Background: Older people as care-receivers are under-researched. We examined the health and well-being of older people with differing levels of care need and receipt. Methods: Community resident older people (N = 1250) from a single UK metropolitan area were randomly recruited, and completed a questionnaire on social exclusion via interview. Participants were categorised into one of the four groups: receiving informal care; receiving informal support; no receipt of informal care/support despite need and no receipt of informal care/support, no need. Findings: Associations (p < 0.001) between group membership and health status (F = 75.7), functional status (F = 159.1), well-being (F = 29.5) and loneliness (F = 28.9) indicated the ‘receiving care’ and ‘no receipt of care/support despite need’ groups had the poorest health profiles. Logistic regression determined primary predictors of group membership. Discussion: A significant group of older people receives no informal care/support despite frailty. Research is needed to determine why some older people do not receive informal care appropriate to their needs.