I manage a small, not-for-profit care home in Norfolk. We have tea rounds, hymn singing, hand-holding and staff who know every resident by name and often even their grandchildren’s names. But we also have empty offices: those once occupied by our deputy manager, care manager (the job I now do) and general manager, all of whom chose early retirement within the past two years.

They are not alone. According to the charity Skills for Care, the adult social care sector has 131,000 vacancies – the highest on record. Turnover for care-home staff hovers around 25 per cent, and growing numbers of managers are leaving due to burnout.

This is the logical outcome of how the care system is built. We have computerised inspection models like Provider Assessment and Market Management Solution or PAMMS, used by several local authorities including my own, Norfolk County Council. PAMMS is commissioned by local councils to inspect care homes on behalf of the people whose care they fund, which in our case is half of our residents. PAMMS covers a broad set of areas: management, safety, clinical governance, workforce training, record-keeping and resident outcomes. Inspectors attend the home, but........

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