Adult social care in West Berkshire

West Berkshire is a comparatively small adult social care market with a distinctive combination of affluence, rural geography, rapid ageing and selective shortages in affordable and specialist care.

The 2021 Census recorded 161,447 residents, an increase of 6.7% since 2011. West Berkshire Council expects total population growth to slow over the next decade, but the age profile is changing much more quickly.

Around 19.6% of residents are aged 65 and over. That older population increased by 34% between 2011 and 2021, while the number aged over 90 rose by 47%.

By 2030, the council expects the 65-plus population to increase by a further 11% and the 80-plus population by around 30%.

That creates a strengthening long-term demand base for adult social care.

But West Berkshire's current Market Position Statement is clear that the opportunity is not simply "more care".

Standard homecare capacity is currently sufficient. The council says there are no general waiting lists and that new domiciliary providers have increased capacity substantially.

The harder problems are elsewhere.

West Berkshire identifies a much more selective pattern of need. Affordable dementia and nursing care, extra-care housing and specialist supported living for people with complex learning disabilities are priorities, alongside suitable mental-health accommodation and respite or short-notice provision. Rural communities in the north and west also face particular access challenges, while services across the district need to respond to ageing and increasingly complex support needs.

For anyone considering starting or expanding a care service, these distinctions matter more than headline population growth.

West Berkshire at a glance

These figures come from different reference periods. They should not be treated as one live operational snapshot. Together they describe a market where overall capacity exists, but affordability, complexity and geography create important gaps.

161,447

Residents at the 2021 Census

6.7%

Population growth between 2011 and 2021

19.6%

Of residents aged 65 and over

34%

Growth in the 65-plus population between 2011 and 2021

47%

Growth in residents aged over 90

30%

Projected growth in the 80-plus population by 2030

36%

Of residents living in rural areas

86

CQC-regulated adult social care services in 2024/25

47 / 39

Non-residential regulated services

746

Nursing and residential beds across 15 care homes in the council's current market analysis

138

Extra-care apartments across three schemes

4,100

Adult social care posts in 2024/25

550

Vacant adult social care posts

18.4%

Estimated workforce turnover

£90.9 million

Gross adult social care expenditure in 2023/24

West Berkshire is ageing much faster than it is growing

West Berkshire's overall population is not projected to grow particularly quickly.

The council's current Market Position Statement expects only modest total population growth over the next decade.

The age profile is different.

The population aged 65 and over has already increased by 34% since 2011.

The number aged over 90 has increased by 47%.

34%

Growth in residents aged 65 and over since 2011

47%

Growth in residents aged over 90 since 2011

30%

Expected growth in the 80-plus population by 2030

By 2030, the 80-plus population is expected to be around 30% larger.

This matters because demand for formal adult social care is concentrated disproportionately among the oldest age groups.

An increase in people aged 80 and over is more commercially relevant to the care market than a similar increase among younger adults.

That ageing profile could strengthen long-term demand for homecare, dementia and nursing support, extra care, respite and community provision. Equipment, adaptations and technology-enabled care may also help people remain independent for longer. The mix of these services matters as much as the overall increase in need.

But West Berkshire is actively trying to avoid every increase in need becoming a residential placement.

The council's direction is strongly home first

West Berkshire's adult social care strategy places a high priority on enabling people to remain independent.

The council describes strengths-based care and reablement as central to its future model.

The strategy focuses on enabling residents to retain or regain independence, whether through reablement following illness, practical support with daily activities, technology or services provided by community and voluntary organisations. The intention is to help people remain in their own homes where that is appropriate, rather than assuming that growing need always requires a permanent care-home placement.

This affects the market.

Population ageing will increase need.

But some of that demand will be absorbed through home-based and community support rather than conventional care-home places.

For providers, future market growth is therefore more likely to favour services that support independence while still being capable of responding when needs become complex.

West Berkshire already has an established care-home market

West Berkshire's current market analysis identifies 746 nursing and residential beds across 15 care homes.

