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Residential and Nursing Care Market Position Statement 2025 - 2040 Residential Care - Overall current market status

The current residential care home market in Walsall is rated as sufficient in terms of supply with the exception of mental-health nursing care, residential EMI (dementia) care and residential respite provision, but not at the quality required overall as a market.

There is good quality provision in the Borough as exemplified by some providers, a couple of which are rated CQC ‘Outstanding’. However, there needs to be a new approach to driving up the quality of all residential care provision in the Borough. There are unoccupied beds in the Borough with an occupancy rate of just over 83% as of February 2025. This suggest that there is further unused capacity in the current market before any new growth is considered against projected demand for residential care.

The stability of the Walsall residential care home workforce also needs stability and growth. Sufficiency of supply is dependent on sufficient, trained and skilled workforce. It is estimated that a significant proportion of the Walsall workforce is based on international recruitment which is at risk through recent Government policy changes.

Please contact us if you wish to work together on altering the type of residential and nursing care you offer, quality improvement work and on recruitment and retention of your care staff.

New providers considering entering into residential care need to be aware that, on the whole, current supply outstrips demand and is being met by existing providers on our Residential and Nursing Open Contract.

You may wish to consider investigating specific areas of hard of source locations or specialist types of care, such as complex nursing care, bariatric care and dementia care. The Council anticipates that some providers may exit the market due to lack of demand for this type of care over time, due to funding issues, ongoing quality concerns or due to workforce supply issues.

Provider dimension

 The covid period resulted in instability for this sector. There is currently an overall estimated 17% vacancy rate in Walsall care homes with a significant number of homes under the average occupancy of 83%. This affects the sustainability and viability of homes for providers. Residential and Nursing providers have reported the following issues from their perspectives in MPS engagement sessions:

  • Dependency on GPs is high
  • Increased complexity of need especially mental health
  • Need to better listen to providers in terms of assessments of needs and costs of care
  • Need for better void management and proactive use of supply
  • Being ‘Good’ CQC rated requires more joint investment in staff and infrastructure
  • Increase in bariatric patients
  • Need for better move - on pathways into supported accommodation for those who can leave bed-based care
  • Providers pick up additional costs not factored into Council rates e.g. family liaison
  • Seeking support from the Council with training, DBS checks
  • Interest in sector-led improvement in Walsall (providers working together to drive up improvement)
  • The current Residential and Nursing Care Services open contract commenced on 1st November 2020 until 31/3/2025. 

The current Residential and Nursing Care Services open contract commenced on 1st November 2020 until 31/3/2025. This has been extended by two years, therefore the open contract expires on 31/3/2027. A new contract will be place for 1st April 2027.

This open contract is therefore in its last two years. The Council, ICB and providers will work together to co-design new models of bed-based care and co-design sessions are in place to facilitate this. The current open contract contains 8 provisions for older people’s bed-based care and 8 provisions for younger adult bed-based care. Some commissioned providers are using digital technology to manage care provision. However, the extent to which this is used varies - some providers are using technology to manage all aspects of their business. We want more providers to be using digital methods to operate their businesses and there is support for this now from a dedicated commissioning lead for digital. Contact adultsocialcarecommissioning@walsall.gov.uk

Market Risks

There are several risks associated with the residential market in Walsall currently:

  •  There are indications of underoccupancy in the residential market in Walsall currently
  • Quality of residential care needs urgent improvement – there need to be more CQC Good or better rated care homes in Walsall. There is a new local approach to quality assurance, reporting and improvement that now aims to drive improvements in quality in bed-based care
  • Some care home accommodation in Walsall is in need of modernisation and investment
  • Risk that some provision will need to be de-commissioned due to quality concerns, lack of demand over time for certain forms of care or non-agreement on fee rates
  • There could be an increase in homes exiting the market due to an increase in costs.
  • Rates paid to Walsall care home providers are lower than most West Midlands comparator Councils.
  • There needs to be different local quality assurance and improvement support for Walsall care homes.
  • Social care workforce risks.
  • There needs to be a better understanding of self-funding client numbers and needs in Walsall and ensuring sufficiency and choice of supply for self-funding clients needing residential care.

Distance from vision

Our expectation is that when adults require a residential placement it is likely the adult’s needs will be more specialist.

The vision for residential and nursing care set out in this MPS needs to be further co-designed with providers and partners. This co-design will continue through the re-commissioning process to 2027. There will be market engagement on this.

There are positive aspects of the current market, particularly local nature of supply. However, over the next 18 months, the Council, partners like the ICB and providers need to go on a significant journey with providers to co-produce these models embedded in time for the new contract that will go live in 2027. 

Please let us know if you would like to be part of co-production of future bed-based models.

Market opportunities

Opportunity to co-design with providers and partners bed-based care models of the future in Walsall, preferably in mixed developments

  • People are living longer and coming into residential care later, so the frailty and complexity of conditions and type of residential care will need to change with new service offers
  • Opportunity for the Council and system partners to work with providers to invest more in driving up the quality of bed-based care, building on the Quality in Care Team and new approaches to quality improvement
  • Opportunities to diversify bed-based provision in areas of the Borough with high current and predicted demand but lower supply
  • Opportunity for more bed-based respite provision
  • Opportunities to fill gaps in types of residential provision such as respite beds, bariatric care, dementia care, drug and alcohol misuse care and care for behaviours that challenge