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Exploring variation in the quality of care home services in England: A National cross-sectional study using administrative data

What are we trying to do?

We are using publicly-available administrative data on care homes that provide services to older people with dementia, registered with the CQC as of January 2020. Distinction is made between care homes that offer nursing services and those that do not.


Our aim is to provide a service-specific analysis focussing on care homes providing services to older people with dementia. We are looking to understand whether certain care home characteristics and geographical risk factors significantly predict care home quality ratings.  



Why is this important?
In England, almost 4% of people aged 65+ (one in seven aged 85+) live permanently in residential or nursing homes. Demographic projections (from 2017 to 2040) show that England will face an increase of 49% in its 65+ population which will further increase demand for adult social care services.


The CQC inspects and regulates different care services in England which have to meet certain requirements; they conduct regular inspections of registered social care organisations and provide overall quality ratings for each service, along with a focus on five different domains associated with care provision.


The CQC’s quality ratings act as a signal for expected care outcomes; however, this information is not always easily available and accessible to consumers.


This study will help to understand which care home characteristics determine long-term sustainability in terms of better quality ratings; whilst also identifying the characteristics associated with a poor rating. This will help local and national commissioners and care service providers develop and design tailored policies aimed at boosting quality ratings. 



How are we doing it?
We will use publicly-available administrative data on care homes to answer the following questions:


  • Is there any significant difference in the rating of homes offering nursing services from those which did not? Which quality domains are most affected?
  • Is there any significant difference of quality according to whether the care home ownership types?
  • Is there any significant difference according to the size of the care home?
  • How does the location of care homes impact their quality ratings?
  • How does the length of time a care home has been operating in the market impact on their quality ratings?
  • What actions could be promoted to improve care home quality?



Who are we working with?


More information



Senior Programme Lead


Mike Spence

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