Of the 746 beds in the council's 15-home market analysis, 102 were dementia nursing beds, 162 general nursing, 281 dementia residential and 201 general residential. That composition is important because a vacancy in one category cannot necessarily accommodate someone requiring a different level of clinical or dementia support.

102

Dementia nursing

162

General nursing

281

Dementia residential

201

General residential

The council itself operates three homes providing 115 beds, although it has been exploring the transfer of those services to external providers.

The remaining market includes independent provision for both publicly funded and private residents.

Occupancy had recovered strongly after the pandemic.

The Market Position Statement records occupancy of around 90% in September 2024.

That is materially higher than the depressed occupancy seen during Covid and indicates a tighter market than several years earlier.

New care homes do not necessarily solve the council's problem

At first glance, West Berkshire's care-home supply appears to be expanding.

A new home opened in December 2024.

Another opened in Calcot in summer 2025.

Further developments have been pursuing planning permission.

But the council explicitly warns that these newer homes are expected to be high cost.

That means new physical bed capacity does not automatically create affordable capacity for local-authority-funded residents.

This is one of the most important facts in the West Berkshire market.

The problem is not simply the number of beds.

It is the number of suitable beds available at a fee the purchaser can sustain.

Affordable dementia and nursing care is a clear gap

West Berkshire identifies additional affordable care-home capacity as one of its principal commissioning needs for 2025 to 2029.

West Berkshire particularly identifies affordable services for people living with dementia, higher-dependency or complex needs, behaviours that challenge and nursing requirements. This is not simply a request for more conventional care-home bedrooms; the financial model and clinical capabilities both affect whether capacity is genuinely usable.

Its analysis suggests that a combination of population ageing, complexity and reduced reliance on out-of-area placements could support roughly one new 60-bed affordable mixed nursing and residential dementia home every five years, in addition to higher-end private developments.

That is a much stronger market signal than general demographic growth.

But the word "affordable" matters.

A developer or operator needs to build the economics around realistic public-sector and mixed-payer fees rather than assume a premium private-pay model.

General residential care has a weaker growth case

The council specifically says it does not see a significant need for additional general residential beds.

That reflects the home-first strategy.

Residents with moderate needs may increasingly receive care through domiciliary services, extra care, reablement, family support and assistive technology. The resulting pressure on mainstream residential demand means that new beds need a more specific market justification than the general ageing trend.

For a new care-home operator, this creates a clear distinction.

A standard residential service has a weaker local commissioning case than a service designed around dementia, nursing or other complex needs.

Rural geography matters

West Berkshire is the least densely populated county or unitary authority in the South East.

Around 36% of the population lives in rural areas.

The main population centres are Newbury and Thatcham, with a significant eastern urban area around Calcot, Purley and neighbouring communities.

But much of the north and west is dispersed.

That has a direct effect on care.

Longer distances between visits increase travel and mileage costs, complicate scheduling and recruitment, and reduce the proportion of time carers can spend delivering billable care. These effects are especially important in dispersed northern and western communities, where a county-wide hourly rate may conceal very different delivery economics.

For care homes and day services, a vacancy may exist but still be far from the person's community.

The council explicitly identifies rural north and west West Berkshire as areas where wider service availability needs to improve.

Homecare capacity has improved substantially

The homecare market is one of West Berkshire's more positive developments.

The council says workforce capacity has increased significantly over the last five years and new domiciliary-care providers have entered the market.

As a result, waiting times are short for all but the most specialist care.

The council's Market Position Statement says there is currently sufficient good-quality homecare provision and no general waiting list.

This is commercially important.

A new agency should not use a generic "homecare shortage" argument.

The evidence does not support it.

The commissioned homecare market is still substantial

As of September 2024, West Berkshire Council funded around 800 older residents across homecare, extra care, supported living and day services.

