By Jayne Connery FRSA FRSPH, Founder and Director of Care Campaign for the Vulnerable
The reported comments from Baroness Casey about private care home ownership will resonate with families who believe that money has been put ahead of their loved one’s care. I understand why. For more than a decade, I have supported families dealing with neglect, poor communication and concerns that were dismissed until the consequences became serious. Where an owner extracts excessive returns while a home struggles to provide safe care, that must be exposed and addressed.
But describing private care home companies as a group as “profiteering off the backs of disabled people” risks obscuring the very problem we need to solve. Providers do not all operate in the same way. Some are making difficult decisions about staffing, maintenance and investment while trying to deliver good, safe care. Others may have ownership and financial arrangements that deserve much closer examination. Residents, families and care workers need the commission to distinguish between them.
The right questions are practical ones. How much public and private money reaches frontline care? How much leaves a provider through debt payments, management fees, rent or dividends? Are staffing levels and training sufficient for the people living in each home? What happens when a family raises a concern? Those questions would tell us far more about a resident’s experience than a broad description of who owns the building.
The reported call to ban foreign companies from owning care homes also needs a clearer case. If the concern is that complex ownership structures make it difficult to see who is accountable, then transparency should be required of every provider. If the concern is that money is being taken out of care without adequate reinvestment, that should be examined wherever the owners are based. The test should be what ownership means for safety, care quality and accountability.
Families rarely begin by asking who holds a company’s shares. They want to know whether their relative is safe, whether staff have time to understand them, and whether someone will act when care falls short. They want honest communication after an incident and confidence that raising a concern will not put their relative’s place at risk. Financial scrutiny matters because it should help answer those questions.
Reform must also look forward. Technology has a place in improving safety and supporting staff, yet it is too often left at the edge of the social care debate. Falls detection, acoustic monitoring and other well-designed systems can help teams identify and respond to risks. Ethical, transparent, consent-led safety monitoring can give residents and families greater choice. Each approach needs clear safeguards, staff training and an honest assessment of whether it improves people’s lives in practice.
Technology cannot compensate for too few staff or poor leadership. Equally, a sector under pressure should not be expected to improve while investment in useful tools and workforce skills is treated as optional. We should ask how providers will fund implementation, involve residents in decisions and ensure that staff can use new systems confidently. The measure of success is whether a person receives safer, more dignified and more responsive care.
I would welcome robust examination of care home finances and ownership. I would also welcome stronger protection for people who speak up, more consistent family involvement, and clear accountability when a provider fails to act on known risks. Good providers should be able to demonstrate how they invest in their workforce, maintain their homes and improve outcomes. Providers that cannot do so should face meaningful scrutiny.
Baroness Casey’s commission has an opportunity to recommend reform that families, staff and responsible providers can recognise as fair. That will require precise evidence about where money goes and what residents experience. Strong language may draw attention to the problem; lasting change will depend on getting those details right.
