According to the latest statistics from the Ministry of Housing, Communities and Local Government, the average cost rose by 41%, increasing from £589,689 per year in 2019/20 to £829,123 in 2023/24. Total expenditure reported by the ministry includes the sum of employee costs and running expenses. 

The data shows significant increases in the North East (64%) and Yorkshire (62%), with expenditure rising in London from £852,161 to £1,144,659 over a five-year period. Other big spenders were the North West, with costs sitting at £1,073,352 in 2022/23. Figures were unavailable for the following year.

The research, which was carried out by Tristone Healthcare, comes as the chancellor announced £555 million of ‘transformation funding’ on Wednesday to ‘break the dangerous cycle of late intervention and low-quality care’ in children’s social care.

But, as costs rise, the funding commitment falls short of where it needs to be, according to Rob Finney – chief operating officer at Tristone Healthcare. 

He commented: “The sector has long called for more funding to resolve endemic issues in children’s social care. An independent review carried out by now-MP, Josh MacAlister, recommended a five-year plan, with significant investment to support fundamental changes.”

The review stated: “Without a dramatic whole system reset, outcomes for children and families will remain stubbornly poor and by this time next decade there will be approaching 100,000 children in care (up from 80,000 today) and a flawed system will cost over £15 billion per year (up from £10 billion now).” 

Finney added: “£555 million over the spending review period is a start, but it will only touch the surface, in terms of what is needed. It’s yet another disappointment for a sector that’s in dire need of central support. With recent government announcements curbing the future recruitment of overseas care staff, as well as apprenticeship funding being pulled for Levels 6 and 7, the social care has been left reeling. The spending review does little to instil confidence amongst industry leaders that long-term and transformational support is going to be forthcoming. More needs to be done.”

However, the latest shift in position by Ofsted has landed differently this time – certainly from a Tristone perspective. Last month, the regulator announced changes to its social care common inspection framework (SCCIF), in response to concerns that some providers are rejecting referrals for children with complex needs due to fears about how it will impact their Ofsted rating.

In many situations, this means children are being placed far from family and friends, experience multiple moves, or end up in unsuitable accommodation. 

The changes are intended to reinforce the purpose of the SCCIF, which was designed to ‘focus on children’s progress and experiences, as opposed to their outcomes’.

Ofsted said the changes would put a sharper focus on:

• How providers promote and sustain stability for children, including those with high needs
• How providers balance the needs of a child requiring placement with those already living in the setting
• The timeliness of a provider’s work to prepare children for their next move
• How accurately placement decisions reflect a provider’s statement of purpose.

Yvette Stanley, Ofsted’s national director for social care, said: “We want providers to be risk-aware, not risk-averse.” 

The move from Ofsted is a helpful one for the sector and one that should be embraced. History and experience tells us that the ‘focus on children’s progress and experiences, as opposed to their outcomes’ has not always been followed; in certain cases, little acknowledgement has been given to the small but significant wins, or the time it takes to really support children with complex needs.

Ultimately, regardless of frameworks and ratings, as providers we have to take a chance on children who come to us with heavier baggage than others. It’s our responsibility to provide them with the best service possible. Surely it’s our reason for being? We have to see the children behind the problems. We have to go on a journey with them and, along the way, celebrate the successes – however small they might be. It’s essential, therefore, that Ofsted recognises those tiny steps forward, rather than taking punitive action if outcomes don’t match tick box targets. 

One big challenge in embracing this approach is around skills development for staff teams. We need to ensure the good people who we employ are trained as well as is possible. It’s all well and good being idealistic about how children with complex needs should be supported, but without the best people to build those relationships, earn the trust of traumatised young people, celebrate the small wins, and provide a safe space for them without fail, then delivering on those promises can be a lot harder to achieve.

While skills and teams are vital, therapeutic care models, such as Dyadic Developmental Psychotherapy (DDP), can also play an important role in informing effective practice and how we successfully manage hard to reach young people. 

Above all, the biggest tool in our toolbox is resilience. Whether it’s children or vulnerable adults, they will always display challenging behaviours and, as providers, as teams, we need to be brave, we need to be resilient. Regardless of how difficult a shift was, to go back in the following day and approach those difficult relationships with the same positivity and care is what separates the great social care professionals from the good.

