Scotland’s care bed supply to be in circa 30,000 deficit by 2036
Specialist business property adviser, Christie & Co, has launched its ‘Scottish Healthcare Market Review 2026’ report, which analyses the supply and demand for new build and development across Scotland’s elderly care market. The report begins with an analysis of the elderly care home sector in Scotland. According to Christie & Co, there are 772 care homes across Scotland, with an average size of 47 beds, which equates to circa 36,000 beds in total. Only 55 % of these homes are purpose-built, 87 % have en suite facilities, and just 36 % have wetrooms. However, the Care Inspectorate’s Care Homes for Adults – The Design Guide 2026 confirms that all new developments must incorporate full wetroom provision, meaning much of the existing provision will struggle to meet required standards.
The Care Inspectorate has also confirmed that new registrations and newly built care homes can now be brought forward at capacities of up to 100 beds, which is a positive and enabling clarification for larger-scale developments. However, while this provides welcome flexibility in design and master planning, there remain important operational considerations around staffing models, including the need to maintain appropriate staffing ratios per unit to ensure safe, high-quality care. Developers and operators will therefore still need to demonstrate that workforce planning, unit configuration, and care delivery structures are robust and sustainable at this scale.
With an average house price in Scotland of £194,000, 34 % of the country’s population owns their home outright. Despite this, there are pronounced regional disparities in affluence, reflected in the wide range of average house prices across local authorities, with more affluent areas such as East Renfrewshire, the City of Edinburgh, and East Dunbartonshire commanding prices well above £280,000, compared with more economically-challenged regions like Inverclyde, North Ayrshire, and West Dunbartonshire, where values sit closer to between £120,000 and £150,000. These differences not only highlight concentrations of wealth around the Central Belt and major employment hubs, but also signal a stronger potential for private pay care resident demand in higher value markets, where household wealth and property equity are typically greater.
Closures & Openings
Between 2021 and 2025, 81 care homes closed across Scotland, totalling 2,637 beds lost. The average size of these homes was 33 beds, with 69 % having en suite provision.
Meanwhile, 55 care homes opened across Scotland, totalling 1,999 new beds, which indicates a net loss of 638 beds over the four years. 14 of the homes that opened were purpose-built – equating to an average of 3.5 new schemes per year – which typically offer full wetroom provision and have an average registration capacity of around 65 beds. The remaining openings comprised newly registered services, including reopened care homes and facilities converted for care use.
New Build Development Activity
Between 2021 and 2025, 47 new care home development schemes were approved across Scotland, representing a pipeline of 2,489 additional beds. This development activity remains heavily concentrated in Scotland’s Central Belt, with smaller clusters of activity emerging in the northeast and parts of the Highlands and Islands, where schemes typically aim to address gaps in provision within more rural or remote communities.
Most new care home projects are being advanced by private operators and developers. However, an increasing number of mixed-use housing schemes now include care provision, and several local authorities are also bringing forward their own developments. This reflects a growing blend of public and private sector activity across the market.
Following the removal of the 60-bed cap on care home developments, Christie & Co expects renewed momentum in the Scottish pipeline as operators gain greater flexibility to progress larger, more commercially viable schemes. This policy shift is likely to stimulate further investment across both urban centres and underserved rural areas, helping to deliver a broader range of modern, purpose-built facilities.
Under the revised guidance, homes accommodating 61 to 80 residents must appoint a deputy manager with 100 % supernumerary time. For developments hosting 81 to 100 residents, each unit must have a dedicated unit manager with at least 50 % supernumerary time. In practical terms, these requirements may influence how developers structure and phase larger schemes.
Christie & Co – Forecasting
While 21 % of Scotland’s current population is over 65, it is anticipated to grow to 25 % over the next 10 years. Similarly, Christie & Co data suggests that the demand for elderly care beds will increase by 12 % by 2031 and 32 % by 2036. There will also be a substantial rise in the prevalence of specialist chronic, age-related conditions like dementia, which will not only increase overall demand for care but will also heighten the need for high acuity, specialist dementia care facilities capable of supporting individuals with advanced and complex needs.
Christie & Co also assessed future bed requirements based on the number of en suite beds (the minimum market standard) and the need for wetroom provision (full-market standard beds), and highlighted a current undersupply of 19,793 wetroom beds across Scotland, which is forecasted to increase to a shortfall of 21,434 by 2031 and a staggering 27,683 by 2036.
Martin Daw, regional director – Scotland, Christie & Co, outlines the opportunities for operators and developers in the market, “Unlike many parts of the UK, Scotland has, in recent years, been overlooked from a new-build development perspective, primarily due to the 60-bed limit. The underlying demand from the ageing demographic in Scotland is, however, growing rapidly. There is a current undersupply of 19,793 wetroom beds across Scotland, and projections indicate that this shortage of market-standard provision will only worsen in the coming years. This growing deficit
underscores the urgent need for strategic planning and investment to ensure that future demand can be met effectively. A large proportion of the existing providers report strong occupancy levels in assets, which may not necessarily be future-proof, highlighting the robust demand trend in the region.
“In many instances, smaller, converted homes are well-placed to cater for their local markets, particularly in areas of lower population density. Based on the undeniable increase in demand and general lack of existing modern wetroom facilities, we believe there is a significant opportunity for both regional and corporate care operators to capitalise on the early mover advantage by investing in new developments across Scotland. Additionally, operators have the opportunity to retrofit or reconfigure older stock that may not currently align with the latest market standards, thereby enhancing their competitiveness and future-proofing their homes. With the sector evolving to meet growing demand, strategic investment in high-quality care facilities will not only address existing gaps but also position operators for long-term success in an increasingly competitive market.”