Deaths of care home residents, England and Wales: 2022

• In England, there were 126,488 deaths of care home residents registered in 2022 (wherever the death occurred); this is a decrease of 0.5% compared with 2021 (127,171 deaths), and a decrease of 3.1% compared with the five-year average between 2016 and 2021 (130,520 deaths, excluding 2020).

• In Wales, there were 6,844 deaths of care home residents registered in 2022 (wherever the death occurred); this is an increase of 3.5% compared with 2021 (6,612 deaths), and a decrease of 1.9% compared with the five-year average between 2016 and 2021 (6,975 deaths, excluding 2020).

• England had a statistically significantly higher age-standardised mortality rate for male care home residents compared with Wales (11,823 and 9,397 deaths per 100,000 male care home residents, respectively); the difference between female care home residents in England and Wales was not statistically significant (9,692 and 9,389 deaths per 100,000 female care home residents, respectively).

• In England, the North East was the region with the overall highest mortality rate (12,413 deaths per 100,000 care home residents) and London was the region with the lowest (8,769 deaths per 100,000 care home residents).

• Dementia and Alzheimer's disease was the leading cause of death in both male and female care home residents in England (accounting for 29.1% and 36.6% of deaths, respectively) and Wales (30.6% and 38.2%, respectively) in 2022.

• Most deaths of care home residents occurred within the care home or in hospital for both England (87.2% and 12.5%, respectively) and Wales (83.5% and 16.4%, respectively).

For further information about this statistical bulletin (previously titled Deaths in the care sector, England and Wales), please refer to our Deaths of care home residents, England and Wales Quality and Methodology Information (QMI) report and our Deaths of care home residents: quality assurance of administrative data methodology.

The term “care home residents” used in this bulletin refers to all deaths where either:

• the death occurred in a care home
• the death occurred elsewhere, but the place of residence of the deceased was recorded as a care home

Comparator figures from the Care Quality Commission (CQC) and Care Inspectorate Wales (CIW) are available in our accompanying dataset.

In 2022, there were 126,488 deaths of care home residents registered in England (47,424 male deaths and 79,064 female deaths), a 0.5% decrease in deaths registered compared with 2021 (127,171 deaths).

In Wales, there were 6,844 deaths registered in 2022 (2,373 males and 4,471 females), a 3.5% increase in deaths registered compared with 2021 (6,612 deaths).

The Care Quality Commission (CQC) receives death notifications from care home providers in England, while Care Inspectorate Wales (CIW) receives notifications for Wales. Deaths notified to these bodies are available in our accompanying dataset.

Age-standardised mortality rates

Age standardised mortality rates (ASMRs) account for population size and age structure (see Section 10: Measuring the Data).

In England, ASMRs for deaths of care home residents in 2022 were 11,823 deaths per 100,000 male care home residents, and 9,692 deaths per 100,000 female care home residents.

For Wales, ASMRs for deaths of care home residents in 2022 were 9,397 deaths per 100,000 male care home residents, and 9,389 deaths per 100,000 female care home residents. The ASMR for females has increased slightly from 2021 (8,562 deaths per 100,000 female care home residents), this is largely because of a slight increase in deaths of female care home residents aged 64 years and under in 2022 (83 deaths) compared with 2021 (68 deaths).

Compared with England, Wales had statistically significantly lower ASMRs for deaths of care home residents for males; however, deaths for female care home residents were not statistically different.

In England, the North East had the highest age-standardised mortality rate (ASMR) for male and female care home resident deaths (14,018 deaths per 100,000 male care home residents and 11,519 deaths per 100,000 female care home residents). London had the lowest ASMR for both males and females, with 9,951 deaths per 100,000 male care home residents and 7,925 deaths per 100,000 female care home residents.

Wales had the lowest ASMR for males compared with the regions in England, with an ASMR of 9,397 deaths per 100,000 for male care home residents. Females in Wales had the second lowest ASMR compared with the regions of England (9,389 deaths per 100,000 female care home residents).

For numbers of deaths registered by local authority, see our accompanying dataset.

