2. A Guide to Care Home Investments
2
Contents
1. Introduction
2. An Ageing Population
3. The Current UK Care Market
4. The UK Care market industry performance
5. Maximising investment returns from the UK healthcare market
5.1 Considerations
5.2 Opportunities & Risks of the UK Healthcare Market
6. Future proof care home investments [infographic]
7. Investor opportunities
7.1 Manor Park
7.2 Ridgeway House
7.3 Butterhill House
7.4 Pontypridd Care Home
3. A Guide to Care Home Investments
3
Introduction
Care Home investments can offer an alternative buy-to-let property opportunity
that can be highly profitable – offering annual returns of 10% or more, as well as the
opportunity for capital growth.
Driven by the rising life expectancy of people within the UK, investments in care home
properties have become increasingly popular as an alternative way of generating a
passive income.
Care Home investments provide an investment opportunity in an ethical sector that
now allow individuals to capitalise on the strength of the healthcare property industry
which has traditionally only been available to institutionalised investors.
4. A Guide to Care Home Investments
4
An Ageing Population
The UK has an ageing population. The proportion of people aged over 65 has increased
over the past 30 years – a trend that is predicted to continue. This trend will place
added pressure on the UK’s health care, social care, housing and the economy.
According to the Office for National Statistics (ONS), the UK is at its oldest ever. In mid-
2014, there were some 11.4 million people living in the UK aged 65 and over – making
up 17.7% of the population, up from 11.1 million the previous year. The ONS predict a
quarter of the population will be over the age of 65 by 2044 . Furthermore, the number
of people aged 75 and over has increased by
89% over the period, now making up 8% of the population.
A rapidly ageing society means an increased number of older people, living longer –
often with chronic, long-term health care requirements. As a result, it is predicted there
will be an 80% increase in demand for health and social care for people with dementia
in the years 2010 – 2030 . According to the House of Lords “Ready for Ageing?” report,
the UK is currently ‘woefully underprepared’
for ageing and there’s significant implications that will result without urgent action.
The need for this transformation in the UK is given additional urgency by a challenging
financial backdrop. The King’s Fund released a report in 2014 that states “The NHS and
social care have reached a critical point. The service faces enormous challenges over the
next 18 months…” The report goes on to state “There is considerable agreement about
the vision for a more integrated service that provides better care in community settings,
and that this vision can deliver both lower costs and better outcomes. However, these
‘transformational’ changes are not costless to implement.”
Proportion of people at older ages, UK population mid-1974 onwards.
Source: Office for National Statistics, National Records of
Scotland, Northern Ireland Statistics and Research Agency
5. A Guide to Care Home Investments
5
The Current UK Care Market
In July 2015, there were 5,627 registered nursing homes in the UK equipped to dementia standards,
and 12,311 residential homes. To appropriately support people, the housing market needs to change
in order to deliver the specialist housing and care required by the elderly.
According to Age UK, more than a third of people over the age of 65 think Britain has become a worse
place to live in the last year . Between 2005/6 and 2013/14 there was an 18% reduction in spend
on older people’s social care – whilst the number of people aged over the age of 65 significantly
increased.
The healthcare industry remains one of the fastest growing markets across the globe and with a
wealth of new property investment opportunities available, the sector offers unprecedented growth
potential. The returns profile of this asset class is also capturing the attention of the wider investment
community.
Knight Frank undertook a specialist property survey in January 2015 of 69 leading investors, developers
and lenders. The survey aimed to understand the attitudes towards specialist investments. When
asked “If you are planning to increase your exposure to specialist property, which sectors(s) will you
be targeting?” A substantial 70% of respondents stated they would look to target the UK healthcare
and student markets.
If you are planning to increase your exposure to specialist
property, which sector(s) will you be targeting?
The survey indicated an increasing appetite for specialist property investors,
of which, Knight Frank predict that the UK care home sector will likely be the
strongest performing segment due to structural undersupply and increasing
demand.
The availability of good quality care homes is still limited, creating
extraordinary levels of demand for profitable facilities. In response to this
demand, UK healthcare property is now widely regarded as a mainstream
asset class with many individual investors turning to this income stream to
diversify their
portfolio. The strong, index-linked income, provides both short and long-term
benefits, and as a result is attracting growing numbers of private investors to
purchase within this sector.
