Research reveals North-South care divide

Mark Walford CEO and Founder TrustedCare’s bi-annual review of its unique English county league table shows care quality is rising but there is a distinct divide between care quality in the West Country and North West of England.  

Over the past six months quality improvements have been seen across residential, nursing and home care services. In December 2016 care quality had slumped by almost 10% (9.17%) from the previous year. Analysis of Care Quality Commission (CQC) data at the midpoint of the year shows that care quality is picking up again, with a near 2% (1.76%) rise since December 2016.

There is good news for people living in the West of the country with Worcestershire taking the number one spot for care quality and neighbouring county Herefordshire coming in third.

Story continues below

West Yorkshire remains at the bottom of the league table and neighbouring counties Greater Manchester and Merseyside are third and second from last. Greater Manchester coming in second from last is of national interest because there has been a complete devolution of health and social care services from Whitehall and NHS England to the county. The county has complete control of how they deliver care and how they spend their annual health and social care budget.

Mark Walford, CEO of, (pictured) said: “Overall it is great to see the number of providers achieving a Good rating steadily on the rise once again.

“The North v South divide on quality is certainly something which must be looked at more closely. It isn’t simply internal factors which effect service providers and the overall quality of care they deliver, the wider market in which they operate has a huge bearing on their performance.

“Local employment market, regulatory and some operating costs are uniform across the country, yet local authority commissioning rates vary hugely across the country and providers in less affluent areas are likely feeling the squeeze.”

Best and worst care by county
County Services rated in the county Services rated Good Services Requiring Improvement
Five Best      
Worcestershire 271 / 296 96% 4%
Rutland 19 / 24 95% 5%
Herefordshire 123 / 132 93% 7%
Berkshire 305 / 364 91% 9%
Cambridgeshire 249 / 299 90% 10%
Five Worst
Staffordshire 444 / 507 73% 27%
Northumberland 130 / 147 72% 28%
Merseyside 529 / 597 69% 31%
Greater Manchester 749 / 888 68% 32%
West Yorkshire 742 / 863 66% 34%


Oxfordshire is the most expensive county to receive care at an average cost of £954.58 per week, whereas Lancashire is the cheapest at £531.27 per week.

There is a definite North-South divide when it comes to the average cost of residential care, with residential care service users in the South paying on average £7,161.55 more per year than the same service user in the North. The cost of care has little bearing on care quality with only one of the top five most expensive counties (Oxfordshire) being in the top ten for care quality.

Most expensive and cheapest care by county
County Care Home per week Quality Rank
Most expensive
Oxfordshire £954.58 10
Wiltshire £879.81 38
Greater London £862.50 28
Bristol £862.08 39
Surrey £859.46 14
Lincolnshire £551.47 34
South Yorkshire £534.58 33
Merseyside £534 45
West Midlands £532.82 32
Lancashire £531.27 31


Since December 2015 the CQC has steadily increased the percentage of services inspected by nearly 4%, from 83.1% to 87%.’s unique analysis first compiled in 2015 not only shows significant shifts in the year-on-year quality of care but also month-on-month – only 9% of services have held their position on the league table since December 2016. Significant shifts in care quality have occurred in Oxfordshire, Nottinghamshire and Surrey, which are outlined below:

Oxfordshire has jumped 35 places from 45th to 10th over the past 18 months for care quality. The rise can be accredited to quality improvements in all care types:  residential services have risen 23 places from 33rd to 10th; nursing care services have risen 22 places from 25th to 3rd; and home care services have risen 28 places from 42nd to 14th.

Surrey has climbed 22 places from 36th to 14th since December 2016 for care quality. The rise can be accredited to quality improvements in residential and nursing care: residential services have risen 26 places from 40th to 14th; nursing care services have risen 35 places from 42nd to 7th; and home care services have dropped 11 places from 7th to 18th.

Tags : Best practiceFeesFundingResearch

The author Lee Peart

Leave a Response