Kent County Council: Adult Social Care Market Intelligence

Kent County Council is one of England's largest adult social care authorities, serving a population of approximately 1.6 million people across a diverse geography that includes major urban centres, coastal towns and rural areas. The county's adult social care market is substantial and varied — an estimated 850 CQC-registered adult social care locations operate within the county, spanning domiciliary care, residential and nursing care, supported living and specialist services.

The county's adult social care market is characterised by significant demographic pressure, an ageing population and persistent challenges in recruiting and retaining care staff. Demand continues to rise across all service categories, and the county faces particular challenges in ensuring adequate provision in coastal and rural areas where provider coverage is thinnest.

This report draws on systematic review of Kent's published Market Position Statement (2024–2026), commissioning strategies, Health and Wellbeing Board strategies and Joint Strategic Needs Assessment; analysis of CQC registration and inspection data; ONS population projections and Skills for Care workforce estimates; and direct engagement with CQC-registered providers operating within the county.

Kent County Council is the largest local authority in the South East by population, serving approximately 1.6 million residents. The county spans 3,544 square kilometres and encompasses 12 district and borough councils. Medway — a separate unitary authority — is geographically surrounded by Kent but administratively independent. Kent County Council is responsible for adult social care, children's services, highways, education and strategic planning across the county.

Kent spends over £500 million annually on adult social care. The population aged 65 and over is projected to grow 28% by 2035 — faster than the England average — driven partly by Kent's attractiveness as a retirement destination and by general demographic trends. Approximately 850 CQC-registered adult social care locations operate across the county, and the county has a well-established mixed market of in-house provision, large national providers and smaller independent operators.

Strengthening the domiciliary care market to reduce reliance on residential placements is a core priority. The council seeks to enable more people to remain at home with appropriate support, and domiciliary care is the primary vehicle for achieving this. The council is particularly interested in providers who can deliver complex care packages at home — including dementia care, end-of-life care and support for people with multiple long-term conditions.

Expanding supported living options for working-age adults with learning disabilities and autism is another stated priority, with a focus on small-scale, community-based settings rather than larger congregate models. The council is also prioritising improved market capacity in coastal and rural areas, where provider coverage is historically weaker than in the county's major urban centres.

Increasing complex care provision to reduce out-of-county placements is a recurring theme in the council's commissioning strategies. Embedding a strengths-based, outcome-focused approach across all commissioned services is a cross-cutting priority aligned with the Care Act 2014.

The provider landscape is unevenly distributed across the county. Coastal areas — including Thanet, Dover and Shepway — face significant gaps in domiciliary care provision, with provider density markedly lower than in the county's urban centres. Rural areas in the Weald and parts of Ashford also face access challenges, with travel distances reducing the viability of short-duration care visits.

CQC ratings across Kent are 82% Good or Outstanding — broadly in line with the national average of 83%. Provider turnover in domiciliary care is high: approximately 15% of providers leave the market annually, primarily citing workforce challenges and fee levels as contributing factors. The residential and nursing care market is more stable, though occupancy rates and self-funder mix vary considerably by location and service type.

The supported living market is growing but remains fragmented, with a mixture of specialist supported living providers, generalist domiciliary care providers offering supported living as an additional service, and registered social landlords.

The Director of Adult Social Services leads strategic commissioning for adult social care, supported by Heads of Commissioning for Older People, Working Age Adults and Market Development. The Integrated Commissioning Board oversees pooled budget arrangements between the council and the NHS for services including continuing healthcare, learning disability services and mental health.

The Kent Care Market Development team is the primary entry point for provider engagement. The team manages provider relationships, market shaping activity and the development of new service models. The council uses a mix of spot purchasing, framework agreements and block contracts, and is increasingly moving towards outcome-based contracting models.

Kent participates in the Kent and Medway Integrated Care System, and the council's commissioning strategies reflect the ICS's priorities around prevention, integration and community-based care.

Demographic pressure is the most significant structural challenge. Kent's 65+ population is projected to grow 28% by 2035, and the proportion of people presenting with multiple long-term conditions is increasing. Without corresponding growth in the provider market, the gap between demand and provision will widen.

Workforce recruitment and retention is the most reported challenge to provider market stability. Providers across Kent report difficulty recruiting and retaining care staff, particularly in coastal and rural areas where competition from other sectors (hospitality, retail) further reduces the available labour pool. Fee levels are a persistent tension between providers and the council, with providers arguing that current rates do not adequately cover the cost of delivering high-quality care.

