Care home bed availability

Background

Care homes are categorised as either residential or nursing homes. Residential homes are those that provide accommodation and help with personal care, such as washing, dressing and taking medicines. Nursing homes are those where there is always a registered nurse on duty to provide nursing care for people with more complex needs.  

In the year to mid-2024, there was a 1.8% increase in individuals aged 65+ in England. It is estimated that by 2050, around one in four people will be aged 65 and over. Demand for social care services is forecast to continue to rise to support a population that is both ageing and increasingly susceptible to multiple long-term conditions. Significant elderly residential and nursing capacity will be required to meet increasingly complex care needs, so it is important to understand trends in the availability of care home beds. 

Care homes also support people of working age who have learning disabilities or other care needs. Life expectancy of people with learning disabilities has been increasing, as has the total number of older individuals with learning disabilities. This will also contribute to the requirement for specialised care homes suited to meet complex needs. 

Community-based support such as home care or supported living can enable people to retain their independence and live at home for as long as possible. Avoiding permanent placements in care homes for people with moderate care needs can be a means of delaying the development of more complex care and support needs. Reduced admissions to care homes from hospital can also indicate improved ability of local health and social care services to work together to ensure people do not experience long hospital stays and are discharged to the right place. However, recent data on delayed discharges from hospitals suggests that a large number of people are waiting for a permanent place in a care home. For more information, refer to our report on publicly funded social care.

Care home bed availability for the elderly

Between 2012 and 2025, the total number of beds in both nursing care homes and residential care homes (together referred to as ‘care homes’) for older people declined from 11.3 per 100 people aged 75 and over to 8.3 per 100 people aged 75 and over – a 26% decrease. Likewise, during the same period, the number of nursing home beds per 100 people aged 75 and over fell from 5.2 to 4 – a 23% decrease. 

Care home admissions 

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 in 2020/21 during the coronavirus (Covid-19) pandemic and recovering slightly in the following years. During the pandemic, concerns were raised about the financial stability of care homes and the possibility of increased closures. A 2021 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.

For younger adults, aged 18 to 64, the rate of admissions to care homes has fluctuated between 12.8 per 100,000 people in 2016/17 and 15.2 per 100,000 people in 2023/24. While this admission rate is considerably lower than that of older adults, it is important to note that working-age adults who enter care homes typically remain resident for significantly longer periods.

Due to significant methodological changes to the data collection, 2024/25 data cannot be compared with figures for previous years. In 2024/25, the rate of admissions to care homes for older adults was 593 per 100,000 people and the rate of admissions to care homes for working-age adults was 17 per 100,000 people.

The overall number of council-supported admissions of adults to care homes has decreased over time, alongside a net reduction in the number of available beds driven by fewer new registrations and an upward trend in closures. While this could partly reflect a policy shift towards community-based care (such as home care, supported living, or extra care settings), the absence of reliable data on these settings makes it difficult to verify whether provision has simply moved elsewhere or fallen overall. There is, however, evidence to suggest a genuine decline in social care provision. The proportion of self-funded residents increased by 9.2% from 2021/22 to 2022/23, suggesting fewer people are meeting eligibility thresholds for publicly funded care. Although self-funding is an alternative, it is unaffordable for many: as of 2022, self-funders paid on average 40% more than local authorities. On top of this, significant recruitment and retention challenges, particularly for registered nurses, have reduced capacity and affect people’s care.