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UK

DEMEN TIA CONGRESS

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October 2016

CQC challenged on fairness in Judicial Review

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The management magazine for the social care sector

‘I cannot fight any more’ – Bristol provider shuts-up shop

National Living Wage – social care pay clears the bar £7.20

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Inside this issue...

News..................................................................4-10 Diary .....................................................................28 Product news.....................................................33 Building with care ....................................34-37

CALLING IT A DAY

NATIONAL LIVING WAGE:

After 20 years as a care home operator, ELIZABETH LAYCOCK tells us why she’s quit .............22

Social care providers extend pay increase to younger care workers ..................................4

Business & property ...............................38-45 Care homes sold...............................................45

COMPANY INDEX

FAIR CALL:

Adara .........................................................................39 Anchor .........................................................................8 Angel Care ................................................................35 Badby Park ...............................................................43 Brunelcare ..........................................................18, 35 Brighterkind .............................................................40 Bupa Care Homes ....................................................37 Care Management Group ........................................10 Care UK .....................................................................35 Caring Homes............................................................16 Community Integrated Care ....................................6 Enham Trust .............................................................34 Four Seasons Health Care .....................................40 Fremantle Trust .......................................................43 Hadrian Healthcare...........................................10, 43 Healthcare Homes ..................................................43 Helen McArdle Care ..................................................6 Hill Care...............................................................10, 42 Holmes Care ..............................................................10 Holmwood Care ..........................................................6 Morris Care...............................................................43 Nightingale-Hammerson........................................44 Noble Care...................................................................6 Orchard Care Homes ...............................................12 Runwood Homes......................................................45 Strong Life Care ......................................................42 SweetTree Home Care Services ............................10 WCS Care.....................................................................6

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October 2016

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news

Providers step up to the mark on National Living Wage Young care workers benefit from boost in pay Four in five young social care workers previously paid below the new National Living Wage (NLW) introduced this April have enjoyed a pay rise as a result of it despite having no legal entitlement, according to a report by the independent think tank Resolution Foundation. The report, which provides the first detailed evidence of how a sector has implemented the NLW, says its implementation by the care sector is encouraging so far, but risks faltering if public funding is not increased. According to the Resolution Foundation, social care employers have overwhelmingly passed on the benefit of the new rate for the over-24s to younger workers, with 83% of young workers previously paid below it seeing their hourly pay increased to or beyond £7.20. There were also wider ‘knock-on’ benefits of the NLW in the social care sector beyond the lowest paid. Looking at pay improvements during April-July 2016 across the workforce as a whole, care providers invested more than twice as much in raising pay than if they had only satisfied NLW requirements and nothing more. Though some of this was be due to normal pay uprating, this

signals the ‘spillover’ effects from the NLW that the Resolution Foundation and the Office for Budget Responsibility predicted. Despite the big pay boost, the report finds no evidence to suggest that employers have handled the wage increase by cutting workers’ shifts. Average hours for social care workers previously paid below the NLW have risen very slightly since its introduction (by 1.1 per cent), slightly faster than the increase for higher-paid workers (0.5 per cent).

but legally covered by the minimum wage is accounted for.

Funding constraint With the extra cost of the NLW in social care set to reach £2.3bn by 2020, the ability of the social care sector to continue to spread the benefits in the way it has so far will be limited. The Foundation says that the solution should not be to row back on the policy. Rather, it calls on the Government to ensure that there are sufficient funds for care providers to continue to implement the NLW without adverse consequences for workers; to recruit and retain the staff needed to meet the demands of an ageing population; and to allow for progression opportunities. “It is great news that the National Living Wage has had a large positive impact on pay in social care, giving hundreds of thousands of frontline care workers a pay rise, with no evidence of hours being cut to foot the bill,” said Laura Gardiner, senior research and policy analyst at the Resolution Foundation. “It is encouraging that younger workers have also benefited from the new 25-and-over rate, despite having no legal entitlement to the National Living Wage. In fact, across the age range, social care employers are clearly doing much more than the bare minimum where pay is concerned, with the average pay rise double what it would have been had bosses just increased pay to the legal wage floor. “As the NLW continues to rise to its target value by 2020 we risk reaching a ‘crunch point’ where a lack of funding leaves the care sector unable to continue to spread the benefits of the NLW. Our ageing population, combined with the prospects of reduced inward migration postBrexit make it essential that more public funding is available for care providers to attract and retain the care workforce we need.”

‘Social care employers are clearly doing much more than the bare

minimum where pay is concerned,

with the average pay rise double what it would have been had bosses just

increased pay to the legal wage floor.’ ‘Bunching’

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While there are many encouraging signs in the care sector’s approach to NLW implementation, the Foundation highlights increased ‘bunching’ of pay in social care at the legal wage floor as a cause for concern. Despite the evidence of ‘spillover’ benefits, one third of the care workforce is now paid the top adult rate of £7.20, up from one quarter when the top adult NMW rate was £6.50. This bunching, says the report, means limited opportunities to progress within the sector, and increases the risk of non-compliance when time not covered by contracted pay rates (for example, when travelling between clients)

Editor-in-chief Dr Richard Hawkins

Coutts sponsors Care Awards winners’ lunch

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This year, for the first time, Caring Times have arranged for a Winners Lunch hosted in the New Year by our partners, the private banking and wealth management company Coutts. From their foundations in 1692 to the present day, Coutts have always worked with exceptional people and maintained their values of excellence. Coutts Commercial head of healthcare Martin Smyth said Coutts’ healthcare specialists understood the unique funding requirements of companies within the healthcare sector. “Through long-standing relationships, we

Caring Times is published eleven times a year by Hawker Publications. ISSN 0953-4873 Printed by Garnett Dickinson Print Ltd, Manvers, Wath-upon-Dearne Average net circulation of 15,566 (July 2015 – June 2016) © Hawker Publications 2016 Deadlines for November issue: Display advert. space booking: 21 September Display advertising copy: 23 September Product news copy: 23 September Editorial copy: 23 September The views expressed in Caring Times are not necessarily those of the editor or publishers.

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deliver banking solutions to meet our clients’ individual needs,” said Mr Smyth. “The team is proud to work with a number of leading care home, assisted living and extracare housing operators and also provides innovative banking for GP surgeries and dental practices. We are delighted to be an official partner at this leading event on the healthcare calendar.” The lunch will include a drinks reception and buffet lunch to be enjoyed by all category winners and sponsors at the National Care Awards 2016, a fantastic chance for the winners to discuss their experiences with each other.

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news

Nursing home fined over burgled personal details A nursing home in County Antrim in Northern Ireland has been fined £15,000 for breaking the law by not looking after the sensitive personal details in its care. An investigation by the Information Commissioner’s Office (ICO) found widespread systemic failings in data protection at Whitehead Nursing Home at the time of a data breach.

The breach came when a member of staff took an unencrypted work laptop home, which was stolen during a burglary overnight. The stolen laptop contained sensitive personal details relating to 46 staff including reasons for sickness absence and information about disciplinary matters. It also held some details about 29 residents

Essex Council says care homes fees are unaffordable Care provider representative body Care England says a fees framework for people living in care homes proposed by Essex County Council will not be adequate to keep homes open. A cost of care exercise conducted by the local authority had found a fair cost of care would be £647 per week for residential placements and £665 per week for nursing but the council has said applying these rates to all providers would be unaffordable. It has instead suggested a fee uplift system that would see current rates increase by a maximum of £13.79 per week. Care England chief executive professor Martin Green said there was little point con-

ducting a costs of care exercise without adhering to the results. “Without adequate resourcing care homes, which are a vital part of the local economy providing employment and also the backbone to the NHS, will simply cease to exist,” said Prof. Green. “Our members have a good working relationship with Essex County Council and want to work with them to ensure that their residents are in a position to be in receipt of the best quality care. It is however unsustainable for a council to conclude what it costs to fund care then pay less than this cost, and expect the independent sector to fund the difference.”

including their date of birth, mental and physical health and ‘do not resuscitate’ status. Ken Macdonald, Head of ICO Regions, said the nursing home had put its employees and residents at risk by failing to follow basic procedures to properly manage and look after the personal information in its care. “Our investigation revealed major flaws in the nursing home’s approach to data protection,” said Mr Macdonald. “Employees would have expected any details about disciplinary matters or their state of health to have been kept safe. “Likewise, residents would not have expected their confidential information to have been stored on an unprotected laptop and taken to an employee’s home. Whitehead Nursing Home had totally inadequate provisions for IT security and procedure and poor data protection training.” Mr Macdonald said the amount of the fine reflected the size of the nursing home business, and that a bigger organisation experiencing a similarly serious breach should expect to receive a much larger fine.

Neil Matthewman steps down as chief executive of Community Integrated Care Community Integrated Care has announced today that Neil Matthewman has stepped down as Chief Executive of the charity. The charity’s chair, Dame Joan Stringer, said that, after discussions with the board of trustees, it had been agreed with Mr Matthew-

Top ratings The following care homes have recently been rated as ‘Outstanding’ by the Care Quality Commission: 21 Lime Street in Evesham, Worcestershire. Provides care for those with learning disabilities and autism. Operated by Noble Care. Redesdale Court in North Shields. Run by Helen McArdle Care. Holmwood residential home in Bungay, Suffolk. Operated by Holmwood Care. Mill Green in Rugby. Provides accommodation and personal care for up to 15 younger adults, who may live with dementia, learning or physical disabilities or a life limiting condition. It is the fourth service run by WCS Care to be rated as Outstanding. White Gables in Felixstowe, Suffolk. 37 beds, older people dementia. Privately owned.

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man that he would step down. “During recent discussions, it has been recognised by all parties that Community Integrated Care, and the wider health and social care sector, face a crucial period of challenge and opportunity, and we agreed that the time is right for new leadership,” said Dame Joan. “We appreciate the contribution that Neil has made in the last five years and we recognise the range of achievements and developments which have been delivered under his stewardship. We thank Neil for the professional manner in which he has approached our discussions.”

Mr Matthewman said that during his time with the organisation, he had been impressed by the dedication and commitment to the people the charity supported. “We have come a long way in five years, but it’s now the right time for a new leader to take the organisation to the next stage in its development,” he said. Mr Matthewman leaves with immediate effect and deputy chief executive Cath MurrayHoward will assume responsibility for the dayto-day running of the organisation while a recruitment process is initiated.

Regulator publishes quality ratings In August, the Care Quality Commission published 547 reports on the quality of care provided by adult social care services in Central England. They are summarised as follows:

INADEQUATE CENTRAL

30

REQUIRES IMPROVEMENT 149

GOOD 361

OUTSTANDING 7

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news

Anchor: lack of retirement housing is costing billions Independent think tank The Strategic Society Centre, and not-for-profit care and housing provider Anchor have partnered to put a figure on the economic impact of the lack of suitable homes for older people in the UK now and over the next 50 years. The Valuing Retirement Housing report demonstrates how the lack of suitable retirement housing affects both older and younger generations. Detailed analysis identifies three key economic factors and estimates a saving of £14.5bn to the public purse over 50 years if just one extra couple among every 50 older homeowners downsized into specialist retirement housing, enabling first-time buyers to get on the housing ladder. This amounts to long-term savings of between £675m and £2.6bn depending on the region. Retirement property makes up just 2% of the country’s housing stock, yet almost two-thirds (63%) of people aged 55+ living in houses with more than two bedrooms are looking to downsize. A major reason for older people staying put is a lack of choice when it comes to moving to more age-appropriate housing.

Anchor’s chief executive Jane Ashcroft said the consequence of poor housing could be catastrophic and older people in particular could see their quality of life diminish. “Those older people that do want to move shouldn’t be trapped due to a lack of suitable retirement homes,” said Ms Ashcroft. “We have failed to address this as a country and for the first time the full impact has been analysed. “The findings evidence a bigger picture many of us in the sector have suspected for some time – that the impact goes much wider than older people themselves. “This is not a plea for financial support from the state, in fact this is an opportunity JANE ASHCROFT: to save billions. With the ageing population ‘The findings evidence a growing all the time, we must prioritise homes for older people now.” bigger picture many of us in Anchor is calling on national governthe sector have suspected for ment as well as local authority decisionmakers to clear the path to enable some time – that the impact retirement housing to be built, convene a goes much wider than older national taskforce on retirement housing, and reform local planning to encourage people themselves.’ more developments.

The three main costs to the public purse identified in the report are: ■ The increased costs of health and care needs for older people living in inappropriate housing (including trips and falls) – estimated at £9,700 per person or £19,400 per couple; ■ The impact of local authority social care entitlement – estimated at £18,600 per person or £37,200 per couple; ■ The financial impact of younger people not being able to get on the housing ladder means they cannot finance their later life without relying on local authority funding – estimated at £54,800 per individual or couple.

Hearing loss charity to work with care Free dementia training homes across the North of England package available online Action on Hearing Loss has launched a project in care homes across the North of England designed to improve the care and support provided to older people with hearing loss and reduce social isolation. With 71% of over-70-year-olds living with hearing loss in the UK the project – ‘Hear to Care’ will pilot and test out changes or improvements which can be made in mainstream long term care settings to improve the diagnosis and management of hearing loss. Action on Hearing Loss staff will work with care workers to ensure that managing hearing loss becomes part of the daily routine of the home, helping to combat the social isolation which sensory loss can often cause. At the end of the three year project, guidance and a toolkit will be produced and made available to care providers across England. Information will also be shared with the Care Quality Commission and other key health and social care organisations to promote best practice. Development projects manager at Action on Hearing Loss Sarah Treadwell-Baker, said the charity would work

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directly within care settings to ensure that all residents were getting the best support to manage their hearing loss. “Whether it is through screening residents to see whether they need hearing aids, providing assistive equipment such as listening devices or offering basic maintenance like re-tubing and replacement batteries to existing NHS hearing aid users, we hope to make a real difference to their quality of life,” said Ms Treadwell-Baker. “We want to make dealing with hearing loss a priority in care home settings to ensure that residents feel confident in communicating and socialising with their peers and continue to enjoy life at the home.” Funding for the scheme was provided by the Department of Health’s Innovation Fund following research undertaken by the charity which found that if the hearing loss of those in care homes is managed effectively, there is a real chance of improving quality of life. ■ For more information on the Hear to Care project, contact Sarah TreadwellBaker, Development Projects Manager, on [email protected] hearingloss.org.uk or 0121 450 8980.

