Simon Harvey: 20 years of care in the South West
2020 has been a significant year for many, and not always for the right reasons.
For Senior Director of Healthcare, Simon Harvey, 2020 also marks two decades since he began work at Christie & Co, in which time he has nurtured his career and witnessed a significant shift in healthcare markets and operational attitudes.
We chatted to Simon about his time at the business and how the care market has evolved since the millennium…
Can you tell us a bit more about your role at Christie & Co?
"I am a Senior Director within the Christie & Co Care Team and, in 2019, was very proud to be named as the company’s 'Care Agent of the Year'.
"I primarily cover care businesses in the South West of England and have sold over 200 homes (some on more than one occasion) and advised on around 10 times this amount since my career began. Despite having worked in the industry for a long time now, I still try to build on my knowledge by getting to know all owners, operators, and acquirers of care homes across my patch."
When did you join Christie & Co? And from where?
"I joined Christie & Co from a local residential agent in Exeter. Up until that point, I’d spent my career selling houses in various locations across Devon and Cornwall (where I was born) and decided that it was time for a change. A colleague I’d worked with previously, who worked for Christie & Co at the time, recommended me for the position and as they say, the rest is history…"
What was Christie & Co like in 2000 and how has it changed since then?
"In many ways, Christie & Co hasn’t changed that much, and the values and principles of the company then are the same today – to work on our client’s behalf to achieve the best possible outcomes – although working practises things have changed considerably.
"In 2000, the internet was still in its infancy (something my children find hard to believe!) and the majority of our enquiries were via the telephone where people had seen adverts in the printed press – we often saw a significant “spike” in enquiry levels on certain days and at particular times in the month and we knew then that these publications had become available.
"Over the following 20 years, our approach has still been to work closely and personally with our clients, aiming to maintain in-person meetings wherever possible, although this year has seen us embrace the technology of virtual meetings which have been well received but I think the majority of us (and our clients, too) are keen to reinstate physical meetings as soon as is safe and practical to do so. Nevertheless, technology plays a more significant role in our working life than 20 years ago with connectivity almost 24/7 – when I first joined Christie & Co and attended meetings, we had no mobile phones so were reliant on using payphones to call in to the office to check if there were any urgent messages! You had to make sure you had plenty of change in your car as it was frowned upon if you had to reverse the charges…!"
How has the market evolved since 2000?
"The year 2000 and the beginning of the new millennium was a time of significant change, with the then labour government having recently issued a white paper under the heading “fit for the future” and advised on the upcoming implementation of new “national minimum standards” for care home bedroom sizes and day space. As a result, there were many operators considering their long-term future in the sector leading to a degree of uncertainty.
"A couple of years later, these standards were amended to apply only to new registrations whether they be new bedrooms to existing facilities or brand-new builds. By this time, though, a large number of care home owners had decided to close fearing that they would never be able to meet the requirements in a Victorian or similar age converted building where the room sizes, requirements for en suite, and other things such as level access throughout, were simply unachievable.
"It was always felt that “market forces” would dictate the suitability of any given property in any given location and this has certainly remained the case as, if you fast forward nearly 20 years, there are still a number of converted care homes in extremely sought-after locations providing high-quality care, and will no doubt continue to do so for many years to come.
"These standards have, of course, meant that new build care homes in the past 20 years have raised the quality of provision significantly, not just in the South West but across the UK. Whilst parts of the South West – Bristol and Cheltenham, in particular – have seen an increased number of new homes, other areas, in particular further west in Devon and into Cornwall, have seen very little in the way of such development, as location and demographic profile in particular, conurbation size plays a part in the selection process.
"That said, the challenge for operators to find suitable sites at affordable sizes in the South East is changing this view somewhat, with Exeter especially having a number of proposed sites and planning permissions along with those homes under construction and built in the last few years we will see a significant increase in the number of purpose-built beds within the city in the next five years. There are also exceptions to this rule which is evidenced by the new home opened in Ottery St Mary which is being operated by Maria Mallaband Care Group and the development by Barchester of a new home in Sherbourne. Elsewhere in the South West the majority of new facilities are being developed by local and regional operators to enhance their own portfolio and nowhere is this more prevalent than in Bristol where operators such as Windmill Care, Grove Care and Cedar Care Homes have developed extensively in the past two decades.
"There are also some smaller operators who have taken it upon themselves to build new facilities – a good example of which is St Georges Nursing Home in Weston-Super-Mare which was developed in 2012 by a local operator and for whom we successfully sold the business to Allegra Care in 2019."
How have buyer profiles changed since 2000?
"In the early 2000’s we saw more “hands on” owners acquiring smaller homes which they intended to operate themselves and often live on or close to the site to. Over the past five years or so, we’ve seen a more business-led new entrant, often with no direct care experience but with a focus on working with the existing care team in the home they acquire to drive forward standards, often investing heavily and, in many cases, seeking to make further acquisitions as they grow a portfolio of care homes themselves.
"The South West has often been an area of focus for such buyers who, predominantly based in the South East, are able to achieve better value for money further west, and where strong demographics from an age profile and, in more cases, good underlying property values, make it an attractive location in which to acquire a care business.
"The relative lack, in most towns, of development of new care homes means that the less inexperienced operators are more confident in taking on homes where there is less or, in many cases, no corporate presence within the area that they acquire."
What about funding?
"The past two decades has seen substantial change in the banks and general funding of the care sector from a transactional perspective and, whilst some banks such as NatWest and Barclays, and to a certain extent other in the High Street such as Santander and Lloyds, have remained pretty much constant, one of the “go to” lenders of the early 2000’s – Citibank – no longer exists in the sector.
"In recent years we have seen increasing appetite from a variety of specialist lenders and 'challenger' banks, demonstrated by the number of deals that are being brokered by our sister company, Christie Finance. This year alone has seen them broker funding packages with over 20 different lenders on healthcare transactions. This would have been unheard of not so long ago."
How has regulation changed?
"The regulator has gone through many changes and reincarnations during this time, from the introduction of the National Care Standards Commission in 2002 – prior to this, residential homes were inspected by the relevant local authority and nursing homes by the local NHS.
"Then there was the Commission for Social Care Inspection (CSCI), and finally the CQC who have now become the regulator not only for the Health and Social Care Sector but right across primary and secondary healthcare including the NHS, GPs etc.
"Over the past few years, there has been a drive to seek continual improvement from care home operators, not just within their physical attributes and condition of their building, but also the care provided, quality and training of staff and other extras such as entertainment and in the new build homes they are going a stage further with cinema rooms, star treatments and the like.
"We have seen the regulator continuously striving to improve the overall quality within care homes - this is certainly the case most recently, with new measures such as the Infection Control Metric – with the introduction of new initiatives to seek to enhance further the quality of care that is being provided."
What do you expect to see in the next 20 years of your career?
"Looking ahead, not perhaps for the next 20 years but certainly this current decade, we are going to see greater influence of technology in the sector and, whilst the delivery of care is extremely personal, the support that can be provided to both the resident and the staff through the use and development of technology is increasing at a fast pace and will no doubt continue to do so.
"There is no doubt in my mind that overall quality in the sector across every aspect has improved significantly in my 20 years at Christie & Co and, whilst it remains an extremely challenging job, the future of the industry is a positive one given the UK demographics with an aging population and it is therefore something that we, as a company, remain fully committed to.
"I personally look forward to many more years of helping people, whether acquiring or retiring, to achieve their goals and would like to take this opportunity to thank all of those people that I have worked with over the last 20 years, and those still involved in the sector that I will hopefully work with in the future and, of course, anyone else who is looking to enter or exit the sector for the first time."