Reports · Jul 2026
The State of Adult Social Care in England
An analysis of the 30,617 adult social care services currently registered in England: how they are rated, the ratings backlog, the domains where care fails, and what separates good homes from poor ones.
The numbers
One sector, measured end to end
adult social care services currently registered in England
carry a current CQC overall rating, under either of its two models
of rated services fall below Good
not inspected or assessed in over five years, or ever
of below-Good services fail on Well-led
below-Good rate in nursing homes, the highest of any care type
Key findings
The ratings backlog is structural
15,747 services, 51% of the sector, have either never been inspected or assessed or have not been inspected or assessed in over five years. Since late 2023 the Single Assessment Framework has replaced routine ratings inspections with ongoing assessments: 6,925 services now hold a rating made under the new model, and publication has recovered from its 2024 low. But 6,942 services (23%) hold no rating of either kind, and 40% of rated services hold a rating more than five years old.
15.5% of rated services fall below Good
Of the 23,675 services that carry a rating, 3,505 are Requires Improvement and 167 are Inadequate. Together that is 15.5% of all rated locations. Ratings made under the assessment model are less often Good: 24.4% are below Good, against 11.8% of those made by inspection.
Well-led fails most often, Safe matters most to residents
Among the 3,672 below-Good services, 98.4% fail on Well-led, more than on any other measure. Safe carries the most direct risk: 3,415 services are rated Requires Improvement or Inadequate on Safe, where medication, risk and infection control are the recurring concerns.
Risk concentrates in nursing homes
Nursing homes have the highest below-Good rate of any care type at 19.9%, against 16.5% in residential care and 12.8% in home care, and they care for the most medically complex residents.
Geography concentrates disadvantage
Luton (34.7%), Medway (33.0%), Bexley (32.9%), West Northamptonshire (31.8%) and Southwark (31.6%) have the highest below-Good rates; one council, Merton, has no rated service below Good. The South East holds the most services by volume, with 5,604 registered locations.
Dignity marks out the best-rated services
Dignity and respect appear in 87% of Good and Outstanding inspection reports and 32% of below-Good ones, the clearest single marker separating strong care from weak. The 2,829 reports analysed are mostly below-Good, and 71% are for services that have since closed.
Figures come from Bridgehead’s analysis of CQC data for the 30,617 adult social care locations currently registered in England, of which 23,675 carry a current overall rating under either of the CQC’s two rating models, as at 7 October 2026. Bridgehead’s CQC Intelligence dashboard draws on the same underlying data updated daily, so time-sensitive figures such as the ratings-backlog count will move slightly as later inspections fall due. Full methodology and sources are in the report.
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