During my career in social care and housing I have seen trends in how care services are delivered come and go. Councils who acted to divest themselves of in-house care provision have often had cause to regret it further down the line, and I consider that I have been fortunate in working within authorities that have retained significant direct provision of care services. This is the case in Central Bedfordshire Council where I have been director of social care, health and housing since its inception in 2009. Since that time, we have worked hard to transform the delivery of care through relationships with the independent sector and also by developing and enhancing our in-house services.

Our programme to replace outdated care homes met with some success as independent providers developed new facilities in our area, but while the development of new care homes continues, recently-opened homes have focused entirely on the ‘self-funder' market – some at rates that are more than double what the council pays. Even where the council has been prepared to offer sites to care home operators, we have been unable to secure commitments to provide sufficient places for people who need public support. I became concerned that the council was at risk of losing access to good quality care in the market and that this trend could continue to the point where there was effectively a ‘two-tier' service where people without high incomes or housing equity would not have access to good quality care.