A free training package aimed at educating health and social care workforces about dementia is now available, having been developed by academics from the University of Bedfordshire. The training package provides a basic introduction to dementia and how it affects people and their loved ones. Senior lecturer in mental health nursing and dementia lead Melsina Makaza said the evidence-based training package would improve professional knowledge, service delivery and provision for people with dementia. “People often have this misconception that when someone gets dementia, that’s it, the person is gone,” said Ms Makaza. “It’s sometimes seen as a death sentence, but that’s not true – the person is still there and we need to make sure health and social care professionals at every level know how best to help them in a person-centred way. “This training package aims to give people with dementia, and their carers, a voice. It is free to access and it has been designed with busy health and social care staff in mind. It is user friendly, can be undertaken in a short amount of time and it takes into account the different ways in which people learn. You can undertake the training at your own pace. “We want to break down the stigma attached to dementia. People with dementia can continue to lead happy and fulfilled lives, providing they have the right support. That’s what we want to raise awareness about.” ■ The training package and other free training information and resources including the ebook Dementia Guide for Carers and Care Providers of Dementia can be found here: hee.nhs.uk/

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in a nutshell...

nuggets of news

Care home costs rise ten times faster than pensioner incomes The annual cost of a care home has increased by £1,536 over the past year – almost ten times the average £156 income gains realised by pensioners over the same period, according to a five year study by Prestige Nursing + Care. Costs for an average single room in a UK residential care home have risen by 5.2% to £30,926, more than double the average pensioner’s income of £14,456, while pensioner incomes grew by just 1.1% over the last year. The annual growth rate of care costs (5.2%) from 2015 to 2016 has more than doubled from the 2.5% growth rate from 2014 to 2015. This is far higher than the current rate of inflation (0.3%) and the fastest growth rate since Prestige began collecting data in 2012. The annual shortfall between care costs and pensioner income amounts to £16,470 (£317

Hill Care partners with National Citizenship Service to enhance residents’ lives Care home operator Hill Care continues to work closely with local National Citizenship Service (NCS) groups whereby young volunteers aged 15-17 are having a huge impact on the lives of elderly residents and the partnerships are working exceptionally well. Recently, Middlesbrough Football Club NCS spent a week at Mandale House in Stockton, as part of their social action project. Hill Care operates 18 care homes across the North of England.

a week), should they need to pay for residential care in later life. This shortfall is up 16% from £14,196 four years ago. The total cost of care annually amounts to 114% of the average pensioner’s income after tax. This shortfall has increased by 9% in the last year alone from £15,089 a year, or £290 a week, in 2015. This means the average pensioner’s income would now pay for less than six months of care, while research from Saga showing the average stay in a residential home is 2.5 years.

Care homes need to boost their activity programmes Care home reviews website carehome.co.uk has urged care homes to improve their activities programmes after analysis of reviews posted on the website suggested that only a half (52%) of residents and relatives rated activities in care homes as ‘excellent’. One in 10 (11%) said activities in care homes were ‘very poor’, ‘poor’ or ‘satisfactory’. Just over a third (37%) said they were ‘good’.

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Jenni Mack and Moira Sneddon, activities co-ordinators at Craigielea, an 85-bed care home in Renfrew near Glasgow, and part of the Holmes Care Group, attended a two-day work shop based at Stirling University in September. The pair’s participation follows a recent visit to Craigielea and four other care homes in England and Scotland by Dr Corrine GreasleyAdams, a contract researcher in the School of Applied Social Science, to carry out research into developing an intervention for personalised physical activity designed for people living in care homes with cognitive problems and dementia. Jenni and Moira are now to take part in the next stage of the research. Craigielea Service manager Sheila Inshaw said activities were a crucial part of care and Stirling University’s research was a wonderful opportunity for staff to enhance the high quality of care and activities already delivered in the home. “We are very excited about being involved in any type of research,” said Ms Inshaw.

Hadrian Healthcare chefs join NACC Head chefs at all Hadrian Healthcare Group’s care homes are now members of the National Association of Care Catering (NACC) with access to specialist resources, guidance, events and training to share with their teams. The luxury elderly care provider had previously carried out research with Northumbria University to optimise its homes’ seasonal

SweetTree shines in Care Certificate training SweetTree Home Care Services has been praised for its implementation of the Care Certificate and called a ‘shining light’ for its work with new starters. Skills for Care’s James Cross made the comments on a recent visit to the firm’s London offices where more than 50 SweetTree carers had completed their Care Certificate by the end of August, with a further 100 expected to graduate by the end of the year. The Care Certificate was introduced last year for all new carers working within a health or social care setting. The programme requires carers to reach a high standard in areas including communication, privacy and dignity, equality and diversity, safeguarding, dementia and mental health. Care workers need to demonstrate their skills meet the required competencies found within the 15 standards. SweetTree learning and development man-

Care home staff assist in Stirling University study

ager Michael Beresford said the scheme presented some challenges for homecare organisations like, such as how to facilitate observations in a domiciliary care setting. “We have worked hard to manage any issues and drive quality standards throughout,” said Mr Beresford. “Overall, the success of the scheme has been down to strong organisation and communication, and making sure all team members know and understand their role within the process.”

menus for nutrition and hydration, and Hadrian Healthcare chefs have won the NACC Care Cook of the Year competition three times. “Food is a key part of our approach to personalised care for each of our residents,” said Hadrian operations manager Karen Brimble. “We take food preparation and presentation seriously because we know that having the right foods can improve someone’s health and in turn their lifestyle. Our catering teams work hard every day to provide tasty and attractive food to restaurant standard whilst meeting many special dietary requirements.”

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Disability care provider celebrates 20th anniversary People from across the country who are supported by learning disability care provider Care Management Group (CMG) came together at one of its services in Essex in August to celebrate CMG’s 20th anniversary. The event marked 20 years of success with CMG growing exponentially from just two residential services in 1996, to becoming one of the

UK’s major disability care providers today. The group now has more than 120 homes in England and Wales which provide support to hundreds of individuals and their families. Before the celebrations got under way, guests were greeted by CMG chief executive Peter Kinsey and also heard from Darren Rose, a service user who has been with CMG for 20 years.

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activities/comment

Orchard Care Homes launches activities accolades

O

rchard Care Homes has set up a scheme to recognise the contribution made by activity co-ordinators. The first homes to be awarded the ‘Centre of Activity Excellence’ accolade are in Yorkshire, with teams praised for their approach to engaging residents in regular activity tailored to their interests. Cherry Trees Care Home in Rotherham and The Hawthorne’s in Birkenshaw, Leeds, received their awards in August. Lisa Webster and Lisa Glynn, activity co-ordinators at Cherry Trees care home in Rotherham, were praised for their team approach to delivering a vibrant plan of activities in the home that sees high numbers of residents participating on a regular basis. Sandra Marsden, activity co-ordinator at The Hawthornes in Birkenshaw, was praised for her dedication to the role, offering a full and varied activity programme in the home that ranges from one-to-one reminiscences sessions, to quizzes, slipper soccer and trips out. “Sandra is always thinking outside the box,” said home manager Heather Middleton. “She is forever looking at ways to enhance the lives of our residents here in the home, and they absolutely love her. Many of the family members comment on the positive impact Sandra and her activities have on the lives of their

activity information boards are maintained, loved ones, and we are extremely happy to reand the activity co-ordinator is managing a ceive this accolade, as Sandra is an excellent defined monthly budget. role model for other activity coordinators.” At least one Centre of Activity Excellence Tracey Tomlinson, director of customer expewill be established in each cluster area of Orrience at Orchard Care Homes, said Cherry chard’s 80 care homes across the country. The Trees and The Hawthornes were two excellent designated centre will then act as a go-to examples of homes where staff worked well topoint to give support and training to those gether, led by vibrant activity co-ordinators and homes in its vicinity. CT the wider team’s enthusiasm for their residents. “This new award is a way for the company to give back to our employees, to share their good news and to give them credit for the work that they do – we hope that they will learn from and inspire each other,” said Ms Tomlinson. To achieve the accolade of Centre of Activity Excellence, each home must achieve certain criteria, this includes: meaningful activities are delivered within the home and they are perHawthornes activity co-ordinator Sandra Marsden son centred, all activity recording is up-to-date, with resident Kath Wild.

Pantomime season for health and social care

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las for Cinderella, her name invoked with tedious predictability to showcase social care as the poor relation of the NHS. Consumed by paranoia induced by this ‘favourite child’ syndrome, providers’ organisations can scarcely turn a corner without finding evidence of health being preferred over social care. And yet the comparison is not remotely like with like. For all their virtues, care homes will never attract the reverence – or the revenue – that is bestowed upon the NHS. It’s the priorities, stupid. That said, the resentment does have a grain of justification. Nowhere is social care’s subordinate status better illustrated than in the special measures process. While stricken hospitals and GPs benefit from programmes of expert support and mentoring – with costs heavily subsidised from public funds – social care providers must find their own salvation. That double standard is echoed in CQC’s approach. When the chief inspector of hospitals assured his Board that the procedure was being implemented to provide support not punishment, his social care counterpart remained revealingly tight-lipped. The guidance for special measures in social care speaks for her: “We expect the provider to seek out appropriate support . . . from its own resources”. Last year the focus was widened from

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individual organisations to the system itself. The ambitiously named “success regime” aims to improve the ways health and care services are commissioned and provided in “challenged” areas; the mood of positivity around the idea of success expected to neutralise the “demotivation and stigma” that has come to define special measures. So, is it feel-good as precursor to do-good, or another ugly sister, albeit with a sunnier disposition? hatever its potential, there are few indications thus far that this wholesystem tack will be any more than a health-dominated project; the vocabulary may be inclusive, but the emphasis is unremittingly on the NHS. You’ll struggle to find examples of social care being valued in and of itself; it tends to be judged only by its usefulness to the NHS, a state of affairs tacitly endorsed by sector grandees as they jostle to audition for the role of back half of the health-and-care pantomime horse. Actually, there is a more important part for them to play. Poor ratings don’t just blight reputations; they can also damage the health

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Is it fair that some providers are discriminated against – even by their own colleagues? Oh no it isn't, says BOB FERGUSON. and well-being of providers and their staff. While the NHS intends to mitigate this human cost, there appears to be no place for that duty of care in the “common purpose” of home owners’ national associations. It has been left to an impromptu grouping of “outstanding” operators, primarily concerned with preserving their own positions, to offer support – and then only to upgrade wannabes rated “good” or “requires improvement”. Services that are either in, or at risk of, special measures are being thrown to the wolves, victims of a noxious cocktail of selfrighteousness and fear of contagion. Things have come to a pretty pass when the most vulnerable are abandoned by their own. In the Cinderella tale, she is forsaken by what passes for her immediate family. For some, therefore, the metaphor is more chillingly prophetic than it might appear at first blush. Worse, there’s no fairy godmother in sight. CT

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inspection & regulation

Successful lawsuit may increase the scope for challenging CQC ratings In July, SSP Health Ltd (SSP), a service provider operating GP practices in England, won a judicial review challenge in the High Court against the Care Quality Commission. The

By LUCY WILLIAMS, solicitor Kingsley Napley LLP

case concerned the fairness of the CQC’s complaints procedure and as a result the CQC is said to be considering the recommendations made by the judge.

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ll providers of health or social care in England must be registered with the CQC and are subject to its inspections. Following an inspection, the CQC publishes a report of its ratings on a four-point scale: Outstanding, Good, Requires Improvement or Inadequate. Of the 21,000 inspections it carried out last year according to its 2015/6 report & accounts, it received some 441 complaints. Its ratings are important both reputationally and practically, as the CQC has the power to put providers into special measures. The CQC’s Provider Handbook currently allows CQC ratings to be challenged in only two ways: 1. On receipt of a draft report, a service provider can challenge the factual accuracy and completeness of the evidence, findings and ratings within 10 working days. 2. After a report is published, a service provider can seek a review of the rating on the ground that the CQC did not follow the proper process – not on the ground that the judgments by the CQC were wrong. SSP’s legal case sought to challenge the limited nature of this handbook provision. On 11 November 2014, the CQC carried out an inspection of one of SSP’s practices in Liverpool. A draft report was produced and the overall rating was “Inadequate”. SSP submitted a response to challenge the accuracy of the report. The CQC’s lead inspector amended some, but not all, of the challenged wording and maintained the overall rating of Inadequate. Despite the senior medical practitioner at the practice asking the CQC's chief inspector of general practice to delay the publication of the report so that his concerns could be discussed, the CQC proceeded to publish its final report. The CQC argued that the proper process had been followed because SSP had been allowed to comment on the draft reports. SSP then requested a review of the rating in relation to the practice. The CQC’s ratings review manager declined this request because the

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complaints made by SSP related to the findings of the report and not a defect in the process which, according to the handbook, is the only ground permissible for a ratings review. As a result of the ‘Inadequate’ rating, the Seaforth Village Surgery Practice was placed into special measures, meaning that it had to improve its service within six months to avoid enforcement action.