Because there is no better therapy than being parented well, whether that’s substitute parenting or otherwise. If a child knows that no matter what they do, they are loved and they are treasured for who they are, that somebody recognises the good things that they bring to the world, and they see in themselves that they are someone worth spending time with, then that is as good a recovery experience as a child can have.

Many of the team took part in the first charity fundraiser in 2022, cycling from London to Paris and, once again, they came up trumps raising nearly £15,000 for a fantastic cause – The Rainbow Trust Children’s Charity. 

The 12-strong team set off on Saturday 26 April, cycling past some iconic landmarks leaving Paris en route to Chateaudun. Day two took them along the Loire, as they took in some stunning scenery on their way to Tours, racking up 168 miles over the course of the first two days.

Day three was a real challenge for some of the riders, with the flat terrain of day two turning into more of an uphill struggle. 90-miles – and a lot of aching muscles later – the team arrived in Poitiers for a well-earned rest. 

After a tough day, day four was a welcomed ‘flat and steady’ 82 mile ride, with the team picking up vital donations from a local en route, before arriving at their penultimate stop of Cognac.

The final day was both hot and high, as the team cycled through 28 degree heat, tackling several challenging climbs, before crossing the finishing line in Bordeaux. With 650km under their belt, and a lot of blood, sweat and tears, the team celebrated reaching their destination by raising nearly £15,000 for The Rainbow Trust Children’s Charity, adding to the £20,000 that was raised during the first cycle challenge three years ago. 

“We’re overwhelmed by the support from people, even those we met en route,” said Yannis Loucopoulos, CEO of Tristone Group and one of the 12-strong team. “This was a really challenging cycle ride, and a gruelling five days, but the team really pulled together and made sure everyone crossed the finish line, raising a fantastic amount for a wonderful charity. Here’s to the next challenge!”If you would like to support the team’s cycle challenge, you can donate here 

It’s little wonder that, within 12 months of joining, he was appointed as group managing director, taking on the responsibility of steering both ProCare Wales and fellow Tristone community business, Next Steps. The move not only demonstrates the speed at which he has settled into the community, but also the confidence bestowed on him to lead teams in a very people-centric way.

It’s this person-centred approach that he believes so wholeheartedly in as a leader –describing himself as ‘passionate’ and ‘committed’ in order to achieve the highest possible standards in quality of life for people in his care. 

Bringing a raft of experience in everything from recruitment to retention, HR, KPI delivery, budgetary management and service growth, he was a natural choice to take on the dual role. As he continues to settle into the group leadership position, we caught up with Oliver to find out more about what it means to be part of Tristone community and what he sees as the main challenges facing the adult social care sector in the coming months and years. 

You’ve built up significant experience working with a range of organisations within adult social care. What attracted you to Tristone? “What appealed to me was the genuine willingness to create fantastic lives for people by focusing on positive outcomes. 

“For a business looking to secure further investment and build an ongoing partnership, you’ve got to explore whether it’s a fit culturally and the outcomes that everybody wants are aligned – and that’s what you get with Tristone. For me, personally, I’ve always felt that developing positive cultures focused on good outcomes for people is fundamentally a strong business model on which to grow from.”

Since joining the Tristone community in October 2023, Oliver has quickly seen the benefits that come from a collective environment where everyone shares the same values and ambitions. 

“We’ve definitely benefited from having access to additional resources,” he explains. “Whether that’s group buying power for certain contracts, or resources to further develop the quality proposition and what the organisation can offer, it’s there at our fingertips. 

“But it’s not just about shared resources,” he continues. “Being part of the Tristone community means that it shares the responsibility and it also shares the risk. Sometimes when you’re leading an organisation or a service, you can feel quite isolated when things aren’t going well. That might be cash flow issues, trying to meet payroll, or trying to get debtors to pay up. As such, tapping into the extensive experience of the wider group is a real valuable resource to be able to lean on.”

It also helps with growth aspirations. While Oliver doesn’t have a set number, or figure, what he is clear about is the ambition to help as many people as they can.

“As a member of the Tristone community, we have access to more experienced investors, especially when it comes to acquiring properties and developing the number of sites that we have as a business,” he explains. “That knowledge and expertise will be vital as we look to support and care for more people and increase the impact we have on the local communities around us.”

