What 21 billion care notes reveal about resident wellbeing: inside Person Centred Software’s national benchmark, the UK’s first for wellbeing in residential care.
Every day, in thousands of British care homes, care workers record how the people they look after seem: settled or agitated, engaged or withdrawn, having a good day or a hard one. Nobody had ever added it up. A new analysis by Person Centred Software (PCS) has found that, across six months of care records, 72.8% of wellbeing observations were positive.
The timing matters. In July, the Prime Minister committed to expediting Baroness Casey’s Independent Care Commission by a year, the most serious attempt at social care reform in a generation. That conversation has no shortage of evidence about system failures: unmet need, delayed discharge, low pay. It has almost none about daily life inside a care home. An inspection rating tells you whether a home meets a standard, not whether residents are having a good day.
The figure holds across the nation. Each of the UK’s eleven mainland regions recorded a positive majority, from 64.6% at the lowest to 80.4% at the highest.
None of which means the sector is comfortable. Workforce shortages, rising demand and financial strain are real and deserve attention, but they have also come to define public perception almost entirely. Research commissioned by PCS this year found that 41% of UK adults believe care homes are worse or no better than 10 to 15 years ago, a view shaped largely by media coverage rather than direct experience. The data suggests carers are delivering more than the public realises: helping residents rediscover hobbies, nurture friendships and live full lives. Those moments rarely make the headlines because wellbeing, unlike a fall count, has always been hard to measure. And what cannot be measured cannot be improved with rigour.
Thirteen years in the making
Closing that gap depends less on technology than on a decision taken thirteen years ago. In 2013, PCS chose to record care in a structured, standardised way, when most of the sector was still writing free-text notes. That choice has produced the UK’s largest structured social care dataset: more than 21 billion structured care observations, recorded consistently across more than 8,000 care homes, covering an estimated two-thirds of the UK’s residential care beds. Around 5,000 of those homes feed the national benchmark; homes can opt out, and some do. It could not be assembled retrospectively. It exists only because carers have recorded the same way, day after day, for over a decade.
How the measure works
That consistency is what makes objective wellbeing benchmarking possible, and it is what IQ, PCS’s care intelligence solution, was built to read. As part of everyday notes, carers record each resident’s wellbeing on a standard scale, from very happy to very unhappy. Applied across millions of observations, statistical methods turn these ratings into percentages comparable across homes and regions. For the past six months, IQ has analysed wellbeing across 68 care themes, with eight indicators now surfaced for care teams, from falls with injury and infection prevalence to hydration and, uniquely, resident happiness.
Happiness is captured six to ten times a day for many residents. A happiness percentage reflects who a home cares for as much as how residents feel: higher-needs residents require more check-ins and are more likely to record unhappiness. More interactions mean more notes reflecting difficult days, so the value lies in comparing homes with similar profiles rather than a single national ranking.
Engagement and happiness rise together
A second, independent measure points the same way. Carers also assess how engaged residents are in their home’s activities, and nationally 71.2% of assessments were positive. The two move together: regions with higher engagement also record higher happiness (r = 0.57). For care teams, that link is practical, because activity provision is a lever a home controls directly.
London: clinically strong, and happy
Homes in the capital recorded the joint-lowest rate of injurious falls, the lowest rate of inadequate fluid offered, the lowest unintentional weight loss and the fewest missed Malnutrition Universal Screening Tool (MUST) tasks of any English region, alongside the highest recorded happiness in the UK, at 80.4%.
Wales leads on safety
Wales leads on the measures that homes control most directly: the lowest infection prevalence in the UK, around half the national figure; the joint-lowest rate of injurious falls; roughly a third fewer missed care tasks than average; and care hours per resident, around 9% above the national average. Welsh homes also record wellbeing more often than anywhere else, around 20% more check-ins per resident than London. Differences like these are exactly why benchmarking should compare homes with similar needs rather than rely on a single ranking.
It’s how the hours are spent
Scotland recorded the fewest care hours per resident in the UK, around 20% below average, yet sits comfortably in the positive majority on both measures. The North East recorded the most care hours, 14% above average, and topped engagement at 73.0%. Together they suggest contact quality matters as much as quantity. On the old North-South rivalry, the data offers a gentler story: southern homes recorded slightly higher happiness, 73.7% against 71.0%, with engagement levels within a decimal point. Different regions have different strengths, and none holds a monopoly on good care.
What it means for providers
The practical value is comparison. Through IQ, homes can see how they stand against anonymised data from thousands of others on a previously unbenchmarked dimension, identifying strengths, gaps, and where to learn from peers. Some findings are unexpected: falls resulting in injury run at roughly 0.2 per care home per month across the dataset.
The same record is beginning to support earlier intervention, too. In homes piloting IQ’s next stage, changes in a resident’s pattern that are easy to miss day-to-day are surfaced for care teams to review so that a conversation can happen sooner. Safety, compliance and clinical quality will always be fundamental. What this analysis shows is that resident wellbeing deserves to be measured with the same rigour, and that, at last, it can be.
