Your editorial on the failures of the privatisation of care services (7 October) rightly highlights the shameful situation that has developed for older people in residential care. The Nuffield Foundation’s research clearly shows that the increasing outsourcing of this provision is associated with lower standards of care. I have known many care home staff and managers, but never known any who do not want the best for their residents. However, nearly all the largest private providers of care home places for older people are now owned by offshore private equity companies for whom profit is the prime motivation. For these companies, economies of scale, low wages, minimum staffing and cost-cutting are the order of the day. They open larger and larger care homes, often built on cheap land, well away from local communities. These silos of residents, many of whom live out their last few months in loneliness and isolation, pay tens of thousands of pounds a year for the privilege. They often have to spend their savings, and most likely will sell their house to fund their care. Alongside this, in recent years, we have the publicly acknowledged failings of the regulator, the Care Quality Commission, which cannot seem to hold these care conglomerates to account, or indeed manage their own activities. Furthermore, every day there are many thousands of beds being occupied in hospitals because places in care homes do not exist, adding to our scandalously long waiting lists. Is it right that frail, sick and vulnerable elderly people should be used simply as profit generators for these companies? Many of us had high hopes when Wes Streeting proclaimed his “National Care Service”, but beyond perversely announcing even greater use of the private sector, very little government policy has emerged to solve the long-standing failures in residential care provision. Norman Edwards Highworth, Wiltshire