What were we trying to do?

We used administrative data to examine the trends in the care homes market (within England) from 2016 to 2020, with a specific focus on Greater Manchester. 

 

We assessed the trends in the care homes market and the main changes that occurred in Greater Manchester compared to the rest of the country.
 

 

Why was this important?

The COVID-19 pandemic disproportionately affected care homes residents and highlighted the importance of the care homes market structure. Early evidence showed how excess care home residents’ deaths were overwhelmingly found in the minority of care homes that experienced COVID-19 fatalities.

 

However, there were other important considerations related to care homes residents, staff mix and the organisational characteristics of care homes. 

 

Therefore, we wanted to understand the structure of the care marketplace and how this had changed over time, with a particular focus on any adaptations that had happened in response to the COVID-19 pandemic. 

 

The study provided important messages relevant to local and national commissioners and care services providers. 

 

 

How did we do it?
We looked at both the Greater Manchester and wider national care home marketplace, and used publicly available data on care homes in England from the Care Quality Commission to address the following questions:

 

• How did the supply of care homes and care homes beds change from 2016 to 2020?
• How did the care home market structure change for care homes that did and did not offer nursing services? 
• How was the care home market reconfigured?
• How many care homes remained, left and/or entered the market?
• How many specialised services were offered?
• Which care home characteristics were associated with more resilience in the market?
• How and to what extent did the pandemic affect the financial viability of providers?
• How could we better design a resilient and efficient care home market?

 

Findings

In the paper Effects of chain ownership and private equity financing on quality in the English care home sector: retrospective observational study, we aimed to examine whether the financing and organisation of care homes was associated with regulator assessments of quality. 

The main findings were:

• All 3 for-profit ownership types had lower overall ratings on average than not-for-profit homes. This was especially the case with independent care homes and private equity chain care homes which were more likely to be rated as ‘requires improvement / inadequate’.
• Independent care homes scored better than private equity chains in the categories of ‘safe’, ‘effective’ and ‘responsive’, but worst in the ‘well-led‘ category. 

 

 

Downloadable resources

 

• Publications

  Patwardhan S, Sutton M, Morciano M. (2022) Effects of chain ownership and private equity financing on quality in the English care home sector: retrospective observational study. Age and Ageing

   

  Espuny-Pujol F, Hancock R, Morciano M., (2021) Trends in survival of older care home residents in England: a 10-year multi-cohort study. Social Science and Medicine

   

  Espuny-Pujol F, Hancock R, Hviid M, Morciano M, & Pudney S., (2021). Market concentration, supply, quality and prices paid by Local Authorities in the English care home market. Health Economics

• Blog
  • Bridging the quality gap: How care homes in Greater Manchester stand with respect to the rest of England? (published in November 2023)

 

More information

 

 

Senior Programme Lead

Mike Spence