Improving Operational and Financial Performance Across a Care Home Portfolio

Q: Connecting Operational and Financial Reviews

Weekly operational governance was linked with monthly financial reporting. This allowed performance discussions to consider how staffing, occupancy and service delivery affected financial results, supporting clearer priorities across the portfolio.

Q: Managing Occupancy and Fee Performance

FCML actively managed occupancy and Average Weekly Fee as part of the work to improve revenue. These measures were reviewed alongside wider operational performance, connecting commercial activity with the management of each home.

Q: Strengthening Staffing Controls

Staffing controls were introduced to reduce agency reliance and improve workforce efficiency. The approach focused on aligning staffing expenditure with occupancy while strengthening oversight of how resources were used.

Q: Monitoring Progress Across the Portfolio

Operational performance was linked directly to financial KPIs, including EBITDA. Continuous monitoring and reporting across the homes helped maintain visibility of progress and identify where further management attention was needed.

How Fulcrum Care Management Ltd supported a care home portfolio following a change of ownership, increasing revenue and strengthening workforce and financial control.

Case Study Overview

Following its transition into new ownership, the care home portfolio needed coordinated operational management to address financial performance, staffing costs and consistency across its homes.

Fulcrum Care Management Ltd (FCML) was engaged to bring together governance, workforce planning and commercial performance management.

Our approach connected weekly operational reviews with monthly financial reporting, giving the management team clearer oversight of the factors affecting income, expenditure and service performance.

Revenue Growth

Increases across all homes

Average Weekly Fee

Increased across the portfolio

Agency Reduction

Lower usage in the majority of homes

EBITDA Improvement

Sustained over the reported three-month period

The Challange

The change of ownership created a need for consistent operational and financial oversight across the portfolio.

At the point of engagement, the homes faced challenges involving financial performance, staffing cost control and variation in operational delivery.

The engagement needed to address:

Consistency in regulatory and operational performance.
Occupancy and Average Weekly Fee.
Agency reliance and staffing efficiency.
Visibility of financial performance across individual homes.
The connection between operational decisions and profitability.

FCML’s task was to establish a coordinated management approach that supported revenue growth and cost control while maintaining a focus on compliance and care delivery.

The Approach

FCML introduced an integrated operational and financial management model, combining governance, workforce controls and commercial initiatives.

Connecting Operational and Financial Reviews

Managing Occupancy and Fee Performance

Strengthening Staffing Controls

Monitoring Progress Across the Portfolio

Why It Worked

Operational and Financial Management Were Connected

Governance and reporting brought the factors affecting care delivery, income and expenditure into the same management process.

Each Home’s Performance Remained Visible

Monitoring across the portfolio supported coordinated oversight while retaining a view of individual service performance.

Workforce Controls Addressed a Key Cost Pressure

Closer management of agency use and staffing efficiency helped improve cost control and margins.

Financial Improvement Was Supported by Daily Management

Revenue and profitability priorities were incorporated into operational reviews and ongoing management activity.

The Result

Revenue Increased Across All Homes

Improved occupancy and pricing strategies supported revenue growth throughout the portfolio.

Average Weekly Fee Increased

Average Weekly Fee rose across the portfolio, strengthening income per person receiving care.

Agency Usage Fell in the Majority of Homes

Reduced agency reliance improved control of staffing expenditure and supported margins.

Staffing Efficiency Improved

Improved staffing ratios and workforce efficiency helped align costs with occupancy.

Sustained EBITDA Improvement

The portfolio recorded sustained EBITDA improvement over the reported three-month period, demonstrating progress in financial recovery.

For Owners and Investors Managing a Portfolio

Portfolio performance depends on understanding what is happening within each home and coordinating the actions needed to improve it.

This case study demonstrates how operational leadership, workforce controls, occupancy management and financial reporting can work together to support improvement across multiple services.

For owners and investors, this approach provides clearer visibility of performance and a practical basis for managing income, costs and longer-term sustainability.

How FCML Can Help

Fulcrum Care Management Ltd provides hands-on management across care homes and portfolios, connecting operational delivery with governance, staffing, occupancy and financial oversight.

Speak to our team about improving operational and financial performance across your care home portfolio.

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