Rebuilding an aged-care network with residents at the center

Six years into a run of attempted turnarounds with five different financial advisors, U.K. aged-care network Four Seasons Health Care turned to AlixPartners. The company was responsible for 17,000 patients and residents, and employed 20,000 staff members. The challenge was to deliver financial stability while ensuring consistency of care.

Four Seasons was stuck in a cycle of doubling down on costs while trying to salvage value for creditors. Joe O’Connor, Partner and Managing Director at AlixPartners, was appointed interim CEO and put on the FSHC Board to lead the operational turnaround effort.

Joe brought with him a team from AlixPartners who could leverage their extensive situational experience and spearhead a sales process that would lead to higher-quality homes for residents and their families.

Bridging the gap between clinical wellbeing and fiscal health

Each care home in a residency network needs to be individual and bespoke. Each home has its own manager, its own mix of needs, indeed its own culture, but also the need for monitoring at a higher level to ensure each gets the resources it needs.

We did a lot of work on governance over the network, working to embed solutions across the network without upsetting the clinical care piece. This required a lot of cultural change to understand how homes were being managed and where the agency side could work more effectively, lowering agency utilization from a peak of 22% to 8%.

Our team worked closely with on-site teams to discuss work plans, answer questions, and look at how best to grow occupancy with care quality at the center of the equation. This turned out not to be a matter of simply filling rooms, but attaining a higher caliber of staff. Caring and talented employees reduced churn and lessened the network’s reliance on agency staff while giving residents and patients a better, more familiar experience.

This work took place at the same time as a quite fragmented sales process.

Our team worked through

39 buyers

900 offers

Transitioning ownership and improving care quality

AlixPartners was advising on real estate transactions, some of which proceeded in clusters of half a dozen homes. It was important for the operational team to preserve morale and ensure continuity through those transitions.

For staff members who found themselves under new management, the priority was to prevent a brain-drain and ensure the value of the business remained steady. We delivered on that promise, reducing attrition by 10%.

We viewed the project as a huge opportunity for ownership and residents alike: these homes hadn’t seen sufficient investment in years, and the care paid off. Four Seasons renegotiated a successful extension of the group’s term loan facility and reduced central costs by 60%.

For the first time in many years, Four Seasons achieved its first “outstanding” rating for care quality and an improvement in ratings for 15% of the homes.