needs more care.

It is whether the exact service being considered sits in a part of the market where demand, commissioning access, workforce and economics all align.

Start with the market gap, not CQC registration

Registration should follow the business model.

A credible business case identifies the precise client group and service, the payer, commissioning or referral route, achievable fees, workforce, property requirements and competing provision. Registration follows these decisions; it does not demonstrate demand or secure customers on its own.

Portsmouth already has 84 regulated adult social care services.

A new provider needs a reason to be chosen.

Decide exactly which Portsmouth market you are entering

A new provider could offer standard or complex homecare, live-in support, residential or nursing care, dementia services, extra care, supported living, learning-disability or mental-health provision, respite, day opportunities or reablement. These are not interchangeable business models.

The relevant costs and risks differ in capital investment, staffing, procurement, occupancy and CQC scope. Treating all of adult social care as one opportunity would obscure the council's very different conclusions about supply in each area.

Standard homecare is a high-caution entry

This is the clearest go/no-go signal in Portsmouth.

The council says supply exceeds demand.

Its former Dynamic Purchasing System had 62 providers, with 47 active.

62

On the purchasing system

47

Actively supplying care

Most referrals attracted multiple offers.

The DPS was closed to new providers.

That means a generic homecare agency is entering a market where providers are already competing for the same publicly funded packages.

Future demand growth is not enough to justify launch

Portsmouth does expect homecare demand to increase.

The ageing population and the policy of supporting people at home will create more commissioned hours over time.

But a start-up has to survive before that future demand arrives.

The business needs evidence that it can win enough work now.

A specialist homecare proposition can be stronger

A more differentiated service may support people with dementia, behaviours that challenge, several long-term conditions or high physical dependency. These needs are becoming more prevalent among people remaining at home.

The average domiciliary package is already increasing in size.

This means complex homecare may have a stronger market case than standard personal care.

Such a model will need appropriate staff training, continuity, medication competencies, robust supervision, clinical escalation and closer working with health services. A provider should test that capability before presenting specialism as its market advantage.

Rapid-response and discharge support may fit the local direction

Portsmouth's health and social care system wants more people supported at home after hospital.

People are increasingly discharged when medically optimised rather than fully recovered.

Possible demand includes rapid-start domiciliary care, temporary intensive packages, reablement, short-term step-down and rehabilitation-linked support. Those services require fast mobilisation and strong links to discharge teams rather than only stable, long-term rounds.

The challenge is responsiveness.

A provider that takes days to onboard a client may not fit the pathway.

Check the live domiciliary-care procurement route first

Portsmouth has been redesigning its homecare commissioning model.

The previous fixed-rate approach has moved toward market-led pricing.

PAMMS is being used to strengthen quality assessment.

The council has also emphasised local providers and market sustainability.

Before relying on council packages, confirm the current procurement vehicle, whether applications from new providers are open, the pricing mechanism, quality thresholds and package-allocation rules. These determine access to work and may have changed since older published arrangements.

Do this before registration.

Do not assume the old £24.40 rate still applies in the same way

The previous fixed rate was £24.40 per hour.

Portsmouth's 2025 procurement decision introduced a market-led rate bounded by minimum and maximum values.

The service needs to model income using current commissioning information.

A homecare business can look viable at one hourly rate and unviable at another.

Private homecare should be tested separately

Portsmouth is not one of the strongest private-pay markets in the South East.

The council's MPS explicitly points to relatively limited self-funding capacity because of deprivation.

That does not mean private homecare is impossible.

It means customer demand should be tested rather than assumed.

A viable private-pay model may require a well-defined catchment, credible brand, referral partnerships and a service that offers something existing agencies do not. This market needs independent testing rather than being inferred from the volume of publicly funded care.

Extra care has one of the strongest local signals

Portsmouth's current extra-care supply is materially below the council's modelled future need.

There are four schemes with 243 units.

The council has nomination rights over 211.

There were no vacancies in September 2025 and a waiting list of 10.

243

Apartments

211

With council nomination rights

10

People on the waiting list

The council's planning model suggests approximately three additional 60-apartment schemes by 2030 and another two by 2040. That is an unusually specific housing-and-care development signal, although forecast demand still needs to be reconciled with planning, funding and current delivery.

1. By 2030

   3

2. Further schemes by 2040

   2

This is unusually clear development evidence.

Extra care is not a conventional care start-up

The demand case may be strong.

The barriers to entry are high.

