Around 223,000 fewer adults in England get council-funded long-term care than 20 years ago

A quarter fewer people get council-funded care than 20 years ago

Around 223,000 fewer adults in England were receiving council-funded long-term care at the end of 2024/25 than 20 years earlier, the Care Quality Commission found in its State of Care report for 2025/26 (opens in a new tab).

That is a decrease of about 25% (from nearly 895,000 at the end of 2003/04 to just over 672,000 at the end of 2024/25), according to CQC's figures on requests and capacity (opens in a new tab).

The council-funded base that providers and commissioners plan around is a lot smaller than it was. The people outside it have not vanished. They are paying for themselves, leaning on family or managing without.

Councils spend more, overspend anyway, and the means test has not moved

This is not a story of councils cutting their spending. After adjusting for inflation, councils spent more on adult social care in 2024/25 than at any point since 2008/09, as the chart below shows. Spending has increased while the number of people getting long-term support has decreased.

The money still does not stretch. Councils across England are overspending their annual adult social care budgets by £715 million, and more than three-quarters of total council budgets now go on adult and children's social care. That leaves commissioners little room to widen who gets support.

The upper capital threshold for state-funded care has stayed at £23,250 for around 15 years. In CQC's view, fewer people now qualify for fully state-funded care, and more must self-fund, rely on unpaid carers or go without. Our guide to what a care home costs explains how the threshold works.

Requests keep coming, and most end with information

Demand has not shrunk with the numbers supported. Just over two million new requests for council-funded support were recorded in 2024/25, continuing a rise in recent years.

For 70% of those new requests, no further action beyond providing information was recorded (opens in a new tab). That figure does not prove unmet need: some people only need advice or signposting, and the published figure does not separate them out.

The number has increased again, but the 20-year figures do not say why

There is a case against reading this as pure decline. The number receiving long-term council-funded support has increased by 10% since its low point in 2021/22.

The 20-year comparison also has limits. It cannot show how much of the decrease reflects falling need, tighter assessment or tight budgets, or whether councils recorded activity the same way throughout. Read it as the scale of change, not a measure of who is going without today.

More agencies do not mean more usable care

The market is growing, just not in a shape that helps commissioners much. Homecare registrations passed 13,500 after 700 more services registered in the year to April 2026, Disability News Service reports from CQC's findings (opens in a new tab).

Around 30% of homecare services in April 2026 cared for four or fewer people, based on CQC's analysis of provider fee data as reported by Disability News Service. The regulator warns this adds complexity to allocating packages, managing contracts and coordinating care. Spread packages across many small agencies and some will not have enough hours to run well.

Care homes are going the other way. The number of homes in England decreased by 8% since April 2019 while beds stayed broadly stable, according to CQC's analysis of care home consolidation (opens in a new tab).

One US-based real estate investment trust, as both operator and owner, now holds 9% of all CQC-registered care home beds in England. The regulator is "watching carefully" the growth of institutional investors (opens in a new tab) in case it threatens plans for a National Care Service, BBC News reported.

Who picks up the people councils no longer fund?

Care England backed CQC's call for a clearer vision on social care reform (opens in a new tab). Care sector leader Mike Padgham argued the "care market must be shaped around people's needs" (opens in a new tab) and called for urgent action on funding and commissioning, as covered in our earlier report on his response.

Councils fund far fewer people long term than 20 years ago, and the market is being shaped by tiny agencies at one end and large investor owners at the other. Can either be steered towards the people left outside council support?