With people living longer, the need for affordable care of high quality to support Europe’s population increases. Over the last ten years there has been an expansion of the private sector in terms of the number of care homes and the places they provide. This increase takes place in a context of decrease or very slow growth in the services provided in public care homes. This report examines services in the public and private sectors, how they differ in the services they provide in terms of the quality, accessibility and efficiency of services. As private provision increases, costs to users are likely to become a more significant barrier issue unless there is an increase in public benefits to subsidise use. There are also some differences in the location of different types of care homes, with private care homes more likely to be found in affluent urban areas. Differences in the types of residents are influenced by the profitability of the services they require. An executive summary is available - see Related content.