The residential care home sector is facing fundamental changes as a result of market forces, rather than the wishes of service users or providers, delegates heard.
National Care Forum director Des Kelly said the sector was increasingly subject to consolidation and takeovers. It specialised more on those with the highest needs, and was expected to provide a more diverse range of services.
He said the developments were not necessarily negative but there was a danger provision could develop without anyone taking control.
Kelly called for mechanisms to be found for providers to work alongside commissioners and service users to open up a debate about the quality of services provided.