Factual inaccuracies SSP’s lawsuit stated that it had made various challenges to the factual accuracy of the draft CQC report which could have been checked by the regulator. However the appropriate checks were not made and the CQC’s original damaging findings were maintained each time. For example, the draft report stated that the practice did not keep a register of elderly patients, however SSP asserted that they did have such a register and detailed where it was kept. The CQC did not check whether there was a register as claimed by SSP but maintained within the final report the assertion that there was no such register. Although the CQC found significant improvements at Seaforth on its next inspection and gave an overall rating of ‘Good’ in its subsequent report, SSP submitted that the ‘Inadequate’ rating had caused significant damage to its reputation. Primarily the case rested on the CQC’s decision to refuse to review the Inadequate rating.

The judicial review decision In relation to the specific factual challenges made by SSP, Mrs Justice Andrews concluded that it was unfair for the CQC to maintain their original finding without making appropriate enquiries. She stated that: “ . . . the regulator has a choice. It can either accept the word of the inspected body and make appropriate adjustments, or it can ask to see some evidence . . . or it can adjust the draft report to state, accurately, that it saw no evidence of that matter at the time of its inspection but that it had been informed subsequently that such evidence existed . . .

What it cannot do is make adverse findings that something does not exist if the regulated body tells it that it does, and it does nothing to test that assertion.” (Emphasis added) So what can a service provider do if the CQC wrongly refuses to change its findings? The current scheme provides that the CQC’s lead inspector will decide whether to amend the draft report following the service provider’s response. Mrs Justice Andrews said that she was “ . . . not persuaded that it is fair that the lead inspector should be the sole arbiter of whether any changes should be made.” Instead, Mrs Justice Andrews said an independent person within the CQC itself would be well-placed to resolve the grievance and that, in this case, “ . . . procedural fairness required the CQC to undertake a review of its response to the proposed factual corrections . . . There is little point in giving someone an opportunity to make factual corrections, if there is no procedural mechanism for safeguarding against an unfair refusal to make them.” any service providers feel that the CQC lacks accountability and that they are powerless to challenge CQC findings. Coupled with the potentially devastating impact of an adverse CQC finding, service providers can understandably dread the day when the CQC “comes knocking”. This case should provide reassurance to health and social care providers. The comments of Mrs Justice Andrews do not compel the CQC to make specific changes, but they are likely to lead to a fairer review mechanism for service providers. Indeed, if appropriate changes are not made despite clear recommendations, the CQC would be in a weak position if they were challenged in future. Service providers should respond swiftly upon receipt of a draft inspection report and challenge any inaccuracies. Should the CQC refuse to review its findings, service providers could refer to this case to argue that an independent review should be conducted before the report is published. Let’s hope that the steps taken following this judgment will ensure that those providing essential services are treated fairly by their regulator. CT

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legal matters - recruitment

New sanctions against those who employ illegal workers

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mmigration has become an intensely scrutinised issue, which has put the Government under considerable pressure in recent years. The Immigration Act 2016, which came into force on 12 July 2016, demonstrates an effort by the Government to strengthen the UK immigration system and tackle illegal working. The Act introduces new sanctions on illegal workers and rogue employers, which make it harder to work illegally in the UK. Given the large number of care staff recruited from overseas, it is essential that care providers are up-to-date with these new rules. The Act now makes it a criminal offence to work illegally in the UK if a worker knows, or has reasonable cause to believe, that they have no permission to do so, with the consequence that wages paid to the illegal worker may be seized as proceeds of crime. This offence is not limited to working under a contract of employment and is intended to cover all types of work, including selfemployment arrangements. Workers found guilty of this offence in England and Wales will face a maximum custodial sentence of 51 weeks and/or a fine. Care providers should be aware that the offence of employing an illegal worker has been broadened to capture employers that know, or have reasonable cause to believe, that an employee does not have permission to work in the UK. Previously, employers had to have actual knowledge that an employee was

working illegally before they could be found guilty of an offence and were able to escape prosecution if actual knowledge could not be proven. Lowering the degree of knowledge to ‘reasonable belief’ makes it easier to prosecute employers that turn a blind eye to illegal working. Employers found guilty of this offence could now face a custodial sentence of up to five years (previously two years), and a fine of up to £20,000 for each illegal worker. mployers who continue to flout the law by employing illegal workers will face the new ‘shut down’ sanction, which enables immigration officers to close a premises for up to 48 hours in specific circumstances. Employers that have either a) previously been convicted of employing an illegal worker; b) received a civil penalty notice in the last three years; or c) failed to pay a previous civil penalty notice, face closure if an immigration officer suspects illegal working and the employer cannot show that right to work checks have been carried out. A closure notice may be cancelled on proof of completed right to work checks, but could otherwise cause a business to be placed under special compliance requirements. Providers should be careful not to ignore information or circumstances that could cause them to know or believe that an employee does not have permission to work in the UK. Detection may be more difficult where staff are dispersed at various locations. Providers

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By PETER GROSE, solicitor, Lester Aldridge www.lesteraldridge.com 01202 786135 should be alert to falsified documents from potential employees who may also not be suitably qualified and therefore pose a safeguarding risk. roviders must have robust policies and procedures in place to ensure that all personnel documentation is up-to-date, and should consider further training for staff involved in recruitment processes. It is clear that the Government intends to take a tougher approach towards illegal working and this makes an increase in prosecutions very likely. Sanctions imposed under the Act could cause serious reputational damage to care providers, given the media’s appetite for such reports in the sector. If a provider suspects that an employee might be working illegally or has an expiring visa, it should seek specialist legal advice as soon as possible, to ensure compliance and protect its business. CT

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catering & nutrition

Sundridge Court makes mealtimes matter more Snacking between meals, weekly weigh-ins and understanding about swallowing are all elements of a training programme that the Sundridge Court care team has been putting into practice to great effect. The 27-bed nursing home in South East London run by Caring Homes signed up to Making Mealtimes Matter, a project by Bromley community team dietetic department and speech and language team (SALT), which was funded and supported by the local Clinical Commissioning Group. The programme, which ran throughout May and June 2016 aimed to: improve knowledge and practices in care homes in the Bromley area in providing nutrition to residents; to educate care teams on swallowing issues, the use of tools in monitoring risks of dehydration and malnutrition, special diets, fortification of meals; the correct usage of supplements and thickened fluids and the correct stages of these. Practical training in the normal swallowing reflex, how this can be affected in due to

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disease processes, and safe and correct practices and systems to managing these issues were included in the course. Home manager Carol Marsh said the programme had made a real difference in educating everyone about a range of topics on all stages of eating and drinking, for example helping people into the best position for swallowing. “Chefs, kitchen assistants, nurses, carers and activities team members all attended and are now aware and involved in making mealtimes matter more,” said Ms Marsh. “We have implemented what we learnt into our daily practices here. It has reinforced to everyone how important to the day mealtimes are. We put on music in the background in the dining room and give people time to enjoy their meal. Many of our residents are quite poorly and need their food mashed or pureed so presentation and colour of food, as well as texture, is also carefully considered.” Ms Marsh said the team were delighted that some residents who had previously needed

help at mealtimes were starting to feed themselves again, and were taking pleasure in eating once more. “Snacks such as milkshakes or cheese and biscuits are offered in between meals and residents are really enjoying it, with steady weight gains. If there are any weight losses, these are reported to the kitchen so that their food can be fortified. When a new resident joins us, they have a food and fluid chart for at least their first week, which is continued as required. Of course, some residents are not going to improve in weight because of their progressive illness but everyone is closely monitored. “Our head chef, Vydya Domah, speaks to residents every day about their food choices. The menus are also discussed regularly and compiled according to residents’ preferences.” Ms Marsh said that, as a result of the training, Sundridge Court had developed a close relationship with Bromley SALT and dieticians, as well as the local dentist and visiting medical professionals. CT

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intermediate care

Reablement unit deemed a success after a 12-month trial Brunelcare’s director of care homes

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hen the Care Act was introduced in 2014, local authorities were give a role to ‘provide or arrange services which are aimed at reducing needs and helping people regain skills, e.g. after a hospital stay’. In response to this service provision challenge, along with a lack of hospital beds in Bristol and South Gloucestershire, the not-forprofit care provider Brunel Care approached both local Clinical Commissioning Groups (South Gloucestershire and Bristol) with a proposal to set up and manage a 24-bed reablement service, Orchard Grove, that was funded by the NHS. Both CCGs along with both County Councils agreed to jointly commission the service, and from there on contributed to the planning and subsequent operation of the centre. Brunelcare would case manage and provide physiotherapy and occupational therapy services as part of the service, as existing reablement type beds were scattered around the city in various care homes. It was felt that there were two downsides of this situation; a) People were likely to be treated in exactly the same way as people receiving long term care, where staff ‘did things for’ rather than ‘do things with’ people; b) Occupational therapists and physiotherapists would have to travel between homes, wasting time and money on an already stretched service.

JAN LITTLE talks about Orchard Grove, a 24-bed reablement unit the charity set up to serve Bristol and South Gloucestershire. criteria by evidencing improvement potential, and by declaring they wanted to return home. The reality was that many of these guests tended to have little family support, lived in unsuitable accommodation and/or were awaiting a package of social care. In some cases, these guests were often both unwilling and unprepared to be “re-abled”. This issue was addressed by having regular review meetings with both locality teams and their discharge teams, which resulted in one locality adapting their admission criteria and the other locality changing their referral processes and introducing a community discharge team.

From the outset, every member of staff was focused on getting people into sustainable long term placements, whether that was the person’s home, an extracare scheme, sheltered housing or care home. Every person was encouraged to manage their own daily activities, cooking, laundry etc. in preparation for their discharge home, with an emphasis on support from families and other local agencies where required. ‘Guests’ were expected to remain in the centre for up to three months.

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1) Effective communication: Our initial intention of reducing the need to perform assessments for potential guests and only using information provided by the hospital had to change as we found the information was not always accurate. Changes to the referral process and working together with the two localities have ensured that sufficient information is now being received. 2) The need to think laterally: Our agreed admission times were between 8am and 8pm, 7 days a week. However, we found many people had spent all day sat in the discharge lounge waiting for hospital transport to bring them to the centre, often having been driven around the city dropping other passengers off, leaving them muddled and unsettled when they arrived and at a higher risk of falling. As we have access to a wheelchair accessible car, we are now able to collect the person from hospital at a more appropriate time reducing the stress and anxiety they experience. 3) Falls management: Most of the people coming through the centre were at risk of falling – in many cases this was the reason for their admission to hospital. The use of positive risk assessing allowed the staff to assist and encourage the guests to be as mobile as possible, and a range of measures for managing falls were adopted.

Feedback from stakeholders

Partnership working Early dealings with the two localities were not very different but enabled two different models to be trialled. Soon after opening, Brunelcare identified the need to improve the assessment processes to ensure that the ‘right’ guests were being referred to the centre. At first, some of the people being referred to the centre via South Gloucestershire, had very high clinical needs which did not match the reablement model, and did not give the person the best opportunity to succeed in returning to their home. Bristol was a slightly different story; their referrals tended to have high social care needs. Brunelcare quickly discovered soon after opening, that anyone could fit the reablement

Learning points

From the CCGs’ perspective, a 78% success rate was reassuring, especially as the service was a new and developing one. Eight of the people who went home would have previously been discharged to a long term placement from hospital. 12% of the guests returned to hospital, which is greater than was expected, and was primarily due to the person becoming suddenly unwell during their stay. Seven guests were returned as they were not able to take part in an active reablement programme due to their severity of dementia.

Lucy Parsons, NHS Bristol Clinical Commissioning Group – “I think the level of service offered has exceeded what we originally anticipated. It seems to me that as the working relationships have developed and the level of trust has become more robust, so more complex rehab needs have been met”. Emma Farwig. Community Discharge Coordination Centre (CDCC) – “Kinlay and her team proactively respond to escalations within the acute trusts. For example on Christmas Eve they were able to discharge two patients early, get the rooms cleaned and admit two patients into those rooms that afternoon. CDCC have built a good relationship with Orchard Grove which is built on trust and respect. When there have been any problems we have been able to work through these together to find an outcome that works for us both”. CT

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Gala Dinner 25 November 2016 Come and help us celebrate 18 years of the National Care Awards BOOK YOUR TABLES AT THE GALA DINNER NOW CONTACT

: [email protected]

“Christie & Co have been delighted to be involved in the National Care Awards since its inception. It remains one of the sector’s premier events, attended by the whole industry, whilst retaining its ethos of highlighting the work done by individuals on a day-to-day basis, providing quality care. It is crucial to showcase all that is good in the sector and remind everyone of the commitment and sheer hard work by many people across the UK.” - Richard Lunn, Director & Head of Care, Christie & Co “Caring Times is delighted that Christie & Co are continuing with their much appreciated main sponsorship of the National Care Awards. Christie & Co have been our partners in building the National Care Awards over 18 years into the largest and most respected Awards in the sector. We encourage all care providers to enter this summer and be part of an event which culminates in the superb Gala Night on 25 November – an event which everyone taking part values, celebrating as it does the very best people in the sector.” – Dr Richard Hawkins, Editor-in-Chief, Caring Times

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CELEBRATING 18 YEARS OF REWARDING CAREERS The 18th consecutive National Care Awards will once again celebrate the very best people in the long-term sector. Following the phenomenal success of the 2015 Awards, we will continue to highlight excellence in all parts of the sector and reward those who work tirelessly to provide consistently outstanding care.