In 2022, most deaths of care home residents registered in England occurred within care homes (87.2%, 110,355 deaths), compared with 12.5% that occurred in hospital (15,774 deaths) and 0.3% occurring elsewhere. Care home resident deaths in Wales follow a similar pattern, with 83.5% of deaths occurring in a care home (5,712 deaths), compared with 16.4% of deaths occurring in hospital (1,120 deaths) and 0.2% occurring elsewhere.

Leading cause of death groupings are based on categories developed by the World Health Organisation (see Section 10: Measuring the data). Table 1 shows the top five underlying causes of death registered among care home residents for England and Wales. For a full list of leading causes, see our accompanying dataset.

Dementia and Alzheimer’s disease was the leading cause of death in all male care home residents aged 65 years and over in both England and Wales.  For male care home residents aged 64 years and under, malignant neoplasm of the brain and ischaemic heart disease were the leading causes of death in England and Wales, respectively. Dementia and Alzheimer’s disease was the leading cause of death in female care home residents of all age groups in both England and Wales.

For breakdowns of leading causes of death by age group, see our accompanying dataset.

Age-standardised mortality rates

Age-standardised mortality rates (ASMRs) are used to allow comparisons between populations that may contain different proportions of people of different ages. These are a better measure of mortality for use in comparison than the number of deaths because they account for the population size and age structure. The 2013 European Standard Population is used to standardise rates.

Care home resident

The term “care home residents” used in this bulletin refers to all deaths where either:

• the death occurred in a care home
• the death occurred elsewhere, but the place of residence of the deceased was recorded as a care home

The figures should not be confused with "deaths in care homes" as reported in other releases, which refers only to deaths which occurred in a care home.

The information presented in Section 10: Measuring the data of our previous release is still applicable for this release of deaths of care home residents registered in 2022.

Age-standardised mortality rates

We publish internationally recognised age-standardised mortality rates (ASMRs) to facilitate comparisons, and these are calculated using the same methods as for all of our mortality releases, as explained in our Mortality statistics in England and Wales Quality and Methodology Information (QMI) report.

Since publishing our previous release, care home population numbers from Census 2021 have been used to calculate ASMRs. This accounts for the impact that the coronavirus (COVID-19) pandemic may have had on the care resident population because of excess deaths of care home residents and fluctuations in occupancy rates. For details of the populations, see our accompanying dataset. For future releases we will be looking to use a more up-to-date source.

Collaboration

In the development of this bulletin, we have worked closely with partner departments across government, including the Care Quality Commission (CQC) and Care Inspectorate Wales (CIW). For more information, please see Section 10: Measuring the data in our previous release.

Coding of deaths

The information presented in Section 10: Measuring the data of our previous release is still applicable for this release of deaths of care home residents registered in 2022.

For further information on how deaths are coded for this release, see our Deaths of care home residents, England and Wales QMI or Section 9: Cause of death coding of our User guide to mortality statistics.

Methodology guides

Information on the quality of data included in this release can be found in our Deaths of care home residents: quality assurance of administrative data methodology. Quality and methodology information on strengths, limitations, appropriate uses, and how the data were created for this release is available in our Deaths of care home residents, England and Wales QMI.

Our User guide to mortality statistics provides further information on data quality, legislation and procedures relating to mortality, and includes a glossary of terms.

The Revisions policy for population and international migration statistics (including mortality statistics) is also available.

Feedback

Comments on this release are welcomed. Feedback can be emailed to social.care@ons.gov.uk.

The strengths and limitations of Office for National Statistics (ONS) care home resident mortality data for England and Wales are the same as those summarised in Section 4: Quality summary of our Mortality statistics in England and Wales Quality and Methodology Information (QMI) report.

The information presented in Section 11: Strengths and limitations of our previous release is still applicable for this release of deaths of care home residents registered in 2022, apart from a change to the years used for the five-year average.

A five-year average of death registrations is presented to ensure that patterns in death registrations are comparable over time without the effect of year-on-year fluctuations.

For this release, covering deaths registered in 2022, a five-year average was calculated using the years 2016, 2017, 2018, 2019 and 2021. This is because of the impact of the coronavirus (COVID-19) pandemic on deaths registered in 2020. For further information on calculating five-year averages for mortality statistics following the pandemic, see our Understanding excess deaths during a pandemic blog.