For Oliver, the Tristone community is ‘unique’ in a sector that continues to face growing challenges and external pressures. 

“For me, it’s group of morally strong people coming together to provide an even greater impact in the sector,” he says. “In my experience, many organisations understandably prioritise themselves, rather than focusing on collaboration and shared experiences. It’s a breath of fresh air to see a group of like-minded people come together to further strengthen what we’re trying to achieve.”

When it comes to those challenges and external pressures, what does Oliver see as the main factors at play in 2025?

This year brings a number of exciting opportunities for us to develop the quality and scope of impact that we deliver for the people we support. At ProCare Wales we are 100% focused on ensuring we are a gold standard, sector leading provider of complex care for adults with learning disabilities. Development of our ‘ProCare Way’ brochure has been a significant, yet hugely inspiring piece of work with a buzz of excitement around its implementation throughout 2025.

Within Next Steps, our vision and commitment to support people out of hospital services and into community homes under specialised, clinical care and support is stronger than ever. Engagement with senior commissioners within local authorities and the NHS, regarding our vision to provide services that are person-centred, robust yet can flex around the fluctuating presentation of our residents, has been overwhelmingly positive. Our commitment to break the cycle of people needing to be re-hospitalised is strong and the development of services around the needs of people makes 2025 a very exciting year for everyone at Next Steps.

2025 also brings a number of challenges for both organisations. The impact of increased Employer National Insurance Contributions (NIC), our desire to ensure good pay rates for our wonderful staff teams, combined with the challenging landscape of fee uplift rates from local authorities and NHS, is profound. However, our desire, commitment and expertise to navigate such challenges, while ensuring we remain on course to achieve the aims for our people is one we are wholeheartedly embracing.

Dawn brings over 30 years’ experience to Tristone, with a wealth of expertise in safeguarding, including leadership in residential childcare, working as a LADO and having been a Director of Safeguarding within the charity sector and in education.

She joins Tristone having previously worked for Rochdale Safeguarding Children’s Board, as well as acting as an independent investigator for national safeguarding panel, Sports Resolutions. At Tristone, she will be responsible for safeguarding strategy, safer recruitment, leading operational auditing activity, including property quality checks for the CQC and 16 to 18-year-old provision, heading up investigations and grievances, as well as joining Tristone’s Independent Safeguarding Board (ISB).

Rob Finney, Chief Operating Officer at Tristone, commented: “We’re delighted to have someone of Dawn’s experience and reputation onboard. 

“Her in-depth knowledge and expertise into safeguarding matters and early intervention across education, the local authority landscape and social care, will be invaluable to our portfolio of businesses, as we continue to take a proactive approach to protecting the wellbeing of every child, young person and adult in our care.”

The ISB was set up in 2021, bringing together some of the industry’s leading figures to independently observe and oversee care and safeguarding matters for Tristone’s nine-strong portfolio of businesses.

Dawn said: “The quality and diversity of the Tristone portfolio was a real draw for me, joining a passionate team of industry specialist who are all committed to delivering the highest standards across the social care sector. 

“Working alongside children, adults and families for the last 30 years, from early help interventions to managing complex children and adult safeguarding cases, has given me vital insight into creating a safe and person-centred approach to care, whereby everyone – adults, young people, children, families and relatives, as well as staff – can trust in the care being provided and have pride in the quality of the offering across the various organisations.”

The Bristol-based care agency has received £126,000 from Lloyd’s Banking Group. It will enable Premier Care Management to fund 21 apprenticeships, including creating new roles.

Lloyd’s Banking Group has committed its surplus Apprenticeship Levy, totalling £500,000, to the Western Training Provider Network’s #ShareToSupport fund, which is supported by the Mayoral Combined Authority (MCA) in the West of England. The fund enables larger employers to support job creation and progression opportunities in the region by funding training for SMEs. 

Hayley Williams, Business Director at Premier Care Management, said: “The support from the #ShareToSupport fund is enabling our staff at Premier Care Management to achieve new qualifications and deliver quality support to our young people with various needs. Having the funding will allow the business to grow and has been an important investment in our team.”