#careawards

INTRODUCING OUR HOST: LARRY LAMB Caring Times are delighted to announce that this years host for the National Care Awards will be the fantastic Larry Lamb. Larry is a popular screen and stage actor with a career spanning over 30 years with two of his best-known TV roles starkly contrasing. In the hugely popular James Corden and Ruth Jones comedy Gavin & Stacey, Larry played Gavin’s Essex businessman dad Mick. For some time, Larry’s role as the affable, easygoing Mick ran alongside his portrayal of Eastenders’ Archie Mitchell, a shady, doublecrossing villain in the best soap tradition. Having recently moved away from acting, Larry presented his own show on London’s talk radio station, LBC. We are very excited to be welcoming Larry to the 18th National Care Awards 2016!

PREVIOUS WINNERS SHARE THEIR THOUGHTS... Previous winner Avnish said “I am delighted to have won this award and for the sector to have felt that I was worthy of winning this prestigious title. I will continue to live up to their expectations.” Avnish Goyal, Managing Director, Hallmark Care Homes and ‘Care Personality of the Year’ winner

Previous winner Sue said “I still can’t believe I won this award. When I got the call, I was very emotional. I feel as if I haven’t just achieved something for myself, but for my team in the young physically disabled unit and my home Greenhill Manor. I wouldn’t have won this award without their support and nomination.” Sue Povey, Hallmark Care Homes and ‘Care Registered Nurse’ winner

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when enough is enough

Saying goodbye to the burden of bureaucracy

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wenty years ago, my former husband and I bought Bradley House in Shirehampton which at the time had only six residents. Within a year we extended the home to accommodate 10 elderly residents from the age of 65 onward. At the time, I had no experience, no diplomas that qualified me to look after older people, I just had a lot of will. The people from whom we had bought the home had set up routines: residents basically had the food that was given to them and did what the owners wanted (bedtime, wake up time, food, etc). Straight away I felt that if a resident wanted something, and if that something made them happy and was safe, then that would be what I would do for them. I would look after them as if they were my grandparents, I would hug and kiss them every day, I would make them feel that being in care was not the end of their life; it would be a new chapter of it. Within about two years I was divorced and have since single-handedly owned and managed the care home. I am also a very proud single mother.

In early August the Bristol Post carried a piece about a small care home owner who, after 20 years, having become so exasperated by the ever-increasing burden of bureaucracy and the lack of support, has decided to call it a day. Caring Times contacted her to find out more and here, ELIZABETH LAYCOCK shares some of her experiences. is one of the top five of the most stressful things to do in one's lifetime and this is for people who are in their prime. Imagine what it can be like for somebody who is elderly, without any family and who perhaps is suffering from mental illness! It should be viewed as a contravention of human rights! It is absolutely flabbergasting to think that this is not enshrined in any law, let alone regulation. There are so many ways to keep elderly people in their care homes. One of them is to

Collaborative support At the beginning, our regulatory body was social services. My first inspector was very strict and not very well liked among the care home owners, but she was an amazing teacher of values. She quickly saw that I cared and she guided me through the whole paperwork side of things; from care plans to medications. She knew her job inside out and she cared too. She helped me enrol on the relevant courses. In those days, you could form a real working relationship with your inspector. They would be there when you needed them and inspections had a collaborative feel. You felt that you were making progress, you felt like you were doing something good and worthwhile, you were praised and acknowledged when you did something that showed good practice and was all for the good of the residents. The inspectors also stayed with you for quite a few years, so they knew you and, more importantly, they knew your residents. I think this is important because older people will often confide in people they know but perhaps not to a complete stranger.

Here to stay Very early on as well I made the decision to keep my residents for the rest of their lives. When one of them became less able or ill, or their needs increased for one reason or the other, I did not move them on. I employed more staff, I worked more myself, I fought to get equipment, I fought to get more funding, I did everything in my power not to move them. It is a general policy in many care homes to move residents on if they no longer fit. Moving

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seek financial help from the NHS through continuing health care funding which is available to anybody regardless of their financial means. It is not the easiest funding to get but if it is justified, and if the case is put together properly, and if you keep on and on at them then you will eventually get it. This extra financial help can then be used to pay for more carers. People who are terminally ill also qualify for fast track help, again through the NHS which again can help pay for more care and can help people stay in their own home, whether it is a care home or their own personal home. Nobody really advertises these funding sources so families find themselves in dire straits because they cannot cope financially and this is added to the heart-wrenching distress they are already suffering because their loved one is dying. The wishes of a person for the last days of their lives should be of utmost importance. Once somebody has been at the home for a while, I have always discussed their wishes for such a time; music, religious needs, food, lighting, etc. For example, one of my residents wanted all her medication stopped but wanted to have sips of sherry and chocolate buttons! And that's what she had! But nobody cares about that.

Inspections

ELIZABETH LAYCOCK: ‘One of my terminally-ill residents wanted all her medication stopped but wanted to have sips of sherry and chocolate buttons! And that's what she had! But nobody cares about that.’

Although conducted to guidelines, inspections are enormously subjective. One inspector might have a particular interest/knowledge in, for example, medication, that another might not have, so that particular inspector might criticise a certain aspect of something you do that another wouldn’t. We had an inspector for a couple of years who had never found a problem with our files not being locked away (they were kept at the back of a cupboard so you could not see them unless you knew they were there) but when we had a new inspector, she gave us an improvement notice because of it. On our last inspection, the day I did the article for the Bristol Post, the inspector told me that we should have our controlled medication recorded in a book and not on loose sheets. We have never had a book, we have always had loose sheets, why hasn't anybody said ■ Continued

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CARE DIRECTOR

ST GEORGE’S PARK CARE HOMES – DITCHLING Circa £65,000 per annum

We are a leading provider of healthcare within the Sussex area, caring for residents who are eldery, frail and mentally ill. We currently have four 60 bedded homes with future development planned. We are looking for a Care Director who will bring to the role their significant experience of managing Nursing Homes at strategic level, and will oversee the running of our homes, ensuring that the care given is of the highest standard, while ensuring that statutory regulations and accreditations are achieved. You will be responsible for the leadership, direction and regular management to support our Home Managers, and will hold overall budgetary and strategic responsibility. Core responsibilities will be: • To ensure timely completion and implementation of action plans in respect of regulatory and corporate requirements. • To ensure relevant staff work within the standards and framework of NMC, CQC and other governing bodies, and to follow and promote a professional code of conduct at all times. • To maintain full compliancy with CQC standards and Safeguarding procedures within our homes. • To ensure that there is always progress in the homes and clear direction is given for development. • To empower our staff to obtain the best possible achievements from them.

This is an integral role within our Organisation and the successful applicant should be able to demonstrate their excellent leadership skills within a care setting and their strong business acumen. They should be forward thinking and have the ability to manage and lead organisational change. To be considered for this post you will need to have held a recent Registered Manager post, and a senior management qualification would be advantageous. A current PIN registration would also be advantageous although not essential. In return we offer an excellent salary and benefits.

Interested parties should apply, in writing, to the Human Resource department, St George’s Park, Ditchling Common, Ditchling, Sussex, RH15 0SF. Telephone: 01444 259720 e mail: [email protected] Further details of our homes can be found at www.anh.org.uk Closing date for applications is: Friday 21st October 2016

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when enough is enough ■ From

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Saying goodbye to the burden of bureaucracy

anything before? Last year I had an inspection by social services who came to the home whilst I wasn’t there. The inspectors took photos inside and outside of the home without my permission, and without asking anybody, which is obviously illegal. This happened during the winter and yes, the garden did not look its best as I am sure most gardens don’t in the winter months. They found a hose which had not been tidied away, one empty can of coke behind a shed, a few broken panes of glass well away from the main house ( the garden is huge) and decided that the home was not safe. This precipitated an inspection by the CQC and one by environmental health – because obviously I would encourage the residents to run around the garden in the middle of winter! I made a formal complaint to social services who did come and apologise, mainly about the photos, as they knew very well that if I had had any money I could have sued them. I also made a formal complaint to the CQC who completely ignored anything I had to say and brought up the files issue and published in their reports that my service was inadequate. None of my objections or complaints are available in the public domain so effectively, I can be accused of anything but have no right to defend myself publicly.

I

am selling the home as I cannot take anymore, I have made everybody aware of this and have been keeping them all posted on what is going on, so what do they do? Inspections! I was so angry during my last inspection that I told the inspector that if I felt at any time that she was disruptive to the residents I would throw her out and then she could close the home and move the residents out as this would save me yet another horrible job. We, as carers, home managers, owners are treated as third class citizens. Although we look after the residents 24 hours a day, every single day of the week, we have absolutely no powers. When a resident is in hospital, as we are not the next of kin, we are not allowed to know what is going on with them, we are not allowed to advocate for them and our views are not considered whenever matters come to a best interest decision. It’s as if we don't know them. It’s as if we don’t exist. Is it so difficult to accept that there are people that actually care? I feel that I have proved this time and again over the years. Many families could tell you and anybody else who wants to hear that I have done my utmost for their family member. I have countless stories that show that I have done everything in my power to better the lives of the residents (I’m not allowed to say “my” residents as this is frowned upon). For example, a resident was placed with us following a stroke. This gentleman was very

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resentful at being placed in a care home, he was so incredibly independent, but the stroke had paralysed one of his sides and he could not cope at home. He was really difficult to look after, often shouting at the carers and complaining about everything. He was desperately unhappy. We tried to find ways to help him settle. We talked to him, when he was willing, and found out that he loved gardening. We organised a vegetable patch for him at the end of the garden and got him involved in all the decisions and in all the plans. This gentleman stayed with us for 15 years and died as one of our residents. At his funeral his son told me that he thought when he placed him with us that he would pass away within months. I miss him to this day and will always do. But no authorities ever praised us for that.

‘After 20 years I cannot fight anymore. The decision to sell up was one of the hardest I have ever had to make in my life but one that I knew I had to make for my own sanity and health.’ Another gentleman had no family and did not have mental capacity to look after his financial affairs, so his affairs were taken over by a solicitor. As this resident had no family and we had been his family for the past five years, I asked if I could organise the funeral. I organised the funeral that I felt the resident would have wanted; he had a “photo coffin” ( the whole of Bristol as he used to love Bristol and used to like driving around with the carers, spotting all the old places he used to go to) and I conducted the service as he was not a religious man and it would have felt horrible to me and to the carers to have somebody who did not know him talk about him. It was a very hard day but I consoled myself with knowing he would have been thrilled with it all. Nobody from the solicitor’s office showed up. Have any of the authorities praised any of us for that or even wanted to hear about it? No, keeping records in books rather than loose sheets is so much more important. At the last inspection the inspector told me that I had to prove and evidence to them that my service is good. I told her that, with respect, they were at the bottom of the pile of the people I have to prove myself to and that the residents will always be at the top! are nowadays is supposedly service user led. This is the biggest pack of lies. If they gave so much importance to what the residents felt they would never even suggest that my service is inadequate. Funnily

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enough at the time of that last inspection one of my residents told the inspectors to leave the home (well, he put it more rudely than that) and to mind their own business as he was happy here and he could see they were upsetting the staff. I would prefer a million times over to spend time with one of the residents, talking, laughing, taking them out etc than look into what new legislation has just come out which means that I have to introduce yet another piece of paper that I need to spend hours filling in each day just to make the authorities happy and give me a good report. Is this what care is? Who are we supposed to care about? The residents or the authorities? Who is more important? I fully support the regulation of care services, I fully support unannounced inspections, I fully support the eradication of all forms of abuse but this has to be done in the right way, this has to be done with people in mind, they are the only ones who matter. I live next door to my care home and have done so since I have converted my garage into a two bedroom house some 12 years ago. I am there every day, I hug and kiss the residents every day ( this used to be frowned upon by the authorities but it’s ok now), I see them every day, I kiss them goodbye when I go on holiday, I stay with them when they are ill, I do what any family member would do as the residents are just that, my family. ut after 20 years I cannot fight anymore. The decision to sell up was one of the hardest I have ever had to make in my life but one that I knew I had to make for my own sanity and health. As if it is not hard enough to have to look after people, to have to see them die year after year, to have to deal with staff, to make ends meet (and if you want to look after people properly it is expensive), to work ridiculously long hours, to have absolutely no life. ’Oh no let’s make her life hell, work against her, criticise her, make her feel worthless and see what happens!’ I feel people should be told the other side. Not all care homes are there to make a profit on the back of vulnerable people. Some people do care about the people they look after. There needs to be a real shake-up in the way the authorities conduct themselves. The six hours spent at my last inspection, inspecting a service that will be sold within a month, that has been looking after people well for the past 20 years, could have been much better used. The inspector is also going to spend countless hours writing her report that I will probably get just before I go to auction. What a complete waste. I do not say my service is perfect – perfection is very hard to achieve, especially on the pittance that social services pays – but I know that it is good and I know that I care. CT

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legal matters

Covert medication - recent case gives guidance for care providers T

he use of covert medication in care homes is a difficult issue and one which is fraught with risk to care providers and potentially service users. The recent case of AG v BMBC & Anor [2016] EWCOP 37 has provided unprecedented clarity and guidance to care providers on how serious this matter is and the care that is required when considering whether or not such administration is appropriate. The facts of the case are helpful in enabling care providers to consider the use of covert medication in the context of their own service provision: ■ The proceedings concerned a service user aged 92. Since 2014 the service user has been accommodated at home having refused respite care. The service user was assessed by a consultant psychiatrist, who confirmed a diagnosis of dementia in Alzheimer's disease and concluded that she lacked capacity to make decisions regarding her care, accommodation and treatment. ■ A best interest decision to place the service user into a care/nursing home was made in the absence of involvement of their adult children. ■ Since December 2014 the service user’s deprivation of liberty in the home has been authorised under a standard authorisation granted under Schedule A1 of the Mental Capacity Act 2005. The authorisation was to last until 17th December 2015. ■ An application was made in July 2015 challenging the standard authorisation initially to consider whether or not the she can safely be managed in the community either for visits or for a permanent return home with support. ■ During the proceedings relating to this challenge it became apparent that part of the service user’s care plan at the home involved the administration of medication covertly. No conditions had been placed on the standard authorisation.