A new scheme needs land and planning consent, substantial finance, development and housing expertise, a landlord or housing-provider model, suitable commissioning arrangements and long-term occupancy management. Many care providers would require an experienced housing or development partner.

A care provider may need to partner with a registered housing provider or developer rather than attempt the whole model alone.

Affordable provision is essential

Portsmouth specifically wants affordable extra care.

A luxury later-living scheme is not the same market.

Prospective partners must test rents, service charges, housing-benefit eligibility, the way personal care is funded and council nomination arrangements. A premium retirement development is not equivalent to affordable extra care, even if the buildings appear similar.

The housing economics and care economics need to work together.

Nursing care has a stronger signal than general residential care

Portsmouth's nursing placement need is projected to increase over the longer term.

Current nursing capacity is highly utilised.

The wider care-home market is also experiencing increasing acuity.

A nursing provider may therefore have a stronger evidence base than a generic residential start-up.

But the staffing model is harder.

Stress-test nursing workforce before property

Do not develop a nursing home and assume nurses will be found afterwards.

Test:

Assess local nurse availability, expected pay, night cover, clinical leadership, agency exposure and retention before purchasing or developing a nursing site. Demand is only commercially useful if registered nursing capacity can be staffed safely.

Nursing demand is only commercially useful if the workforce can be sustained.

Purpose-built residential provision can have an advantage

Many Portsmouth care homes operate from converted Victorian properties.

Converted Victorian homes may struggle with narrow corridors, accessible ground-floor rooms, space for large equipment or bariatric support. Modern premises designed for higher-acuity care could offer genuine advantages.

However, property suitability must be tested alongside local demand, achievable fees, construction costs and sustainable staffing. A modern building does not automatically create a viable home.

General residential care still needs a specific case

Portsmouth does expect residential need to rise.

But the council's strategic direction is to keep people independent for longer.

That means a general residential home should not rely solely on ageing.

A more credible offer may concentrate on dementia, complex needs among younger adults, neurodivergence, physical disability or particular clinical capabilities. Population ageing alone is insufficient justification for generic beds.

Under-65 residential care deserves investigation

Portsmouth says more people under 65 are requiring residential placements.

Many existing homes are registered mainly for older residents.

This creates a possible gap.

But the target group needs to be specific.

"Under 65" can include people with very different needs.

The provider should understand the exact cohort.

Supported living is a major learning-disability market

Portsmouth already supports 272 people with learning disabilities in supported living.

Only a much smaller number are in residential or nursing care.

That confirms the strategic direction.

A service aligned with the council's direction will prioritise independence, community participation, access to personal space and outcomes that support residents' preferences. This is a more useful basis for housing and staffing decisions than opening a generic shared house.

Do not start supported living with a house

The common mistake is to secure property first.

The stronger sequence is:

1. identify the cohort
2. confirm commissioner need
3. define staffing
4. understand housing specification
5. source the property.

Portsmouth's commissioning evidence is detailed enough that providers should not need to work backwards from an empty house.

Out-of-city learning-disability placements are worth investigating

Portsmouth has 55 people with learning disabilities supported outside the city.

This is a meaningful signal.

But not all 55 placements represent an addressable market.

Some of the 55 out-of-city placements reflect personal preference, family location, specialist requirements or legal considerations. A provider needs to understand which individuals commissioners would like to support locally before treating the entire count as addressable demand.

The provider should identify which cohort commissioners genuinely want to support locally.

Smaller supported-living schemes may be safer commercially

Portsmouth wants accommodation that avoids institutionalisation but is still operationally viable.

This generally favours smaller schemes.

Larger schemes can increase the risks of incompatible residents, vacancies, institutionalised environments and complex staffing. Smaller schemes can sometimes match individual needs better, although they still need economically sustainable staffing and appropriate accommodation.

The property should be designed around the actual support model.

Mental-health supported living has a stronger signal than residential care

The council's direction favours flexible housing, recovery-focused support, step-down pathways, social inclusion and increasing independence. Those objectives provide a more specific commissioning basis than simply adding conventional mental-health residential beds.

This is stronger evidence than a generic mental-health residential model.

The council has published a detailed property brief

The council's preferences include flats within the same building, shared housing for people with higher support needs, staff sleep-in space, accessible layouts, distinct step-down accommodation, safe design, outdoor space and public transport. Smaller schemes within Portsmouth may fit the brief more closely than large, speculative developments.

A provider with access to suitable housing may therefore have a clearer route into this market.

Large mental-health schemes carry void risk

Portsmouth explicitly warns that schemes above roughly six units may be difficult to fill unless carefully designed.

That is important.

