Financial modelling for City & County Healthcare Group’s (“City & County”) buy‑and‑build programme

“The JCK team gave us clarity and confidence through years of rapid expansion. Their modelling capability helped us understand the impact of each acquisition, manage leverage and covenants, and maintain control through successive ownership changes. Their support became a core part of how we made decisions.”
— Mark Harrison, former CFO, City & County Healthcare Group

The Situation

City & County Healthcare Group is a leading UK provider of domiciliary and community care services. The group was formed in 2009 following Sovereign Capital’s acquisition of London Care, at that time one of the larger domiciliary care providers in the South East.

The business pursued an ambitious buy‑and‑build strategy, completing 15 acquisitions in its first four years and rapidly scaling from a regional operator into a national care provider. A subsequent management buy‑out backed by Graphite Capital continued this expansion, adding a further 18 acquisitions before the group was ultimately sold to Global Infrastructure Partners, a US‑headquartered private equity firm.

As City & County grew from 13 branches to more than 260 locations nationwide, management required a financial modelling framework capable of supporting sustained acquisition activity, changing ownership requirements and increasing operational complexity.

Our Approach

Our role was to provide City & County with a robust, flexible and decision‑ready modelling framework that could keep pace with an evolving buy‑and‑build strategy and successive ownership changes.

• Creating a practical, scalable modelling framework: City & County had an existing financial model following its initial platform acquisition, but it was not designed to support rapid expansion. We rebuilt the model into a clear, intuitive structure that management could update monthly, providing consistent group‑level reporting and visibility over cash flow, working capital, leverage and covenant headroom as acquisitions were executed.
• Supporting acquisition‑led growth at pace: As acquisition activity accelerated, we maintained an acquisition‑ready model that allowed management to assess individual deals, run multi‑deal scenarios and understand the cumulative impact of transactions on funding capacity and risk. This enabled informed decision‑making across more than 30 acquisitions.
• Adapting to ownership transitions: As City & County moved through secondary and tertiary ownership, the financial model needed to meet the expectations of new investors and lenders. We refreshed and adapted the model at each stage, ensuring assumptions, structure and outputs aligned with transaction requirements while maintaining continuity for management. This provided a consistent financial foundation through periods of ownership change.
• Delivering clarity across a complex group: As the group scaled nationally, we helped management make sense of financial performance across an increasingly complex organisation. We consolidated data from multiple operating units and service lines, enabling performance to be understood both at group level and by segment. As a full‑service firm, we also provided wider advisory support when required, offering coordinated input through a single point of contact.

The Result

City & County Healthcare Group grew from a regional operator into the UK’s largest home‑care organisation, completing more than 30 acquisitions during its expansion. Our modelling support underpinned key strategic decisions throughout the group’s growth journey, helping management manage leverage, understand risk and maintain control as complexity increased.

As the organisation matured, City & County developed the internal capability to manage its modelling requirements, allowing us to step back. A former City & County CFO later re‑engaged JCK in a new role leading another acquisition strategy – reflecting the long‑term value and confidence placed in our advice.