such treatment must be administered in accordance with a law that guarantees proper safeguards against arbitrariness. Treatment without consent is also potentially a restriction contributing to the objective factors creating a DOL within the meaning of Article 5 of the Convention. Medication without consent and covert medication www.ridout-law.com 020 7317 0340 are aspects of continuous supervision and control that are relevant to seriousness of covertly administering the existence of a DOL. It must therefore medication without the appropriate use of best attract the application of Section 1(6) of the interests procedures. Act and a consideration of the principle of less In practical terms, care providers can draw restriction and how that is to be achieved. the following conclusions from the ‘1(6) Before the act is done, or the decision judgement and use the ruling as a guideline made, regard must be had to whether the on what is determined, in law, to be the purpose for which it is needed can be as correct procedure: effectively achieved in a way that is less 1. Care providers must flag up the potential restrictive of the person’s rights and freedom or actual use of covert medication with the of action.’ relevant authorities and ensure that there are

By JENNY WILDE, Senior associate solicitor Ridouts Professional Services

‘Any change of medication or

treatment regime should trigger a review from the managing

authority where such medication

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n light of this information, the judge in the case requested further evidence from the parties involved relating to the use of this medication. After considering this information the judge made some observations: “25. Although it is not an issue for me to determine I accept that treatment without consent (covert medication in this case) is an interference with the right to respect for private life under Article 8 of the ECHR and

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is covertly administered.’ “Such intervention must be proportionate to the circumstances of the case and accord with the principle of minimum intervention consistent with best interests.” He added: “29. All parties agreed that covert medicines should only be used in exceptional circumstances and when such a means of administration is judged to be necessary and in accordance with the Act (MCA). The guidelines published by NICE (National Institution for Healthcare and Excellence) provide that medication should not be administered covertly until after a best interest meeting has been held, unless in urgent circumstances” he judge’s summary in this case acts as excellent guidance for any care provider in this situation. He clearly emphasises the need for careful consideration of such decisions and endorses NICE’s guidance on this matter, reminding providers of the

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supporting assessments of capacity and that a best interest meeting has taken place involving the decision maker, the person, the persons family, the provider and relevant professionals; 2. If it is agreed that the administration of covert medication is in the person’s best interests then this must be recorded and placed in the person's medical records/care home records and there must be an agreed management plan including details of how it is to be reviewed;

3. All relevant documentation must be easily accessible on any viewing of the person’s records within the service; 4. The existence of such treatment must be clearly identified within any application for a DoL; and 5. Any change of medication or treatment regime should also trigger a review from the managing authority where such medication is covertly administered. This would only apply where there is already a current standard authorisation in place. The questions of capacity and best interests are always complex and when combined with medication can prove to be a minefield for providers. These simple guidelines, as asserted by a judge, can assist providers in ensuring that any action they take is within the law. CT

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catering/diary

Food labelling - its importance in care home catering

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ilk, eggs, shellfish, soybeans, nuts, celery, mustard and cereals containing gluten are just some of the 14 key allergens that the Government has identified and ordered to appear on all food labels in the UK. Food intolerances are on the rise and, while serious allergies are quite rare, when they do occur, they can be fatal. This means that care home caterers need to be familiar with the constituents of every ingredient used in the kitchen. Recently, a restaurant owner in North Yorkshire was jailed for manslaughter after a customer died due to an allergic reaction, following a recent decision to swap almond powder for a cheaper nut-based alternative that contained peanuts. This is a stark warning to care home caterers to know exactly what is in the food they are serving, as well as to care home managers to ensure that all their staff are clued-up and properly trained on allergens since the enforcement. A recent survey by the Food Standards Agency and charity Allergy UK, carried out ahead of Allergy Awareness Week in April, suggested that improvements have been made for those with allergies since the new labelling rules were imposed, but more work still needs to be done. The survey found that one in four

people suffered a reaction while eating out in a restaurant and more than two thirds of consumers have experienced staff not understanding the severity of an allergy. Catering for allergens is no longer just about appealing to a wider audience, it’s about complying with the law. Care homes need to be able to provide detailed information about all meals served to residents (and their families) upon request – creating a whole host of additional paperwork. Many care homes, particularly smaller independent ones which have leaner staff numbers, have struggled to find the time for these changes.

Great food for some; a serious risk for others. In some cases, extra staff have been recruited or current staff re-directed to manage the admin, as opposed to focusing on front-line services.

Hawker Events OCTOBER ■ Barclays/Knight Frank/Pinsent Masons Round Table DATE: October 5

■ Barclays/Knight Frank/Pinsent Masons Round Table DATE: November 11 VENUE: Pinsent Masons HQ, London

■ National Care Awards

VENUE: Cardiff Castle

■ Annual Care Conference for Wales

DATE: November 25 VENUE: Hilton London Metropole

DECEMBER

DATE: October 6 VENUE: Cardiff City Stadium

■ Barclays/Knight Frank/Pinsent Masons Round Table DATE: October 21 VENUE: River Station, Bristol

■ Barclays/Knight Frank/Pinsent Masons Round Table DATE: December 2 VENUE: New Hall Hotel, Birminham

■ Caring Times Christmas Lunch DATE: December 15 VENUE: Dorchester Hotel, London

NOVEMBER ■ 11th UK Dementia Congress DATE: November 1-3 VENUE: The Brighton Centre, Brighton

For further information on all these events, or to book a conference place, telephone Jessica Harman on

020 7720 2108 Ext. 202.

■ Dementia Awards

Alternatively, email

DATE: November 3

[email protected] or visit www.careinfo.org/conferences

VENUE: The Brighton Centre,

to download a booking form.

Brighton

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October 2016

By ANDY BADGER, Managing director Acquire, Foodbuy Ltd But catering for residents with allergies and other special dietary requirements, such as coeliacs, dysphagia sufferers, vegans, vegetarians, diabetics and those following halal and kosher diets, doesn’t have to be difficult. There are many services which have been developed to help care home caterers navigate the allergen laws and serve food that is safe for allergy sufferers. Online tools, such as eprocurement platforms, can harness a huge range of in-depth information at a click of a button. This makes identifying potential dietary and/or allergy challenges simple and easy – allowing care home staff to focus on providing a better eating experience for all. CT ■ For more information go to www.acquireservices.co.uk

Seminars Conferences and Exhibitions OCTOBER ■ Depriving Children & Young People of their Liberty Lawfully DATE: October 4 VENUE: The Training Suite, Peter Edwards Law, Hoylake, Wirral, Merseyside ORGANISER: Peter Edwards Law Tel: 0151 632 6699 E: [email protected]

■ Introduction - MCA & Deprivation of Liberty Safeguards DATE: October 18 VENUE: The Training Suite, Peter Edwards Law, Hoylake, Wirral, Merseyside ORGANISER: Peter Edwards Law Tel: 0151 632 6699 E: [email protected]

■ Care Roadshow Cardiff DATE: October 18 VENUE: Cardiff City Stadium ORGANISER: Broadway Events Tel: 01425 838393 W: www.careroadshows.co.uk

■ Health & Social Care Provision in Northern Ireland - Next Steps for Reform DATE: October 18 VENUE: Belfast ORGANISER: Policy Forum Tel: 01344 846796 W: www.policyforumforni.co.uk

■ Next Steps for Devolution of Health & Social Care Services in England DATE: October 20 VENUE: Central London ORGANISER: Westminster Health Forum Tel: 01344 846796 W: www.westminsterforumprojects.co.uk

For a free listing of your care sector focused event, email the editor: [email protected]

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transport

Mobility scooters - are care homes doing enough?

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ost care home residents depend on others to help them to get around. As well as requiring human support, many older people use mobility aids such as walking frames and mobility scooters. Many modern care homes are being built with specific mobility scooter charging bays. Much like the bays for electric cars, these provide a place to park a scooter whilst it is plugged in to receive a power boost. Of course, there are also care homes without such facilities. Charging a mobility scooter in a corridor, or using an extension cable from a window, is a health and safety risk: as well as potentially being a fire risk, if not properly maintained and regularly checked, a mobility scooter on charge may be blocking a route that is needed in the event of emergency evacuation. Many residents are obliged to charge their mobility scooters in their own rooms, due to rules about keeping the scooters out of communal areas. Does this put individuals at an increased risk of tripping and falls? Storage of each individual mobility scooter should be factored into any health and safety reports, or care home risk assessments. Many care homes have their own transport

ANDREW ATKINSON, managing director of Mobility Smart, examines some of the issues associated with residents using mobility scooters in a care home setting. 0800 567 7222 [email protected] facilities, in the form of large cars or minibuses, to take residents to medical appointments, hospital visits, days out and other social events Ideally, these minibuses and cars should also have space for mobility scooters, no matter what the type. Whilst some residents will have folding mobility scooters that are easy to accommodate, others will have heavy duty scooters that cannot be easily packed away. It may be within a care home operator’s rights to ask that all residents use folding mobility scooters, so that they can be packed and transported with ease, ensuring that every resident will have their scooter with them on day trips or other excursions. If this route is taken, care homes should be sure to include their mobility scooter restrictions within the documents they

provide to existing and new residents, and their families. If residents will need to change their scooters for a different style, they should be given a reasonable amount of time to do so and should not be missing out in the meantime. If a need arises for a resident to use public transport, rather than a minibus managed by their care home, there will be even further difficulties. Accompanying a resident, it will quickly be discovered that accommodations for mobility scooters are simply not made – they won’t fit easily on buses, they certainly won’t fit in a taxi, and you can forget about trying to find somewhere to park a scooter on the train. The challenge for care homes is to manage residents’ requirements regarding mobility scooters and other walking aids, whilst ensuring safety and fairness for everyone. CT

nutrition

apetito launches a new dining experience at specialist dementia home in Blackburn apetito launched a new dining experience in partnership with Community Integrated Care’s brand new specialist dementia home, EachStep Blackburn in May 2016. EachStep Blackburn provides a holistic range of care and support from one cutting-edge service, to assist people who live with dementia throughout their journey with the condition. Phil Benson, Manager of EachStep Blackburn has been particularly impressed with the apetito meal experience; “apetito meals have gone down so well with the people we support helping them to maintain weight and enjoy wonderful dining experiences.”

home and anecdotal evidence suggests care home staff battle daily to help residents maintain a healthy weight. “Modified diets, for those with dysphagia (difficulty chewing and/or swallowing), are a particular worry and our battle is always weight loss. Every week we fight to keep our residents healthy.” says Phil. “Previously, to support people on modified diets food had to be specially prepared and in the past we’ve had to improvise with pureeing food which means taste and presentation weren’t what we aspired them to be. The apetito Puree Classic range of moulded food is a revelation.

Major concern Since opening, 32 out of the 33 residents at EachStep Blackburn people have not lost weight since the apetito meal service was introduced. Weight loss is a major concern for those working in care settings. People are highly likely to lose weight on entering a care

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Full and happy lives In directly, when someone eats well, other areas of their lives become easier as well. As Phil says; “This is the key to providing person centred support and enabling people to lead full and happy lives.”

apetito are the UK’s leading creator of meals for the health and social care sector, making a real difference, allowing people to eat for health whether they are at home, in hospital or in care. apetito have twice won the UK’s highest business accolade – The Queen’s Award for Enterprise – most recently in April 2016. Community Integrated Care is one of Britain’s biggest and most successful charities, supporting over 5000 people across England and Scotland who have learning disabilities, mental health concerns, autism and agerelated needs – such as dementia. The charity has been recognised for its pioneering work at the likes of the National Dementia Awards, National Care Awards, 3rd Sector Care Awards and Skills for Care Accolades. ■ To find out more and book a FREE tasting session, visit www.apetito.co.uk/carehomes or call 0800 545 2631

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software feature

CareDocs keeps residents’ care plans always up to date Do you spend far too much of your time checking that your residents’ care records are up to date? Wouldn’t it be wonderful if you had a system that showed at a glance if any details were missing or records needed updating? If that sounds too good to be true then you need to know about CareDocs. All the necessary information – including daily notes and care plans – is constantly monitored to check that it’s being updated and nothing is out of date. If a resident’s records are not updated within 24 hours of the last note then it automatically generates a warning message. The system will also ensure that essential details such as the doctor’s contact details are recorded and updates to journals and short-term care plans are constantly monitored. A common criticism from CQC inspectors is that care plans are not reviewed on a regular basis. CareDocs can be programmed to automatically produce a reminder so you never have to worry that your care plans are out of date. You can update care plans with any changes in circumstances as often as you wish and then evidence regular reviews of care plans quickly and easily. As well as residents’ records, CareDocs can monitor daily checks such as fridge and freezer temperatures and equipment servicing schedules. ■ If you would like a free demonstration in your home without any obligation then please go to our website – www.caredocs.co.uk – or call us on 0333 500 5115

