Spending on the UK adult specialist care sector, which delivers long-term social care services to about 700,000 younger adults aged 18–64 in England with learning disabilities and autism, physical disabilities, brain injury, mental health and substance abuse needs, has continued to grow as the number of adults receiving support increases and payroll costs inflate, according to research published by LaingBuisson int he eighth edition of the Adult Specialist Care UK Market Report.

Highlights include:

  • The adult specialist care services market in the UK is worth an estimated £21.3 billion (£18.0 billion in England alone) for financial year 2026/27.
  • A sharp, post-Covid increase in spending has driven a 5-year Compound Annual Growth Rate (CAGR) estimated at 8.6% in nominal (cash) terms and a 1.9% CAGR in real terms, after adjusting for social care price increases.
  • But despite the post-Covid surge, real terms council spending on long-term social care for younger adults (aged 18-64) across England in 2024/25 (latest available figures) is still below its 2009/10 peak.
  • Meanwhile, underlying demand continues to grow.
  • Councils prioritise services for people with the highest needs, and strict eligibility criteria mean that many younger adults with low level needs may receive little or no support other than informal support from family and friends.
  • Annual per person costs of publicly funded services in 2026/27 are estimated at:
    • Residential settings: £106,000 per year
    • Council-paid Direct Payments: £26,000 per year
    • Homecare: £28,000 per year
    • Supported living: £82,000 per year
    • Other council-paid services: £43,000 per year
    • Non-residential drug and alcohol: £3,000 per year
    • Overall average: £26,000 per year
  • Demographic change is the main underlying driver of demand, in particular the ageing of the learning-disabled population, which is the largest client group.
  • The shift from residential to supported living is projected to continue in the future, reinforced by the expansion of housing options for younger adults as investment in supported accommodation expands in a supportive policy environment.
  • At the same time, this latest report from LaingBuisson highlights what may prove to be a halt in the declining trend in care in residential settings, as the remaining care home population becomes more dependent and diminishing returns set in for transitions to supported living in community settings.
  • The social care recruitment and retention crisis which followed Covid has eased, to the extent that many investors and providers are no longer reporting workforce as their principal operational challenge.

Report author, and Founder and Executive Chairman of LaingBuisson, William Laing, says:

“The £21 billion spent on adult specialist care is ultimately underpinned by society’s willingness, in the UK as in all other developed countries, to spend large sums on the care of younger adults with the highest levels of need. Individual lifetime costs sometimes run into several million pounds.

“The independent sector (mainly for-profit) is now the mainstream provider of social care – supplying 94% of services. The cost of any roll-back to public provision would be prohibitive. The independent sector is highly competitive. It demonstrated its resilience during Covid, though there is a long tail of micro-providers which may be fragile.

“In a growing market, infrastructure funds have been among many investors backing adult specialist care providers. This is despite pressure on margins by local authority and NHS funding bodies, which have led to a halving since 2011/12 of aggregate operating profitability of those providers that report profit and loss to Companies House.”