ANALYSIS: Just 1% of care homes achieve Outstanding

Research I

Just 1% of elderly care homes are rated Outstanding according to our analysis of CQC data. 

One hundred and four elderly care specialist homes of 20 beds or more have achieved Outstanding.

Corporate providers accounted for more than two-thirds of top ratings (68.3%) with not for profit providers taking 19%, family providers 10% and local authorities making up just under 3%.

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Not for profit providers are more prominent when looking at the leading groups with the most Outstanding care homes. Not for profits make up four out of the top nine providers with WCS Care first, (5 homes, including two for people with disabilities). Also represented are: Anchor (2), Methodist Homes (2) and The Royal British Legion (2).

HC One is the only large corporate to appear among the top providers, thanks to its recent acquisition of Helen McArdle, which boasts four outstanding homes.

In line with CQC’s emphasis on person centred care, the smaller homes in terms of number of beds take the greatest share of Outstandings. More than 80% of Outstanding homes are for 60 beds and under, with almost 50% between 20 and 40 beds.

Research III

Residential care homes account for almost two-thirds of outstanding homes (63.5%) with nursing homes taking a third (32.7%) and residential and nursing homes taking the remainder (3.8%). These figures reflect the more challenging operational environment for nursing homes which include the well-documented nursing shortage and greater difficulty in caring for people with more acute care needs in a low local authority fee environment. This combination of factors has led to major care home providers such as Anchor pulling out of nursing care altogether.

The CQC figures back the assertion that Outstanding is more about the quality of care provided than the environment, with the proportion of purpose-built and converted Outstanding homes evenly split at 50:50.

As of the end of May, only three homes have achieved outstanding in all five categories – Peregrine House run by Aikmo Medical in Whitby, Mary & Joseph House run by the Joseph Cox Charity in Manchester and, most recently, Arcot House Residential Home in Sidmouth (see Devon Care Home Joins Outstanding Elite). Peregrine House provides residential care for up to 37 people over 65. Mary & Joseph House offers rehabilitation and residential care for up to 41 people with mental health conditions, including those with dementia, and physical disabilities. Arcot is a 23-bed converted residential home.

At the other end of the spectrum almost two-thirds of homes (62.5%) gained overall Outstanding through achieving the minimum two top ratings. A quarter achieved three Outstandings, and 10% achieved four. ‘Safe’ is the most difficult outstanding rating to achieve gained by only Peregrine House, Mary & Joseph and Arcot. ‘Effective’ was the next most difficult with 31 instances. Well led (84), responsive (71) and caring (70) were the most common Outstandings.

London and the South East accounted for most Outstanding homes by region (28.8%), followed by the South West (22.1%) and the Midlands (21.2%). More than 50% of Outstanding homes are in the South with just 18% in the North indicating the emergence of a North-South divide in care quality.

Research II

Authors
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