This report identifies where each pound that goes into the care home industry ends up by using a forensic study of the accounts of over 830 adult care home companies, including the 26 largest providers. The companies examined have a combined income of £10.4bn, representing 68% of the total estimated market value for independent providers in 2017.

The plans, which each cover an average population of about 1.25 million, have been produced under extreme time pressure and in the absence of a legal basis for joint planning between the different organisations in the NHS and local government that are involved.

The financial assumptions underpinning the Government's plans to close the NHS's 30-billion-pound funding gap by 2020/21 are unrealistic and are likely to lead to a decline in the quality of and access to healthcare for patients. Subsequently there is a growing risk that that some vital services will collapse.