The council's data included 100 people receiving domiciliary support in extra care, 655 receiving domiciliary care at home or supported living, 87 accessing day opportunities and 36 using direct payments. Another 319 used equipment or monitoring services. Those figures describe different forms of commissioned support rather than a single pool of available homecare customers.

36

Using direct payments

and

319

Using equipment and monitoring support

100

Using extra care with domiciliary support

655

Using domiciliary care at home or supported living

87

Using day opportunities

The council sourced support from around 35 providers.

This was a 25% increase in the number of funded users compared with 2020.

So the market is substantial and growing.

It is simply not obviously undersupplied in standard homecare.

Homecare is moving toward enablement rather than task delivery

West Berkshire wants domiciliary providers to support people to do more for themselves where possible.

That is a different model from simply completing every task for the person.

The council wants providers to strengthen independence and confidence through reablement, appropriate technology and support that avoids unnecessary long-term dependency. In practice, this requires providers to demonstrate outcomes as well as the completion of visits, including whether people can safely do more for themselves over time.

For providers, this changes how quality is judged.

The commercial proposition increasingly needs to be about outcomes rather than only hours delivered.

Rural homecare remains harder

Although general homecare supply is sufficient, the council says around 35% of demand sits in rural north, west and south-east West Berkshire.

That creates operational challenges.

Providers need enough package density to make rounds efficient.

A new agency may therefore find stronger opportunity in a specific rural locality than in the already well-served market overall.

The council is also interested in greater involvement from voluntary and community organisations in these areas.

Extra care is strategically important but undersupplied at affordable levels

West Berkshire's 138 existing extra-care apartments are distributed across schemes in Newbury, Thatcham and Hungerford. Those western centres have an established offer, while the absence of comparable provision further east creates a different geographic question for prospective housing and care partners.

There is no comparable provision in the eastern part of the district.

The council expects demand for extra care to increase.

It also says there is a shortage of affordable extra-care provision while more expensive retirement apartments are in surplus or continuing to be developed.

That distinction is critical.

A high-end retirement development is not equivalent to affordable housing-with-care.

Future extra care needs to support greater complexity

West Berkshire does not simply want more extra-care apartments.

It wants schemes able to support people as their needs increase.

The council has indicated interest in smaller, community-integrated developments of around 30 flats that connect residents with local facilities and can respond as physical or cognitive needs increase. Suitable design and care arrangements should reduce avoidable moves into residential or nursing homes while maintaining independence.

For providers and developers, extra care is therefore a combined housing-and-care opportunity.

Respite is another identified shortage

The council says local respite-bed supply is limited.

This matters because respite supports both the person receiving care and unpaid carers.

Without appropriate short breaks, family arrangements can become unsustainable and lead to earlier long-term placement.

Potential solutions include flexible short breaks, short-term beds, step-down capacity and arrangements that are cost-effective for commissioners. Because respite demand may fluctuate, providers need to test realistic utilisation, staffing and booking patterns before treating the shortage as a straightforward commercial opportunity.

A provider needs to test utilisation carefully because respite demand can be intermittent.

Learning-disability demand is changing in complexity more than headline numbers

West Berkshire expects the overall population of people with learning disabilities to remain broadly stable between 2025 and 2030.

But the age structure and complexity are changing.

The council forecasts an 11% increase in the transition-age population aged 18–24 and a 12% increase among people aged 65 and over. Both groups bring distinct requirements, with younger adults moving from children's provision and older residents potentially developing age-related conditions.

It also expects more people with profound and multiple learning disabilities to survive into adulthood and more older adults with learning disabilities to develop age-related physical conditions.

Providers may increasingly need to support learning disability alongside physical disability, dementia, complex behaviour and other health needs. Services designed for one narrow profile may not be equipped to accommodate that changing combination of needs.

Supported living is a major local market

Of the roughly 243 funded supported-living placements, 177 are within West Berkshire and 66 are outside the district, principally around Reading. This demonstrates an established market with significant cross-boundary use, although the location of a placement does not on its own prove that it is unsuitable.

