Yes, it is hurting the SEO. For more information than you might ever wanted to know about this, see the comprehensive blog post that Dr. Pete (an SEOmoz associate) posted last night at http://www.seomoz.org/blog/duplicate-content-in-a-post-panda-world. That should be a good starting point to understand why you don't want this happening, and how to start to fix it. The comments touch on case sensitivity as well, even though he didn't include that in the post itself.

You can only see a small percentage of the keywords driving traffic, due to (not provided) and Google not sending data on the vast majority of keywords.

It looks like the original poster knows of these sites but is having difficulty finding good freelancers from these sites. Do you have recommendations for finding good freelancers through these sites?

What about searching for articles about care homes on BBC then seeing if any of those have missing links on an article-by-article basis? If you're lucky, they may also have a tag or a section that fits closely enough with your topic that you can find a listing of all of the articles that are withing that tag/category and just review those.

David,

Have you read Dr. Pete's post about Should I Change my URLs for SEO? He talks about this very topic.