Care homes – small is beautiful?

There are 16,197 care homes in England, providing a total of 459,377 beds – one bed per 120 people, or more than enough beds for the entire population of Malta.

With so many care homes, how do you find a good one? The Care Quality Commission (CQC) register and inspect care homes. Analysis of data made available by CQC suggests that smaller homes are more likely to provide better care.

When the CQC inspect a care home, they give it an overall rating of outstanding, good, requires improvement, or inadequate. Along with the overall rating they score the home on whether it is caring, effective, responsive, safe, and well-led.

Care home size varies from 1 to 215 beds, but the median size is 23, and 75% of care homes have 40 beds or fewer.

We grouped care homes with a published CQC inspection by number of registered beds, and looked at the proportion of homes within each size group that scored “outstanding” or “good” for each inspection category.

You can use the interactive chart below to explore the results (click here to view the chart fullscreen). The area of each bubble indicates the number of homes in that particular size group.

For each of the inspection categories, there is a general downward trend in the likelihood of a care home passing inspection as the size groups become larger. The trend becomes less stable past 60 beds – likely due to smaller numbers of homes in the larger size groups. The drop off in likelihood of passing a CQC inspection is particularly pronounced between 9 and 10 registered beds:

So, why are smaller homes more likely to pass CQC inspections? One possible explanation can be found by examining how the results from each of the inspection categories correlate with the overall results. Of the five categories, “well-led” shows the strongest relationship with the overall results.

In the chart below, you can click on a category name to show or hide that category’s data.

Are smaller care homes more likely to pass CQC inspections because they have better leadership? If so, is this because smaller homes are, by nature, easier to manage?

We’ll be exploring this topic more in the upcoming weeks, and our visualisations are continuously updated as new data is published. If you liked what you’ve read, why not register for access to our free beta programme.

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