Admissions to care homes

We analyse how the number of council-supported admissions of adults to residential and nursing care homes has changed over time.


Last updated: 24/02/2022

Access and waiting times
Social care


Avoiding permanent placements in care homes can be a measure of delaying dependency, and the ability of local health and social care services to work together to reduce avoidable admissions to care homes. It is widely thought that people prefer to retain their independence and live at home for as long as possible. However, care home admissions are not a simple measure of quality, as they can also be an indicator of a lack of decent affordable provision, as for some people admission to a care home can represent an improvement in their situation.

How have admissions to care homes changed over time in England? 24/02/2022

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The overall number of council-supported admissions of adults to care homes (residential and nursing homes) has decreased over time. This could be interpreted as being due to a shift in preference towards home-based social care. But since there is no reliable data on home care, it could also represent a fall in social care provision. As there is an ageing population, it could indicate an increasing level of unmet need.

For older adults (aged 65 and over), the rate of admissions to care homes decreased gradually from 659 per 100,000 people in 2014/15 to 584 per 100,000 people in 2019/20, before decreasing more substantially to 498 per 100,000 people in 2020/21.  This represents a 24% drop in the rate of admissions between 2014/15 and 2020/21. During the coronavirus (Covid-19) pandemic, concerns have been raised about the financial stability of care homes and the possibility of increased closures. A recent report estimated that care home occupancy fell from a pre-pandemic average of 87% to a low of 79% in June 2020, due to excess deaths in care homes and fewer admissions. It is worth noting that the bed availability data presented here is based on the number of beds available on 31 March each year.

For younger adults, aged 18 to 64, the rate of admissions to care homes has fluctuated over the last seven years between 12.8 per 100,000 people and 14.6 per 100,000 people; in 2020/21 the rate was 13.3 per 100,00 people. 

About this data

This indicator uses data from NHS Digital’s Adult Social Care Outcomes Framework (ASCOF). Indicator 2A measures the number of council-supported adults whose long-term support needs were met by a change of setting to residential and nursing care during the year (excluding transfers between residential and nursing care), as a rate per 100,000 population.

For this indicator, ASCOF sources data from the Short and Long Term Services (SALT) collection. In 2017/18 new routes of access relating to self-funders and new sequels were added to SALT. The impact on the ASCOF scores is expected to be small but this should be considered when comparing data from 2017/18 with previous years.

Data for this indicator is collected from each local authority. In 2020/21 Hackney Council did not submit their data because of a cyber-attack. To ensure 2020/21 data is comparable to previous years, NHS Digital calculated the aggregate totals using 2019/20 data from Hackney Council. Further details can be found in the Adult Social Care Activity and Finance data quality report.

For more information, please see the ASCOF Handbook of Definitions.