In the bastardized US version of the show, he seems to mostly be turning them all into the same restaurant. Also, his makeovers don't have a great track record (check Wikipedia, and also Yelp). I also think the advice you'd distill out of the show is pretty superficial:
* Reduce your menu to simple, accessible dishes with a restaurant "specialty".
* Reduce price.
* Source fresh ingredients.
* Redecorate.
What annoys me most about the show (even the BBC version) is that personnel changes never seem to be on the docket --- you have people that clearly shouldn't running a kitchen, and at the end of the episode there they are, plating Ramsay's sauteed skate wing.
That's not true. Some of the great earlier episodes had HUGE blowups between Ramsay and the not fit for kitchen people. Watch the Babylon, NY episode, or the one about the Indian restaurant in NYC.
I think you fail to consider that the places he goes into are usually owned by a family or a clueless person. He can't go in and say "well, honestly since you asked to be on my show, it's clear that YOU are the problem. You'd be better off if you just closed."
Uh, clearly he could choose not to "take the cases" of restaurants that were structurally incapable of improving. And yet his producers do, because they are the ones willing to embarass themselves on this show.
More importantly, the fact that Ramsay is willing to yell and bare his chest for the camera does not change the fact that he does not seem willing to stick to his guns and demand that they fire the old guy in the kitchen and hire a talented Ecuadorian to take his place.
* Reduce your menu to simple, accessible dishes with a restaurant "specialty".
* Reduce price.
* Source fresh ingredients.
* Redecorate.
What annoys me most about the show (even the BBC version) is that personnel changes never seem to be on the docket --- you have people that clearly shouldn't running a kitchen, and at the end of the episode there they are, plating Ramsay's sauteed skate wing.