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Care Sector Alert - Summer 2011

Sarah Ellson


United Kingdom

Care Sector Alert - Summer 2011

According to a recent UNISON report the home and day care market is worth an enormous £4bn a year. However, in recent weeks a number of large corporations in this sector have been shown to be struggling largely as a result of having adopted high risk business strategies prior to the recession. On 11 July 2011 Southern Cross announced that it was set to wind up its operations and there are concerns about the financial stability of its major competitor Four Seasons. It is thought by sector experts that the fundamental reason behind these worrying announcements has been that in order to raise capital, big borrowings were made with unrealistic repayment terms. Other failings and consequences resulting from the large scale borrowings undertaken to expand in this sector have meant that a number of home and day care businesses have changed hands many times. The Priory, which has 50 care homes, has changed ownership five times in the past eleven years, and as a consequence the consistency of the care provided has varied significantly.

For a sector looking and striving to deliver a consistent level of high quality care and for those small and medium sized home and day care providers looking to expand, the answer for some home and day care brand and business owners (the “franchisor”) has been and can be franchising. With the franchise model the need for large scale borrowing is virtually non-existent, making it extremely attractive to such small and medium sized home and day care providers. Franchisees i.e. those businesses looking to become part of the franchisor’s brand and network, are required to invest in commercial property and staff thereby reducing the burden on the franchisor to invest its own capital. The result is a much more stable system that, if run and managed effectively, guarantees the long-term consistency clients in this sector need.

The home and day care sectors are however heavily regulated and require both trained personnel and a working knowledge of the regulatory framework. Provided that the care provider has an established system, procedures and controls in place and these are replicated and followed by the franchisee, then what can appear to be a daunting regulatory framework (as imposed by the Care Quality Commission) can actually become part of the structure and building blocks of a successful business. The combination of the franchisor’s own high standards and a regulated framework should help ensure that clients receive the high quality of care that the industry strives for.

Within the home and day care sectors franchising is a potentially very attractive vehicle for  expansion for both existing care businesses and for potential entrants to the sector. New and existing home and day care businesses can expand into territories that they otherwise would not be able to penetrate and without having to borrow or invest large capital sums. It is attractive to franchisees as it is a potentially financially lucrative sector which through the franchise model can be entered relatively cheaply, whilst at the same time providing a franchisee with an existing brand, system and support structure. More importantly, it is hugely beneficial for clients to have the long-term consistency in their care. Unlike a corporate operation, a franchisee has not only a personal financial commitment in the business but also has the potential to lose much more than ‘just their job’ if they fail to comply with both the franchisor’s and the Care Quality Commission’s standards.

Graeme Payne, Partner

Care Quality Commission


CQC calls on Castlebeck to make root and branch improvements - CQC, 28 July 2011

The Care Quality Commission has made unannounced visits to 23 facilities run by the Castlebeck Care Group, and has found serious concerns about four of the services run by the group, and that a further seven do not fully comply with essential standards of quality and safety.

CQC prosecute Mayfair cosmetic surgeon - CQC, 16 June 2011

The Care Quality Commission have prosecuted Dr David Anthony Waghorn for carrying out cosmetic surgery without being registered to do so under the Care Standards Act 2000.

CQC Second Annual Report published - CQC, 7 July 2011

The CQC have laid their second report on their work as the regulator of England’s health and adult social care services before Parliament.

CQC publish first of detailed reports into dignity and nutrition for older people - CQC, 26 May 2011

The Care Quality Commission (CQC) has published the first 12 reports from an inspection programme which examines whether elderly people receive essential standards of care, including whether they are receiving dignity and respect, and whether they are getting the food and drink they need. A report is due out in September which will comment on the results of this programme.

Care Quality Commission finds East Sussex Hospitals NHS Trust failed to protect the safety and welfare of people who use its services - CQC, 17 May 2011

The CQC have identified major concerns with five essential standards at Eastbourne District General Hospital, including staff who did not understand adult safeguarding processes. They also had concerns with seven essential standards in respect of the Conquest Hospital in Hastings.