Source: Knight Frank, Specialist Property The Core
Markets, 2015
6. A Guide to Care Home Investments
6
The UK Care Market Industry Performance
With £4.5bn worth of deals occurring in the healthcare market in 2014 (Source: CBRE
UK Healthcare Marketview, Q1 2015), the UK healthcare market continues to attract
investors due to long rental leases, and RPI index-linked annual rental increases. Subject
to asset quality, business attributes and location, there is increasing evidence that banks
and lending institutions are prepared to invest and
support operators across the healthcare spectrum, due to the strong, supporting
demographic argument.
According to the IPD’s Healthcare Index, UK healthcare property outperforms all other UK
commercial property with total UK returns across all UK healthcare property increasing
over the last 12 months from 5.6% at the end of 2013, to 9.0% at the end of 2014.
Compared with only 1.5% p.a. for all UK property, the care industry is a significantly more
profitable and secure option.
Furthermore, the market has demonstrated robust returns from a stable marketplace
since the index was launched in 2007, demonstrating an impressive risk-reward profile in
comparison to other UK property sectors.
John Hearle, Chairman and Head of Healthcare, Aitchison Raffety states,
The secondary healthcare sector and specifically care homes is a rapidly growing part of
the healthcare market. The increasing demand for suitable elderly care is a key driver.
Currently, up to 80% of the UK’s care home stock is below ‘institutional’ quality – providing
a clear case for investment in future-proofed care facilities.
The new healthcare investor sees major opportunities in acquiring real estate that takes
advantage of the long-term demographic movement, combined with the medium-term
benefits of real estate investments and the short term availability of high-quality stock
with relatively low demand.
“Healthcare property is a solid, long-term, secure investment showing steady
growth and a lack of volatility. Some people may see the sector as ‘comfortably
boring’ but certainly for Primary Healthcare, that is what the investor wants.”
7. A Guide to Care Home Investments
7
According to Knight Frank, healthcare properties are predicted to be the best performing asset in the healthcare sector and offer substantial returns for investors, however it’s
important to consider all the risks and rewards involved to ensure investors maximise their returns.
1. Specialist management, with a commitment to excellence
As the operational success of a care home property relies heavily on the reputation
and management of the property, it is important to work with properties committed
to excellence and a first-rate attitude to providing premium care and superior
management. Managers and staff should all be welltrained and informed of all industry
guidelines.
2. High quality facilities that are patient driven and offer significant
treatment advances
Progressive technology and forward-thinking facilities will ensure both residents and
care staff alike benefit. Unlike traditional or refurbished care homes, futureproof
facilities will ensure the longevity of your investment and the success of the individual
care property. Aspects such as hygiene, catering and activities offered should all be
considered when evaluating the quality of the property.
3. Solid business models & financial positions
Ensuring a sound business model that consistently brings profits into the business is of
course the foundations of any successful investment.
4. Competitive differentiators
Professional associations and guidelines are in place to ensure the duty of care is
maintained in the UK. It is important to assess the quality service provision against
industry guidelines from the CQC (Care Quality Commission).
5.1 Considerations
“The future for healthcare real estate investments is looking more
positive than at any time in the last five years”
Maximising Investment Returns From The UK Healthcare
Market
8. A Guide to Care Home Investments
8
1. Under-supply of good quality stock in the UK – currently there is only one dementia
care home bed for every four that are needed. Rising demand coupled with limited
supply indicates the cost of care and value of facilities can only go up.
2. Continuing need to upgrade & replace – Many existing inappropriately used and
sub-standard properties need upgrading and significant investment, despite the
massive investment that has already been made in medical facilities over the last
15 years.
3. The demand is driven by structural, demographic changes – rather than cyclical
change or new demand. All evidence proves we’re living longer and whilst we
all want to live in our own homes for as long as possible, mental and physical
deterioration in the elderly can make this impossible.
4. Relatively high-yielding. High-quality, primary healthcare facilities are seeing
transactional yields of 7 per cent or better (Source: Colliers) and offer more stability
in periods of weak financial markets and reduced consumer spending.
5. Long-term occupancies & long leasebacks – Investing in a long lease property can
offer attractive long-term cash flows, with the added benefits of stability, security
and potential capital gains.
1. Demanding management with specialist nature – The multi-tenanted and
operational nature of some specialist properties requires an intensive management
structure and relies on the success of the individual operator. The specialist nature
of the properties should be considered as properties completed to dementia
standards offer limited scope to change the use, as well as to add value.
2. Reputational Risk – The mistreatment and misconduct of residents and relies
entirely on the operator responsible for the care homes. The key is to invest with
your eyes open and perform full due diligence on the operators.
3. Higher potential costs – high quality providers may also operate with higher costs
due to investments in quality facilities and services within the enterprise.