Coastal deprivation creates additional complexity. Several of Kent's coastal towns have higher-than-average levels of deprivation, and the intersection of poverty, poor health outcomes and limited provider coverage creates a particularly challenging commissioning environment.

Domiciliary care in coastal and rural areas is the most clearly identified growth opportunity. Providers who can demonstrate the ability to deliver reliable, high-quality domiciliary care in areas of historically weaker provision will find a receptive commissioning environment.

Supported living for adults with learning disabilities and autism is a growth area across the county, driven by the council's commitment to reducing out-of-area residential placements. Providers with experience in developing and operating small-scale supported living schemes should engage early with the Care Market Development team.

Complex care — particularly dementia and mental health — is a third area of opportunity. Providers who can deliver complex care packages at home, and who can evidence specialist staff training and support, will differentiate themselves in this market.

Culturally competent services for Kent's diverse communities, including growing South Asian and Eastern European populations, represent a further opportunity. Providers who invest in cultural competence as a demonstrable operational capability will stand out.

Kent's scale and diversity mean that no single provider strategy will work across the entire county. The market conditions in coastal Thanet are fundamentally different from those in commuter-belt Sevenoaks. Providers should consider a sub-regional approach — identifying specific areas within the county where their service model, workforce strategy and operational capability are best aligned to commissioner need.

The workforce challenge cannot be solved solely by individual providers. It requires a system-level response that includes local authority support for recruitment campaigns, coordinated approaches to training and career development, and fee levels that enable providers to pay competitive rates. Providers who engage constructively with the council on workforce development — rather than simply reporting the problem — will build stronger commissioner relationships.

Outcome-based contracting is the direction of travel. Providers who prepare now — by building the evidence systems, outcome measurement capabilities and service models that outcome-based commissioning requires — will be ahead of the curve.

The Director of Adult Social Services (DASS) holds statutory responsibility for adult social care in Kent and leads strategic commissioning. Heads of Commissioning cover Older People, Working Age Adults and Market Development respectively. The Integrated Commissioning Board oversees pooled budget arrangements between Kent County Council and the NHS for continuing healthcare, learning disability services and mental health.

Adult Social Care Commissioning — responsible for strategic commissioning of care services across all service categories, including domiciliary care, residential and nursing care, supported living and specialist services. Brokerage — manages day-to-day placement of care packages, maintains provider relationships for spot purchasing and tracks market capacity. Market Development — responsible for provider engagement, market shaping activity, framework development and innovation in service models. Quality Assurance and Contracts — monitors provider performance, manages contract compliance and oversees the quality assurance function, including liaison with CQC.

The Kent Care Market Development team is the primary entry point for providers seeking to understand commissioner priorities and framework opportunities.

Kent County Council, Market Position Statement 2024–2026.

Kent County Council, Joint Strategic Needs Assessment.

Kent County Council, Published Accounts, 2024/25.

Kent County Council, Commissioning Strategies (adult social care).

Kent Health and Wellbeing Board, Strategies and meeting papers.

Kent and Medway Integrated Care System, Plans and strategies.

CQC, Active locations data, January 2026.

ONS, Mid-year population estimates, 2024.

ONS, Subnational population projections, 2022-based.

MHCLG, English Indices of Deprivation, 2019.

Skills for Care, The state of the adult social care sector and workforce in England, 2025.

NHS England, Adult Social Care Activity and Finance Report, 2025.

Odelia Group, Direct provider engagement and cross-authority MPS analysis, 2025–2026.

This report is part of the Odelia Local Authority Intelligence Series — a growing collection of evidence-led council-level research into adult social care provider markets across England.

Each report in the series follows a consistent, rigorous methodology: systematic review of published Market Position Statements and commissioning strategies; analysis of CQC registration and inspection data, ONS population projections and Skills for Care workforce estimates; direct engagement with CQC-registered providers operating within the authority; and structured review of Health and Wellbeing Board strategies and Joint Strategic Needs Assessments.

The series is designed for commissioning teams, provider development leads, sector analysts and care providers seeking to understand local authority priorities, provider market dynamics and opportunities for provider development.

Explore the full collection at the Odelia Local Authority Intelligence Hub or read about our research methodology.