The Enshittification of Care: Is It Happening — and Can We Stop It?

What is the enshittification of care?

Enshittification is the writer Cory Doctorow’s word for what happens when the wealth a service creates is steadily extracted from it, until the service decays. In care, it means something very simple: the quality of care falls because the money that should sustain it has gone somewhere else. Is it happening? In parts of the sector, yes — and under more than one ownership model. The good news: independent homes are the best placed in the sector to get ahead of it.

Where did the word come from?

Doctorow coined the term in 2022 to describe why the big platforms — Facebook, Amazon, Google — all seemed to get worse in the same way. It struck such a nerve that the American Dialect Society made it their 2023 word of the year, and in 2025 he turned it into a book, Enshittification: Why Everything Suddenly Got Worse and What to Do About It.

His argument runs in three stages. First, a platform is genuinely good to its users, because it needs them. Then, once users are locked in, it shifts the value to its business customers — the advertisers, the sellers, the people paying for access to those users. Finally, once everyone is locked in, it claws back value for itself and its shareholders, and the whole thing curdles. The service still exists. It just quietly stops being for you.

And it stopped being an internet word some time ago. The clearest example in Britain right now isn’t a social network — it’s water. Decades of dividends flowed out while the infrastructure quietly degraded, and the public noticed the difference between what they pay and what they get. Support for bringing water back under public control now stretches right across the political spectrum, including among voters who would once have considered the idea unthinkable. When wealth leaves a service faster than it’s reinvested, people eventually feel it — and they stop believing the brochure.

Once you’ve seen the pattern, you see it everywhere. So let’s be honest about our own sector.

Is it actually happening in care?

Here’s the fair answer: care is not a platform, and most of the people in it — including most owners — are motivated by something money can’t fully explain. But three layers around care show the pattern clearly enough that every operator should recognise it.

The middle layer between you and families. The big care directories began as a genuinely useful thing: one place for families to search. Today, the sector’s largest directory sells care homes an Enhanced subscription at £990 a year and a Platinum tier at £1,980 a year — and among the listed benefits are “higher ranking than basic listings” and a “ranking boost”. That’s not a scandal; it’s simply their business model, and the tools are useful. But it means the order a worried daughter scrolls through isn’t purely a ranking of care — it’s partly a ranking of subscription. Visibility in the place families trust is rented, not earned. That is textbook stage two.

The ownership layer. A University of Manchester study of 10,803 English care homes, published in Age and Ageing, found that private-equity-backed chains were 6.6 percentage points more likely to be rated “Requires Improvement” or “Inadequate” than not-for-profit providers — with the gaps showing up in safety, effectiveness and responsiveness. That is a statistical pattern, not a verdict on any individual home, and there are excellent corporate homes and struggling independents. But when a home’s surplus is being pulled upward to service debt and investor returns rather than reinvested in the floor, residents and staff feel it first. That is extraction — the engine of enshittification.

Two things need saying plainly here, because this is not an argument against profit — and it is not only a story about investment firms.

First: margin is not the enemy. Margin is why a care home can exist at all. It funds the pay rise, the refurbishment, the extra activities coordinator, the owner’s own livelihood after years of risk and 6am phone calls. Operators are entitled to do well from doing good work — that’s the deal, and we’d defend it.

Second: extraction is a behaviour, not an ownership structure. It doesn’t need a fund in another country; it can happen quietly in a family-owned group too. If the rewards of the business are visibly growing while carers’ pay hasn’t moved in five years and the building hasn’t seen investment in as long, staff and families do that maths — and the perception, fair or not, lands in exactly the same place as it does for the investment firm. The question that decides whether a home is being enshittified isn’t who owns it or whether it makes money. It’s simpler: does enough of the wealth this home creates find its way back into the care? When the answer is yes, profit and quality rise together — and everyone, including the owner, is better off for it.

The marketing layer. Average private fees have climbed to roughly £1,302 a week after an 8.5% annual rise (Savills, 2026) — while, from a family’s point of view, homes have never been harder to tell apart. Every website promises “person-centred care” in a “homely environment”, and AI tools are now flooding the sector with content that sounds plausible and says nothing. Families respond the way all of us respond to sludge: with scepticism as the default. Prices up, distinctiveness down, trust down. That’s the curdling.

Here’s the pattern side by side:

What are the warning signs for your home?

