Four Seasons Health Care

Four Seasons Health Care is an independent provider of health and social care services. It owns The Huntercombe Group, a provider of inpatient mental healthcare and brain injury rehabilitation. Four Seasons, as it is today, was created by buying out smaller chains of care homes and re-branding them as evidenced by the takeovers of Tamaris (formerly Quality Care Homes) and Bettercare.

Up until 1997 Four Seasons was a small operator working only in Scotland. The fortunes of the business were changed with the appointment of Hamilton Anstead as Chief Executive Officer. There followed a rapid expansion programme for the business which transformed it within 7 years into the largest care home operator in the UK (it was subsequently overtaken). The business was attractive to many suitors and as a result it was sold for £775 million in 2004. Anstead ceased to be CEO in 2005.

The company was acquired in 2006 by Three Delta LLP, the investment fund backed by the state of Qatar, and further expanded. The acquisition was funded by debt which was readily available in a market where investors saw rising property prices and continuing demand for care for the elderly, much of it paid for by the public sector. However, the company was unable to pay its debts and with a downturn in the property markets was unable to refinance and the owners walked away, losing their investment.

Dr. Peter Calveley was appointed CEO in 2007 and his senior management team were left to resolve debts of circa £1.5 billion as a result of borrowings by its owners to buy the homes.

The Group completed a financial restructuring in December 2009, with lenders – banks and other financial institutions – agreeing to swap about £780 million debt for equity in the business, so becoming its new shareholders. Maturity of the remaining debt has been extended to September 2012. It is currently reviewing options for permanent resolution of the remaining debt. The debt and equity holders are supportive and the Group is confident this will be achieved next year before the maturity date. Four Seasons is now trading profitably. Under Calveley’s leadership the quality of care performance has changed from below sector average, to having 89% of its homes rated as good or excellent by the Care Quality Commission.

This turnaround in quality has helped to drive up occupancy to levels of circa 88%. Another factor in the Group’s performance is Calveley’s strategy of anticipating market changes in order to provide specialist care. Four Seasons has 80% nursing or high dependency beds and 20% residential in contrast to the sector average of 55% residential. It has developed services for people who are physically frail or suffering from the onset of dementia, chronic neurological conditions, respite care, intermediate care and rehabilitation, terminal care. Because there are few readily available alternatives for high dependency care – such as care provision at home – the market for higher dependency care is more resilient than the market for residential care.

As of July 2011 the Group had achieved substantial expansion without new borrowings, by acquiring the operations of Care Principles with 17 hospitals and homes – nearly doubling the size of FSHC’s specialist care business and 1,000 additional care home places (c. 6% growth) through acquisitions over the preceding year from Craegmoor and Eton Square Healthcare. As of September 2011 the group was expected to acquire over 100 care homes from the collapsed provider Southern Cross, which would make it the largest provider in the UK. These include 54 owned by Loyd's Property.