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Homecare and Supported Living UK Market Report 3ed

  • ID: 5027059
  • Report
  • April 2020
  • Region: United Kingdom
  • 329 Pages
  • LaingBuisson


  • Active Assistance Group
  • Anchor Hanover
  • Brunelcare
  • Community Integrated Care
  • Helping Hands
  • Nurse Plus

The third edition of the much respected report on the UK homecare and supported living market, written by health economist William Laing, is essential reading for anyone involved in this fragmented and growing market. This includes investors, advisors and providers as well as commissioners of these services for which independent providers predominate.

Covering the market as it was in 2019, the report was completed in March 2020, just as the UK was going into lockdown because of Coronavirus. The report, therefore, provides a helpful summary of the ‘state of play’ just before it experienced the impact of Covid-19 both operationally and economically and is a valuable tool for understanding the underlying dynamics of the sector.

New in this year’s report is data on the number of people being looked after by each registered homecare service, as recorded by the CQC on the day of inspection. Market concentration, defined as the market share held by the four largest providers, stood at just over 9% in this market worth £9.5 billion in 2018/19.

Key challenges for the market continue to include staff retention and turnover. The report asks what impact the Coronavirus will have on a workforce which is largely paid only just above the National Living Wage but who will be putting themselves in harm’s way throughout the crisis. Will measures to deal with staffing issues be accelerated or stymied as a result of the economic impact of the Coronavirus?

This influential report provides an indispensable update on the current state of this market which supports some 1 million people across the UK at a time when the role of the people working in it has never been so important.

What the report covers

  • Market
  • Politics and regulation
  • Payors
  • Major providers
  • Investors
  • Staffing
  • Market Potential
  • Appendices
  • Glossary
  • Key Legislation
  • Regulators
  • Trade bodies
  • Financial Appendix

Who is the report for

  • C-suite professionals working in homecare and supported living providers
  • Local Government and Clinical Commissioning Group commissioners
  • Homecare agencies
  • Directors of Adult Social Services
  • Care advisors
  • Banks and other financial institutions
  • Investors and private equity
  • Long-term care insurance providers
  • Local and national government
  • Care sector trade bodies
  • Lawyers
  • Policy advisors
  • Think tanks
  • Management consultants
Note: Product cover images may vary from those shown


  • Active Assistance Group
  • Anchor Hanover
  • Brunelcare
  • Community Integrated Care
  • Helping Hands
  • Nurse Plus





1.1 Market definition
1.2 Further context on market definitions
1.2.1 Adult social care services
1.2.2 Non-residential adult social care services
1.2.3 Complex care
1.2.4 Clinical Homecare
1.2.5 NHS Community Health Services
1.2.6 Informal care Changes in families’ willingness to provide informal care
1.3 Market size
1.3.1 Market value of homecare and supported living
1.3.2 Market value of ‘other’ non-residential social care services
1.3.3 Market value of clinical homecare
1.3.4 Market value of telecare and telehealth
1.4 Segmentation
1.4.1 Segmentation of homecare and supported living
1.4.2 Segmentation of other non-residential care services
1.5 Market growth – historical
1.5.1 Homecare and supported living Historical market value trends Historical local authority funded activity trends Paucity of official data Historical NHS funded activity trends
1.5.2 Clinical homecare – historical market growth
1.5.3 Telecare historical market growth
1.6 Funding
1.6.1 Funding of homecare and supported living
1.6.2 Funding of ‘other’ non-residential social care services
1.6.3 Funding of clinical homecare
1.6.4 Funding of telecare (and telehealth)
1.7 Supply and demand
1.7.1 Homecare volume of demand
1.7.2 Supported living volume of demand
1.7.3 R egional variations
1.7.4 Balance of demand and supply – will workforce shortages constrain supply? Workforce statistics from Skills for Care Will labour availability be a hard constraint on future expansion of supply Inadequate rewards for enterprise as a constraint on expansion of supply Constraints on demand
1.8 Drivers of demand – future growth prospects
1.8.1 Homecare drivers of demand Demography Demographic counter drivers of demand for homecare Activities of daily living Financial resources
1.8.2 Supported living drivers of demand Learning disabilities Projections of supported living services for all younger adults
1.8.3 Clinical homecare drivers of demand
1.8.4 Telecare (and telehealth) drivers of demand Barriers to adoption of telehealth at scale A broader view of telecare and telehealth technology embedded in a range of services
1.9 Homecare and supported living in Scotland and Wales
1.9.1 Scotland
1.9.2 Wales
1.10 Business models – homecare and supported living
1.10.1 Common features of all homecare and supported living business models Asset-light business model Providers as intermediaries between care workers and customers Low pay
1.10.2 Full service (employed carers) or introduction only agencies (self-employed carers)
1.10.3 Mainstream ‘time and task’ dispersed homecare (short duration visits)
1.10.4 Live-in homecare
1.10.5 Supported living and homecare delivered to clustered settings Housing with care developments Supported living in clustered settings
1.10.6 On-line platforms – digital technology enabled homecare providers
1.10.7 Complex care
1.10.8 Reablement
1.10.9 Franchises
1.10.10 Outcome-based commissioning
1.10.11 Clinical homecare
1.10.12 Telecare and telehealth
1.11 Key operational statistics
1.11.1 Operating margins
1.11.2 Homecare unit costs borne by local authorities
1.12 Performance measures
1.12.1 EBITDA as a percentage of revenue
1.12.2 CQC ratings in England
1.12.3 Service user satisfaction in England