Lloyds Banking Group’s pledge was made possible by rules in the Apprenticeship Levy that allow large employers to share some of their training funds with smaller companies. The commitment will help cover the costs of apprenticeships and help combat skills shortages across the West of England. 

The buy-and-build-and-hold investment group has built a strong reputation as a long-term investor, acquiring high-quality businesses that deliver sustainable, commercial success alongside positive social impact. This is delivered by adopting a federalised and operationally decentralised model with centralised capital allocation. 

Yannis Loucopoulos, CEO of Tristone Group, commented: “Our transition to Tristone Group is so much more than a name change; it is a true reflection of our position as a group and the role we play as an impact investor.

“From the very beginning, we have placed great emphasis on forming supportive and close relationships with management teams through a clear corporate structure that provides teams with the autonomy they need to shape their businesses, while also benefitting from our proven value creation programme, which leverages our strategic, financial, legal and wider community expertise and resources. 

“Tristone Group provides us with the perfect brand identity as we continue to grow and deliver against that commitment to our portfolio.”  

Tristone has built a 10-strong business community, completing seven acquisitions in the last three years. The business community includes: Premier Care Management, ProCare Wales, Sportfit Support Services, Juventas Services, Dimensions Care, Seaside Care Homes, Beyond Limits, Next Steps, and South West Intervention Services, with 100% of services rated as ‘outstanding’ or ‘good’.

In 2024, Tristone Healthcare – part of the Tristone Group – saw revenue rise from £30.5 million to £43 million across the Tristone community. Tristone’s portfolio has also seen employee numbers grow from 696 to 808. In 2024, Tristone also featured in the E2E Job Creation 100, after achieving a 195% growth in employee numbers during that period.

Beyond Limits is an organisation that provides specialist care to adults with complex needs through bespoke supported living, allowing individuals to live independently. This not only reduces the burden placed on unpaid carers, such as family and friends, but also provides a route out of institutionalised care, enabling people to lead meaningful and rewarding lives. In Doreen’s own words, “we support people through thick and thin.”

A recent report, featuring Beyond Limits – A Deep Dive into the Small Supports Experience in Plymouth – highlighted the difference the provider is making by taking a different approach to bespoke supported living. This included significant cost savings to the public purse, as well as positive outcomes for those individuals in their care. The report stated that the organisation improved wellbeing scores from an average of 2.6 to 8.3 out of 10, generating an economic value of more than £750,000 for nine individuals in just one year.

Social care for adults with complex needs has long been regarded as the poor relation in the sector, with children’s and elderly care readily attracting more attention and headlines. This is a point not lost on Doreen. She is a vehement advocate for people with learning difficulties, mental health issues, and other support needs, fighting not only for their right to live an independent life, but also to have the same human rights as other people – something she believes is compromised in a system that often resigns them to long spells in institutionalised care. 

The challenges for Doreen and Beyond Limits are no different to other social care providers in many respects, but there are nuances that come with each sub-sector, which includes transforming the care agenda and ultimately closing care institutions. 

“People with learning disabilities and mental health issues can often get stuck in long stay hospitals and large institutions for many years,” she explains. “Aside from it being a big waste of taxpayers’ money, those individuals are not getting good enough care. What we need is an individualised support approach that assigns appropriate budgets to each individual. 

“While there is fantastic work happening every single day to achieve excellent outcomes for people, there is a real need for the sector to modernise its thinking. We need to move away from the mentality of ‘them and us’ and start to think about how we would design adult social care services if we were doing it for ourselves – it would be entirely different. Fundamentally, more focus needs to put on people’s human rights and the simple requirements of providing individuals with their own home, a family life, and the power to manage their own personal budgets and choose their own course in life. They are citizens of this country, just like you or me. They have got the right to good quality care, as well as a good home.”

The issue of finding a good home is a significant one for Doreen. “Ensuring there is enough good housing for people with disabilities to live in, so they can lead independent lives with the right support structure around them, is hugely important,” she comments. 

Prior to the General Election, Labour touched upon ‘home-first care’ to help people live independently, but it steered away from detail. It’s clear that more needs to be said and done around adult social care across the piste – whether this is by stimulating the investment market through greater mortgage options, or by looking at the part housing benefits have to play in the supported living system.

