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Care homes closures raise questions over the quality of provision

New research found that virtually all care homes that were forced to close in England by the CQC were run on a for-profit basis.

 The research, which was led by experts at the University of Oxford and funded by the Nuffield Foundation, assessed the number of care homes which had been forced to shut their doors by the Care Quality Commission (CQC).

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Experts discovered that almost all involuntary closures since 2011 occurred in for-profit care homes – 804 out of 816 closures. This equates to one in 30 for-profit care homes having been closed involuntarily by the CQC during this time period.

Within the research – the study can be found in full in The Lancet Healthy Longevity – experts have raised questions about the role oof the private sector in exacerbating the care sector’s ongoing crisis.

Co-author of the study, Dr Benjamin Goodair, said: ‘Social care services in England are on a knife-edge of a crisis: underfunded, understaffed, and struggling to supply the quality of care deserved by the most vulnerable people in society.

‘However, this new data challenges the assumption that these pressures can be eased by outsourcing more social care to the for-profit sector. Instead, what is needed is a comprehensive assessment of the impact of for-profit provision on the quality and sustainability of adult social care in England.’

An involuntary closure is typically a last resort for care homes that have put their residents at risk, or whose care services have continuously failed to meet industry standards. However, 52 of the homes which had been forced to close had been rated as ‘good’ during their last CQC inspection.

According to the researchers, this suggests that these homes posed urgent safety concerns, with residents at acute risk of harm. The researchers estimate that up to 20,000 residents were forced to relocate urgently due to enforced care home closures since 2011.

The results are particularly concerning given the increasing dominance of for-profit care homes in the sector: according to the CQC data, in September 2023 more than 85% of all care homes in England were operated by for-profit providers; in 2011, the figure was 78%.

Lead author of the study, Dr Anders Bach-Mortensen, said: ‘Involuntary closures are currently absent from the debate on outsourced care. Although these are rare events, enforced closures typically involve serious regulation and safety breaches that can inflict substantial costs to both the local authority and residents in need of relocation.

‘But most importantly, the neglect leading up to an enforced and acute closure can be traumatic and harmful for residents. To protect care users going forward, it should be a priority to investigate if there are systematic reasons for why these enforcements occur almost exclusively in private for-profit provision.’

The new results reinforce the findings of previous studies which found that care homes operating on a for-profit basis tend to deliver poorer care than third and public sector providers.

Image: Jose Fontano

More on this topic:

Government must act as social care starts to break

Unpaid carers say loved ones didn’t get care they needed

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