Most long-term care for older people in the UK has been provided by independent organisations since the 1980s. This article draws on interviews with various stakeholders in the sector, as well as secondary sources. The evidence shows that government policies in the areas of funding, regulation and the labour market are facilitating the concentration of long-term care provision. Three areas of related concern are identified: firstly, the effects of increased ownership transfers; secondly, issues relating to standardisation; and thirdly, the possibility of a decline in the quality of care if local monopolies emerge. It is concluded that government regulation must be concerned with the structure of the market, as well as the conditions within care homes, if the interests of residents are to be protected.