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Section One: Care Homes for Older People

Table 1 - Care Homes by Sector, Places and Residents, March 2005

Table 2 - Care Homes, Places, Residents by Sector / Places per 1,000 Population, 2000 - 2005

In March 2005 there were 980 care homes for older people (20 of which were specifically for those with dementia). This compares to 1,060 care homes for older people in March 2000 and represents a reduction of 80 homes over this 5 year period.

The 38,327 registered places in March 2005 represent 46.4 places per 1,000 population and consists of 5,849 places (15 per cent) in the Local Authority/ NHS sector, 27,965 places (73 per cent) in the private sector and 4,513 places (12 per cent) in the voluntary sector. Between March 2000 and March 2005 the total number of registered places fell by 753 (1.9 per cent) although this figure has increased in each successive census since

March 2003 as chart 1 illustrates. The change in registered places between March 2000 and March 2005 varied between sectors. In the Local Authority/ NHS sector there had been a decrease of 611 registered places (9.5 per cent) whilst in the private sector there had been a small increase with an additional 142 places (an increase of less than 1 per cent). Finally, in the voluntary sector there had been a decrease of 284 places (a reduction of 5.9 per cent).

During the same period, the number of residents had fallen by 766 (2.2 per cent) from 34,355 to 33,589.

Of the 38,327 registered places, 33,636 were occupied on census night with an additional 772 places unavailable. Unavailable places are places that are temporarily or permanently out of use, perhaps due to refurbishment or building work. The remaining 3,919 registered places were vacant on the night of the census. The occupancy rate (occupied or unavailable places as a percentage of all places) was therefore 89.8 per cent.

Table 3 - Registered Places in Care Homes for Older People, Local Authorities with the Largest Increases/Decreases

Source: SCHC1 March 2005

Table 3 shows the local authorities with the largest increases and decreases in the number of registered places in care homes for older people between March 2000 and March 2005. Annex B contains details of registered places for each census between these dates for all local authorities.

The biggest increase in registered places since March 2000 has occurred in South Lanarkshire where the number of registered places has risen from 2,506 in March 2000 to 2,949 in March 2005 (a 17.7 per cent increase). This is despite a recent decrease in places in South Lanarkshire, the number having fallen from 3,006 in March 2004. Since March 2000, the number of care homes in South Lanarkshire has increased by 2. Other local authorities to have experienced large increases in the percentage of registered places were Clackmannanshire, where an additional 31 places had been added since March 2000 (an increase of 15.3 per cent), Fife, where there had been a 12.4 per cent increase in the number of places since March 2000 and North Lanarkshire where the figure was 11.9 per cent.

The biggest percentage decrease in the number of registered places since March 2000 occurred in Aberdeen City. Here there had been a 16.4 per cent decrease, a reduction of 310 places. This corresponded to a net decrease of 6 homes over the same period. Other local authorities to have experienced a large decrease were the City of Edinburgh (a 12.9 per cent reduction in the number of places and a net decrease of 14 care homes), Stirling (11.5 per cent) and Dundee City (also 11.5 per cent).

Overall, across Scotland there had been a 1.9 per cent reduction in the number of registered places in care homes for older people. This corresponds to a decrease of 753 places.

Registered places and Occupancy Rates in Care Homes for Older People by Local Authority: March 2003 - March 2005

Table 4, below, shows the number of occupied, vacant and unavailable places in care homes and the number of places registered per 1,000 population aged 65 and over by local authority. It also provides the occupancy rates for March 2003 - 2005 by local authority. The occupancy rate is based on occupied and unavailable places as a share of total registered places. Information on unavailable places was first collected in March 2003.

An occupied place is one which currently has a resident or is committed to a resident who is temporarily absent (for example in Hospital). Places may be unavailable for a number of reasons including redecoration, reduced staffing and building works.

Across Scotland there were 46.4 registered places in care homes for older people for every 1,000 of the population aged 65 and over. This ranged from 29 in the Orkney Islands to 61.3 in South Lanarkshire.

South Lanarkshire also had the second lowest occupancy rate of all local authorities in Scotland. The occupancy rate in

Table 4 - Occupied, Vacant and Unavailable Registered Places by Local Authority Care Homes for Older People

Source: SCHC1 March 2005

South Lanarkshire in March 2005 was 85.4 per cent. In the previous three censuses, South Lanarkshire had the lowest occupancy rate. This position is now held by North Lanarkshire where the occupancy rate on 31 March 2005 was 81.7 per cent.

Across Scotland as a whole the occupancy rate was 89.8 per cent, the lowest level since this information was first collected in March 2003, down from 90.8 per cent in September 2004 and from 92.6 per cent in March 2003. For the second census in succession the highest occupancy rate was in Dundee City where 94.8 per cent of available places were either occupied or unavailable although this was down from 98.1 per cent in September 2004. Dundee City had 38.3 places per

1,000 population aged 65 and over, one of the lowest levels of all local authorities.