You can’t fix the whole sector from one home. You can absolutely spot when the pattern is creeping into your own corner of it:

• More of your enquiries arrive through intermediaries who charge you for access to them — and the charge rises each year.
• Your position in a directory changes with your subscription tier, not with your CQC rating or your reviews.
• A search for your home’s own name shows portals above your own website.
• Your marketing looks and sounds like everyone else’s — because it was generated the same way everyone else’s was.
• A supplier or agency keeps the assets — your website, your photography, your data, your contacts — when the contract ends, so leaving means starting again.

And one to check in the mirror, gently: if the business is visibly rewarding its owners more than it did five years ago while pay and the building look much as they did then, that’s the same pattern seen from the inside — and your team will have noticed before you have.

If two or more of those feel familiar, the pattern has found you.

Why is it happening?

Because the conditions that used to prevent it have weakened. Doctorow argues platforms decay when four constraints fail: competition, regulation, the ability to switch, and the power of the people doing the work. Care has its own version. Most homes have beds to fill — average occupancy sits around 87% — which makes operators price-takers for anything that promises enquiries. Families in crisis don’t comparison-shop the way regulators imagine. And the sector’s marketing has consolidated around a handful of intermediaries that everyone feels obliged to pay. Extraction thrives exactly where dependence lives.

How do good care homes resist it?

This is where independent homes hold the better cards. There’s no investment committee between you and the decision to put this year’s surplus into the team, the building or the family experience — you can decide that tomorrow morning. As families (and the AI assistants they ask) get better at spotting the difference between homes that reinvest and homes that extract, being demonstrably on the right side of that line becomes a genuine competitive advantage — one the biggest operators will find hardest to copy.

Beyond that, resistance isn’t about shouting — it’s about refusing to be dependent. Enshittification only works on people who can’t leave.

Own your route to families. Your website, your Google Business Profile, your reviews, your photography, your enquiry data. If it’s paid for, it should be yours — and if a supplier keeps it when you go, that tells you whose asset it really was. Around 94% of families start their search on Google, not on a portal; being findable directly is the single biggest reduction in rent you can make. (Our guide to care home SEO covers where to start.)

Treat directories as a channel, never the channel. They’re useful. Dependence on them is the trap. Measure what each one actually sends you and pay for what performs — nothing else.

Be the un-enshittified option. Real photographs of your actual home. Named people. Straight answers about fees on your own website. In a sector drowning in identical AI sludge, honesty reads as radical differentiation — and it’s the one thing that can’t be extracted from you.

Stay legible to the machines families now ask. More families are asking ChatGPT and other AI assistants to shortlist homes. Fresh, accurate, structured information on your own site is how you get cited rather than skipped — we’ve written about how AI search treats care homes before.

Convert what you already have. The cheapest enquiry is the one already in your inbox. Before buying more visibility from anyone, fix the follow-up — most homes are leaking enquiries they already paid for.

The sector’s drift toward extraction is real. But it isn’t destiny — it’s a business model, and business models only work on the willing. A home that owns its assets, answers families honestly and measures its own pipeline is remarkably hard to enshittify.

If you’d like to know how dependent your enquiry pipeline currently is on rented ground, our Free Enquiry Review will show you in five minutes — no obligation, and you keep the findings. (That’s rather the point.)

Frequently asked questions

What does “enshittification” mean in plain English?
It’s the slow decay of a service as its owner shifts value away from the people the service exists for — first good to users, then good to paying business customers, then good only to itself. The word was coined by writer Cory Doctorow and named 2023 word of the year by the American Dialect Society. In care, the short version is: the quality of care falls because the wealth has been extracted.

Does making a profit mean a home is being enshittified?
No — the opposite. Healthy margins are what fund better pay, refurbishment and stability, and operators deserve to do well from doing good work. Enshittification is specifically when the wealth a home creates stops finding its way back into the care — a pattern that can appear under any ownership model, corporate or independent. The test is where the money flows, not who owns the home or whether it profits.

Are care home directories bad for my home?
No — they’re useful, and many families use them. The risk is dependence: if most of your enquiries arrive through a channel you rent, your costs are set by someone else’s shareholders. Treat directories as one measured channel alongside a strong website, Google presence and reviews you own.

What’s the first practical step to protect my home?
Audit what you actually own. Your website, domain, photography, reviews, contact data and enquiry records should belong to you, not a supplier. Then measure where your enquiries really come from — you may find you’re paying for visibility in places that send you very little.