‘It was about as far at odds with our provider failure protocol…as you can get’: Untangling care policy when care homes close

This article takes an extreme case - the emergency closure of a care home on a Friday evening - to explore how a lack of coordination between national and local stakeholders led to a brutalising experience for frail residents and social care staff. Care home closures sit at the interface of multiple policy domains including funding, infrastructure, staffing, quality assurance and regulation. Drawing on interviews with managers and wider stakeholders, the article highlights how vertical and horizontal coordination mechanisms failed to deliver a timely and effective closure process. We explain this not as an extreme and atypical case but rather of an exemplar of what can happen when poor policy design creates risks that fail to provide adequate provision for vulnerable people. It also highlights that policy is not always a process of adding more layers and entanglements. Sometimes—often at a point of crisis—the mixed threads of policy need to be pulled apart to clarify legal responsibilities and liabilities. When this cannot be done effectively, people are exposed to unacceptable levels of risk and distress.