177

In West Berkshire

and

66

Outside the district, mainly around Reading

The council usually has around 20 people waiting for supported living at any one time.

It says overall place numbers are broadly sufficient.

The problem is matching the right setting to the right person.

That makes supported living another example of the difference between capacity and suitable capacity.

Complex supported living is a clear gap

The clearest gap concerns people with highly complex support needs, behaviours that challenge or profound and multiple learning disabilities. A generic supported-living vacancy may not provide the environment, staffing or specialist expertise needed to support those individuals safely.

The council wants additional settings capable of supporting people who might previously have required residential care.

The council is interested in a range of accommodation models, from single-person settings and shared homes to larger supported environments, including developments with health partners or neighbouring authorities. The appropriate model should follow individual need rather than be chosen solely on property availability.

For specialist providers, this is one of the clearer opportunity areas in the district.

Learning-disability out-of-area placements remain significant

As of September 2024, West Berkshire funded 108 adults with learning disabilities in long-term residential or nursing care.

Only 42 were in West Berkshire.

Sixty-six were outside the district.

1. Outside the district

   66

2. In West Berkshire

   42

Some distant placements are historic or reflect specialist need.

But the council's direction is to increase local provision and reduce avoidable out-of-area care.

That creates a stronger business case for specialist local services than for generic accommodation.

Ageing with a learning disability creates a new service challenge

The emerging gap concerns adults with learning disabilities who also develop dementia, sensory impairment, physical disability or other conditions associated with ageing. Providers must combine the person-centred skills of learning-disability support with appropriate frailty and health expertise, which neither conventional supported living nor general older-person care may supply automatically.

Traditional learning-disability services may not be designed for frailty or dementia.

Older-person homes may not be designed around learning-disability support.

This creates a market need at the intersection of two service models.

Providers able to bridge that gap may solve a genuinely underdeveloped local problem.

Mental-health demand has risen sharply

West Berkshire's mental-health care demand has changed significantly.

In September 2024, 236 people were receiving some form of council-funded mental-health support.

That was 88% higher than in 2019.

88%

Increase since 2019

and

£5.9m

Council funding, four times the earlier level

The council says funding had quadrupled over the same period to £5.9 million.

The council links this growth to changes in law and commissioning, the psychological and economic effects of the pandemic, increasing complexity and more young people transitioning from child and adolescent mental-health services into adult provision. These pressures contribute to a distinct specialist market rather than simply a general increase in residential care.

This is one of the fastest-changing parts of the local care market.

Local mental-health accommodation is in short supply

West Berkshire has very limited residential, nursing and supported accommodation specifically for mental-health need.

The local stock described by the council comprises a male-only ward-in-the-community model, supported-living settings in Newbury and Thatcham, and approximately 35 flats across those settings. With no very-short-notice option, commissioners may have to place people outside West Berkshire even when a suitable local placement would be preferable.

There is no very-short-notice accommodation.

As a result, many people needing this level of support are placed outside West Berkshire.

Two-thirds of mental-health supported-living placements are outside the district

The council says around two-thirds of its mental-health supported-living placements are outside West Berkshire.

That is a particularly strong market signal.

The council is seeking more local supported living, step-down and forensic accommodation, short-notice crisis capacity and recovery-focused daytime support. These needs involve different levels of acuity and risk, so a credible provider should specify precisely which pathway and client group it is equipped to serve.

The council specifically says it would welcome proposals from providers capable of addressing this gap.

Emergency and respite mental-health provision is another acute need

West Berkshire identifies a strong need for one or two very-short-notice settings.

The purpose would be to support people when community arrangements temporarily break down and reduce unnecessary hospital admission.

This is a niche but highly specific commissioning opportunity.

It also requires careful operating design because demand may be urgent, irregular and high risk.

Physical disability demand is more community based

West Berkshire supports 227 residents with physical disabilities and sensory needs across different services.

The council says conventional residential demand for working-age people with physical disability is low.

