One of the most effective ways to track the quality of care being delivered across the country is through data and trends. This makes it a vital resource for care home investors, owners and providers to have when assessing their care homes against the competition and to see where standards are rising – or beginning to fall. We’ve analysed the trends via our CQC Dashboard to understand how care rankings have changed in Q3 2022, to reveal the regional ups and downs you’ll need to watch out for next year.

Overall, the Care Quality Commission (CQC) league tables for regional care home performance have remained largely unchanged in England since March 2021. However, some interesting details can still be found in how the number of care homes achieving these ratings has shifted over the latest quarter in 2022.

Our CQC Dashboard, which provides the most up-to-date insights for regional trends in social care performance, make it possible for care investors, owners and providers to dig deep into what’s happening within their locality, but our analysts have assessed the regional trends to create insights for what 2023 might hold.

The regional leaders for care

The top achievers of ‘outstanding’ CQC ratings, the South West (6%), North East (5.9%) and East Midlands (5.3%), have firmly held these top three positions, in this order, since April 2020. However, both the South West and East Midlands have experienced a 0.1% decrease since July 2022, with the North East alone seeing no change across Q3.

The same is seen at the bottom of the ‘outstanding’ rankings, with no changes in placements since July 2022 – but a general 0.1% decrease in the number of care homes with these ratings. This includes the North West (2.9% in July, to 2.8% in October), London (2.5% to 2.4%) and West Midlands (unchanged at 2.3%).

London sees an increase in ‘good’ care – but the picture is not all rosy

Greater shifts start to become more apparent as we investigate how the rankings have changed in care homes rated ‘good’. Most significantly, London’s increase from third place in July 2022 (78.5%) to first place by October (80%), means it now outperforms both of the long-serving first and second regions: South West (79.3%) and North East (79.1%). This marks a positive 1.5% increase in ‘good’ London care homes across the quarter, but it should be noted that it is still 1% lower than the number of London care homes rated ‘good’ across the same period in 2020 (81%).

This is the first time London has managed to shift itself into a higher-ranking placement for ‘good’ rated care homes since February 2021. However, the reason for this may be double-edged.

As we have seen, the number of ‘outstanding’ rated care homes in London has fallen, with a 0.1% decrease across the quarter, which will have contributed to a higher number of ‘good’ care services. Additionally, the number of care homes in London that are rated ‘requires improvement’ has decreased by a welcome 1.3%, with a proportion of these care services receiving better CQC assessments.

This could reveal that a standardised, middle ground is forming for London care services, as both previous ‘outstanding’ and ‘requires improvement’ care homes begin to meet in the middle. The only issue with this trend is that the number of London care homes rated ‘inadequate’ has also seen an increase, from 0.8% in July 2022 to 1.3% in October — making it the biggest percentage increase for the region across all ratings at +0.5%.

The takeaway point for care home investors, owners and providers is that, although one region may have a strong ranking for ‘good’, it may also be faced with challenges in upholding the same quality of care across all services. This makes it extra important to be careful to not let standards slip, or you may see yourselves falling into lower brackets.

Concerns as poor care performance grows

Whilst promising trends have been seen in some regions, there has also been a steady increase in the proportion of ‘requires improvement’ and ‘inadequate’ rated care homes since the UK coronavirus lockdown.

Since July 2022, the top three ‘requires improvement’ regions have remained stubbornly in place – with more care homes receiving this rating overall across these three regions. The East Midlands was up 0.1% since July (to 21.5%),  while Yorkshire & The Humber saw a significant rise of  0.4% (to 20.5%). The only decrease amongst these top three was in the West Midlands, which was down 0.1% since July 2022 (to 20.1%), shifting it down into third place.

Unfortunately, the West Midland’s lowered rate of ‘requires improvement’ care homes is not a reflection of better standards across care services, but rather an increase in ‘inadequate’; across the quarter, the number of care homes in the West Midlands that need specialist support has grown by +0.4% to 1.7%, whilst the number of ‘good’ rated care homes has fallen by -0.2%.

The East Midlands (+0.2%) and Yorkshire & The Humber (no change) have also remained amongst the top three for ‘inadequate’ rated care homes in the country. Surprisingly, however, despite having consistently high rates of ‘good’ and ‘outstanding’ care homes, the East of England holds the title for the highest rate of ‘inadequate’ care homes at 2.4%, up 0.1% since July 2022. This, much like the trends seen in London, could be a sign that quality and standards are beginning to relax in some care homes across this region, impacting their overall rankings and showing a need for support.

Our summary of third-quarter care rankings

Overall, similar trends are being seen across the CQC league tables: the number of high-performing care services is generally decreasing, with more care homes settling into middle-place or lower rankings.

In the case of regions that were already receiving a high number of ‘requires improvement’ or ‘inadequate’ ratings, a lack of improvement is certainly being seen, with no upturn yet.

There are a number of reasons why this may be the case – but our recommendation remains the same: if care home owners, managers and providers don’t address falling standards soon, the rates of poor assessments from the CQC will continue to rise. This is especially true for the East Midlands, Yorkshire & The Humber and West Midlands, which are consistently seeing low rankings in care service quality across the board.

For care investors and providers, this makes an opportunity to stand out in these regions by implementing and communicating better quality care, building a reputation among local communities for stand-out quality of care for residents to boost occupancy and make your care home more attractive for prospective employees, which will in turn help change these trends for the better. Our expert care consultants regularly work with care homes to help them improve their ratings from ‘requires improvement’ to ‘good’ and support them through every aspect of their service to ensure the best quality of care for their residents. This can ultimately build more confidence with the regulator and help to improve commercials.

If you need expert guidance and support in how to improve and retain better ratings, our expert consultants are here to help. Get in touch to find out how Fulcrum consultants can help to identify issues with a care service through audits, provide up-to-date training and mentoring for care home managers and staff, and give you peace of mind that your care service will shine amongst the trends in 2023.

If you want help improving or maintaining your rating, please get in touch for a free initial consultation.