When it comes to business priorities, Beyond Limits closely aligns with the national picture, which shows that improving outcomes for service users is number one for 34% of social care businesses. 

“Ultimately, funding is not being used to achieve great things and deliver fantastic outcomes, and that needs to addressed as a matter of urgency,” says Doreen. 

She also agrees with nearly a third of respondents (31%) that more needs to be done to address the endemic recruitment and retention issues in social care. 

“More funding is needed in the area of employment in the care sector,” she explains. “The work is taxing, difficult and involves safeguarding the lives of others. Therefore, more money should be injected into the sector to enable providers to pay employees a higher rate of pay to acknowledge the importance of their role, as well as the outstanding work that is carried out day in, day out for some of our most vulnerable people. On the other hand, as a sector, we also need to make sure that what funding we do have is used in a more efficient and innovative way to provide better services, which ultimately save money in the long term. ”

The Deep Dive report highlights that this approach works. Beyond Limits has shown that a care model that prioritises holistic wellbeing can be highly effective and lead to both improved quality of life for individuals and significant cost savings of more than £200,000.

In the last 12 months, Tristone Healthcare’s portfolio of businesses saw the value of social impact rise through the creation of jobs, training, improving the physical and mental wellbeing of its workforce, while contributing to local causes. This comes after the investor launched a charitable foundation, with a percentage of future deal value being invested into its Tristone Community Fund. 

The Tristone foundation will support local communities by promoting health and wellbeing, education and employment, while helping to create safer and thriving neighbourhoods. Grants will be awarded to grassroot charities, local community groups and the voluntary sector to create both immediate impact and a lasting legacy.

In 2024, Tristone Healthcare saw revenue rise from £30.5 million to £43 million across the Tristone community. This includes Premier Care Management, ProCare Wales, Sportfit Support Services, Juventas Services, Dimensions Care, Seaside Care Homes, Beyond Limits, Next Steps, and South West Intervention Services, with 100% of services rated as ‘outstanding’ or ‘good’.

Tristone founder and CEO, Yannis Loucopoulos, said: “It’s been another exceptional year for the Tristone community – a year that has been defined by the level of social impact generated across the group and the positive outcomes achieved for the vulnerable individuals in our care. What’s more, the growth achieved by the group has come through a desire to try and solve an industry-wide sufficiency problem and make a real difference in the sector. This has resulted in a record number of services opening across the business community to meet demand.

He added: “The passion and dedication of each and every member of our team has helped to make a significant difference to the lives of hundreds of individuals across the country, while generating considerable economic value.”

A recent report by the National Development Team for Inclusion (NDTi) showed that the small support work carried out by Beyond Limits – a Tristone Healthcare portfolio company – generated an economic value of more than £750,000, with wellbeing scores for nine individuals featured in the report increasing from an average of 2.6 to 8.3 out of 10. The report also highlighted that through the work of Beyond Limits, more than £950,000 was saved in the use of other public services for six of the nine individuals. This includes hospital, ambulance, police and justice, GP, healthcare and social care services costs over a 12 month period – equating to more than £158,000 per person. 

Loucopoulos added: “The powerful fiscal, economic and social results highlighted within this report show the effectiveness of a care model that prioritises holistic wellbeing, leading to both improved quality of life for individuals and significant cost savings.”

In a year of continued expansion, Tristone’s portfolio has seen employee numbers grow from 696 to 808. In 2024, Tristone also featured in the E2E Job Creation 100, after achieving a 195% growth in employee numbers during that period. In total, the community of businesses has supported 686 people over the course of the year, up from 639. In addition, residential care capacity grew to accommodate 102 individuals; semi-independent accommodation now stands at 209; with community living services delivering care to 46 individuals. 

Loucopoulos continued: “As political and economic headwinds begin to ease, 2025 will hopefully provide a more stable environment for the Tristone business community to thrive. There are still fundamental issues within the sector that will need to be addressed through collaboration between social care providers and greater investment at government level, but we’re confident the year ahead will enable the group to continue to demonstrate a significant impact – not just on the people in our care, but on the wider community.”

