England has 480,491 care home beds across 14,797 active CQC-registered care homes, 4.4 beds for every 100 people aged 65 and over.[1] That single national figure is the one most people would quote, and it is also close to useless for any specific decision. The real picture is a wide spread: inner-London boroughs running at under a third of the national density, parts of the North East and South Coast running at five or six times that rate, and CQC quality ratings following a geography that does not track supply at all. This article works through what the underlying region and local-authority data shows, and what it means for occupancy, fee-setting and site selection.
The national baseline, and why it hides more than it shows
Across a population of 10,981,092 people aged 65 and over,[3] England's 14,797 active care homes provide 480,491 beds,[2] a national density of 4.4 beds per 100 over-65s.[1] A further 101 registered homes are flagged dormant, registered but not yet operating, and are included in the location and bed counts, which therefore slightly overstate current operating capacity.[1]
Some of those beds serve working-age adults, in learning disability, mental health or physical disability services, so beds-per-100-over-65 is a density proxy rather than a literal elderly-occupancy ratio. It is still the best available cross-region comparator, because it is built from the same CQC location data and the same ONS population base for every area, so the relative gaps between regions and local authorities are meaningful even where the absolute ratio is imperfect.
Regional supply: London and the South West sit below the national average
Bed density by region ranges from 3.4 to 4.9 beds per 100 over-65s, a 44% gap between the tightest and loosest regional markets.[1]
| Region | Beds per 100 over-65s | Care homes per 100k over-65s | Good-or-above % | Churn rate (12m) |
|---|---|---|---|---|
| London | 3.4 | 115.0 | 82.7% | 5.3% |
| South West | 4.2 | 138.8 | 83.7% | 4.4% |
| East of England | 4.3 | 124.7 | 71.5% | 4.9% |
| North West | 4.3 | 128.3 | 73.6% | 5.3% |
| East Midlands | 4.5 | 144.2 | 74.1% | 6.2% |
| West Midlands | 4.5 | 144.8 | 69.4% | 3.7% |
| Yorkshire and The Humber | 4.6 | 133.7 | 73.8% | 5.7% |
| North East | 4.7 | 127.8 | 86.5% | 6.4% |
| South East | 4.9 | 146.8 | 75.2% | 3.8% |
London is the clear outlier on supply, 3.4 beds per 100 over-65s against a national 4.4, despite having the second-highest quality share of any region at 82.7% Good-or-above. The South West, East of England and North West all sit modestly below the national average too. At the other end, South East (4.9) and East Midlands and West Midlands (both 4.5) run above the national figure, and the North East, at 4.7, combines above-average supply with the highest closure/deactivation churn rate of any region, 6.4% in the trailing 12 months.[1]
Where the care deserts are: inner London by a wide margin
Restricting to local authorities with at least 5 active care homes (to stop a single-home area distorting a per-capita ratio), the ten lowest-supply local authorities in England are all inner-London boroughs.[1]
| Local authority | Active care homes | Beds | Beds per 100 over-65s | Good-or-above % |
|---|---|---|---|---|
| Haringey | 24 | 375 | 1.3 | 87.5% |
| Hackney | 13 | 314 | 1.4 | 84.6% |
| Southwark | 13 | 521 | 1.8 | 76.9% |
| Westminster | 9 | 488 | 1.8 | 77.8% |
| Camden | 11 | 510 | 1.9 | 81.8% |
| Kensington and Chelsea | 11 | 443 | 2.0 | 72.7% |
| Tower Hamlets | 10 | 387 | 2.0 | 90.0% |
| Newham | 23 | 595 | 2.1 | 82.6% |
| Brent | 49 | 1,048 | 2.4 | 83.7% |
| Hounslow | 32 | 885 | 2.4 | 78.1% |
Haringey and Hackney are the two tightest markets in England, at 1.3 and 1.4 beds per 100 over-65s respectively, under a third of the national 4.4 rate. Every local authority in the care-desert table is also carrying a Good-or-above rating share above the national average of 76.0%, in most cases well above it: Tower Hamlets (90.0%), Haringey (87.5%) and Hackney (84.6%) all sit near or above the North East's regional-leading 86.5%. Thin supply and strong ratings sit together in every one of these boroughs, which points to sustained, unmet demand rather than a market operators are avoiding on quality grounds.
Where supply is deepest: Middlesbrough, Surrey and the South Coast
At the other end of the distribution, the ten best-supplied local authorities (again restricted to areas with at least 5 active homes) run at close to five times the density of the tightest care deserts.[1]
| Local authority | Active care homes | Beds | Beds per 100 over-65s | Good-or-above % |
|---|---|---|---|---|
| Middlesbrough | 48 | 1,793 | 6.9 | 85.4% |
| Surrey | 387 | 15,067 | 6.3 | 74.2% |
| Windsor and Maidenhead | 42 | 1,887 | 6.3 | 66.7% |
| Croydon | 129 | 3,475 | 6.1 | 85.3% |
| Kingston upon Thames | 44 | 1,588 | 6.1 | 72.7% |
| Leicester | 101 | 2,827 | 6.1 | 72.3% |
| East Sussex | 296 | 9,036 | 6.0 | 78.0% |
| East Riding of Yorkshire | 151 | 5,731 | 5.9 | 68.2% |
| Stoke-on-Trent | 84 | 2,703 | 5.9 | 72.6% |
| Blackpool | 71 | 1,720 | 5.7 | 0.0% |
Unlike the care-desert list, the best-supplied local authorities show a more mixed quality picture: Middlesbrough (85.4%) and Croydon (85.3%) are both above the national Good-or-above rate, but Windsor and Maidenhead sits at 66.7%, below the national average despite having the third-deepest supply in England. A saturated bed market is not automatically a high-quality one; supply and CQC outcomes are separate variables that need checking independently for any given local authority.