Care Homes for Older People: Facilities

Table 5: Facilities in Care Homes - March 2005

Source: SCHC1 March 2005

On census night a total of 37,555 places were either occupied or vacant across all care homes in Scotland. Of these 32,248 (86 per cent) were in single bedrooms, 4,954 (13 per cent) were in double bedrooms and 353 (around 1 per cent) were in bedrooms with 3 or more places. Since March 2003 there has been a small increase in the proportion of places in single bedrooms (up from 83 per cent) and a corresponding reduction in the percentage in double bedrooms (down from 16 per cent). Annex C provides the percentage of available places in single rooms for the Local Authority/ NHS sector and the private/voluntary sector for each local authority. In the Local Authority/ NHS sector 5,387 of the 5,607 available places (96 per cent) were in single rooms. In 17 of the local authorities 100 per cent of the available places were in single rooms and in all but one of the local authorities more than 87 per cent of places were in single rooms. In the private/voluntary sector 84 per cent of the available places were in rooms with one place registered. This included all available places (100 per cent) in Shetland Isles. More than three quarters (75 per cent) of all places were located in single rooms in 27 of the 32 local authority areas.

Table 6: Ensuite Facilities in Care Homes March 2003 - March 2005

Source: SCHC1 March 2005

As table 6 shows, en-suite facilities were available in just over two third of all available places (25,140 places or 67 per cent). The proportion of available registered care home places with en-suite facilities has remained steady at 67 per cent since 30 September 2004, the number of places offering en-suite facilities having increased by 107 and the number of places without en-suite facilities having reduced by 130. Ensuite facilities were available in 70 per cent of places in single bedrooms.

Annex D shows the number and percentage of rooms with en-suite facilities split between the Local Authority/ NHS sector and Private/Voluntary homes. This shows that, across Scotland, in the Local Authority/ NHS sector 2,012 of the 5,607 available places (36 per cent) had en-suite facilities whilst 72 per cent of all private/voluntary homes had en-suite facilities.

There is also significant variation in the proportion of rooms with en-suite facilities between local authorities. In the Local Authority/ NHS sector all of the available places in East Renfrewshire, Shetland Isles and South Lanarkshire had en-suite facilities. By comparison none of the available places in this sector in North Ayrshire, Midlothian, East Ayrshire, Renfrewshire or Clackmannanshire offered en-suite facilities.

In the Private/Voluntary sector all of the available places in Clackmannanshire and the Shetland Islands had en-suite facilities whilst none of the 16 available places in Orkney Islands were en-suite. In 14 of the 32 local authorities more than 75 per cent of places had en-suite facilities in this sector.

Overall, since March 2003, the proportion of places with en-suite facilities has risen from 61 per cent.

Care Homes for Older People: Closures and New Homes

Table 7: Care Home Closures by Sector

Source: SCHC1 March 2005

Table 7 shows that 7 care homes closed between September 2004 and March 2005. Whilst this is lower than in previous census periods, there were 25 closures in the year between March 2004 and March 2005, up from 23 in the previous year. The 7 homes that closed had an average of 21.7 places compared to the average size of all open care homes on 31 March 2005 of 39.1 places. Indeed, since March 2000, the average size of the 146 care homes which have closed was 23.9 places whilst the average size of all care homes open on a census night has ranged from 36.9 to 39.1 places during this period. Of these home closures the majority, 97 homes (66.4 per cent of closed homes) operated in the private sector. This is comparable to the 65.6 per cent of homes open on 31 March 2005 which were in the private sector. The average size of these closed homes was 22.4 places compared to an average of 43.5 places in privately operated homes open on the census night. Twenty-nine closed homes (19.9 per cent of closures, again comparable to the 18.9 per cent of open homes that operated in this sector on census night) were local authority run homes and had an average size of 27.5 places compared to 31.6 places in homes open on 31 March 2005. The remaining 20 closures (13.7 per cent) operated in the voluntary sector. On census night 15.5 per cent of open homes were in this sector. The average size of these closed homes was 25.9 places compared to an average size of 29.7 places amongst voluntary homes open on the most recent census night. Annex E provides a local authority split of care home closures between March 2000 and March 2005.

The 48 care homes which have closed between March 2003 and March 2005 provided a total of 1,181 places before closing, as shown in table 7. Of these, 931 places were available and, amongst these, 259 (or 27.8 per cent) had en-suite facilities. This compares to 67 per cent of places in homes open on 31 March 2005. In addition, of the 931 places available in these homes before they closed, 634, or 68.1 per cent of available places, were in single rooms. Amongst all care homes for older people open on 31 March 2005, 86 per cent of places were in single rooms.

