The number of care homes for adults in Scotland has declined by a fifth over the last decade.

A Public Health Scotland census showed there were 1,037 care homes for adults and 40,502 registered places on 31 March 2023, down by 19% and 5%, respectively on 31 March 2013.

The number of people aged 18 and over in care homes fell by 6% during the period to 34,365 from 36,578.

Estimated occupancy on 31 March 2023 was 85% compared with 86% on 31 March 2013.

While the number of residents in private sector care for older people rose by 2% (456) during the period, the number of local authority and not for profit residents fell by 33% (1,073) and 20% (812), respectively.

Scottish Care chief executive Donald MacAskill said there had been a shift in provision from small charitable and family businesses to larger organisations.

MacAskill added the “real story” was the “disproportionate loss” of care homes in rural and remote areas.

He said inadequate funding from the Scottish government and COSLA meant care homes were closing to state funded clients and only being available to private funders.

The current National Care Home Contract rate is £880, well below independent analysis of the true cost of nursing care of around £1,300-1,400, the Scottish Care head said.

“The state is simply not paying the true cost of viable and sustainable quality care,” said MacAskill. “Care homes cannot continue to plug that gap any longer and so whether as a charitable care home or private they are effectively no longer available to state funded individuals. The care home may remain open but is closed to state admissions.

“As more and more people are living with dementia the overall number of closures and reduction in last 10 years means we are simply not prepared for the number needed in the next 20. We need more, not less, even with people being supported in the community as it is clear that home care is on its knees too.”

A spokesman for Parklands Care Homes said: “The latest figures confirming a 19% drop in the number of care homes for adults in Scotland over the past decade should serve as a wake up call to ministers. The Scottish government needs to work urgently with the sector to ensure a sustainable future for social care.”

A Scottish government spokesperson said: “We are working with partners to improve social care services and deal with the challenges the sector faces. Adult social care support is vital to all who require additional support, whether that is to live independently at home, in the community, or to move into a care home.

“No one wants to see the closure of good quality care homes but unfortunately this can happen for a number of reasons, such as quality concerns or care homes changing ownership.

“We’ve increased funding and pay rises for social care support staff to help deal with the consequences of reduced staffing because of Brexit, the pandemic, and rising costs of energy and inflation, and are working towards our commitment to increase spend in social care by 25% by the end of this Parliament, an increase of over £840 million.”