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OPINION: A two-tier sector

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It’s been a month of contrasting fortunes for care home providers across the country as cost and regulatory pressures create an increasingly polarised two-tier sector.

In the top tier, February saw a string of homes receiving the CQC’s coveted top accolade.

Given the CQC’s historical inclination towards smaller properties seen as more compatible with person centred care, it was particularly refreshing to see a 69-bed home – Luxury Care’s Regency Manor in Poole – gain ‘outstanding’.

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Whether this is a sign that a greater number will meet the top requirements than the current narrow 1%, only time will tell.

While the onerous regulation regime is undoubtedly contributing to better practice in some homes and providers, many are finding the burden too much to bear.

I heard a familiar tale of woe from one such provider, a specialist in dementia care, in Norfolk, while getting out and about.

Recently rated ‘requires improvement’ by the CQC like many other homes, the operator shared his exasperation with a care system which he felt had let him down.

Over the years he has seen his wage costs rise from 50% to an unsustainable 82.2%.

He shared his frustration at having to rely on agency staff, whose costs double those of permanent workers, because of the lack of nurses and carers.

Retaining staff was another major issue with many being attracted by better benefits and salaries elsewhere.

The home’s difficulties stemmed from its reliance on inadequate fees from Continuing Healthcare (CHC) residents who occupy a significant number of its beds.

He told me that CHC fees can be as little as half the actual cost of care.

His business was being crippled by the high daily staffing costs needed to meet the complex care and safety needs of its residents which cost the business an extra half a million pounds each year.

He accused the CQC of being arrogant, unsupportive, prejudicial and lacking in understanding.

He said the only way to reduce his losses was to reduce his occupancy of 1:1 clients.

I had a real sense of a care owner fighting for the life of his business, while feeling he had been cut adrift by the authorities.

With no sign of a let up in cost and regulatory pressures in the year ahead, many providers like this will fall by the wayside.

Tags : CQCOpinion
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The author Lee Peart

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