Care Homes for Older People: Newly Opened Care Homes

Table 8: New Care Homes by Sector

Source: SCHC1 March 2005

Since March 2000, 68 care homes have opened in Scotland. Over 60 per cent of these (41 homes) opened in the private sector whilst 15 homes opened in the local authority sector (22 per cent) and the remaining 12 (18 per cent) were run by voluntary organisations. These 68 new care homes offered a total of 2,639 places upon opening and had an average of 38.8 places varying from 51.4 places in new private sector homes to 18.9 places in new homes in the Local Authority sector. The average size of new voluntary sector care homes was 20.6 places. Annex E provides details of new care homes which opened between March 2000 and March 2005. The information is split by local authority.

Table 9: Facilities in New Care Homes and Closed Care Homes since March 2003

Source: SCHC1 March 2005

Table 9, above, shows that since March 2003 a total of 33 care homes have opened. Upon opening, these homes offered a total of 1,610 places and of these, 1,472 (91.4 per cent) had en-suite facilities and 1,528 (94.9 per cent) were in single rooms.

Care Homes for Older People: Registered Places per Care Home

Table 10: Size of Care Homes - March 2005

Source: SCHC1 March 2005

Table 10 and chart 2 show the number of homes with different numbers of places in each sector.

Over 40 per cent of all care homes for older people (400 homes) had between 20 and 39 registered places and this was the most common care home size in each of the 3 sectors.

Of the 185 care homes in the local authority sector, 131 had fewer than 40 places (70.8 per cent) and all but one home had fewer than 60 places. There was a similar distribution in the voluntary sector with 118 of the 152 care homes in this sector (77.6 per cent) offering less than 40 places and all but 8 care homes (5.3 per cent) offering fewer than 60 places. In the private sector, larger homes were more prevalent. More than half of the 643 care homes in this sector offered 40 or more places (324 homes or 50.4 per cent) and 20 of these (3.1 per cent) offered 100 places or more. From table 1, there was an average of 39 places in care homes for older people on the most recent census night. This varied between sectors with an average of 32 places in homes operated by Local Authorities/ NHS, 43 in the private sector and 30 in the voluntary sector. When compared to the average home sizes in March 2000 this represents an increase in the average size of private care homes from 40 places whilst the average size has fallen by around one place in local authority run homes and has remained stable in voluntary homes. Overall, the average size of a care home for older people has risen from 37 to 39 places since March 2000.

Care Homes for Older People: Admissions, Discharges & Deaths

Table 11, below, shows the number of residents in care homes on 30 September 2004 and on the most recent census night, 31 March 2005 along with admissions, discharges and deaths in the intervening period. On 30 September 2004 there were 33,983 residents in care homes, 33,060 of these were long stay residents and 923 were short stay. Over the subsequent 6 months, there were 16,221 admissions and 16,615 deaths and discharges. Thus, on the most recent census night there were 33,589 residents in care homes for older people. Nine hundred of these were short stay residents and the remaining 32,689 were long stay residents. There has been a decrease of 394 residents between these two census periods; this is around 1.2 per cent of the residents in care homes on 30 September 2004.

Of the 16,221 admissions during the 6 months between 30 September 2004 and 31 March 2005 7,007 (or 43 per cent) intended at admission to be resident for 6 weeks or more. The remaining 9,214 (57 per cent) consisted of residents for whom the predominant reason for admission was to provide respite care or whose intention was to stay for less than 6 weeks.

Table 11: Number of Admissions, Discharges and Deaths in Homes for Older People September 2004 - March 2005

Source: SCHC1 March 2005

In care homes run by local authorities or by the NHS there were a total of 5,231 admissions. These accounted for 32 per cent of all admissions (11.8 per cent of all long stay and 47.8 per cent of all short stay admissions). In the Local Authority/ NHS sector, the majority of admissions (84.2 per cent) were for short stay or respite.

In the private sector there were a total of 9,132 admissions, 5,504 (60.3 per cent) of which were long stay and 3,628 (39.7 per cent) short stay. In total these represented 56.3 per cent of all admissions and included 78.6 per cent of all long stay and 39.4 per cent of all short stay admissions.

Admissions in the voluntary sector accounted for the remaining 11.5 per cent of all admissions including 9.6 per cent of all long stay and 12.8 per cent of all short stay admissions.

Between 30 September 2004 and 31 March 2005, 11,201 residents were discharged from care homes. Two thousand and eighty six of these discharges were long stay residents and 9,155 were short stay residents. Discharges from local authority run homes accounted for 43.6 per cent of all discharges whilst 43.8 per cent of all discharges were of residents in the private sector and 12.6 per cent were in the voluntary sector.

During the 6 months preceding the most recent census 5,414 care home residents died.

Of these the majority, 5,292 (97.7 per cent) were long stay residents and 4,276 of these were in the private sector.

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