4. Poor business models – it is important to understand where the income is coming
from and the nature of those people. Is the income coming from local authorities,
private wealth or foundations? The mix of these determines the achievable rents
for the operator.
5.2 Opportunities 5.3 Risks
Maximising Investment Returns From The UK Healthcare
Market
9. A Guide to Care Home Investments
9
Future Proof Property Investments
The need for suitable UK care homes is inevitably increasing and there is significant need for practical living and accommodation solutions for the elderly.
One in five care homes in England are failing to meet set national standards for safety and care, which is driving a passion for developing this asset class from
both businesses, banks and individuals.
One in Four
people above 90 are living in
communal care homes.
There are
12 million
over 60s in the UK alone.
Care for the elderly is worth
£14.5 billion
each year.
Demand will grow
60% by 2023,
increasing to
150% by 2043.
10. A Guide to Care Home Investments
10
Investor Opportunities
Healthcare real estate can accommodate mainstream investor requirements.
Structured rents where the investor is insulated against fluctuations in operator performance and income
bring healthcare into the residential investment market.
Unitised care home opportunities provide an affordable, profitable and ethical investment proposition.
11. A Guide to Care Home Investments
11
Manor Park Nursing Home
Green Street, Holt, Wrexham LL13, 9JF
PROPERTY HIGHLIGHTS
Near a sleepy village called Holt.
Direction:
From Wrexham look for the A534
to Nantwich known as the Holt
road. After leaving Wrexham you
will pass the Wrexham Golf Course
follow this road for 3-½ mile and
you will reach the left turn to Holt
village. On entering the village you
will pass Bellis Brothers garden
centre. Continue along the main
road passed the village square with
the War memorial, and on reaching
the Peal O Bells pub on the right
hand side with the church directly
behind it. The village Green will be
on your left hand side and Manor
Park directly behind it.
Parking:
On site Parking
OPPORTUNITY
HIGHLIGHTS
8% - 10% Assured Net
Returns Per Annum
Guaranteed Buy Back
(3, 5, 9, 15 & 20 Years)
Paid Quarterly
Returns Per Annum
A Hands-Off Investment
Fully Managed Care Home
INVESTMENT DETAILSINVESTMENT STARTING FROM £64,999
Local Authority / Social Services: Wrexham County
Borough Council.
Type of Service: Care Home only (Residential Care)
– Privately Owned , Registered for a maximum of 28
Service Users
Registered Care Categories*: Dementia • Mental
Health Condition • Old Age
Specialist Care Categories: Alzheimer’s • Challenging
Behaviour
Admission Information: Ages 65+.
Languages Spoken by Staff (other than English): British
Sign Language, Welsh.
Single Rooms: 28
Rooms with ensuite WC: 9
Facilities & Services: Day Care • Respite Care •
Physiotherapy • Own GP if required • Own Furniture if
required • Pets by arrangement • Close to Local shops
• Near Public Transport • Minibus or other transport •
Lift • Wheelchair access • Gardens for residents • Bar/
Cafe on premises • Phone Point in own room/Mobile •
Television point in own room
Actual UK Sterling Sum
Invested
Assured Returns
Year 1 Year 2 & 3 Year 4 & 5
£75,000 8% 9% 10%
£100,000 9% 9.5% 10%
£125,000 9.5% 10% 10%
£150,000 10% 10% 10%
Actual UK Sterling Sum
Invested
Guaranteed Buy-back
In 3 Years In 5 Years In 9 Years In 15 Years In 20 Years
£75,000
9%
£81,750
15%
£86,250
23%
£92,250
30%
£97,300
40%
£105,000
£100,000
9%
£109,000
15%
£115,000
23%
£123,000
30%
£130,000
40%
£140,000
£125,000
9%
£136,250
15%
£143,750
23%
£153,000
30%
£162,000
40%
£175,000
£150,000
9%
£163,500
15%
£172,500
23%
£184,500
30%
£195,000
40%
£210,000
PAYMENT SCHEDULE
Paid quarterly directly to your bank
Review Score
from 5 Reviews
JAN
31
APR
30
JUL
31
OCT
31
9.6
EXIT OPTION 1 OPTION 1
STRATEGIES Guaranteed buy back options from RB
Carehomes (3, 5, 9,15 & 20 years).
Selling at your own discretion to any
third party.
Recession-proof / Ethical investment
• No maintenance & ground rent
• Assessed care is inevitably required
• Room variants depending on investment levels (£64,999 and up)
• High Demand for beds / locations.