2.1 History: emergence of the independent sector as the dominant supplier of adult social care services from the late 1970s
2.1.1 Emergence of a large scale, publicly financed homecare sector from 1993
2.1.2 Benign financial environment 2003–2009
2.1.3 Austerity 2011/12
2.1.4 Why did outsourcing of social care become mainstream so rapidly?
2.2 Policy context – high degree of cross-party consensus
2.3 Main areas of government policy which impact on the operating environment for homecare and supported living
2.4 Public funding of social services
2.5 Regulation of social services
2.5.1 Underpinning legislation in England – Health and Social Care Act 2008 Fundamental standards
2.5.2 Scotland, Wales and Northern Ireland
2.5.3 Scope of regulation – services covered and not covered in England
2.5.4 Scope of regulation in Wales and Scotland
2.5.5 Registrable entities
2.5.6 History of last two decades – deregulation accompanied by tougher enforcement Replacement of National Minimum Standards with less prescriptive Essential Standards Fundamental Standards of Quality and Safety 2014 Risks to providers from breaches of regulations and Fundamental Standards Stronger enforcement powers Provider failure, market oversight and light touch financial regulation Next phase of regulation Providers’ views of regulation
2.5.7 Scotland’s rating system
2.6 Regulation of payroll costs
2.6.1 National Minimum Wage and National Living Wage
2.6.2 Pension legislation
2.7 Integration of health and social care
2.7.1 Integrated Care Systems and Accountable Care Organisations
2.7.2 The Better Care Fund
2.7.3 Scotland’s health and social care integration policy
2.7.4 Bed blocking – inadequate integration at the health and social care interface
2.8 Other government policies relating to adult social care
2.8.1 Personalisation and self-directed care: Direct Payments and personal budgets
2.8.2 Intermediate Care
2.8.3 Charges for publicly funded non-residential care services
2.8.4 National eligibility criteria
2.8.5 Other aspects of The Care Act 2014 General responsibilities of local authorities Market shaping – duty to promote diversity and quality and to ensure market sustainability Assessment of need and eligibility criteria Duty of local authorities to meet needs for care and support Duty to prepare personal budgets Contracting out of core local authority functions
2.8.6 National Service Framework for older people and the single assessment process
2.8.7 Consumer information to support choice
2.8.8 Long-term care funding – an as yet unresolved policy issue The Royal Commission 1997 leading to the introduction of NHS funded free nursing care The Labour administration’s National Care Service White Paper in 2010 Coalition government – the Dilnot proposals The 2017 Conservative election manifesto – the ‘death tax’ Prospects under Boris Johnson’s Conservative administration

3.1 Payor profile overview
3.1.1 Supported living payor profile
3.1.2 Homecare payor profile
3.2 Financial environment by payor type
3.2.1 Covid-19
3.2.2 Public funding – austerity not yet over
3.2.3 Expansion of supported housing – an exception to austerity
3.2.4 Private funding
3.3 Market dynamics by payor type – balance of market power
3.3.1 Publicly funded services – exercise of monopsony purchasing power
3.3.2 Private and quasi-private consumers – market power balanced
3.3.3 Insurance and other intermediaries

