The firm’s Scottish Healthcare Market Review 2026 examines supply and demand across the market, pointing to a widening gap between existing provision and future need as the population ages.

There are currently 772 care homes across Scotland, providing around 36,000 beds, with an average of 47 beds per home. However, the report notes that just over half of these facilities are purpose built, while only 36 per cent include wetrooms, a feature now required in all new developments under updated guidance from the Care Inspectorate.

This shift in standards is expected to render much of the existing stock outdated, increasing pressure for redevelopment and investment.

Between 2021 and 2025, 81 care homes closed across Scotland, resulting in the loss of 2,637 beds. Over the same period, 55 homes opened, adding 1,999 beds, leaving a net reduction of 638 beds.

While some new developments have been purpose built, many openings have come from conversions or re-registrations, reflecting a mixed approach to expanding capacity.

Development activity has remained concentrated in the Central Belt, with smaller clusters in the north east and more rural areas, where projects are often designed to address local shortages.

Recent changes to planning guidance, including the removal of the 60 bed cap on care home developments, are expected to encourage larger schemes. New homes can now be developed with up to 100 beds, although operational requirements around staffing and management structures remain a key consideration for providers.

The report highlights a growing mix of public and private sector involvement, with local authorities increasingly bringing forward their own schemes alongside private developers and operators.

Demand for elderly care is set to increase sharply over the coming decade. While 21 per cent of Scotland’s population is currently aged over 65, this is projected to rise to 25 per cent within ten years.

According to Christie & Co’s analysis, demand for care beds is expected to grow by 12 per cent by 2031 and by 32 per cent by 2036. At the same time, the prevalence of age related conditions such as dementia is also expected to rise, increasing the need for specialist, high acuity care.

The report also identifies a significant shortfall in wetroom provision, estimating a current deficit of nearly 20,000 beds meeting full modern standards. This gap is forecast to widen to more than 27,000 by 2036.

Martin Daw, regional director for Scotland at Christie & Co, said the findings underline the scale of opportunity and challenge facing the sector.

‘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.’

The report concludes that without significant and sustained investment, Scotland’s care sector will struggle to meet future demand, particularly for modern, high quality facilities capable of supporting an ageing population.