#adultspecialistcare

In partnership with

WEBINAR Adult Specialist CareA key part of social care infrastructure validated by coronavirus

The Market Map

Adult Social Care

Care Homes for

Older People

• How many providers will go out of business if they don’t receive a government

bailout

• Where will fees for specialist services go post Covid? Will the contracts ever be

at the right price even at small scale?

• What is the experience of the providers on the panel of getting local authorities

to compensate for additional PPE costs?

• Have providers given feedback about challenges with ensuring their clients

adhere to the government guidelines?

• How damaging, financially, has Covid19 been in relation to extra costs through

Bank staff, and could the new £600m be used?

Key themes

Live polling

Market Report

• Homecare and Supported Living

#adultspecialistcare

WEBINAR: Adult Specialist Care

William Laing

Chairman

LaingBuisson

Submit your questions at sli.do

Event code: asc

Peter Jennings

Partner

Grant Thornton

In partnership with

John Whitehead

CEO

Exemplar Health Care

Mitesh Dhanak

Chairman & Founder

Precious Homes

Steve Scown

CEO

Dimensions

#adultspecialistcare

William Laing

Chairman

LaingBuissonSubmit

questions at

Sli.do

#asc

Value by client type

Value by support setting

Value by funding source

Slow transfer of residential to non-residential care

76,269 75,339 72,683 69,664 66,985

77,000 78,954 80,909 84,214 88,194

76,285 82,110 84,285 84,190 93,605

48,715 36,125 39,540 39,010 53,910

-

50,000

100,000

150,000

200,000

250,000

300,000

350,000

2015 2016 2017 2018 2019

Care home residents Supported living users

Direct payments Other 'lower ticket' non-residential services

Residential

Total: CAGR +2.1%

Sector profitability - EBITDAR margin

-20%

-10%

0%

10%

20%

30%

40%

50%

2004 2006 2008 2010 2012 2014 2016 2018 2020

Priory Specialist Division (y/e Dec) Voyage (y/e March)CareTech (y/e Nov) PrimeLife (y/e March)Exemplar Healthcare (y/e March) Care Management Group (y/e Feb)*Regard (y/e March)* Achieve Together (y/e March)*AGGREGATE Leonard Cheshire

Additional costs due to coronavirus

• Relatively protected from cost pressures compared with the older care sector

because of service user characteristics and staff interactions

• PPE and deep clean

• Payroll (sick pay, overtime, agency)

• Net loss of revenue from occupancy reduction (deaths and slower new

admissions)

#adultspecialistcare

John Whitehead

CEO

Exemplar Health CareSubmit

questions at

Sli.do

#asc

1

Clinician-led care for adults living with complex physical and/or mental

health needs in medium sized (30 beds) homes.

20 years of improving the lives of our service users.

Recognised by Commissioners for our excellent clinical outcomes in high

acuity care.

Strong staff engagement and resourcing to meet people’s needs.

Strong CQC ratings.

Greenfield-led national expansion from an established base in North

England and the Midlands.

We are a leading provider of specialist nursing care for younger adults in the UK31

Nursing homes

860Beds

>90%Good or

Outstanding CQC ratings

>90%Occupancy

<5%Agency staff as % of total staff cost

2

Our experience – Coronavirus (COVID-19)

LaingBuisson – May 2020

Sadly we have lost some of our residents to the virus, but this has been relatively low compared

to other providers - average age of our service users is 56 and the majority of the people we

support have mental health conditions as opposed to physical health or elderly frailties.

Early intervention – we secured PPE through direct procurement from global suppliers.

Only limited PPE was provided by CCGs and Local Authorities - less than 1 weeks supply provided

to homes since March overall.

Disjointed, slow response from CCGs and Local Authorities in relation to recompense for

additional costs incurred with managing the virus.

Staff absence due to Coronavirus (COVID-19) peaked at 7% with predictive data analytics,

minimising agency use.

Exemplar Health Care entered the crisis in a strong position - embedded high-quality processes,

very low staff attrition with high tenure and minimal agency usage. Fortunately, we continue on

the same track.

3

Outlook

LaingBuisson – May 2020

Covid-19 has highlighted social care along with its position as number two to the NHS re:

– Government focus and reporting

– ability to enact change fast across a distributed funding network.

The media focus has been on the impact of the virus, however, not necessarily on the longer term

social care challenges and economics.

The underlying overall social care operating model remains today unchanged.

Core failings of funding for the social care sector are likely to continue without a concerted

Governmental effort (despite prolonged rhetoric).

Future change is helped by the public’s increased attention on social care’s challenges.

This current, heightened public engagement is however now set against a challenging fiscal future.

#adultspecialistcare

Mitesh Dhanak

Chairman & Founder

Precious HomesSubmit

questions at

Sli.do

#asc

Impact● People

○ Our Service Users

○ Our Team Members

● PPE

● Processes

● Performance

World Post Covid-19 for Precious Homes

• Actively raise the profile of the Social Care sector, especially its talented workforce

• Embrace technology/ Encourage WFH

• Develop a Robust Pandemic Contingency Plan

• Continue weekly communication with the teams

#adultspecialistcare

Steve Scown

CEO

DimensionsSubmit

questions at

Sli.do

#asc

True leadership is revealed in the crucible of a crisis

Khang Kijarrro Nguyen

Facts are stubborn things, but statistics are pliable

Forwards or backwards?

#adultspecialistcare

Peter Jennings

Partner

Grant ThorntonSubmit

questions at

Sli.do

#asc

Specialist care

• Investor themes pre-COVID-19

• How has COVID-19 impacted this

• What investment activity is still

happening and when will it pick

back up?

© 2020 Grant Thornton UK LLP.

Commercial in confidence

• More diverse investor base

• Social infrastructure

• Consolidation drivers

• CQC regulator focus

• Commissioner focus

27

Investor themes pre-COVID-19

© 2020 Grant Thornton UK LLP.

Commercial in confidence

28

Recent M&A

Investor Target Acquiror

⚫ Infrastructure funds Choice Care Group

CMG & Regard

Homeleigh Care

Kisimul & Hesley

iCON

AMP

Ancala

Antin

⚫ Private Equity Ambito, Clearwater Care & Pathways Care

Aspirations Care

Christchurch Group & Independence Homes

Liaise Loddon

Values in Care and Courtyard Care

Salutem

Elysium Capital

Active Group (backed by Montreux)

Sequence Care (backed by Horizon Capital)

Swanton Care & Community (backed by Apposite)

⚫ Propco Vision MH, Fieldbay, TLC Civitas

⚫ OpCo Envivo Group

Optima Care

Valorum

⚫ Listed and larger trading companies Cambian

Danshell

Lighthouse, Broadham, Chalkdown House

Caretech

Cygnet

Elysian

© 2020 Grant Thornton UK LLP.

Commercial in confidence

• Critical infrastructure

• Care worker recognition

• Operational stress rather than financial stress

• Investor appreciation and renewed appetite

• Emerge stronger?

29

Impact of COVID-19

© 2020 Grant Thornton UK LLP.

Commercial in confidence

• A number of live deals that continue to progress

• Finding new ways of working

• A number of larger deals had paused – not

necessarily because of COVID

• A number of larger assets that were going to

come to market late 2020

• Investment funds already refocussing on

Specialist Care

• Lender / Debt fund appetite and ability to

transact

30

What investment activity is still happening and when will it pick back up?

Thank you again to our partners

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