Analysis of CQC Ratings of Care Home Business Performance in England: Implications for Quality Improvement

According to the most recent data provided by the Office for National Statistics (ONS) in 2023, there are 372,035 residents in care homes in England. Many of these residents experience a low quality of life due to poor service delivered in those facilities. The Care Quality Commission (CQC) strives to regulate the health and social business in the country to promote the health and well-being of these residents in care homes. CQC measures the quality of care services delivered in different care homes in England ranging from inadequate to outstanding, depending on the performance of the care homes in the different CQC domains (safety, caring, effective, responsive, and well-led). However, care homes in England are in different regions, and care home ownership types vary from for-profit, third-sector, or public ownership types. It is therefore paramount to investigate the relationships between the quality of care and location regions, ownership types, and care home closures. This study investigatesthe relationship between location regions of care homes and the quality of care services provided and evaluates the quality of care services delivered by different care homes in various local authorities in England. This study also further investigates the relationship between care home ownership type in England and the performance of care homes. It evaluates the relationship between ownership type on the closure of care homes in England, and the relationship between quality of care services and care home closures. A descriptive design was adopted for the study, using data from the CQC database on the active care homes in England and their ratings up to August 2024. The study's findings revealed a significant relationship between the care home location region and the quality of care service in England. Notably, the exceptionally high-quality performance of the care homes in the Northeast reflects an outstanding positive impact (compared to other regions in England) in the health and social care sector. Also, there is a significant relationship between care home ownership type and quality of care service. Most care homes in England are very caring, responsive, and effective; but many do not perform very well in terms of safety and leadership. Also, the proportion of highly rated care homes within each ownership type is highest for the public ownership type, followed by the third-sector, and lowest for the for-profit ownership type. Furthermore, there is a significant relationship between care home ownership type and care home closure. The findings of this study reveal that within each ownership type, a higher proportion of care homes are closed involuntarily by the CQC for the for-profit ownership type, compared to the third-sector and public ownership types; and a higher proportion of care homes are closed voluntarily for the public ownership type, followed by the third-sector and for-profit ownership types. Finally, there is a significant relationship between quality of care services and care home closure. The significant number of involuntary closures due to low overall quality ratings suggest that most care homes closed involuntarily due to low performance in the CQC domains; while, the high proportion of voluntary closure of care homes with high-quality ratings, suggests that those care homes did not close due to low performance in the CQC domains. Instead, the reasons for such closures might be attributed to other factors. Recommendations for future studies were made in this study.