Reports · Jul 2026
The State of Adult Social Care in England
An analysis of all 65,313 registered adult social care services in England: how they are rated, the 81% inspection void, the domains where care fails, and what separates good homes from poor ones.
The numbers
One sector, measured end to end
registered adult social care services in England
carry a current CQC overall rating
of rated services fall below Good
not inspected in over five years, or ever
of below-Good services fail on Well-led
Inadequate rate in nursing homes, double that of domiciliary care
Key findings
The inspection void is structural
52,923 services, 81% of the sector, have either never been inspected or not been inspected in over five years. Since late 2023 CQC's Single Assessment Framework has sharply reduced the number of published ratings, so a current rating on its own is no longer a reliable guide to quality.
One in five rated services falls below Good
Of the 32,538 services that carry a rating, 5,455 are Requires Improvement and 1,344 are Inadequate. Together that is 20.9% of all rated locations.
Well-led fails most often, Safe matters most to residents
Among the 6,799 below-Good services, 97.2% fail on Well-led, more than on any other measure. Safe carries the most direct risk: 7,424 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 a 5.9% Inadequate rate, roughly 2.4 times the 2.5% rate in domiciliary care, and they care for the most medically complex residents.
Geography concentrates disadvantage
Walsall (35.5%), Medway (34.8%), Slough (34.6%), Luton and Portsmouth (34.3%) have the highest combined below-Good rates. The South East holds the most quality risk by volume, with 11,900 locations including 238 rated Inadequate. London has the lowest Inadequate rate.
Dignity marks out the best homes
Good homes cite dignity and respect in 87% of their reports. Poor homes cite it in 32%. It is the clearest single marker separating strong care from weak.
Figures come from Bridgehead’s analysis of CQC data for all 65,339 registered adult social care locations in England, of which 32,538 carry a current overall rating, as at this report’s publication. Bridgehead’s CQC Intelligence dashboard draws on the same underlying data updated daily, so time-sensitive figures such as the inspection-void count will move slightly as later inspections fall due. Full methodology and sources are in the report.
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