Most support for working-age residents with physical disabilities is delivered through supported living, homecare, direct payments, equipment, monitoring or day opportunities. The stronger service proposition is therefore often one that supports independence in the community rather than adds traditional residential capacity.

The market direction is therefore toward independence rather than institutional care.

Workforce numbers are comparatively stable but vacancies remain high

Skills for Care estimated around 4,100 adult social care posts in 2024/25, with approximately 3,500 filled and 550 vacant. While filled posts had increased during the preceding year and turnover was comparatively low, the vacancy estimate still signals significant recruitment pressure for new and expanding providers.

3,500

Filled

and

550

Vacant

The sector added around 175 filled posts during the preceding year, while the estimated 18.4% turnover rate was substantially below both regional and national averages. Even so, around 550 vacancies represent a significant staffing challenge for a district of this size.

Nursing recruitment is a particular constraint

West Berkshire's own Market Position Statement identifies qualified nursing staff as a critical local issue.

The pressure is most consequential for dementia nursing, complex nursing and higher-acuity care: the very services where the council sees some of its clearest unmet need. Without a sustainable nursing workforce, a building and a commissioning opportunity cannot be converted into safe operating capacity.

A provider can identify a strong market need and still fail if it cannot recruit nurses.

Workforce availability therefore needs to be tested before property investment.

Adult social care is a major public expenditure market

West Berkshire recorded gross adult social care spending of £90.9 million in 2023/24.

Net spending was £65.3 million.

£90.9

West Berkshire recorded gross adult social care spending of million in 2023/24

£65.3

Net spending

25%

Gross expenditure had increased by since 2019/20

75%

Of spending

Gross expenditure had increased by 25% since 2019/20.

Around 75% of spending was with private, charitable and voluntary providers.

The council says it expects external provision to increase further over time.

This reinforces the role of the independent market.

But public expenditure should not be mistaken for an open market available to any new provider.

Commissioning routes, affordability and service need still determine access.

The 2026–30 strategy reinforces the same direction

West Berkshire approved a new Adult Social Care Strategy 2026–30 in September 2026.

The new strategy emphasises high-quality support, better transitions into adulthood, appropriate technology, strong partnership working and co-design with local people. Its broader ambition is for people to receive the right support, in the right place, at the right time.

Consultation also emphasised shorter waits, prevention, independence, coordination between agencies, support at home and smoother transitions. These priorities reinforce rather than replace the direction of the Market Position Statement.

What does the West Berkshire market actually show?

West Berkshire has a substantial and growing adult social care market.

But the strongest opportunities are highly selective.

General homecare

Supply is currently sufficient and there is no general waiting list. The stronger opportunity is rural coverage, specialist care or more enabling models.

Care homes

Headline bed capacity is growing, but much of the new supply is high cost. Affordable dementia and nursing capacity remains a clear gap.

General residential care

The council does not identify a significant need for more standard residential beds.

Extra care

Affordable supply is insufficient, particularly in the east of the district and for schemes able to support increasing complexity.

Learning-disability supported living

Overall numbers are substantial, but complex provision and local capacity need to improve.

Mental-health supported living

One of the clearest gaps. Two-thirds of current supported-living placements are outside West Berkshire.

Respite and emergency provision

A recurring need across older people, learning disability and mental health.

Workforce

More stable than many areas, but nursing recruitment and total vacancies remain significant constraints.

The strongest business cases therefore sit where a provider can combine affordability, specialism and local access.

If you are still deciding whether the opportunity is strong enough for the service you have in mind, the Should I Start? Market Report can apply the same local evidence to your planned service in West Berkshire, including your service type, stage and intended customer group.

Questions to answer before starting a care service in West Berkshire

A prospective provider should be able to answer:

Those questions should be answered before significant investment in registration or premises.

If the local market case already looks strong and you are moving towards CQC registration, you can get a proposal comparing specially selected and verified CQC registration specialists for the service you plan to register.