Residential and nursing care

Rochester castle

The service

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There's a diverse residential and nursing care market operating in Medway with a range of providers from large national providers with numerous homes across the country, to small independent providers operating only one care home in Medway.

Most residential and nursing care settings in Medway are for older people (aged 65 and over). Adults below the age of 65 can have their needs met in residential and nursing homes. These homes generally specialise in providing care for those with a:

  • learning disability
  • physical disability
  • mental health need.

The majority of all care homes in Medway are in the private or not for profit sector.

The current landscape

In April 2026, the Care Quality Commission (CQC) data shows that there are currently 67 residential and nursing care homes in Medway. These homes have a combined total of 1,756 registered beds. The type of service registered to be provided at these homes is broken down by service user band below:

Older persons: 43 homes (1,521 beds)

  • residential care: 29 homes (725 beds*)
  • nursing care 14 homes (796 beds*)

Working age adults: 36 homes (367 beds*)

  • mental health: 18 Homes (226 Beds*)
  • physical disability: 10 Homes (114 Beds*)
  • learning disability: 25 Homes (226 beds*)

*Some care homes have dual registrations. This means they are able to provide care and support to different service user bands. The bed numbers listed above therefore exceed the total number of beds and care homes in Medway (some beds and care homes have been counted twice).

As is shown in the data above, care homes are predominantly for older people delivering a range of services including:

  • long term care
  • respite
  • reablement
  • discharge to assess (assessment beds) used to determine someone’s long term care needs.

CQC ratings 

These ratings are correct as of April 2026.

The CQC ratings for all 67 care homes in Medway are:

  • inadequate: 4 (6%)
  • requires improvement: 14 (21%)
  • good: 41 (61%)
  • outstanding: 1 (2%)
  • not rated: 7 (10%).

For older persons (43 homes):

  • inadequate: 2 (5%)
  • requires improvement: 11 (26%)
  • good: 24 (56%)
  • outstanding: 0 (0%)
  • not rated: 4 (9%).

For working age adults (36 homes):

  • inadequate: 3 (8%)
  • requires improvement: 4 (11%)
  • good: 24 (67%)
  • outstanding: 1 (3%)
  • not rated: 4 (11%).

For the whole Southeast region (2,754 homes):

  • inadequate: 26 (1%)
  • requires improvement: 426 (15%)
  • good: 1,961 (72%)
  • outstanding: 112 (4%)
  • not rated: 217 (8%).

For the entire country (National, 14,805 homes)

  • inadequate: 128 (1%)
  • requires improvement: 2,234 (15%)
  • good: 10,696 (72%)
  • outstanding: 600 (4%)
  • not rated: 1,147 (8%).

The most up-to-date ratings can be found on the CQC website.

This data suggests that CQC rating across homes in Medway compares lower than the average across the Southeast region and nationally.

The number of homes is comparatively smaller in Medway and is subject to large percentage swings based on a small number of homes. This means Medway has a higher percentage of care homes rated as requires improvement and a lower percentage of homes rated as good.

Medway is committed to supporting providers to improve quality standards within the service provided and continues to work with providers through dedicated resource to support improvements.

Contract management

The CQC regulates care homes. The Council's Quality Assurance Team and Commissioners also review and audit the services provided. We use these to review the performance of commissioned services and ensure the safety and wellbeing of users.

Contract monitoring is key to improving outcomes for older people who need residential care with and without nursing.

The contract for care and nursing homes has new quality requirements and improved standards. These have been developed in consultation with: 

  • service users
  • families
  • carers
  • referrers
  • service providers.

Medway Council rates

In March 2026, we informed the market of our fee uplifts for the financial year 2026 to 2027. In our correspondence we referenced the:

  • council’s financial situation
  • ongoing work to right-size the adult social care department
  • investment in prevention and reablement services.

Our residential and nursing care weekly band rates for 2026 to 2027 are:

  • standard residential: £824
  • dementia residential: £875
  • standard nursing: £1,030
  • dementia nursing: £1,081.50.