• Expected to exceed 40,000 by 2020
• Specialised fit-for-purpose buildings & equipment
• Qualified & experienced management teams with skilled &
trained workforce
• Multi-faceted specialist service offerings (resi-dential, nursing,
dementia & mental health, and learning disability)
• Fully assessed and bespoke care packages designed for Dementia
12. A Guide to Care Home Investments
12
Ridgeway House
Residential Care Home In Llawhaden, Narberth
PROPERTY HIGHLIGHTS
The Ridgeway House, in Narberth, is a
forty-six capacity care home that strives to
maintain a pleasing and comfortable living
environment for those who have daily care
needs. Carers are available around the
clock and make sure that all care packages
are personalized to suit the needs of the
individual, with some respite provision also
available for the surrounding community.
A well-established home in a rural setting 10
miles east of Haverfordwest but convenient
for Swansea and the M4, Ridgeway occupies
an ancient site with a well-documented
history back to medieval times and can even
boast a visit from Lord Nelson and Lady
Hamilton.
Each of the rooms has a television point
and nurse call system, while residents
enjoy freshly cooked meals that can be
personally prepared for their individual
nutritional needs. Ridgeway has its own
transport for day trips and hospital visits,
while hairdressers, chiropodists and
physiotherapists all visit the home.
OPPORTUNITY
HIGHLIGHTS
8% - 10% Assured Net
Returns Per Annum
Guaranteed Buy Back
(3, 5, 9, 15 & 20 Years)
Paid Quarterly
Returns Per Annum
A Hands-Off Investment
Fully Managed Care Home
Recession-proof / Ethical investment
• No maintenance & ground rent
• Assessed care is inevitably required
• Room variants depending on investment levels (£64,999 and up)
• High Demand for beds / locations.
• Expected to exceed 40,000 by 2020
• Specialised fit-for-purpose buildings & equipment
• Qualified & experienced management teams with skilled &
trained workforce
• Multi-faceted specialist service offerings (resi-dential, nursing,
dementia & mental health, and learning disability)
• Fully assessed and bespoke care packages designed for Dementia
INVESTMENT DETAILS
INVESTMENT STARTING FROM £64,999
• 41 single and 3 shared rooms (19 en suite).
• Conditions cared for are older people
generally,people with physical difficulties
and dementia
• Care period: Longer stay / Short stay and
respite Facilities available for family or
friends to stay overnight
• Residents may bring their own furniture
• Activities are actively arranged
MARKET ANALYSIS
• The population of Llawhaden is ageing.
• Between 2001 and 2011 the number of
residentsabove the age of 65 increased by
25% (representingalmost 31,000 additional
people)
• The number of residents above the age of
85 hasincreased by 38% (an increase of
over 5,000).
Actual UK Sterling Sum
Invested
Assured Returns
Year 1 Year 2 & 3 Year 4 & 5
£75,000 8% 9% 10%
£100,000 9% 9.5% 10%
£125,000 9.5% 10% 10%
£150,000 10% 10% 10%
Actual UK Sterling Sum
Invested
Guaranteed Buy-back
In 3 Years In 5 Years In 9 Years In 15 Years In 20 Years
£75,000
9%
£81,750
15%
£86,250
23%
£92,250
30%
£97,300
40%
£105,000
£100,000
9%
£109,000
15%
£115,000
23%
£123,000
30%
£130,000
40%
£140,000
£125,000
9%
£136,250
15%
£143,750
23%
£153,000
30%
£162,000
40%
£175,000
£150,000
9%
£163,500
15%
£172,500
23%
£184,500
30%
£195,000
40%
£210,000
PAYMENT SCHEDULE
Paid quarterly directly to your bank
Review Score
from 5 Reviews
JAN
31
APR
30
JUL
31
OCT
31
9.6
EXIT OPTION 1 OPTION 1
STRATEGIES Guaranteed buy back options from RB
Carehomes (3, 5, 9,15 & 20 years).
Selling at your own discretion to any
third party.
Change in population
by age group between
2001 and 2016
13. A Guide to Care Home Investments
13
Pontypridd Nursing Home
Residential Care Home In 49 Woodland Terrace, Pontypridd Cf37 1Jg,UK
PROPERTY HIGHLIGHTS
Pontypridd Nursing Home is skilled in
providing mental health-related care
provision, offering personalised support for
adults with dementia and also for those with
a learning disability. Comfort Care Homes
are known for maintaining facilities that
support the personal freedoms of residents,
while being welcoming places to visit, clean,
hygienic and secure. Employees are well
supported with training programmes, with
the provider keen to invest in talent in order
to guarantee the quality of provision over
the long term.