New excellence award consultation begins - CQC, 9 May 2011

The Care Quality Commission have started consulting on plans for a new excellence award scheme for adult social care services in England. They would like feedback on how the scheme should work in advance of the scheme being launched in April 2012.

Sector publications


Thousands of care homes have no registered manager - Community Care, Friday 29 July 2011

According to Action on Elder Abuse, more than 3,000 care homes in England do not have a registered manager, reflecting a crisis of quality in the sector.

Ofsted proposes two-week long, unannounced inspections - Community Care, 27 July 2011

Ofsted have announced plans to change the way inspections of local authority children's services are carried out, and these could in future consist of a two-week, on-site, unannounced visit that will include direct observation of interactions with children and families. The new regime will focus more on listening to children.

Baby P social workers given leave to appeal against sackings - Community Care, 30 June 2011

Maria Ward, the practitioner allocated to Peter Connelly’s case, and Gillie Christou, Ward's manager at the time have been granted leave to appeal against an employment tribunal ruling that upheld their sacking following the Peter Connelly’s death.

Council wrongly deprived autistic man of his liberty, High Court rules - Community Care, 9 June 2011

A council breached a 21-year-old autistic man's human rights by refusing to allow him to be placed in the care of his father, the Court of Protection has ruled. The Court of Protection has ruled that Steven Neary was deprived of his human rights by Hillingdon Council which has incorrectly applied the deprivation of liberty safeguards (DoLS) under the Mental Capacity Act.

Hospitals to face dementia care scrutiny - Community Care, 6 June 2011

The Scottish government has vowed to improve hospital care for dementia patients by increasing inspections to see if they are meeting standards on acute care for older people, while also facing scrutiny from the chief nursing officer on the quality of their dementia care.

First Tier Tribunal for Health Education and Social Care


Douglas Allanson v General Social Care Council (2011) 1846 SW 

The appellant was registered with the Care Council for Wales (“CCW”) as a social worker and had received an admonishment for five years from the CCW as he had made several persistent and unwarranted advances to a female colleague and had failed to maintain appropriate and professional boundaries with two service users. The appellant’s application for registration with the GSCC was refused and the decision was appealed to the First Tier Tribunal, which confirmed the decision to refuse registration as the appellant had failed to demonstrate that he was of good character.

Simpson  v General Social Care Council (2011) 1815 SW-SUS

An appeal was brought against the decision of the GSCC to suspend Mr Simpson from the Social Care Register for a period of two years after being found to have repeatedly accessed non-work related websites, some with adult content during working hours.  The appeal succeeded as although suspension was necessary to maintain public confidence, the actions of the appellant did not put service-users at risk and the public were at no direct harm.

ID v The Secretary Of State For Children Schools And Families [2009] 1733.PT

The appellant was a teacher who had been acquitted of indecent assault against four girls and had also been the subject of an investigation into an indecent assault against his own daughter  The appellant was referred to the Independent Safeguarding Authority and was barred from employment under Section 142 of the Care Standards Act 2002. The appeal was dismissed as it was satisfied that the appellant did commit each of the sexual acts alleged and due to the seriousness of each matter he was unsuitable to work with children.

LV  v OFSTED [2011] 1882 EY-SUS 

LV appealed against the suspension of her registration as a child minder for 6 weeks, pending completion of an investigation by OFSTED into claims that she smacked a child several times on the buttocks with considerable force.  The appeal was dismissed as the Tribunal found that a short period of suspension was justified whilst matters were investigated.

DM v General Social Care Council [2010] 1766.SW

An appeal was brought by DM against a decision by the GSCC Conduct Committee to remove him from the Register of Social Workers.  It was alleged that the appellant had approached members of the public and had made sexually suggestive advances to them, had shown them his social work identity card and had consumed cocaine. The appeal was allowed as the Tribunal concluded that the sanction applied was too severe.

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