The state of health care and adult social care in England 2025/26

The following analysis relates to 6,294 adult social care services (care homes, homecare and supported living) assessed under our current assessment framework. We have been using this framework since the beginning of 2024. During this time assessments have been largely risk based, so the services assessed may not be representative of all services across the sector.

Our ratings of care homes as at August 2026 show that more than 7 out of 10 of the 3,783 care homes assessed under our current framework are providing good (67%) or outstanding care (3%), while the remaining care homes required improvement (27%) or are providing an inadequate care service (3%) (figure 8).

Figure 8: 7 out of 10 care homes are providing good or outstanding care
Proportion of care homes rated using our current assessment framework with an overall rating of outstanding, good, requires improvement or inadequate, August 2026

Source: CQC, ratings data

Around 9 in 10 care homes are rated as good or outstanding for providing caring (89%) and responsive (88%) support. However, we found the most common problems are related to their leadership, as around a third of care homes were rated as requires improvement (31%) or inadequate (3%) for the well-led key question (figure 9).

An analysis of our assessment data looking specifically at the quality statements under the well-led key question identified concerns in governance, management and sustainability in particular, with shortfalls in standards identified for more than half (55%) of the care home assessments that looked at this quality statement. This quality statement relates to the requirement for services to have clear responsibilities, roles, systems of accountability and good governance. In a focus group to inform this year’s State of Care report, CQC inspectors and specialists fed back that the key concerns included leaders not having the time and support they need to provide good oversight and drive improvements, and not listening to staff or acting on their feedback.

Figure 9: Leadership issues identified in a third of care homes 
Key question ratings for care homes, rated using our current framework, August 2026

Source: CQC, ratings data

Regionally, for care homes assessed under our current assessment framework, those in the South West and London areas have the best ratings for the quality of care, with 82% and 80% rated overall as good or outstanding respectively. The North West has the poorest overall ratings for care homes, with only 59% of all assessed services rated as either good (56%) or outstanding (2%) (figure 10).

Figure 10: The quality of care homes varies across the country
Overall ratings for care homes rated using our current assessment framework by region, August 2026

Source: CQC, ratings data

In the homecare sector, as at August 2026 we have assessed 2,121 services under our current assessment framework since January 2024. Of these, 80% have been rated as either good (76%) or outstanding (4%), while 18% were rated as requires improvement and 2% as inadequate (figure 11).

Figure 11: 8 in 10 homecare services are providing good or outstanding care
Overall ratings for homecare services using our current assessment framework, August 2026

Source: CQC, ratings data

We have assessed 390 supported living services since January 2024, of which, 78% were rated as either good (74%) or outstanding (4%), while 19% were rated as requires improvement, and 2% as inadequate.