Over 500 care homes in England waiting 8 years for inspection
Backlog grows as CQC promises to step up visits
523 care homes in England have not been inspected by the Care Quality Commission (CQC) for at least eight years, new analysis reveals.
The backlog has grown sharply since the pandemic, although the first significant increase appeared as early as 2017.
The analysis also shows that the average care home in England has gone over four years without a full inspection.
Outdated ratings raise concerns that standards in some care homes may have declined without being identified by the regulator.
An Age UK spokesperson said: “Delays to care home inspections mean older people being placed at unnecessary risk by poor quality homes not complying with standards. This is unacceptable and needs to be urgently addressed.”
Families searching for a care home may be relying on an indicator that no longer reflects the current quality of care. Some well-rated homes may have declined, while others may have improved but still carry lower ratings. An alternative is for families to assess homes by visiting in person, speaking to staff and asking questions.
Andy Gill, founder of Dementia Active, a charity providing social activity groups for people with dementia, said: “From our work with families at Dementia Active, one of the biggest challenges is that moving into a care home is rarely just a practical decision - it is an emotional one.”
He added that decisions are often being made under significant time pressure: “A hospital admission, a fall, a carer becoming unwell, or a sudden deterioration can force families into making choices quickly.”
This can make visiting a care home beforehand difficult in practice.
Mr Gill added: “My advice is always to start exploring options earlier than feels necessary. Looking early does not mean acting early.”
In response to the new findings, Chris Badger, the Chief Inspector of Adult Social Care at the CQC, told us: “We know that we need to increase our rate of assessments to make sure that we update the ratings of providers and give the public confidence in quality of care.”
The CQC is the independent regulator of health and social care in England, overseeing around 12,000 care homes, as well as hospitals, GP practices and other services.
The regulator has faced significant scrutiny in recent years. A review conducted in 2024 found serious organisational failings, impacting its ability to carry out regular assessments. The number of inspections fell from almost 15,800 in 2019 to 6,700 in 2023. The CQC accepted the review’s recommendations at the time.
Following this latest analysis, the regulator reaffirmed its commitment to increasing the rate of inspections.
Mr Badger said: “In the short term, we are making progress and on track to meet assessment targets as agreed with the Department of Health and Social Care.”
Previously, care homes received two full inspections each year: one announced, and one unannounced - a standard that has not been met since 2016.
Now, the CQC says it collects other information to monitor care homes continuously and direct resources to the highest-risk settings. This includes safeguarding concerns, as well complaints and feedback from staff, carers, and families, with the aim of carrying out responsive inspections where risks are greatest.
Mr Badger added: “When people share their concerns about poor care with us, they can have confidence that we will act to hold providers to account to ensure people are kept safe and treated with the dignity and respect they deserve.”
Some operators suggest the current approach is insufficient. Methodist Homes (MHA), a not-for-profit operator of 71 homes, says 10% of their homes have not had a full inspection in nine years. While it values the CQC’s work, it is calling for a higher inspection rate.
MHA said: “Our biggest ask of CQC is that they increase the rate of inspections they carry out, so no service has an inspection report which is more than five years old, as old inspection reports do not reflect current practice in a home.”
Where care home operators change ownership, new operators also inherit existing ratings, meaning any improvements made after a takeover may not be reflected for several years.
MHA added: “All inspections also need to look at the whole service rather than focus on specific areas where concerns might have been raised.”
It also said inspections play a wider role in sharing good practice across the sector, which can be limited when fewer inspections are being carried out.
The new figures suggest a growing backlog that could prove increasingly difficult for the CQC to address.
An Age UK spokesperson said: “Regulation of the care industry has been repeatedly cut back over the years due to cuts in funding and this issue is not going to be resolved without fundamental reform.”
“The Government has to recognise that up-to-date information, regulation and inspection is essential to help older people and their families make decisions about services about care in later life.”