OPPORTUNITY
HIGHLIGHTS
8% - 10% Assured Net
Returns Per Annum
Guaranteed Buy Back
(3, 5, 9, 15 & 20 Years)
Paid Quarterly
Returns Per Annum
A Hands-Off Investment
Fully Managed Care Home
Recession-proof / Ethical investment
• No maintenance & ground rent
• Assessed care is inevitably required
• Room variants depending on investment levels (£64,999 and up)
• High Demand for beds / locations.
• Expected to exceed 40,000 by 2020
• Specialised fit-for-purpose buildings & equipment
• Qualified & experienced management teams with skilled &
trained workforce
• Multi-faceted specialist service offerings (resi-dential, nursing,
dementia & mental health, and learning disability)
• Fully assessed and bespoke care packages designed for Dementia
INVESTMENT DETAILS
INVESTMENT STARTING FROM £64,999
Facilities & Services
• Palliative Care
• Day Care
• Respite Care
• Physiotherapy
• Separate Dementia Care Unit
• Own GP if required
• Own Furniture if required
• Close to Local shops
• Near Public Transport
• Wheelchair access
• Gardens for residents
• Residents Kitchenette
• Television point in own room
Single Rooms 56
Shared Rooms 1
Rooms with ensuite 22
Actual UK Sterling Sum
Invested
Assured Returns
Year 1 Year 2 & 3 Year 4 & 5
£75,000 8% 9% 10%
£100,000 9% 9.5% 10%
£125,000 9.5% 10% 10%
£150,000 10% 10% 10%
Actual UK Sterling Sum
Invested
Guaranteed Buy-back
In 3 Years In 5 Years In 9 Years In 15 Years In 20 Years
£75,000
9%
£81,750
15%
£86,250
23%
£92,250
30%
£97,300
40%
£105,000
£100,000
9%
£109,000
15%
£115,000
23%
£123,000
30%
£130,000
40%
£140,000
£125,000
9%
£136,250
15%
£143,750
23%
£153,000
30%
£162,000
40%
£175,000
£150,000
9%
£163,500
15%
£172,500
23%
£184,500
30%
£195,000
40%
£210,000
PAYMENT SCHEDULE
Paid quarterly directly to your bank
Review Score
from 5 Reviews
JAN
31
APR
30
JUL
31
OCT
31
9.6
EXIT OPTION 1 OPTION 1
STRATEGIES Guaranteed buy back options from RB
Carehomes (3, 5, 9,15 & 20 years).
Selling at your own discretion to any
third party.
14. A Guide to Care Home Investments
14
Sources
Age UK; Later Life in the United Kingdom: http://www.ageuk.org.uk/Documents/ EN-GB/Factsheets/Later_Life_UK_factsheet.pd-
f?dtrk=true
MSCI: Healthcare Outperforms All Commercial Property: https://www.ipd.com/ about/media_centre/news_archive/2015/UK%20
Healthcare%20Annual%20 2014%20results.pdf
http://realestate.ipe.com/investors-in-healthcare/10001774.fullarticle
1
Ageing of the UK population, Released 25th June 2015: http://www.ons.gov.uk/ ons/rel/pop-estimate/pop-
ulation-estimates-for-uk--england-and-wales--scotlandand- northern-ireland/mid-2014/sty-ageing-of-the-
uk-population.html
2
House of Lords Report: Ready for Ageing?: http://www.cpahq.org/cpahq/ cpadocs/UK%20Parlia-
ment%20HOL%2 Ready%20for%20the%20Ageing. pdf?WebsiteKey=b62c9100-bdad-479a-a8c3-
2a484d7c8297&=404%3bhttp%3a% 2f%2fwww.cpahq.
3
The NHS Productivity Challenge, The King’s Fund (May 2014): http://www. kingsfund.
org.uk/sites/files/kf/field/field_publication_file/the-nhs-productivitychallenge-kings-
fund-may14.pdf
4
Care Quality Commission: http://www.cqc.org.uk
5
Age UK: http://www.ageuk.org.uk/latest-press/life-in-britain-has-got-worse-
saythird- of-over-65s 6Knight Frank: http://www.knightfrank.co.uk/com-
mercial/healthcare
6
Knight Frank: http://www.knightfrank.co.uk/commercial/health-
care
15. UNITED KINDGOM
Tel: +4420 3897 4284
Address: 88 Wood Street Barbican, London EC2V 7RS
HONG KONG
Tel: +852 2824 8351
Address: 181 Queens Road Central,No 88 Wood Street, Hong Kong
Website: carehomeinvestment.uk Email: info@carehomeinvestment.uk