Introduction
This factsheet series presents potential new indicators derived from
NHS England (NHSE) Primary
Care Dementia (PCD) Data publications. Each factsheet explores
different topics relating to people with dementia in England. Their aim
is to raise awareness and gather stakeholder feedback to inform the next
steps.
This is the third factsheet in the series and concentrates on the
topic of care home residency for people with dementia. The symptoms of
dementia increase in severity over time and some people will need
support in a care home. There were an estimated
248,000 people with dementia living in
care homes in February 2023. It is important to understand where
people live and have enough care home places to provide high quality
care in the right place at the right time.
The PCD publications provide information about people with dementia
to help providers and commissioners make more informed decisions. They
discuss a wide range of topics including incidence, prevalence,
comorbidities and end of life care. This factsheet also uses Care
Directory (CD) data from the Care Quality Commission (CQC) to
understand more about care home provision. The CQC monitors the quality
of care services and the CD publication is a complete list of locations
they regulate. Themes include care homes, number of beds, type of care
and geographical location.
Please select the relevant section on the left to see further details
about the charts, data quality and methods used in this publication. To
view other factsheets in this series, please see our Fingertips
website.
Main findings
The main findings from this factsheet are:
-
of the 480,000 people who had a recorded diagnosis of dementia in
December 2023, there were at least 175,000 people (37%) recorded as
living in a care home
-
the majority of the 175,000 people in care homes were living in
residential care (137,000 people, 78%), while a smaller proportion lived
in nursing homes (38,000 people, 22%)
-
the proportions of people living in a residential care home ranged from
at least 16% (in the London region) to 33% (North East and Yorkshire)
-
the proportions living in a nursing home ranged from at least 5% (in the
East of England) to 11% (South East)
-
the proportion of people with no recorded residence category is
consistently high (45% nationally in December 2023) but evidence
suggests that the care home categories are
well reported and the not recorded residence types are more likely
to be private residents
-
the total number of care homes has decreased between 2018 and 2023 (from
15,842 to 14,773)
-
the number of homes providing care for people with dementia has
increased to 7,504 homes (+6.9%) with the number of dementia beds
increasing by 11.4% to 340,016
Residence type data
The Office for National Statistics (ONS) estimated that the care
home population was around 372,000 people in February 2023 while the
Alzheimer’s Society (AS) estimates that two
thirds of care home residents have dementia. Using these figures, we
can estimate that there were around 248,000 people with dementia
(including those with a recorded diagnosis and those without) living in
care homes in February 2023. This section looks at new PCD data about
people with a recorded dementia diagnosis and a recorded type of
residence. The total number of people with a recorded dementia diagnosis
was 480,000 in December 2023. People of any age are included in these
numbers, although the vast majority of people (97% in December 2023)
with dementia are aged 65 or over.
The residence categories available in the PCD data during the
analysis period were residential care home, nursing home, private
residence and other residential type. Other residential type is used
when no residence type has been recorded on the GP system, therefore
this category has been renamed to not recorded in this publication. The
proportion of people with no recorded residence category is consistently
high (45% nationally in December 2023), therefore counts and proportions
in the residential care home, nursing home and private residence
categories could be underreported and should be treated as minimum
estimates. However, evidence suggests that the
care home categories are well reported
and the not recorded residence types are more likely to be private
residents.
The numbers in this section are rounded due to the uncertainty around
the missing data. National and subnational counts are rounded to the
nearest 1,000 and nearest 100 respectively. Proportions are presented to
the nearest whole number but have been calculated based on the raw
data.
National data
Figure 1 and 2 below, show the counts and proportions of people with
recorded residence types in England by month. The main findings from
these data were:
-
of the 480,000 people who had a recorded diagnosis of dementia in
December 2023, there were at least 175,000 people (37%) recorded as
living in a care home
-
the majority of the 175,000 people in care homes were living in
residential care (137,000 people, 78%), while a smaller proportion lived
in nursing homes (38,000 people, 22%)
-
there was a small increase (1 percentage point) in the proportion of
people living in residential care homes over the time series
-
the proportion of people living in a nursing home remained static (8%)
over the time series
Regional and ICB data
Figure 3 and 4 show the proportions of people with recorded residence
types by NHS region and by ICB for December 2023. To view a residence
type more clearly, click on categories in the chart legend to turn them
on or off. The North East and Yorkshire region has been abbreviated to
‘NE and Yorks’ in order to fit into the chart label. The main findings
from these data were:
-
there was high variation in the proportions of people living in each
residence type across the regions and ICBs
-
the proportions of people living in a residential care home ranged from
at least 16% (in the London region) to 33% (North East and Yorkshire)
-
the proportions living in a nursing home ranged from at least 5% (in the
East of England) to 11% (South East)
-
there was 8 fold variation (2% to 16%) across ICBs in the proportion of
people living in nursing homes
-
there was 3 fold variation (12% to 38%) across ICBs in the proportion of
people living in a residential care home
Care home data
This section concentrates on care home data from the monthly CQC CD
publication. It looks at the number of care homes and care home beds
across England, split out into care homes who provide services for
people with dementia (dementia homes) and care homes who look after
other service users (other care homes).
The term dementia beds describes the total number of beds in a
dementia home. This assumes that 100% of beds in dementia homes are used
by people with dementia, while in reality, it is more likely that a mix
of patient types will be cared for. This means that the dementia bed
counts presented here are likely to be overestimates.
The following charts look at counts of beds and homes in December
each year, and also at the annual percentage change between years in the
number of beds. The counts in this section are not rounded because the
care directory has 100% coverage of the places regulated but percentages
are rounded to 1 decimal place for easier reading. The main findings are
as follows:
-
the total number of care homes has decreased between 2018 and 2023 (from
15,842 to 14,773)
-
the number of homes providing care for people with dementia has
increased to 7,504 homes (+6.9%) with the number of dementia beds
increasing by 11.4% to 340,016
-
the number of beds in other types of care homes has decreased from
152,602 to 115,983 (-24.0%)
Chart interaction
All of the above charts have been created in an interactive format
using R programming and the plotly
package.
Where multiple categories are presented in the same chart, the legend
of the chart will be interactive. Click once on a category to remove it
from the chart and get a clearer view of the remaining categories. Click
on the category again to bring it back.
Each chart also has a tool bar at the top right which can be used to
interact with the chart and data points. Descriptions of each tool are
included below.
Table 1: Chart tools