Medway's current residential care position

Medway has a robust provision for residential care, although there are deficiencies in certain areas, such as:

  • lack of adequate care for those with high frailty and nursing needs
  • shortage of residential and nursing beds for dementia patients, as well as for functional mental health, which has led to several individuals being accommodated outside of Medway
  • lack of long-term, planned nursing respite care
  • scarcity of specialised care for individuals under the age of 65
  • both Medway Council and independent providers are under financial strain
  • shortage in the residential and nursing care workforce, which reflects the national position
  • fewer services in the more rural wards of Medway.

Current service use (as of April 2026)

We currently commission 872 Residential and Nursing Care placements. This includes placements in Medway and outside of Medway.

Of these, 680 placements are for older people. The breakdown of which is below:  

Residential care (428 placements)

  • residential standard: 154
  • residential dementia: 277*.

*Includes block beds, which are all assumed dementia placements.

Nursing care (240 placements)

  • 134 nursing standard
  • 106 nursing dementia.

We currently commission 160 residential care placements for working age adults, these are broken down as follows:

  • learning disability: 101 Placements
  • physical disability: 28 Placements
  • mental health: 31 Placements.

More information about current service use can be found in our Joint Strategic Needs Assessment (JSNA).

List of current block beds and in-house capacity

We have 3 25-year block contracts for older person’s residential care. The number of beds varies during the lifetime of the contracts. The current bed numbers are listed below:

  • Strode Park Foundation (Platters Farm): Contract started 1 April 2013 to 31 March 2038 - 26 beds
  • Agincare (Rochester Care Home and Victory Care Home): Contract started 1 September 2013 to 31 August 2038 - 66 beds
  • Avante Care and Support (Amherst Court): Contract started August 2010 to July 2035 - 22 beds
  • 36a Birling Avenue, Rochester is a Medway Council owned and operated residential care home that provides respite care to working age adults with learning disabilities.

Recommissioning Residential and Nursing Services

The current framework contract for residential and nursing care for older persons and working age adults was developed several years ago and there's a need to update the specification and terms and conditions of the contract.

The commissioning of good quality nursing and high-frailty dementia nursing care continues to be a top priority, ensuring we meet the complex needs of our most vulnerable population.

We look to work with providers that will:

  • collaborate with the acute hospital discharge services and all relevant partners, including Adult Social Care, other commissioned services and the voluntary and community sector as required, to enable safe timely transfers of care
  • facilitate planned and timely admissions of new residents in the care homes 7 days per week, including the evening
  • work within a trusted assessor model, as appropriate
  • complete the NHS Capacity Tracker daily to support system flow
  • continue to engage with quality officers and commissioners to further improve quality standards
  • join new framework agreements for the provision of residential care
  • ensure the use of Medway's Integrated Community Equipment Service (MICES) that will deliver good care and timely admissions.

Assessment Bed Service

The assessment bed service has 8 beds and is an important part of our wider health and social care services. They provide short‑term, bed‑based support for adults who cannot be assessed in hospital or at home. This means recovery and assessment can take place in a more appropriate environment.

The assessment bed service helps:

  • us meet statutory duties under the Care Act 2014
  • with hospital discharge and patient flow in line with national hospital discharge and community support guidance
  • ensure that long‑term care decisions are based on an individual’s functional ability and support needs once they are stable.

The assessment bed service supports individuals to regain independence where possible. The service will establish whether an individual can return home, or if they need long-term care and support.

Assessment beds are not used for:

  • long-term care
  • end-of-life care
  • emergencies.

Going forward, we’ll check how well the service is working with our partners. Before commissioning the service again, we’ll review:

  • demand
  • activity
  • outcomes
  • value for money.

This review will also consider how the assessment bed service performs in the following areas:

  • discharge performance
  • sustainable use of health and social care resources
  • maximises independence.

The current contract for this service runs until 31 March 2027. We’ve shared this information to provide transparency about our strategic approach and future commissioning activity.