In the middle sits adult social care, specifically designed for those people with learning disabilities, mental health issues and other support needs. Often losing the limelight to the more headline-grabbing sectors of children’s and elderly social care, it provides vital support for vulnerable individuals and much-needed respite for unpaid carers. Like its counterparts, it also requires much-needed attention and an injection of funding that is well spent. It is a complicated picture, bound by red tape and restricted by costly hierarchical and complex decision-making – a system that desperately needs to be reformed and slimmed down to help streamline services. 

While each distinct sub-sector has its own unique challenges, what marries them together are common themes and pain-points that are not exclusive to one over the other. These include: recruitment, business confidence, output and demand, as well as the ability to grow and remain profitable. 

In a bid to understand the sentiments of businesses, specifically in children’s and adult social care, Tristone Capital has carried out an in-depth survey to understand the views of individuals within the market across those key themes. The aim is to create a State of the Industry Report that provides us with a snapshot of the challenges and opportunities that exist in the sector. 

‘The Social Care Snapshot 2024’ opens the door on a sector that offers so much to many, but is often hamstrung by the actions of others. But what drives companies, what keeps business owners awake at night, and what ambitions they have for the future?

Biggest challenges

Workforce challenges, combined with the rising costs of running a social care business, are two of the biggest pressures facing the sector. 

‘The Social Care Snapshot 2024’ has revealed that recruitment and retention remain a significant priority for the sector, with more than a third of respondents (36%) admitting that they cannot hire enough people with the right skills. 

The national picture shows that immigration remains the biggest workforce issue, more than four years after Brexit. Over a third of businesses (37%) stated that immigration restrictions stop them from recruiting enough people. This is compounded by the cost of recruitment, the high use of agency staff, as well as a COVID-19 hangover that continues to impact the jobs market. The difficulty of replacing staff after the pandemic spikes, in particular, in the North West at 60%.

The reality is, social care has lost a lot of good people to other sectors in recent years, and needs to regain a competitive advantage when it comes to talent and skills – a point not lost on a quarter of social care businesses that have placed investing in people as their biggest investment priority. 

Previous Governments have tried and failed to tackle the issue. That’s why sector leaders believe that it’s essential Labour listens to the workforce challenges being faced by the industry and that politicians work collaboratively with business leaders to ensure it becomes an attractive career prospect for future employees. This includes ensuring that qualifications are robust and accessible, with more apprenticeships and training and development on offer.

Along with other sectors, managing the costs of running a business is also a significant concern to social care providers, according to the survey of more than 100 industry leaders. The national picture shows that managing costs is currently the biggest challenge facing the sector (35%), closely followed by accessing new sources of capital to fund growth (34%). This is mirrored across several regions in the UK, including the North West, the Midlands, the East of England and the South East, where 67% of respondents said that increased operating costs was the greatest pressure facing their business over the next six months – the highest of any region.

Social care providers have faced a litany of economic and political pressures over the last few years, driven by the COVID-19 pandemic and exacerbated by the cost-of-living crisis, while other external factors have contributed to creating a strained outlook that has been instrumental in how businesses function. 

While inflationary pressures have eased in recent months, the damage has already been done for many, with more than a quarter of respondents (29%) admitting that this is the biggest challenge facing their business.

Hope and expectation

With a new Government now firmly in place, the state of the industry report has also highlighted a renewed sense of hope and expectation, with many seeing it as an opportunity to refine business priorities and approach the next six to 12 months with renewed purpose. Central to that is improving the outcomes of service users. More than a third of respondents (34%) ranked this as their top priority, peaking at 60% in both the North West and the East of England. 

This is arguably the most important objective in social care, regardless of the political or economic backdrop; however, what is interesting to note is the added desire to grow and expand, with raising new finance for growth (32%) and opening new services (32%) making up the top three. 

What is reassuring to see is, despite the ongoing pressures and questions surrounding profits, investment intentions are high, with businesses both nationally and regionally planning to inject capital in the next 12 months to meet growth ambitions.

It is those growth ambitions that will set the tone for 2025. Yes, there are sector-specific and wider socio-economic issues that will always heavily influence this market, but social care businesses clearly believe that they are also the masters of their own destiny and intend to set their own path, despite the endemic challenges that exist.

To read the report in more detail, visit our reports page.