Nearly 250 adult care homes have closed in Scotland over the past decade, according to the latest national census.

The figures from Public Health Scotland show that the total number of residential care homes has fallen by 19%, from 1,282 in March 2013 to 1,037 by March of this year.

There are signs that the trend has slowed in recent years, with an average of 31 premises closing annually between 2013 and 2018 compared to 18 per year between 2018 and 2023.

The fastest rate of closures has been seen for homes specialising in care for adults with learning disabilities and mental health problems, with numbers down by 37% and 27% respectively.

The number of care homes for the elderly - who account for over 90% of all care home residents - declined by 13% over the decade, from 911 to 792.

Rising utility costs, staff shortages and the expense of providing nursing care to the growing percentage of residents with complex care needs, such as advanced dementia, has been blamed for the trend. 

The Scottish Government has committed to increasing the hourly wage for care workers to at least £12/hour from April 2024 as part of efforts to improve staff retention in the sector. 

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Dr Donald Macaskill, CEO of Scottish Care - the umbrella body for private operators - said many smaller premises are struggling as a result of factors such as increasing utility costs, staff shortages 

He said: "What we are finding increasingly is particularly rural and remote and small care homes and charitable-run homes are having to close at a rate that we've never experienced before. 

"The data may indicate just a marginal change but it's the story which lies behind that of care homes being taken over by other organisations, the changes that that brings because smaller family-run businesses and charities aren't able to make the sums add up."

The total number of registered places within all adult care homes in Scotland has also fallen by 5% over the decade, from 42,755 to 40,502, as operators have consolidated services into larger premises.

The percentage occupancy has remained stable and was 85% in the year ending March 2023.

Care home fees have increased substantially, however.

By the end of March this year, a self-funded care home resident requiring nursing care was paying £1,328 a week on average, compared to £728 a week in 2013.

This compared to £910-a-week for a resident requiring nursing care whose fees were covered by the state.

Self-funded residents have seen their weekly costs increase by more than 80% over the past decade, compared to an increase of around 50% for the costs charged to councils.

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The Herald: The gap in charges between self-funding and council-funded care home residents has widenedThe gap in charges between self-funding and council-funded care home residents has widened (Image: PHS)

In Scotland, as of April 2023, anyone with capital over £32,750 - such as property or savings - is required to cover their care home fees in full.

Residents become exempt once their capital falls below £20,250.

Most care homes for older people have a mixture of self-funded and publicly funded residents, but Public Health Scotland noted that the difference between what they are charged has been widening in recent years.

It said: "The gap between the cost of publicly funded and self-funded care has grown between 2013 and 2023, particularly since around 2015.

"Until around 2014, the average gross weekly charge (with nursing care) was broadly comparable to the expected charge adjusted for inflation, for self-funded and publicly funded long stay residents.

"Since then, the actual weekly charge has been higher than the expected charge adjusted for inflation, especially for self-funded residents. This has become particularly pronounced since around 2017."

The number of care homes run by voluntary or not for profit operators and by local authorities or health boards have declined by 38% and 27% respectively over the past decade, compared to a slower decline of 5% for those operated by the private sector.

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Public Health Scotland said this meant that the "percentage of care homes for older people run by the private sector increased from 69% (633 out of 911) of the total in 2013 to 76% (602 out of 792) in 2023".

Around 80% of all care home residents are now in private-run premises.