The quality picture: Well-led is the weakest CQC domain nationally
Nationally, 76.0% of active care homes hold an overall CQC rating of Good or Outstanding: 4.2% Outstanding, 71.8% Good, 15.2% Requires improvement, 0.8% Inadequate, and 8.0% Not yet rated.[1] Breaking the rating down by CQC's five assessment domains shows the same homes performing unevenly across different aspects of care.[1]
| CQC domain | Good-or-above % |
|---|---|
| Caring | 94.1% |
| Responsive | 92.1% |
| Effective | 88.9% |
| Safe | 77.8% |
| Well-led | 74.7% |
Caring is the domain the sector performs best on by a wide margin, 94.1% Good-or-above, with Responsive close behind at 92.1%. Well-led is the weakest domain nationally at 74.7%, below even the overall combined rating of 76.0%, and Safe is the only other domain below 80% at 77.8%. That gap, a strong Caring score sitting alongside a materially weaker Well-led score, is a governance and management pattern rather than a frontline-care pattern, and it is consistent enough across the dataset to be worth checking on a domain-by-domain basis for any specific target, not just the headline overall rating.
Closure and deactivation churn: registration turnover, not solely business failure
758 care homes deactivated on the CQC register in the trailing 12 months to 23 July 2026, representing 23,319 beds and a national churn rate of 4.9%.[1] A deactivation on the CQC register can reflect an outright closure, but it can also reflect a change of registered provider or a relocation, so the figure is best read as registration turnover rather than purely business failure.[1]
Regional churn ranges from 3.7% in the West Midlands to 6.4% in the North East, a gap that does not track bed supply in either direction: the North East combines above-average supply (4.7 beds per 100) with the highest churn, while the West Midlands combines above-average supply (4.5) with the lowest churn. Among the individual care-desert local authorities, churn is also uneven: Westminster shows a 25.0% churn rate on a small base of 9 homes, while Hackney, Kensington and Chelsea, Tower Hamlets and Hounslow all show 0.0% deactivations in the same 12-month window.[1]
What this means for occupancy, fee-setting and acquisition site selection
Three practical readings follow from the supply and quality data together, not from either measure in isolation.
- Occupancy pressure runs highest where supply is structurally thin and quality is already strong. Every local authority in the care-desert list carries a Good-or-above share at or above the national average, which is consistent with sustained unmet demand rather than a market operators have deliberately avoided. For an existing home already trading in one of these boroughs, that combination supports a firmer line in fee-rate negotiations with the local authority, backed by the local supply data rather than a general appeal to cost pressure.
- A well-supplied local authority is not automatically an easier or a harder market; it depends on quality too. Middlesbrough and Croydon combine deep supply with above-average quality, a genuinely competitive but well-regarded market. Windsor and Maidenhead combines deep supply with below-average quality, which reads more as an opportunity for a new entrant able to differentiate on rating than as a market to avoid.
- Well-led is the domain most worth checking on any acquisition target. At 74.7% Good-or-above nationally, against 94.1% for Caring, a target home's Well-led rating is more likely than any other domain to be the weak point in an otherwise strong inspection history, and it is the domain most directly tied to the financial and governance controls a buyer inherits.
None of this replaces a proper acquisition or site-selection financial model. Local authority fee rates, workforce availability and the specific property's condition and registration all sit alongside the supply and quality data covered here. Our buying a care home service page and the care homes hub cover the wider financial and tax position for both acquisition and new-build decisions.
Using the full dataset
Every figure in this article is aggregated by region or local authority. No individual care home, provider or registered manager is named anywhere in the underlying dataset or on this page.[1] The complete region and local-authority breakdown, including every local authority in England and a CSV download, is published in our UK Care Home Density & Quality Index. For the business-formation and survival side of the sector, see our UK Care Business Survival Index and Care Provider Business Index.
Sources
- Care Home Tax UK Care Home Density & Quality Index, July 2026 data pull. 14,797 active CQC-registered care homes, 480,491 beds, 101 dormant homes, national density 4.4 beds per 100 people aged 65 and over (population 10,981,092); 76.0% Good-or-above overall (Outstanding 4.2%, Good 71.8%, Requires improvement 15.2%, Inadequate 0.8%, Not yet rated 8.0%); domain ratings Caring 94.1%, Responsive 92.1%, Effective 88.9%, Safe 77.8%, Well-led 74.7% Good-or-above; 758 deactivations and 23,319 beds lost in the trailing 12 months to 2026-07-23, national churn rate 4.9%; care-desert and best-provided local authority lists restricted to local authorities with at least 5 active care homes. Available at: /research/uk-care-density-quality-index. Compiled from CQC and ONS open data. Retrieved 2026-07-23.
- Care Quality Commission. HSCA Active Locations, Deactivated Locations, and ratings by domain (Safe, Effective, Caring, Responsive, Well-led). Published under the Open Government Licence v3.0 at cqc.org.uk/about-us/transparency/using-cqc-data. Data retrieved 2026-07-23.
- Office for National Statistics. Mid-2024 population estimates (MYE24), local authority districts and regions, England. Published under the Open Government Licence v3.0 at ons.gov.uk. Vintage: mid-2024, published 2025.