4.1 Market structure – homecare and supported living
4.1.1 Spectrum of providers
4.1.2 Market concentration and market leaders by revenue Slow consolidation
4.1.3 T ypes of provider
4.1.4 Scale of individual services
4.1.5 Exits and entries Exits Entries
4.1.6 Business failures and recapitalisations
4.1.7 Sources of capital
4.1.8 Segmentation by provider type
4.1.9 Economies of scale and scope
4.1.10 Value of brands
4.1.11 Diversification
4.2 Market structure – clinical homecare
4.2.1 Market concentration and market leaders by revenue
4.2.2 Consolidation (absence of)
4.2.3 Exits and entries
4.2.4 Business failures and recapitalisations
4.2.5 Sources of capital
4.2.6 Segmentation by provider type
4.2.7 Economies of scale and scope
4.3 Profiles of major operators
4.3.1 Achieve Together (formerly The Regard Group and CMG)
4.3.2 Active Assistance Group
4.3.3 Affinity Trust
4.3.4 Age UK
4.3.5 Agincare Group Ltd
4.3.6 Alcura UK Ltd
4.3.7 Alina Homecare
4.3.8 Allied Healthcare
4.3.9 Alzheimer’s Society
4.3.10 Alternative Futures
4.3.11 Amcare Ltd
4.3.12 Anchor Hanover
4.3.13 Apex Prime Care Ltd
4.3.14 Appello
4.3.15 Ark Home Healthcare
4.3.16 Aspirations
4.3.17 Audley Group Ltd
4.3.18 Baywater Healthcare
4.3.19 Berkeley Home Health
4.3.20 Bluebird Care
4.3.21 British Red Cross
4.3.22 Brunelcare
4.3.23 Calea UK Ltd
4.3.24 Care UK
4.3.25 CareTech
4.3.26 Carewatch
4.3.27 Centra Group
4.3.28 Cera Care
4.3.29 Choice Care Group
4.3.30 Choice Support
4.3.31 City & County Healthcare Group
4.3.32 Clece Care Services
4.3.33 Community Integrated Care
4.3.34 Complete Care Group
4.3.35 Creative Support Ltd
4.3.36 Dimensions
4.3.37 Direct Health Group Ltd
4.3.38 Eden Futures
4.3.39 Future Directions CIC
4.3.40 The Good Care Group
4.3.41 Grosvenor Health and Social Care
4.3.42 HCRG (aka CRG)
4.3.43 Healthcare at Home Ltd
4.3.44 Healthcare Homes
4.3.45 Helping Hands
4.3.46 Hft
4.3.47 Home Instead Senior Care
4.3.48 Housing 21
4.3.49 Independent Clinical Services Group
4.3.50 Interserve Healthcare Ltd
4.3.51 Leonard Cheshire Disability
4.3.52 Lifeways Group
4.3.53 Lloyds Pharmacy Clinical Homecare Ltd
4.3.54 Marie Curie Cancer Care
4.3.55 Mears Care Division
4.3.56 Mencap
4.3.57 MiHomecare Ltd
4.3.58 Nurse Plus
4.3.59 Prestige Nursing + Care
4.3.60 PrimeLife
4.3.61 Radis Community Care
4.3.62 Sanctuary Group
4.3.63 Somerset Care Ltd
4.3.64 Springfield Homecare Services Ltd
4.3.65 TBS GB Telematic & Biomedical Service Ltd
4.3.66 Tunstall Healthcare Group Ltd
4.3.67 Turning Point
4.3.68 Voyage Care
4.3.69 Westminster Homecare Ltd
4.3.70 Your Life Management Services Ltd

5.1 Major transactions in the homecare and supported living space
5.2 Current investors in homecare and supported living and their portfolios
5.3 Past investors

6.1 Artificial intelligence
6.2 Digitally enabled homecare providers
6.3 Market potential for publicly funded homecare and supported living
6.3.1 Integration of health and social care
6.3.2 Alternative models emerging from the social work and nursing professions Local Area Coordination model The Buurtzorg model Scope for applying alternative models in the UK


Note: Product cover images may vary from those shown


A selection of companies mentioned in this report includes:

  • Achieve Together (formerly The Regard Group and CMG)
  • Active Assistance Group
  • Affinity Trust
  • Age UK
  • Agincare Group Ltd
  • Alcura UK Ltd
  • Alina Homecare
  • Allied Healthcare
  • Alzheimer’s Society
  • Alternative Futures
  • Amcare Ltd
  • Anchor Hanover
  • Apex Prime Care Ltd
  • Appello
  • Ark Home Healthcare
  • Aspirations
  • Audley Group Ltd
  • Baywater Healthcare
  • Berkeley Home Health
  • Bluebird Care
  • British Red Cross
  • Brunelcare
  • Calea UK Ltd
  • Care UK
  • CareTech
  • Carewatch
  • Centra Group
  • Cera Care
  • Choice Care Group
  • Choice Support
  • City & County Healthcare Group
  • Clece Care Services
  • Community Integrated Care
  • Complete Care Group
  • Creative Support Ltd
  • Dimensions
  • Direct Health Group Ltd
  • Eden Futures
  • Future Directions CIC
  • The Good Care Group
  • Grosvenor Health and Social Care
  • HCRG (aka CRG)
  • Healthcare at Home Ltd
  • Healthcare Homes
  • Helping Hands
  • Hft
  • Home Instead Senior Care
  • Housing 21
  • Independent Clinical Services Group
  • Interserve Healthcare Ltd
  • Leonard Cheshire Disability
  • Lifeways Group
  • Lloyds Pharmacy Clinical Homecare Ltd
  • Marie Curie Cancer Care
  • Mears Care Division
  • Mencap
  • MiHomecare Ltd
  • Nurse Plus
  • Prestige Nursing + Care
  • PrimeLife
  • Radis Community Care
  • Sanctuary Group
  • Somerset Care Ltd
  • Springfield Homecare Services Ltd
  • TBS GB Telematic & Biomedical Service Ltd
  • Tunstall Healthcare Group Ltd
  • Turning Point
  • Voyage Care
  • Westminster Homecare Ltd
  • Your Life Management Services Ltd
Note: Product cover images may vary from those shown