Innovative new software cuts the cost of training in the care sector iCareHealth’s new Electronic Medication Management software features an inbuilt eLearning module, designed to reduce the costs of staff training in the care industry. The unique Learning Management software gives staff access to resources that help them develop and practice the skills and activities that form a core part of their duties. Training costs are reduced since there is no need to schedule training events, minimal time is required away from the workplace and travel costs and expenses are cut. As Rohan Vendy, CEO at iCareHealth, explains – “Every time a new process is put in place or changed, training needs to happen. Yet upskilling staff in new processes, policies and technologies is expensive and hard to manage.” For managers, the application provides intuitive workflows in which they can see at a glance the progress each individual is making. Evidence of training competency can be easily obtained, while for staff the ability to train anytime and anywhere and be able to view skills and career progression is a welcome boon. ■ www.icarehealth.co.uk

Support for care providers to help move beyond compliance and create real improvement It can be a daunting prospect to think about your responsibilities if you’re a care and support provider. Preparing for Care Quality Commission inspections, adherence to the Care Act 2014 and fulfilling other important duties might make you wonder where you need to start. A new partnership will support providers in building on their achievements to date and driving improvement across the sector. Quality Compliance Systems (QCS) is teaming up with improvement agency the Social Care Institute for Excellence (SCIE). Together they can help you to promote and develop good practice in care, meet your compliance obligations, encourage improvement and run your care business as efficiently as possible. New materials will be produced to guide this including developments to the QCS dashboard for subscribers, blogs, webinars and other helpful tools: SCIE resources will link with QCS’s dashboard for social care providers Monthly blogs will give the latest information The organisations will collaborate in updating QCS products, policy and procedures SCIE will join the QCS care improvement board. SCIE’s Chief Executive Tony Hunter says: “We’re keen to support improvement in the quality of adult social care, by offering expert support before and after CQC inspections and by helping providers in their responsibilities under the Care Act. The partnership with QCS will help the sector provide services which improve people’s lives.” QCS’s Managing Director, Mat Whittingham says: “We are really excited to be working in partnership with SCIE. Their world class resources will enhance the support we provide our clients and help us to drive quality and innovation across the sector. We believe that collaboration and the wider sharing of resources is key to the delivery of person-centred, diverse and well-led care.” ■ For more information on this exciting new partnership and their upcoming projects or the QCS system, visit their website at www.ukqcs.co.uk

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product news

New dryer from Armstrong in near constant use at Oaklands Oaklands Care Home in Waterlooville is a privately owned care home with capacity for 31 residents in a mix of single and shared rooms. Its specialist registration categories include dementia, stroke, bi-polar and visual impairment and it has an excellent reputation locally for the quality of care it provides. Originally a single farm house it has had two large extensions and also taken over the next door house to increase its capacity. The laundry handles everything in the home – bed linen, towels, table linen and all the residents’ personal clothing and is in use pretty well continuously according to Marilyn Collins, manager of the home. Last year the tumble dryer needed to be replaced and the owner contacted Armstrong Commercial Laundry Systems who supplied and installed a Huebsch gas heated stacked tumble dryer, allowing them to dry two loads simultaneously. The laundry is operated by a specialist member of staff during the day, but often care staff will need to do additional loads at other times. “We’re delighted with the new dryer”, Marilyn told us. “We pride ourselves on a very personal level of care here, for instance we don’t use agency staff - I have my own bank of carers - as consistency is so important. Keeping up with the laundry and it all coming out looking good is an important aspect of this care and this machine has been excellent since it was installed.” ■ For further information contact Armstrong Commercial Laundry Systems, 01635 263410, [email protected], www.armstronglaundry.com

Bidvest Foodservice launches its Christmas range Bidvest Foodservice has unveiled its Christmas portfolio for this year’s festive season. With over 80 new products, the range has been developed by the expert team of chefs at the leading foodservice supplier, to provide care home operators with a partnership which delivers everything they will need to plan ahead and create a memorable Christmas for their residents. Following a year-long development process, the festive products include a vast array of items which match current and up-coming trends, popular flavour profiles and prevalent dietary requirements – which are of particular importance for care home caterers. Using extensive market research and insights, customer feedback and supplier input, the range has been developed to ensure the products cater to the requirements of both the residents and care home caterers. The range includes firm favourites, such as traditional mince pies, turkey and pigs in blankets, as well as new items that are tailored to the care sector, such as joints of meat which have been reduced in size to cater for residents with smaller appetites and allow flexibility with cooking times, whilst also reducing waste. From delectable canapés, sumptuous joints of meat, tempting desserts, to kitchen essentials, crackers and crockery, care home operators can create a calendar of Christmas events which capture the festive spirit for residents and their visiting friends and family. Bidvest Foodservice has recently acquired Yarde Farm, a super-premium brand of exciting, award-winning, flavoured ice creams and sorbets. Yarde Farm has created some indulgent new flavours especially for Christmas, including Cinnamon Crunch Ice Cream, Ginger Ice Cream, Crisp Apple Sorbet and Elderflower Sorbet, which not only compliment Bidvest Foodservice’s new festive range of desserts perfectly, but are a great option for residents who require a softer diet. ■ For more information, please visit: bidvest.co.uk/Christmas

Gainsborough extends warranty to two years on all powered baths

Gainsborough Specialist Bathing, part of the world-leading Care in Bathing group, has introduced a new comprehensive two-year warranty on all of its hi-lo and assistive powered baths. Hand-built in Great Britain, Gainsborough manufactures the widest range of proven accessible baths that deliver greater care, dignity and safety in care homes and hospitals. Through the assistance of powered height adjustable, bather transfer seats and other specialist design features, disabled bathers with conditions such as dementia can experience a more pleasant bathing experience. Moving and handling risks are also reduced and carers are protected from potential back and muscle injury – helping to reduce potential staff sickness levels. Gainsborough is regarding as the respected leader by many healthcare providers and offers a holistic service from initial site survey through to bathroom design, installation and after sales support. Gainsborough has complete confidence in the quality and reliability of its products and believes this peace of mind should be extended further with its clients. Hence all new Gainsborough baths, including the flagship and highly versatile Gentona, are now supplied with a comprehensive 2-year parts and labour warranty*. This offer illustrates Gainsborough commitment to providing durable, high performance baths that meet the challenges of high-traffic care environments. This warranty means purchasers and specifiers can rest assured that ongoing equipment budgets can be managed more effectively and efficient Gainsborough service technicians will ensure any potential down-time is minimised. Gordon Farmiloe, Gainsborough Managing Director comments: “We are delighted to extend our warranty period to 2 years on all baths – providing even more assured performance and value to our customers. Our latest range of world-class hi-lo baths continue to be at the forefront of assistive bathing.” ■ www.gainsboroughbaths.com

Autumn is welcomed by Care Roadshow Cardiff With Autumn brings with it the second Care Roadshow to grace Cardiff soil. Following on from the successful launch last year, Care Roadshows are excited to be returning to Cardiff City Stadium on 18 October. The event tailored for the Welsh care community hosts an array of informative seminars focusing on The Regulation & Inspection of Social Care (Wales) Act 2016 as well as the new Social Care and Wellbeing Act

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that is going to make big changes to the way care is provided in Wales this year. A representative from Care Forum Wales will be following on from the seminars conducted by Care and Social Services Inspectorate Wales (CSSIW), Alzheimer’s Society and the headline sponsors Quality Compliance Systems (QCS) to round off the day with the key issues from a provider perspective. The popular Oomph! will be joining the line-

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up for not one but two workshops to highlight the importance of a positive attitude and creating a varied activity programme. Following the anticipated Cardiff event, Care Roadshow will be hosting its final 2016 event at Epsom Downs Racecourse on 15 November. ■ To register for free tickets to these events visit www.careroadshows.co.uk or call 01425 838393.

October 2016

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building with care

Enham Trust opens intermediate care facility Not-for-profit specialist care and support provider Enham Trust has recently opened Cedar Park, a 10-unit intermediate care facility, at its 122-acre site near Andover in Hampshire. For more than 50 years Enham Trust has operated as a pan-disability charity and now provides care and support to 7,500 people. The Cedar Park development will be a new model of provision for the charity which has hitherto operated mainly as a social landlord offering supported housing across seven local authority areas, along with residential care for people with a range of disabilities, as well as operating social enterprises to help disabled people into work. The Trust also plans to open a 14-bed neurological rehabilitation unit at its Andover site next year. Chief executive Peta Wilkinson said the Cedar Park apartments marked the beginning of a new service in Hampshire and would be available to local authority funded, privately

funded and direct payment customers. “The apartments are available for customers who require a limited level of care and support for a short period of time,” said Ms Wilkinson. “We envisage the units being used by people leaving hospital but who are not ready to go home, by disabled, elderly and vulnerable people who need a short break with appropriate care and support, and by carers and families looking for respite stays.” Ms Wilkinson said the decision to build the

Cedar Park units because local health trusts were under ever increasing pressure from delayed discharges. “As a long established charity we probably have some advantage over private sector providers in that we feel confident in our relationships with CCGs and health trusts. “The demand is unquestionably there and I am sure that hospitals will make increasing use of units like Cedar Park to relieve the pressures on hospital beds.”

Enham Trust’s 10-bed Cedar Park intermediate care unit will be available to local authority

PETA WILKINSON: ‘The demand is unquestionably there and I am sure that hospitals will make increasing use of units like Cedar Park.’

funded, privately funded and direct payment customers.

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building with care

Brunelcare-Ashley House wins retirement living contract Brunelcare - Ashley House consortium has been awarded a contract by Bristol City Council to provide a care facility in Hengrove, Bristol as part of the Council’s retirement living programme which started in 2013 and aims to deliver around 1,000 additional extracare housing units across the city. The Hengrove project will include 200 extracare housing units as one or two bed apartments which will be available for rent, shared

ownership and private sale. The site will also feature a 63-bed specialist dementia care home and include other associated health, retail and leisure facilities to benefit the whole community. When the build is completed Brunelcare, a registered charity, housing association and major provider of housing, care and support, will manage the scheme on a day-to-day basis. Architects Penoyre & Prasad have based the multi-million pound facility’s design based on Stirling University’s best practice guidance to offer state-of-the art, age appropriate and dementia friendly accommodation with a range of tenure types across the extra care housing. Particular attention has been given to the layouts of each area of accommodation, including internal and external Computer image of the hub area of the retirement living scheme planned for Hengrove in Bristol. security and the inclusion of natural daylight.

“The next steps will be public consultation and planning applications, before starting on site,” said Jonathan Holmes, director for Ashley House, a health and community care property partner working with providers and commissioners in the public, private and community sectors. “We will be working with the local community and Bristol City Council to realise what is an innovative scheme, joining health, housing and care together in one location, to facilitate better outcomes for all.”

Work to start on Angel Care’s new 55-bed home in Suffolk Work is soon to begin on Angel Care’s 55-bed nursing and dementia care home in Woodbridge, Suffolk. Along with its sister company MNS Care, Angel Care operates 11 care homes in total, with MNS having recently opened a 46-bed facility in Harrow which caring for residents from the Asian community.

Care UK celebrates £18m investment in three new care homes Major milestones have been marked on three care homes being developed by Care UK with topping out ceremonies held at a trio of new homes in Sevenoaks in Kent, Horsham in Sussex and Ferndown in Dorset. Weald Heights in Sevenoaks is set to be Care UK’s flagship development and, when complete, the three-storey facility will boost provide residential, dementia and nursing care for up to 80 older people, as well as creating jobs in the local community. The £6m care home in Horsham will become home to up to 82 residents and will be known as Skylark House when it opens just before Christmas this year. In Dorset, the Mayor of Ferndown, Councillor Mike Parkes, led an event with representatives from Care UK and Pennyfarthing Homes to celebrate the completion of the roof of the new Ferndown Manor care home. This project will create up to 120 jobs when the care home is fully commissioned and will welcome the first of its 75 residents in January 2017. Care UK currently offers 114 care homes in locations as a diverse as Edinburgh, Worcestershire, Suffolk and the south coast.

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Construction personnel, Care UK and partner representatives at the soon-to-be-completed 80-bed care home in Sevenoaks, Kent.

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October 2016

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The 12th Annual Care Conference for Wales 6 October 2016 • CARDIFF CITY

STADIUM

Organised by

9.00 – 10.05 Registration, Networking and Exhibition viewing 10.05 – 10.15 Chair’s Introduction Mario Kreft MBE, Chair of Care Forum Wales

Supported by

12.10 – 12.40 How to Bring Your Home Back to Life. Jermaine Harris, Life Coach, Peak Performance Strategist & Author 12.40 – 1.50 Lunch, Networking and Exhibition viewing

10.15 – 10.40 (Key Plenary) Minister’s Address: Rebecca Evans AM, Minister for Social Services and Public Health

1.50 – 2.20

Introduction of the Welsh Language standards. Meri Huws, Welsh Language Commissioner

10.40 – 11.10 Funding staffing and the bottom line. Michael Hodges, Head of Care Consultancy, and Max Weidl, Associate Director, Care Consultancy, Christie & Co

2.20 - 3.00

Driving Towards an Excellent Compliance CSSIW Report. Margaret Rooney, AreaManager South East seconded as Project Manager R & I Bill, Care and Social Services Inspectorate Wales

3.00 - 3.30

Q & A Panel of Experts Session

3.30pm

Tea and Close

11.10 – 11.40 Coffee, Networking and Exhibition viewing 11.40 – 12.10 Well-being and health for people with dementia in care homes. Jane Fossey, Associate Director of Psychological Services, Oxford Health NHS FT

Book online at www.careinfo.org/wales-2016 Or contact [email protected] • Exhibitors & sponsors: contact [email protected]

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building with care

In 2014-15, Bupa UK invested £28.3m to retrofit energy efficient and renewable technologies into its nationwide property portfolio, reducing carbon emissions and its environmental impact. After a review of energy consumption and an ongoing commitment to carbon reduction, the health and social care provider installed solar PV, LED lighting, ground and air source heat pumps and Combined Heat and Power (CHP) systems to further enhance the performance of many of its residential and nursing homes, offices, hospital and clinics. With plans to reduce total carbon emissions globally by 20% by the end of the 2015 against a 2009 baseline, Bupa UK engaged Bosch Commercial and Industrial to install bespoke heating systems. Each system installed at 150 locations throughout the UK comprised of a CHP module paired with condensing boilers.

