Adult Specialist Care M&A Landscape in 2026
The adult specialist care M&A market remains active in 2026, but it no longer looks as it did during the height of consolidation.
Demand for appropriate services for adults with learning disabilities, autism, complex mental-health needs, acquired brain injuries and major physical disabilities remains strong.
Suitable provision can still be difficult to develop, particularly where a service requires specialist staff, experienced management and an appropriate property.
Strong demand does not automatically translate into an active sale market, however. It also does not mean that every care business will attract the same level of buyer interest.
In previous years, acquisition activity was led by a relatively small number of national and private equity-backed care groups. These businesses acquired regularly, expanded across the country and often competed for the same acquisition opportunities.
Many of those groups remain active. Achieve Together, Cygnet, Consensus Support and Eden Futures continue to appear in the market, while privately owned providers including National Care Group and Potens have also made acquisitions. The difference is that established consolidators are generally acquiring more selectively, while a much wider range of regional and medium-sized providers is completing individual transactions.
Our new report, Adult Specialist Care M&A Landscape in 2026, considers how the buyer market has changed, where acquisition funding is being directed and what buyers are likely to value in a specialist care business.
What does the changing market mean for owners?
1. The most obvious buyer may not be the best buyer
Our analysis identified more than 80 adult specialist care transactions between January 2025 and September 2026, involving 73 different buyers. Only nine buyers made more than one acquisition, and repeat buyers accounted for less than a quarter of the transactions identified.
This means that owners should not assume that a future buyer will necessarily be one of the sector’s best-known national groups.
A regional provider may place particular value on a business that strengthens its presence in an existing area. Another buyer may be looking for a specific type of service, an experienced workforce or suitable property in a location where developing new provision would be difficult.
An approach from a familiar buyer may be credible, but it does not show what the wider market might be prepared to offer. Restricting a sale process to the obvious names risks missing a buyer for whom the business has greater strategic value.
2. Established care groups are being more selective
Several large specialist care groups have remained under the same private equity or infrastructure investor ownership for extended periods. Longer ownership periods can affect how much money a group has available for acquisitions and whether its immediate priority is growth, refinancing or preparing for a future sale.
This does not mean that acquisition funding has disappeared. Sovereign Capital Partners invested in Apollo Home Healthcare in February 2026, while STAR Capital took a majority investment in Glenholme Specialist Care in June. Achieve Together and Lifeways have also completed substantial refinancings.
The practical point for an owner is that a buyer’s historic reputation for making acquisitions does not necessarily reflect its appetite today. Its current funding, priorities and ability to complete a transaction all need to be tested.
3. Strong demand does not guarantee a strong valuation
Local authority gross current expenditure on adult social care reached £29.4 billion in 2024/25, of which £23.6 billion related to long-term support. Approximately £11.5 billion was spent on long-term care for working-age adults.
Growth in expenditure reflects a combination of higher fee rates and changes in the number and complexity of the people receiving support. It should not be interpreted as equivalent growth in care capacity.
Care providers continue to face pressure from wage increases, employer National Insurance, staff vacancies and the cost of agency workers. Fee increases from commissioners do not always keep pace with these costs.
A buyer will therefore look beyond the general level of demand. It will consider the quality and location of the services, regulatory and safeguarding history, staffing stability, occupancy, referral patterns, fee levels, commissioner relationships and the strength of the management team.
Providing care for people with more complex needs may support higher fees, but it does not automatically make a business more valuable. Buyers will want evidence that the fees properly cover the staffing, property and clinical resources required to provide that care safely and sustainably.
4. Buyers value the profit they expect to continue
A buyer will usually value a care business by taking its sustainable annual trading profit and applying an agreed multiple. For example, if the agreed multiple is seven times sustainable profit, that profit figure is multiplied by seven to calculate the initial value of the business.
The profit measure commonly used is EBITDA, which means earnings before interest, tax, depreciation and amortisation. In straightforward terms, it is a measure of the underlying profit generated by the business before financing, tax and certain accounting charges.
The important issue is not simply the EBITDA shown in the latest accounts. It is the level of profit the buyer believes will continue after the sale.
Genuine one-off costs and personal expenses paid through the company may be removed where they will cease. One-off or temporary income must also be excluded.
Owner remuneration needs to be treated carefully. Dividends are paid from profits and therefore cannot be added back to EBITDA. Where an owner works in the business, the calculation must include a realistic salary and employment costs for that role, whether the owner remains or the buyer needs to employ a replacement.
Profit from a recently opened service may be included where it is already operating, placements and fees are confirmed, and all the associated staffing and property costs have been allowed for. Possible future placements and services that have not yet opened will not normally be included.
5. The headline value is not necessarily what shareholders receive
Multiplying sustainable EBITDA by the agreed multiple produces the enterprise value. This is the value placed on the trading business before taking account of its cash, borrowings and certain other balance-sheet items.
The amount attributable to the shareholders is known as the equity value. It is calculated by starting with the enterprise value, adding any cash that can pass to the shareholders and deducting items such as bank debt, finance leases and relevant corporation tax liabilities. There may also be an adjustment if the level of working capital left in the business at completion differs from the amount agreed with the buyer.
The treatment of any freehold property must also be clear. Depending on the transaction, the property might be included in the business valuation, valued separately or retained by the owners and leased to the buyer.
Payment terms matter as much as the headline valuation. Some of the price may be paid immediately, while the remainder may be deferred, dependent on future performance or reinvested into the buyer’s group. Two offers using the same profit multiple can therefore produce very different outcomes for the shareholders.
6. Preparation and buyer selection protect value
Owners do not need to be planning an immediate sale to start preparing. The same work that supports a future transaction will usually strengthen the business under continued ownership.
This includes developing management beneath the shareholders, reducing unnecessary reliance on agency staff, maintaining clear information on occupancy and referrals, understanding profitability by service, documenting fee arrangements and producing reliable monthly financial information.
A credible market remains for good adult specialist care businesses. It is now broader and less predictable, making it more important to identify the right buyers, establish the sustainable profit of the business and understand exactly how any proposed valuation would translate into proceeds for the owners.
The strongest outcome is unlikely to come from simply accepting an approach from the first credible buyer. It will come from matching the strengths of the business, and the objectives of its owners, with the buyer and transaction structure best suited to them.
About Eclipse
Eclipse Corporate Finance is a specialist healthcare M&A advisory firm supporting owners and shareholders through company sales, private equity investments and management buyouts.
We would be pleased to speak in confidence with owners considering how the changing adult specialist care market may affect the value of their business or their longer term strategic options. Further details of our experience and how we support specialist care businesses can be found on our specialist care M&A page.
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