I think I read that st Mary's is very big, it's like a small hospital, and also has some old, long wards. It probably should have been divided into units, before now.
If preschool education, childcare and nursing homes were under state management but had proper career progression and payscales comparable to education and hospital staff, would that be better? Childcare near me is a mix of large nurseries, preschools in random premises, registered minders, and unregistered minders. My kids went to random premises for preschool, but it was a lot cheaper then!