Championing CHP Optimised for buildings with continuous heating and hot water requirements and high electricity usage, CHP is said to be perfectly suited to a care home consumption pattern. The systems installed by Bosch aim to meet the baseload energy requirements within the care homes, using natural gas to generate electricity with the heat produced as a byproduct then used for space and hot water heating. Each Bosch 19kWe CHP unit acts as the lead heat source, and for every 56kWh of gas input the unit creates 19kWh electricity and at least 32kWh heat (36kWh possible with condensing technology). Having been installed in 89 Bupa care homes throughout the UK, the benefits of the CHP systems have been felt both by the organisation as well as the individual sites. For example, Summerhill care home in Kendal has generated more than 78,000 kWh of electricity since installing CHP. This energy would have cost more than £8,000 if it had been purchased from the national grid and has avoided 40 tonnes of carbon being released.

Generating results As the electricity produced costs much less than purchasing power from the grid, each new system made an instant impact. The collective annual savings across the 89 sites are set to

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PHOTO: leeboswellphotography.com

Bupa retrofits its care homes with Combined Heat and Power from Bosch surpass £1.1m in the first year and has avoided almost five kilo tonnes of carbon emissions. This substantial reduction will vastly improve the environmental impact of Bupa UK by providing more than 14MWh of self-generated electricity per year. Using CHP technology will also help to shield Bupa UK from rising energy prices, with a Combined Heat and Power units like this one can cumulative saving of more than £7m presignificantly reduce a care home’s energy costs. dicted by 2020. Taking Netherton Green care home in Dudsolve the issue as promptly as possible. ley as an example, the daily consumption of The BMS system allows Bosch to view how electricity at this site now takes the form of many hours the appliance has run for and even only a small amount of grid electricity, with when the next service is due. The manufacturer about half replaced with self-generated encan also analyse any performance shortfalls – ergy. The CHP system produces a continuous all of which ultimately create opportunities for energy load, and the Solar PV helps to top-up the CHP module to be repaired proactively the peak hours usage. rather than in response to a breakdown or for the system to be restarted automatically withThe measures applied by Bupa at Netherout the need to send an engineer to the site. ton Green have resulted in a reduced daily As well as the technological challenges pregrid electricity consumption of 80%. An LED sented by such a large CHP project, the number project at the site reduced the electricity of sites involved also presented various logistiusage by 20%, followed by a further drop of cal challenges. With nearly 100 different sites more than half once the CHP system was inand plant rooms to account for- many within stalled. A final significant reduction occurred Victorian or graded buildings, and each with after a Solar PV fitting. their own individual space and time limitations, Monitoring success a flexible approach was necessary. Working CHP technology straddles two disciplines, closely with Bupa UK, Bosch developed a simbridging the gap between traditional heating plified Hydraulic Solution designed to minimise and electrical generation. As such, its implethe impact on the site and therefore on resimentation is often less mechanical than other dents and staff. systems and one of the potential associated “We have over 350 properties in the UK, challenges of CHP for Bupa UK was trouwith care homes representing 85% of our enbleshooting on site. For example, when a modergy consumption, so we wanted to make a ule switches off and the heating system’s concerted effort to ensure our existing buildback-up boilers kick-in automatically, staff on ing stock is performing as energy efficiently site often remain unaware that the module is as possible,” said Bupa UK property director no longer in operation. Brita Sread. While a secondary heat source may spring into “Although utilising energy efficient and reaction to avoid loss of heat for residents, the newable technologies is standard practice in consequence is that no electricity is being gennew build properties, we knew that reducing erated during that period. This will have a sigour energy consumption at source across our nificant impact on the payback period of the existing care homes on a mass scale would sigCHP module in question. nificantly minimise our environmental impact, To remedy, this Bosch installed a remote though a number of these being of Victorian monitoring BMS system for all 89 sites so that construction added to this challenge.” both parties could be notified via text message ■ For more information, go to www.boschor email immediately if a CHP module stops industrial.co.uk or call 0330 123 3004 working for any reason; enabling them to re-

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business & property

Drive for quality or head for the hills? C

are homes have seen a marked improvement in quality over the last 10 years. It would be unwise to be so bold as to say that the market is perfect, but generally there continues to be a drive for quality, with the current generation of care homes being remarkably different to the lightly modified buildings which were at one point the mainstay of the market. It is important, however, to establish how we perceive quality and to gain a broader conception of how quality can be delivered within the industry. I am sure we can all agree the vital role that the physical environment of a care home plays in delivering quality. Recent years have seen new benchmarks set for the architectural diversity, spatial provision, range of facilities and general thoughtfulness in the design of care homes. In fact the current generation of care homes are able to create an atmosphere for residents which is far closer to the reality of life and community outside of supported environments. Quality, though, is a two-pronged fork. It is partly about property, but it is also about the provision of care itself. During a recent inspection of a care home I stumbled across a very good example of

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high quality care delivery in action. It was the simple use of a cinema room to fuel a group of residents’ passion for films – an interest which could easily have gone unnoticed by the care staff if they had busied themselves with more routine (admittedly often vital) matters. This is not revolutionary by any means, but it did make a clear statement about the quality of care delivery. The management and staff team had a strong focus on not only providing care in medical terms, but providing excellence in care through enrichment of the residents’ lives. Whilst this example is directly from the private pay market, quality care delivery of this type is not just exclusive to this segment of society. It can also be observed at the other end of the spectrum in a variety of ways, from the simplicity of growing vegetables, to the organisation of a residents’ Olympics. We must also recognise the largely underappreciated fact that focusing on quality of care makes a genuine difference not only to the lives of the residents, but also to the business. Valuation in the UK is very much focused on bricks and mortar. That’s fine when you are

By TOM ROBINSON, Director, healthcare advisory team, Cushman & Wakefield

looking at the quality of facilities, but by valuing care homes as businesses we get to see first-hand how the standard of care delivery in medical, compliance and regulatory terms can have a positive impact on trade, and how focus on quality in a broader sense makes a positive contribution.

G

aining a reputation for quality in this form of care, where providers strive for care delivery beyond that which is required and take a more holistic approach, will reinforce reputation, occupancy, help grow fees and, presuming everything else is in order, these benefits will have a net contribution to the bottom line. Furthermore, taking this approach attracts and retains the best staff – those who see care ■ Continued

on next page

www.careinfo.org – Caring Times official website

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business & property ■ From

previous page

as a vocation rather than simply a means to an end are likely to be better carers. This is not idealism with philanthropy at the core of recruitment, it is a mind set with quality care at its core, and quality care, when delivered in a commercial manner, becomes reinforcing. The observation that the quality of care homes have seen a marked improvement in the last 10 years is based on more than simply innovation of property. It is also a measure of innovation in the quality of care delivery, something we have seen in care homes big and small, with fee profiles at the top and at the bottom of the spectrum. We have also seen care homes fail and fall into the clutches of administrators and the blame being laid upon an inability to invest in the property sufficiently, when in practice it was more about the lack of focus on quality care. Conversely this brings an opportunity for the right operators to acquire such failing businesses and bring them back to viability through a combination of investment and quality care. No matter what budget they work with, they should brace themselves against many of the market pressures and focus on this mind set. This should ensure that a viable, stratified care home sector remains. CT

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Ridouts reconfigures to extend service offering Health and social care solicitors Ridouts have changed the firm’s legal identity from a Limited Liability Partnership (LLP) to a Public Limited Company (PLC). Incorporation into a PLC in the legal sector offers an alternative business structure authorised by the Solicitors Regulatory Authority (SRA) and enables firms to appoint non-solicitor shareholders. Ridouts are one of a small number of law firms to now have a PLC status and the only health and social care specialists in the UK to have made this move. Since becoming a PLC, Ridouts has changed its official name to Ridouts Professional Services PLC and will soon relocate to new premises of in the heart of Marylebone, London. Shareholders and directors remain unchanged – Paul Ridout,

Valerie Ridout, Neil Grant and Caroline Barker. Managing Director Paul Ridout said the transition from LLP to a PLC enables Ridouts to improve its multi-disciplinary service to clients, allowing the practice to meet various health and social care regulatory needs. A new team of highly experienced health and social care consultants has been established following the appointment of Claire Ferrari, Duncan Howells, Bhavna Keane-Rao, Gerry Kennedy, Julie King and Anne Smith, enabling Ridouts to offer clients an unrivalled suite of advice all under the one roof. “This move will be great for Ridouts clients and staff alike and provides a platform for development and the achieving of very ambitious growth targets,” said Mr Ridout.

RBS supports Adara acquisitions Northampton-based Adara Group has acquired two care homes; Burlington Hall in Woburn Sands and The Shrubbery in Higham Ferrers. An undisclosed funding package has been provided by the Royal Bank of Scotland to support the deal. Adara was established in January 2016 by experienced care home operator Sue Hanspaul, with her husband Mike and son Sandy. Sue has been involved with the running of both Burling-

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ton Hall and The Shrubbery since their inception and this deal sees her acquire full ownership of both homes under the Adara Group. Sue Hanspaul was formerly a community pharmacist and has been a care home operator since 1988. She has already begun plans to enhance the current facilities available at both care homes. This includes a programme of refurbishment and raising the standards of care.

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business & property

Four Seasons takes a positive view in the wake of improved performance I

mproved business performance by Four Seasons Health Care saw the group end the second quarter of this year with almost £40m of cash which, says group chairman Robbie Barr, together with further expected disposals of properties that are loss making, under-performing or not core to the business strategy, provides sufficient medium term financing. “Performance for the second quarter of 2016 was ahead of expectations,” said Mr Barr. “We have continued to build on the turnaround which began at the end of 2015 and the quarter on quarter decline of last year has been replaced by quarter on quarter improvements. Occupancy in our homes and hospitals is up; revenues and EBITDA are up; quality performance has improved and embargoes remain at the lowest level they have been in many years.” The company reports: ■ EBITDA at £13.6m, was £4.4m higher than Q1 of this year, 25% up on Q2 last year and higher than any quarter since 2014. ■ Revenue of £174m was £3m higher than Q1 of this year and approximately £12m higher than Q2 of 2015 after adjusting for closed and sold homes. ■ Occupancy across the group’s care homes has increased to 87.5%, which is the highest level since 2014. This compared to an average of 85.3% during 2015. In The Huntercombe Group’s services in areas of mental health and brain injury, occupancy increased to 82.3% compared to an average of 78.8% for 2015. ■ Embargoes across the care homes averaged three in the quarter and have been consistently low all year. The group is achieving much better regulatory and customer satisfaction ratings. ■ The group has continued to invest in its estate, spending £10.2m in the quarter which included maintenance capex of £6.8m, equating to more than £1,300 per bed on an annualised basis. Developments are continuing at a 28-bed new build at the Frenchay Brain Injury Rehabilitation Unit, Bristol and an eight bed extension at La Haule Care Home in Jersey. The Brighterkind homes refurbishment programme continues.

Challenging market Mr Barr said that, in common with all care providers, Four Seasons continued to feel pressure resulting from the challenging market environment and under funding of care. “However, there have been positive devel-

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We have a stronger management team who have empowered our front-line people to take the initiative to improve the daily experiences of our residents – and they do. This has led to a sharp increase in workplace satisfaction from 81% last year to 87% now. “We have transformed our care quality and as a result customer satisfaction ratings have risen to 97%, from 92% a year ago, although of course there is always more to do. Embargoes on new admissions are at an historic low of just two, and have TIM HAMMOND: been for much of the year, and our regulatory ratings have ‘We have a stronger risen from behind the market to stand comparison with management team who major competitors. “A key driver of our improved have empowered our quality performance is our marfront-line people to take ket-leading Quality Of Life Programme, which has been rolled the initiative.’ out to all homes. Residents, their families and health professionals can use “There has been a 40% increase in the iPads that are linked to purpose designed Funded Nursing Care payment, which is paid software systems, to tell the company what by the NHS to nursing homes for the element they think about any aspect of care. The inof resident care requiring a nurse. Following a formation is transmitted in real time to the review the Department of Health has inhome manager and regional manager. Using creased this from £112 to £156 a week per this feedback, care teams can find and fix isperson, until the end of the year. This puts the sues and niggles quickly or implement sugFunded Nursing Care payment on a more realgestions for improvements. This is very istic basis after many years of no rises or very different from the paper-based surveys conlow rises despite the shortage of nurses that ducted across the industry once or twice a has driven up the costs of employing them. year, where feedback is usually out of date by The new rate was announced in July so was the time it is collated. In just 12 months, we not a factor in our improved results, but it will have received more than 110,000 pieces of make a difference in the future as most Four customer feedback. Because of all this we Seasons homes provide nursing care. have improved our reputation and trans“As I have said previously, the group has formed our financial performance.” been engaging with key stakeholders to find a opments,” he said. “We have reached fair fee rate agreements with a large proportion of the local authorities who commission our services. These agreements recognise the additional costs of the National Living Wage, although they do not make up for the under-funding of care that already existed. We are still negotiating with a number of authorities, including some who have disappointingly made fee offers that are unreasonable and unsustainable.

long term solution for the group’s debt and capital structure, which we aim to resolve during the course of 2016. Meanwhile, we continue to have sufficient financing for the medium term and we do not see this process having any effect on day-to-day care provision.” our Seasons chief executive Tim Hammond said good progress had been made in transforming the company’s care homes business over the last two years and the effects of this were now showing through in significantly improved performance against all of its key measures. “We are transforming our organisation,” he said. “A new leadership team was put in place during 2014 and in just over two years, we have engaged 180 new managers, many replacing those who were struggling to perform.

