“Each Group Company [which includes Elmcare] has at all times conducted its business in accordance with, and has acted in compliance with all applicable laws, regulations, orders and byelaws of any relevant jurisdiction”
“Each Group Company has at all times complied in all material respects with their registration with the CQC as a provider of Regulated Activities in connection with the Business and all requirements issued by the CQC and there are no requirements issued by the CQC and which are outstanding as at the date of this agreement”
“No Group Company…nor any person for whose acts such Group Company may be vicariously liable…is engaged in or involved in or otherwise subject to…any dispute with, or any investigation, inquiry or enforcement proceedings by, any governmental, regulatory or similar body or agency in any jurisdiction”
“No Group Company…is affected by any subsisting or pending judgment, order or other decision or ruling of a…governmental, regulatory or similar body or agency in any jurisdiction;…and there are no facts or circumstances likely to give rise to any Group Company becoming subject to such a judgment, order or other decision or to be a party to any such undertaking or assurance”
“All notices and correspondence received by each Group Company from the…CQC in the 12 months preceding the date of this agreement have been Disclosed”
“Copies of all reports prepared by…the CQC in respect of any Care Home during the period of 3 years preceding the date of this agreement have been disclosed and there are no outstanding reports due to be prepared by the…CQC following an inspection of any Care Home”
“CQC’s view is they cannot stay the same. They either have to improve or they have to leave the market. In my professional opinion, and having watched services be rated and see the consequence of ”inadequate” rating, it is very difficult for a provider to make the improvements that they need. ……. Usually by the time that a service has reached the point where they are inadequate, it doesn’t happen overnight. So a service rarely goes in reality from being fantastic one day to being inadequate the next day. It will have been happening over a long period of time. Things will have started to deteriorate, things will have started to get worse, thing are not being picked up. Governance is really, really key in all of this, in monitoring and making sure that things are all of the time as they should be. It just it will have happened over a long period of time. For a service to be inadequate, there are systemic and cultural issues that can’t just be easily rectified. So if I go into do an inspection as an inspector, and I say this care plan isn’t up to date, that is one issue. But if I actually look at the care that is delivered to that person and it absolutely is as it should be, everybody understands what that person needs, everybody understands the risks that are involved with caring for that person, whilst I will still require that service to update that care plan, that isn’t going to be of serious risk to me, because they can quickly update that care plan. If however, those care plans are not only not up to date, nobody knew they weren’t up to date, because they are not being monitored, people’s care is not therefore as it should be, staff don’t know what it is they have to deliver to that person and the risks, it is a much bigger issue and it’s all then about who is monitoring that service , who is training those staff , who is making sure that everybody knows the needs of every single person? So it’s much more systemic and it comes from the leadership, the way that the manager manages that service, the governance of that service, the constant oversight. Having managed a service as well as regulated services, it is not an easy job at all. It’s really not. And there is much more to it than just, you know, making sure everybody is okay. You have however many people in that service and you have to meet the individual needs of every single one of those people safely. It’s not easy. When you reach that point of it being inadequate, it is incredibly difficult to turn it around. That is certainly what I have seen in my professional opinion.”
“It is important to point out that the inadequate rating is not a result of an abusive culture or an uncaring and unpleasant environment for the service users, which would be extremely challenging to rectify. The central issue here is that the necessary processes and controls, largely relating to COVID, were not in place and this is something we can act on quickly by installing our existing processes and controls, and by properly integrating the home into our wider organisation with the additional oversight this will bring.…we hope it will allow us to demonstrate to you the quality of our operational team in the UK, and so long as the team delivers there should be no impact on the base case business plan cashflows.”
“The issue is isolated to one of the homes there is no risk of contagion in other homes, the CQC isn’t removing residents from the home and therefore there should be no impact on the headline cashflows. There will be additional legal costs incurred by the Borrower, but we are working to have a proportion of these be contingent. There will also be some costs associated with advisor fees if we need to engage valuers to quantify the impact on equity value of the seller’s misrepresentation.”
“The impact of the special measures and turnaround required at Elmwood on the finances has been far greater than we initially foresaw and as a result, whilst we have not broken our covenants, we will come quite close to the default level on the Debt/EBITDAR covenant. The EBITDAR from Elmwood has been materially impacted by two factors: 1. On the revenue line we have lost 7 residents (this is due to 4 deaths and 3 being removed by contracting authorities) and due to the special measures we have been unable to replace them with new residents-this has an annualised impact on EBITDAR of c£300k , and 2. On the cost line we have incurred c£250k more in agency staff cost at Elmwood than we would expect as the cultural re-set at the home has required a heavy turnover in legacy staff, particularly with respect to the nursing, which has meant a greater reliance on agency to meet any short term shortfalls. The remaining 6 homes in the portfolio continue to perform in line with expectation, but with Elmwood now close to breakeven as a home level P&L we have a 20% shortfall in the overall level EBITDAR for the portfolio. .. This overhaul has been a huge task for management, but we are confident now the home is fit for purpose and will be recognised as such by CQC. -We continue to wait on the CQC for a re-inspection of the home and anticipate this in the coming weeks, in the meantime we continue to receive positive feedback from the contracting Las[local authorities] on the improvements that have been made at the Elmwood home and indeed across the full Elmcare portfolio.”
“I am of the opinion that the reduction in the profitability of Elmwood House as a result of occupancy reductions would have been a temporary phenomenon and that once the restriction on seeking to obtain CQC approval for a placement had been lifted and the CQC rating had returned to “Good” the profitability would have largely returned to the previous level.”