by Tom Morris, MD, tdm recruitment
I’ll say the thing most people in this sector won’t say out loud: later living has a construction culture problem, and it’s been getting away with it for years because demand was strong enough to paper over the cracks. That’s not true anymore, and I think a lot of people are about to find that out the hard way.
Here’s where we actually are. Only 77 new care homes opened across the UK in the past year. Set that against a 139,000-bed shortfall and the sector is building roughly a third of what it needs. Everyone quotes that stat and nods along like it’s a market condition that just happened to us. It isn’t. A good chunk of it is self-inflicted.
Land and planning get all the attention because they’re visible. By which I mean, you can point at a committee decision, a councillor, a slow local authority, and say, “there’s the problem.” Delivery capability doesn’t get talked about the same way, because admitting you don’t have it means admitting your own operation is the weak link, not the planning system.
But later living gets hit by the construction skills shortage harder than almost anything else in resi, because of what these buildings actually are. Medical gas. Enhanced ventilation. Backup power. Nurse call systems. M&E alone can be 35–50% of build cost, against 15–25% on a standard scheme, and the trades who can do that work properly are the scarcest people in the entire construction industry right now. CITB says the sector needs 41,200 more workers every year through to 2030. We are nowhere near that.
And here’s the bit that should actually worry people: there were close to 4,000 construction insolvencies in the year to July 2025, 17% of all UK corporate failures. That’s not a rounding error; that’s a sign the whole delivery chain underneath this sector is thinner and more fragile than the investment headlines suggest. Losing a contractor mid-build used to be a nightmare scenario you planned around. Now it’s closer to a base case.
So why does this keep happening? Because for a long time, procurement in this sector has rewarded whoever can quote the lowest number and the shortest programme, not whoever can actually deliver a healthcare-spec building on a fragile supply chain without it falling over. Developers have been able to get away with treating later living construction like “resi with a stairlift and some grab rails,” because for a while, demand was forgiving enough that even a badly-run scheme eventually got built and sold. That forgiveness is gone. The market’s tighter, the money’s more discerning, and the operators who cut corners on delivery capability are going to be the ones explaining a year-long slip to their board, not the ones celebrating a launch.
I don’t think this is a popular thing to say, but I think it’s the honest read: a lot of the “construction constraint” people complain about is actually a construction competence gap, and it’s been hiding behind a supply-and-demand story that’s convenient because it doesn’t implicate anyone.
What actually changes this: developers who go and find genuinely specialist technical delivery people, not generalist project managers who’ve drifted into later living from standard resi, and who treat contractor risk management as a board-level concern, not something that gets discovered three months into a programme slip. That’s a hiring decision before it’s anything else, and it’s the one most operators still aren’t taking seriously enough.
A site with consent is not a delivered building, and pretending otherwise is how you end up explaining a nine-month delay to investors who were told eighteen months ago that this was a twelve-month build. If that’s a conversation you’re already having, or one you can see coming, I’d rather talk to you now than after it’s happened.
