Example: pre-acquisition due diligence, a nursing home under offer
Report date: 24 September 2026. Evidence cut-off: 17 September 2026, the date of the site visit.
Scope, evidence and limitations
- Documents examined
- The latest CQC report and action plan, three months of falls audits, one month of rotas and agency bookings, induction records, the safeguarding log and the management structure.
- Site visit
- One day, including observation of care in communal areas.
- People consulted
- The deputy manager and the nurse in charge.
- Limitations
- Staff files, resident care records and financial records were not reviewed. Findings reflect the evidence available at the time of the review.
Summary
The review identified concerns requiring further investigation and a documented response before the buyer reaches a decision. The implications depend on the evidence obtained and the resources required to address the findings.
Priority risks
Priority ratings combine the potential for harm to residents, how urgently action is needed and the likely disruption to the service. High: action needed immediately or before the buyer reaches a decision. Provisional: rated once the outstanding evidence is received.
High Clinical governance
- Finding
- Monthly falls audits were completed, but no analysis or follow-up action was recorded for three months.
- Evidence
- Falls audit forms for the last three months, with no matching entries in the action log.
- Management explanation
- The deputy manager said falls were discussed at handover; no record was available.
- Possible consequence
- Patterns in falls may go unnoticed, increasing the risk of harm and of concern about oversight.
- Recommended action
- Analyse the last three months of falls now and agree an action plan; then continue monthly analysis, reviewed by the clinical lead.
- Lead and timing
- The seller's home manager: initial analysis and action plan promptly; monthly analysis continuing after implementation.
- How completion is checked
- Immediate: the initial analysis and action plan seen by the buyer. Sustained improvement: later monthly analyses show actions closed and their effect checked.
- Implication for the buyer
- If unresolved at completion, the buyer would inherit a falls process that records incidents without learning from them, and the work of embedding analysis and follow-up. A wider review of clinical governance should test whether the same weakness affects other processes.
- Resources and dependencies
- Clinical lead time for analysis and review, and training for nurses in incident review. Costs sit outside this review and should be estimated with the buyer's financial advisers.
High Staffing
- Finding
- Night nurse shifts were often covered by agency nurses with no recorded induction to the home.
- Evidence
- One month of night rotas and agency bookings compared with the induction records.
- Management explanation
- Management said agency nurses are shown round on arrival, but this is not documented.
- Possible consequence
- A nurse unfamiliar with residents, medicines systems and emergency procedures may be in charge at night.
- Recommended action
- Verify the induction records now, and require a documented induction before any further agency deployment.
- Lead and timing
- The seller's home manager, immediately and before any further agency shift.
- How completion is checked
- Induction records seen for every agency nurse on the next month's rota.
- Implication for the buyer
- The buyer would inherit reliance on agency nurses at night and the work of putting induction and continuity of night nursing in place. Service disruption is possible if agency supply changes during the transition.
- Resources and dependencies
- Management time to induct agency nurses, and recruitment to reduce reliance on agency cover. Agency and recruitment costs sit outside this review; the buyer should obtain current agency spend and rates from the seller.
High Management
- Finding
- The registered manager post is vacant and the deputy is covering.
- Evidence
- The management structure provided by the seller.
- Management explanation
- The seller said recruitment is under way; no start date was confirmed.
- Possible consequence
- The seller has not shown who is accountable for care, safeguarding decisions and regulatory notifications while the post is vacant. The buyer should not rely on the current arrangements until this is confirmed in writing.
- Recommended action
- Confirm in writing who is accountable now and what interim support is in place, then agree a recruitment plan.
- Lead and timing
- The seller, immediately for interim accountability; the buyer, before completion for the recruitment plan.
- How completion is checked
- Written confirmation of interim arrangements, and a recruitment plan agreed between seller and buyer.
- Implication for the buyer
- The buyer would inherit a vacant registered manager post and reliance on interim leadership. The transition plan needs to address continuity of management and the support available to the deputy.
- Resources and dependencies
- Interim management capacity, recruitment expenditure and induction support require assessment. An estimate needs the recruitment terms, interim support costs and expected appointment date, which the seller should provide.
Provisional Safeguarding
- Finding
- Two safeguarding referrals were raised last year, but their outcomes were not recorded in the home's log.
- Evidence
- The safeguarding log, showing referral dates without outcomes.
- Management explanation
- Management believed both were closed with no further action, but had no written outcome.
- Possible consequence
- Unresolved concerns or required actions may be unknown to the buyer.
- Recommended action
- Obtain the written outcomes and bring the log up to date.
- Lead and timing
- The seller, before the buyer reaches a decision.
- How completion is checked
- Outcome letters seen by the buyer, and any continuing concerns identified.
- Priority
- Provisional. A firm rating will be set once the outcomes and any continuing concerns are known.
- Implication for the buyer
- The buyer needs the outcomes to confirm that no concerns or required actions transfer at completion.
- Resources and dependencies
- Time to obtain the outcomes from the local authority. Any further resources will depend on what the outcomes show.
Unanswered questions for the seller
- Staff turnover and sickness absence for the last 12 months
- Outcome letters for the two safeguarding referrals
- Evidence supporting the actions marked complete on the CQC action plan, and an update on outstanding actions
Implications for the proposed acquisition
On the evidence provided, current management and staffing arrangements fall short of the oversight an ownership transition needs: the registered manager post is vacant, interim accountability is unconfirmed and night nursing relies on agency nurses without recorded induction.
Before reaching a decision, the buyer should obtain evidence of interim management accountability, agency nurse induction arrangements and the outcomes of the safeguarding referrals. A wider review of clinical governance should test whether the weaknesses in falls oversight extend to other processes.
The buyer should consider the management capacity, staff training and external support required to address confirmed weaknesses. These costs should be estimated with the buyer's financial advisers before completion.
These findings inform the buyer's wider due diligence. Financial viability is a matter for the buyer's financial advisers, and the decision to proceed rests with the buyer.
This short extract is not a complete assessment. A full report covers every area within the agreed scope, with the evidence reviewed for each finding.
