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PRIVATE CARE

Here are three reasons why we but can you really be a specialist in every globe, creatng a sector with no incentve
should care. type of learning disability support within to change and do things diferently.
the same residental home – or even the What interest do private equity,
. e ne atve i ac o all o is same organisaton – efectvely? pension funds and investment banks
e on ca e an su o have in people with learning disabilites?
As a provider’s debt burden increases, a oes e u u e look like Their frst and main responsibility
the amount of money available to spend Aside from the obvious risk of a Southern is to secure a return on their
on actual support decreases, partcularly Cross scandal happening in the learning investment and that surely creates a
in these fnancially constrained tmes, disability sector, what does the future confict with providing good quality
when annual increases from councils have look like? Should we just accept the care with a long-term view of
been hard to come by. It used to be a status quo – ever larger providers personal development.
commonly held view that 70% of care borrowing more and more money,
home fees went on staf – some of the having more power in the market, no e o e a ical e s see
large private providers have pushed this the increasing commodifcaton of people l councils borrowing money (money is
narratve themselves – but their company with learning disabilites? Or should very cheap for local government) and
accounts paint a diferent story. It is not we be agitatng for more change. building community-based setngs
unusual to see providers spending only There contnues to be huge pressure on for people with learning disabilites to
55% of their income on stafng (income, the Assessment & Treatment (ATU) have a proper tenancy in;
let us remember, that comes entrely sector for change, as the recent excellent
from local government and the NHS). #7daysofacton campaign demonstrated. l commissioning of more supported
Private providers are much beter than It argued that people with learning living and proactve work with the
the state or the third sector at managing disabilites in ATUs were being treated as many providers who want to work
costs – so the growth pressure is ofen fnancial assets and the provider had no with us to provide more community-
on fnancing their debts, debts that have incentve to move people on. based support – to be clear, this can
arisen through business decisions their include private providers;
investors have made to extract
maximum value in a short period of tme. Private providers are l a decisive move away from people
The upshot of this is that there is less much beter than the state with learning disabilites being seen
money to employ staf, and those staf or the third sector at as an asset that can be traded
you do employ are paid low wages. managing costs – so the every three to fve years by faceless
This impacts on the quality of money people;
care provided. growth pressure is ofen on
fnancing their debts, l freeing up of money from debt
. e e ve se incentves a co e debts that have arisen through repayment in the system to pay
o nee in an asse o o ow a ains business decisions their support workers a decent wage and
Whether a provider does a sale and investors have made to extract atract more people to work in this
leaseback on their buildings or is fantastc sector.
simply owning its buildings and maximum value in a short
borrowing against them, having a physical period of tme. The upshot Let’s fnally put choice and control
asset helps the valuaton of the business. of this is that there is less at the heart of learning disability care.
Many providers have each bed valued on money to employ staf,
commercial terms and then use this to and those staf you do
inform the valuatons of their business. *Ivan Farmer is a pseudonym
Additonally, some borrowing can be employ are paid low wages.
predicated on occupancy levels. All of this This impacts on the quality
leads to a perverse incentve of investng of care provided.
in models of support that do not lead to
more independent living, with the risks
that resultant ‘voids’ will cause problems There is a risk that we just move that
with their fnancial backers. problem down from ATUs to residental
care and we will all be discussing this
. islea in clai s o s ecialis again in fve years tme. There is a large
There are of course some truly specialist amount of development actvity by some
private providers who support complex providers to create step-down provision
people extremely well and are paid fee from ATUs that has the appearance of
levels accordingly – as they should be. supported living but is, in fact, residental
However, for an investor, being a care, with all the lack of security and
specialist provider is atractve as there opportunity that brings.
is a premium that can be charged on the
fees. How many tmes have you looked up CURRENT REALITY
a residental home because it has We could argue that for many people
‘specialist’ in its Google search terms and with learning disabilites that is their
then found it is specialist in everything current reality. They are a fnancial asset
going? This might look good to an investor being traded by private capital across the

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