The residential care market – myth or reality

For the majority of people, as we age, we may not go into a care home. Many of us will need some form of care and support in later life, possibly provided by family and friends. Where extra support is necessary, we may choose to adjust our accommodation to suit our changing needs, or pay for care from a home care agency. But, were specialist support is required then residential care may be the answer.

For those who need care in residential settings, this is often seen as the last resort and a decision that is taken with a degree of reluctance when no other option is available.

We are familiar with the global population profile forecast and expected growth in the over 65s. Yet there still remains minimum choice and provision of care services for the older adult.

Limited progress in the choice and options of care services in the market means that the main provision of care continues to be delivered through care homes and domiciliary care agencies. Housing with care, also known as extra care in retirement living communities, currently accounts for a very small percentage of the adult social care market.

Few of us will need to use state-funded social care when we age. Yet since the 1990s care delivery has remained the same in the UK. The commissioning of care is largely handled by local authorities, creating a market that is excessively complex and variable from local authority to authority. This has lead to market conditions that focus on driving down price at the expense of quality.

The image of residential care is negatively portrayed in the media and is not helped by the complexities of the market itself. The inconsistency of quality standards and the difficulty of navigating the care system creates unfavourable conditions for the end customer – the person who is actually in receipt of care – usually at a moment in time when the decision to move into residential care is taken at a highly stressed period.

I attended the annual conference of the Residential Forum at the beginning of this month. The discussion topic for the two day duration of the conference was whether the residential market was a ‘myth or reality’.

Des Kelly, John Kennedy, Margaret Flynn and Jonathan Stanley gave thought-provoking accounts of the current residential market conditions, providing an explanation of the lessons that should have been learnt from previous incidents within the market which clearly hadn’t. They explored the dynamics of the market in the four countries of the UK and questioned the degree to which it serves the needs of the end-user for both children and adults services. 37e448c8-8709-4af6-9c59-857bdc51f5b4.jpeg

Working in small groups, we discussed the theme in many different angles, and concluded that the residential care market was in fact not a market in the true sense of what makes-up a market because the customer was not always sovereign in the decision-making process. 

Choice was limited and often dominated by a complex commissioning system which operated to protect itself, so making the system ineffective. 

To solve these problems, we agreed that there needed to be a political will to address the social care crisis that went beyond sound bite political statements, but a clear national strategy for social care.

We unanimously agreed that there was a need for positive leadership at provider, professional and political levels, supported by sustainable long-term funding. 

In addition, the customer must be central to the decision-making process and provided with greater choice, so that they can receive services that meet their needs delivered to high standards. 

Residential care settings can be a positive choice for people and provide life-enhancing services for both children and adults.

About the Residential Forum

The Residential Forum was founded in 1994 as an initiative of Dame Gillian Wagner and with the support of the National Institute for Social Work. Its purpose is to promote the achievement of high standards of care for children and adults living in nursing homes, residential homes and schools, and to contribute to improving the quality of services throughout the four countries of the United Kingdom.

For more information on the Residential Forum visit

Edna Petzen @LyndenConsult is director and marketing consultant at Lynden Consulting, a strategic management, marketing and communications company. Lynden Consulting has a proven track record in implementing successful strategies to achieve excellence and tangible results for providers in health and adult social care. Get in touch to find out how we can help.

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