Providers in some areas increasingly turn to people who pay their own costs, the Care Quality Commission says, making it harder for councils to buy care for residents who need state help.
Care providers in some parts of England are increasingly turning to people who pay their own bills, making it harder for councils to buy care for residents who rely on state help. That is one finding of the Care Quality Commission’s annual report, according to BBC Health’s account.
The regulator describes the existing funding system as fragile: people either pay for care themselves or, for the poorest, receive state help with the costs. The shift towards self-funders is therefore creating difficulties for councils responsible for buying publicly funded care.
The five largest care-home owners increased their combined market share by 26% over two years, driven by interest from US property investors. Together, they own around one in seven homes. The 26% figure measures growth in their share, not a rise of 26 percentage points.
Small care homes have long represented only a tiny part of the market, but their numbers have fallen significantly over 14 years. Small homes combining care with nursing support have declined by a quarter. These smaller homes are considered important for specialist and personalised care.
Home care—help with tasks such as washing and dressing in a person’s own home—is moving in a different direction, with more small providers. Nearly a third of these services care for four or fewer people. The CQC says this fragmentation could create inefficiencies.
Chris Badger, the CQC’s chief inspector of adult social care, said economic pressures and councils’ difficulties buying services were reshaping the market “largely by accident rather than design”. He called for a clearer vision focused on people’s needs.
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Martin Green of Care England, which represents care providers, called for tangible support for smaller homes. He said changes to employer national insurance contributions, inflation and rising energy costs were making smaller homes unviable, and warned that closures would continue without progress on a funding settlement.
Greater concentration of care-home ownership could bring benefits, but the report also raises concerns about possible higher prices and poorer care quality. Those are risks, rather than established outcomes, which the CQC says need monitoring. The Department of Health and Social Care said the findings showed the scale of the challenge the government inherited and reaffirmed its commitment to overhaul social care.
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