Hertfordshire will see a significant rise in older people living with frailty and dementia in the coming years – with care demands in some areas increasing up to 300% by 2042, according to a council report.

Hertfordshire County Council's adult care services cabinet panel met on Thursday, October 23, where they were presented with the council's draft "Care Homes Commissioning Strategy for Older People".

Commissioners from the council's adult care services have come up with the five-year strategy which aims to tackle the challenges around caring for an increasingly older population.

Priorities include addressing "significant and sustained increases in the number of older people", as well as tackling a lack of affordable care options and a need for improvement in the experiences of people living with dementia.

A further priority is an "education gap" in care homes in dealing with residents with "non-cognitive" symptoms of dementia – such as agitation, aggression, wandering and mood changes.

A report into the strategy stated: "Residential and nursing care commissioning for older people is a major area of statutory responsibility, activity, and financial commitment for the council, with residential and nursing purchasing for older people totalling £110.7m for 2025/26."

The report cited an inspection of the council's care services by the Care Quality Commission, which rated it "Good" overall, with its sub-category for partnerships achieving an "Outstanding" rating, although Ofsted did highlight priorities concerning nursing care.

The document went on: "Significant progress has since been made in this area, most notably a 10-year variation to the Quantum Care contract for residential and day services has been implemented, bringing forward a range of benefits including the supply of over 500 residential and nursing beds, improved access routes to care and savings on bed costs."

Carers with "lived experience" of frailty and dementia have contributed to a new care model put forward by the council's public health team, while adult care services have trialled a care home service for people with non-cognitive symptoms of dementia.

Herts Care Providers Association (HCPA) is also working with adult care services to establish a specialist dementia training course for care home settings, which has also fed into the plan.

Cllr Rachel Carter (Green, Hertford Castle) said: "Obviously, we're going to need more people to work in care homes with the appropriate level of training as well. So how is that supply going to be brought forward? Obviously, we've got fewer young people being born, and there are fewer people going into that workforce."

Kristian Tizzard, deputy head of service at the council's integrated accommodation commissioning, said: "At the moment, there are a few programme elements that address workforce, we're working very closely with Herts Care Providers Association to promote care as a career, including as a care worker in a care home.

"We work very closely with providers to make sure that our commissioning arrangements are sustainable so that they are able to offer relatively attractive working conditions. Staff encourage them to come and work in the service.

"Going forward, we know that the workforce is a very significant challenge. The short-term goal will be to be compliant with anything in the Employment Rights Bill which may introduce higher paying conditions for people who work in care settings, including care homes.

"It's very difficult to say where we'll be in relation to that, but I think the aim is already to make sure that we have favourable paying conditions for staff in Hertfordshire.

"There is a significant number of overseas workforce working in both support at home and care home services in Hertfordshire at the moment.

"One of the most pressing areas is nursing recruitment. I think there are around 40,000 nurse vacancies nationally, and the NHS is the main employer of nurses. That does remain a very significant challenge.

"When we think about care homes opening, one of the bigger risks tends to be nurse recruitment. Our experience in the short-term is that those providers have been able to successfully recruit nurses, but I think it's going to have to be a very significant focus going forward because it will remain under pressure."

Cllr Calvin Horner (Lib Dem, Bishop's Stortford), vice-chair of the committee, said: "The one area you might touch on is the economics of this.

"We need to ensure that a lot of the places that we provide and commission are affordable, and therefore, we need to have a large estate that will provide affordable space. Really, I suppose I'm commending this plan."

After discussion, members voted to endorse the plan to the cabinet.