The existence of mental-health need does not mean a large development is safe.

Referral volume and compatibility need to be proven.

Generic mental-health residential care is a weak entry case

Portsmouth says current highly complex residential capacity is sufficient.

Some providers have high void levels.

That is clear negative evidence.

A provider should not ignore it simply because national mental-health demand is rising.

Respite can be a specialist opportunity

Current learning-disability short-break provision does not suit everyone.

People with complex needs or environmental sensitivities may struggle with existing options.

Any specialist respite business needs a realistic view of booked occupancy, planned and emergency stays, staffing flexibility and compatibility between guests. Short-break demand may be genuine yet intermittent, which must be reflected in the financial forecast.

Day opportunities may offer a non-traditional route

Portsmouth is redesigning community opportunities around employment, skills, participation and independence. Some models may fall outside CQC-regulated personal care and need a different commissioning and operational strategy.

Some of these opportunities may not require CQC registration if regulated personal care is not being delivered.

That should be established before deciding that registration is necessary.

Decide who will pay

The purchaser could be Portsmouth City Council, NHS Hampshire and Isle of Wight, a person using direct payments, a private customer or a jointly funded health and social-care arrangement. Each has different contracting, referral and pricing considerations.

Each creates a different business model.

A council-funded service depends on procurement access.

A private service depends on customer acquisition.

A jointly funded complex service may require additional clinical and contractual capability.

Model public-sector economics carefully

Portsmouth is a relatively price-sensitive market.

A provider should not assume premium rates will be available.

The service needs to work at the rates the actual purchaser will pay.

Build the cost model around the actual fee attainable for the service and its funding route, allowing for wages, employer costs, training, management, property, insurance, travel and suitable technology. A demonstrated care need cannot support a business whose costs exceed realistic income.

Workforce conditions are comparatively favourable

Skills for Care estimates Portsmouth's vacancy rate at 4.1% and turnover at 17.8%.

• 4.1%Vacancy
• 17.8%Turnover

Both are lower than regional and national averages.

This is encouraging for new providers.

But it should not create complacency.

Specialist recruitment remains the real test

The most credible gaps often require registered nurses, autism expertise, positive behaviour support, mental-health skills, complex-care competencies and experienced managers. Portsmouth's favourable aggregate workforce figures do not answer whether these staff can be recruited for a particular service.

The provider should test that labour pool specifically.

Portsmouth's compact geography helps homecare operations

The city is geographically small.

The city can support shorter journeys, less mileage and fewer gaps between visits than rural authorities. That is operationally beneficial, but it also makes standard domiciliary care comparatively attractive to established competitors and contributes to oversupply.

That is operationally positive.

But it also explains why so many providers can compete within the same footprint.

A geographic advantage does not remove market saturation.

Neighbourhood health will affect future commissioning

Portsmouth has seven approved neighbourhood health areas under its 2026–29 strategic plan.

The council's neighbourhood strategy emphasises integrated health and social care, prevention, care closer to home and proactive management of long-term conditions. Providers that coordinate within these pathways may be better positioned than standalone services.

Providers that can demonstrate neighbourhood integration may be better aligned with future commissioning.

Check CQC scope properly

Not every social-care-related service requires the same registration.

For many homecare providers, Personal care is the relevant regulated activity.

Supported housing itself is not CQC-regulated.

Day opportunities may also sit outside regulated activity depending on what is delivered.

The service model should determine registration scope.

A practical Portsmouth market-entry test

Before moving forward, score the 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 Portsmouth against the same local demand, supply and commissioning evidence used in this analysis.

Which Portsmouth services deserve the closest look?

Standard homecare

High caution.

Current supply exceeds demand.

Complex homecare

Stronger opportunity if the provider has genuine capability.

Rapid-response and discharge support

Potentially attractive if commissioning access is clear.

Extra care

One of the strongest long-term development signals.

General residential care

Moderate caution unless the proposition addresses a specific gap.

Nursing and high-acuity care

Stronger local signal.

Learning-disability supported living

Strong strategic alignment where the cohort and property are clearly evidenced.

Mental-health supported accommodation

A clear development priority.

Generic mental-health residential care

Weak current signal.

Specialist respite

Potential niche where existing provision is unsuitable.

When should you move to CQC registration?

A registration-ready plan identifies the client group, activity, purchaser, procurement and referral routes, realistic fees, workforce and registered manager, appropriate property, correct regulatory scope and sufficient working capital. The application should accurately reflect the service, rather than resolve unresolved market-entry decisions.

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.