Social care 360: providers

6. Care home places

The total number of care home places is slowly declining 

Why is this indicator important?  

The number of places in residential and nursing homes (collectively called ‘care homes’) is an important measure of social care capacity and usage. However, it is only a partial measure because social care support is far wider than care homes: much care is provided at home, for example, but there are no publicly available measures of home care capacity.  

What was the annual change?  

Overall, there was a small increase in the number of care homes places in 2023/24, up from 455,000 to 456,000. This was made up of a very small fall in the number of residential home places and a slightly larger increase in the number of nursing home places. Overall, the number of care home places per 100 people aged over 75 in the population fell from 8.8 to 8.6. 

What is the longer-term trend?  

Since 2012, there has been an 8,000 fall in the total number of care home places, made up of a 14,000 decline in residential home places, offset by a 6,000 increase in nursing home places. 

The trend is more obvious when population size is taken into account. In 2012, there were 6.1 residential home places and 5.2 nursing home places for every 100 people aged over 75, but by 2024 this had fallen to 4.4 and 4.2 respectively.   

However, there is a great deal of variation within regions and between sectors, with the South East and West Midlands both seeing a 12% increase in overall nursing home places since 2014 and the East of England seeing a 9% increase, but the North East seeing a 9% fall and Yorkshire and the Humber seeing a fall of 21%. Similarly, London has seen a fall of 19% in residential home places and the South West 11%, while the East Midlands has seen an 11% increase. 

The average size of care homes has also increased over time. In 2012 the average residential home had 19 places but by 2024 this had increased to 22, and the average nursing home had increased from 46 to 52 places. 

What explains this?  

An overall fall in the number of people using care homes is consistent with the broad policy direction of supporting people at home (this applies to publicly funded care: we have less knowledge about trends in decisions made by people who pay for their own care). It is also consistent with people’s frequently stated preference to remain independent in their own homes.   

Covid-19 may have accelerated this trend because the high number of deaths in care homes, and the limitations on visiting, meant some people were reluctant to move to or use care homes. In 2019/20, 584 per 100,000 of the over-65 population had their publicly funded long-term care needs met by admission to a care home but in 2020/21, at the peak of the Covid-19 crisis, that fell by 15% to 498 per 100,000 population. However, in 2023/24, this had increased once again to 566.  
 
The regional variation in care and nursing home places is explained, at least in part, by the market for care. Self-funders of care typically pay around 40% more for their places than council-funded residents so it is no surprise that there are more care home places in areas with higher numbers of self-funders.