Outsourcing care homes has reduced both the availability and quality of care for the most vulnerable, especially in the poorest areas, according to new research from Oxford University’s Department of Social Policy and Intervention, funded by the Nuffield Foundation. The study raises concerns about the role of private, for-profit companies in worsening the care sector’s ongoing crisis.

This research, the first of its kind to track care home closures across England over time, shows that the move toward for-profit care homes is not due to better care quality. In fact, care homes run by charities and local authorities consistently receive higher ratings from the Care Quality Commission (CQC), but they are 1.6 to 1.8 times more likely to close than for-profit homes.

“Good charity-run and local authority care homes are shutting down, particularly in the most deprived areas,” the researchers report. “This is troubling because for-profit homes don’t consistently provide high-quality care in these areas, raising serious questions about whether outsourcing has unintentionally compromised the fairness and accessibility of care for vulnerable people.”

Rising issue

The study adds to the growing body of evidence about the rise of outsourcing in social care over the last 30 years. The data suggests that competition introduced by outsourcing does not put quality or fairness first.

The concerns highlighted by the CQC, advocacy groups, and other regulators point to the need for a coordinated approach to support these essential services, ensuring they can continue to deliver high-quality care, especially in the most deprived areas. Solving these challenges will require joint efforts from policymakers, funding bodies, and the care sector to create a stronger and more fair system.

The analysis was based on data on forced closures requested from the CQC and publicly available information. Care homes run by registered charities, local councils, and NHS Trusts were classified as ‘not-for-profit’ or public, while those run by private companies were classified as ‘for-profit.’