F

Intermediate care Mr Hammond said Four Seasons is working with Clinical Commissioning Groups and local authorities to develop and trial provision of intermediate care for patients whose medical condition has been stabilised, to enable them to be discharged from hospital. “Enabling people to be discharged safely and avoiding the need for admissions to hospital frees-up beds that are needed for scheduled treatments as well as having the potential to save the NHS money,” said Mr Hammond. “We believe that Four Seasons, with more than 300 homes offering nursing care, is uniquely placed to support commissioners to ensure good outcomes for older people who rely on getting the health and social care that they need.” CT

www.careinfo.org – Caring Times official website

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business & property

Recruiting a high-calibre care home manager

R

ecruiting a ‘good’ care home manager is becoming more and more of a challenge. Recruitment is all about people – and, people are unpredictable – they make decisions which even the best recruiters cannot predict. However, there are a few simple things that a care home operator can start considering when scoping-out a recruitment plan. There are a lot of things that are out of the employer’s control throughout the process, but that said – they should be doing the things they can control, well – in order to maximise the chances of achieving a positive result.

Be clear about what is being looked for Different sectors will want managers with particular skillsets – care is no exception. Which skills are important to do well in the role? Which skills are not so important? What experience are seen as being most important? Care is a difficult sector to attract a lot of quality candidates for – consider making experience less of a necessity, and more of an “added extra”. Consider candidates with fewer years of experience within a care setting but with strong, transferable management skills – this will open the talent pool of available candidates. Before the recruitment process can begin, there must be clarity around who you’re trying to attract – otherwise it is less likely that the right person for the job will be recruited.

‘Sell the position’ in the job ad The success of the recruitment process depends entirely on the employer’s ability to attract talented candidates. Are you doing it right? Think about it – what sold the job to you? What made you want to apply for the role? Then advertisement can begin to come together. Candidates’ attention needs to be caputed – and this needs to be done quickly. How many job applications have you only read the first couple of lines for, before deciding that it’s not the job for you? If you’re like me – a fair few. A straight description of

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your company to the candidate won’t add any value – adding value comes when you begin to sell your company. There’s no point in offering someone the exact same job that they already have – what makes you a more attractive employer? How will your company help them to reach their full potential? What’s the employee culture like? From the beginning, every application process is a two-sided affair. In this instance, you’re answering the candidates’ question – “Why would I want to work for you?”.

Be proactive Job adverts are effective and impactful – but, they only attract the candidates tha are looking for them. An employer shouldn’t stop there. There are a wealth of tools at an employer’s disposal when it comes to advertising job vacancies. Which of them could be used to be more proactive? By this, I don’t mean an employer should go to an agency to help them source candidates – this should only ever be a last resort – but there are a number of platforms that can be explored to help with recruitment – each of them requiring minimal resource. For example, there are more than 20 million LinkedIn users within the UK alone. This is an enormous talent pool. From this talent pool, there are 44,000 job applications each day. This begs the question; if you aren’t using LinkedIn to advertise your job vacancies – why not? Social media platforms aren’t the only way to be proactive; current employees will know what makes a good manager – who is the best manager they have ever worked for? Why were they the best manager? Internal resources can be advantageous and should be used.

Keep them engaged throughout the process The chance of candidates dropping out during the process should be minimised, to maximise the chances of recruiting the manager you

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By DAVE BEESLEY, Talent director at Cohesion [email protected] 0121 713 8320 need. Candidates drop out for a number of different reasons – one of their biggest bugbears is that they aren’t kept in the loop. This is a very simple thing, requiring minimal resource, which can deliver a better candidate experience. Map out specific touchpoints, and make sure that you communicate with the candidate. The candidate experience is very much in your control – it’s the candidates’ first sustained period of contact with your business and, in the world of recruitment, first impressions count. Candidates will judge you on their hiring experiences – if they have bad experiences, they are likely to perceive it to be the way that the company works. As a result, they may be more inclined to turn down an offer. Make sure that they have everything they need, for each stage of the process. Simple courtesy calls before assessment centres and interviews will help you to make sure that all of your candidates are as prepared as they can be. Making sure that your candidates are prepared will ease their nerves – the more relaxed they are, the better they are likely to perform throughout the process. Before the recruitment process even begins, an employer should be looking to maximise the likelihood of recruiting a ‘good’ manager. There are a number of factors that cannot be controlled – people are unpredictable. However, you can maximise the likelihood by doing the things that you can control, well. CT

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Lloyds helps Strong Life Care to complete fourth acquisition A Yorkshire care operator has accelerated its plans for growth with the acquisition of a new care home in Barnsley, funded with a seven figure loan from Lloyds Bank Commercial Banking. The purpose-built 60-bed home, Highstone Mews in Worsborough Common, will be Strong Life Care’s fourth acquisition, adding to its existing homes in Barnsley, Wakefield and Newark in Nottinghamshire. As part of the acquisition, Strong Life plans to make a number of renovations to the prop-

erty to make it more accessible to residents with dementia. These will include the development of a ‘mock street’, featuring images of a post office and village bakery to create an environment that will spark memories, encourage conversation and promote independence and self-esteem. “The funding Lloyds Bank has provided over the past couple of years has been integral in helping us pursue our expansion strategy,” said Strong Life managing director Harpreet

Banwait. “We look forward to continuing our relationship with the bank as we work towards achieving our 700 bed milestone within the next five years.”

Derbyshire care provider refinances with Barclays Derbyshire care business Hill Care Group has secured funding from Barclays to consolidate its banking with one provider and refinance for growth with a £26m term loan. The funding deal with Barclays is the biggest the bank has agreed with any care operator in the North of England this year. Established in 2001, Hill Care operates 18 care homes with more than 1,000 residents across the north of England and has plans to acquire and build new facilities. Managing director Wendy Waddicor said her company’s priority was improving the quality of life for tits residents, maintaining their privacy, dignity and ability to manage their own lives.

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“Barclays shares our enthusiasm, aspirations and appetite for growth and we are delighted to strengthen our relationship with the bank,” said Ms Waddicor. “The new funding and consolidation of our finances under one umbrella will enable us to realise our ambitions.” Barclays relationship director John Anderson said the deal demonstrated the bank’s understanding of the sector and commitment to healthcare businesses. “Having a focused industry specialism enables us to understand the current social and economic headwinds experienced by operators,” he said.

From right: Strong Life Care managing director Harpreet Banwait, group operations manager Bev Cooper, area director healthcare & education East Midlands & Midlands Phil Wilson, relationship director healthcare East Midlands & South Yorkshire David Ingleson.

www.careinfo.org – Caring Times official website

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business & property APPOINTMENTS

in association with

Hadrian Healthcare Group has appointed Lucy Gradwell as manager for The Manor House care home in Knaresborough. Starting her career as a care assistant, Lucy has worked her way up through various care roles to manager, gaining experience in nursing, residential and dementia care settings and taking every opportunity for training along the way. Hadrian Healthcare managing director Jas Gill said: “Lucy has fantastic knowledge of all aspects of care home management and is focused on providing great elderly care for all The Manor House clients, leading her team by example.” Complex care provider Badby Park Group has appointed Paul Hill as its new chief executive. Paul will head up the group’s growing portfolio of specialist complex care facilities, including the multi award-winning Badby Park, Daventry and Adderley Green, Stoke. Paul has held senior leadership positions in several health and social care organisations over the last 10 years, including Swanton Care and Community, Consensus and the National Fostering Agency. Most recently he was the chief operating officer at Holmes Care where he was responsible for the day-to-day operation and commercial performance of the group’s care home portfolio. An experienced care professional has been appointed manager at Morris Care’s Stretton Hall care home in All Stretton, Shropshire. Jonathan Breese joined Stretton Hall after six years as deputy nurse manager at Morris Care’s Isle Court home in Bicton, Shrewsbury. The promotion sees him head a 50-bed home which provides short and long term care for elderly people, with specialist care for those living with dementia. Not-for-profit care provider The Fremantle Trust has appointed Alison Ritchie as director of quality and governance. Alison joins the Trust with 36 years of experience working in the care sector in the strategic and operational delivery of excellent person-centred support. Her career-to-date includes roles in service management, social work and safeguarding, in both the public and private sectors. In her new role Alison will lead in the drive for continual change and improvement programmes which enable people who use the Trust’s services to effectively balance the need for specialist support with the ability to live independently. Colchester-based Healthcare Homes Group has internally promoted Mathew King to the position of finance director. Before joining Healthcare Homes, Mathew worked as a chartered accountant, carrying out audit work on the organisation whilst working for another company. He specialised in large corporate organisations and gained exposure to a number of complex business cases. He will be looking to progress a number of projects to implement new group finance systems. These will improve the efficiency and accuracy of management information across the business.

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October 2016

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business & property

Hammerson House - a £36m upgrade with no debt

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elen Simmons has been in post as chief executive of NightingaleHammerson, a not-for-profit provider caring for Jewish residents in Greater London for almost three years, succeeding Leon Smith who retired last July, having held a fundraising role with the organisation since November 2013. A chartered accountant, she has spent nearly 20 years as a director in charities including Crisis, Homelessness, MS and Jewish Care. “I’m not Jewish, but one of my answers to that question is that I didn’t have MS and I wasn’t homeless when I worked for those charities,” she said. “My original connection with the Jewish community was when I was finance director of Crisis, living in Stepney, and I went to age Concern in Tower Hamlets to do some befriending. They matched me with a little Jewish lady in Stepney Green. “We clicked - I was absolutely fascinated by her stories – her parents had come over on a boat from Russia, she’d worked in a bullet factory during the war, he husband has been an East End boxer in the days before it was regulated. She turns 100 this year and she’s considering coming into Nightingale and quite excited by that. “It was in that context that I looked at the position with Jewish Care. I have been struck with the commitment from the community, in the volunteering and desire to provide the very best for its elderly community. What I’ve found at Nightingale-Hammerson is a desire to be the best in the country. I love the fact that we’re striving to be excellent in all aspects of care, not just in providing a culturally Jewish service within the care sector. “I’m a chartered accountant and I went to do some work for Crisis, at a time when their finance director was leaving, so I jumped straight in as finance director. The role of finance director in charities is one that has broadened year on year – they start by taking on facilities, then they take on HR, then strategy, planning and KPIs and you find that all they’re not taking on is services, depending on the charity. So those aspects of the chief executive’s role haven’t been too difficult; building relationships with all the key stakeholders is what takes time and building communication, which is a challenge for everybody, and making sure that we are changing in order to meet the needs of future residents.”

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ightingale in Wandsworth, South London and Hammerson in Barnet, North London, merged into a single charity in April 2012. Many would say that Nightingale is already one of the best care providers in the country, with only the age and

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With a £36m redevelopment of Hammerson House in the London Borough of Barnet about to begin early next year, Nightingale-Hammerson’s chief executive HELEN SIMMONS talked to Caring Times editor Geoff Hodgson about the organisation’s achievements and the Hammerson project. closing it. When commissioned in 2019 the new facility will provide about 120 beds. “We are creating a new unit here at Nightingale so that 16 Hammerson House residents can come as a group,” said Ms Simmons. “There are about 36 residents still at Hammerson; about 20 of them are coming to Nightingale and 16 of them will be together on the new unit. For those Hammerson residents who wished to remain in North London we have worked hard to find HELEN SIMMONS: them a care home of their choice.” Nightingale House is being ‘We have pledges in continually developed and over the now for more than £4m past decade the charity has spent at least £10m in a programme of new and we haven’t really build and upgrading existing facilities. “You need to be continually started the capital reinvesting and I think that’s part of campaign yet.’ the problem Hammerson had – it didn’t have the funds to invest, and I Clinical services think that’s the case with many care homes,” “We partner with our local GP practice and we said Ms Simmons. have had an arrangement with them for many “At Hammerson, we are closing the home years whereby we pay for an enhanced next spring, demolishing it and we plan to service, which is something many care homes begin rebuilding next summer.” do,” said Ms Simmons. The price tag for the Hammerson “The difference is that they are prepared to redevelopment is around £36m and put in a GP here, 9 to 5, Monday to Friday. We Nightingale is committing £20m of its also have our own physios and OTs in-house – reserves as a starter and the charity plans to a team of nine people which I believe is the fundraise for the remainder largest in-house care home therapy team in “We have pledges in now for more than the country, and we’re looking to increase it. I £4m and we haven’t really started the capital do wonder how other care homes cope campaign yet,” said Ms Simmons. without it – of the 165 residents we have at “We will be going to the community with a Nightingale at the moment, it used to be that very coherent story of what we’re doing, why about half of them would need physio once a we’re doing it and what the need is. week, now it’s everybody, and many would like “Although it’s located in the heart of the it more than once a week. And physio is just Jewish community in North London, something we provide; it’s not an extra, it’s not Hammerson didn’t have the funds or the an add-on. Whether a resident is local fundraising ability to redevelop the site. It’s a authority funded or privately funded, wonderful site, originally donated by the everyone receives the same, as part of the Hammerson family, but the bedrooms were no charity ethos. We also have visiting opticians, longer fit for purpose. Nightingale had some dental services, and chiropody.” reserves and some fundraising capacity so it was a happy marriage and was good for both Hammerson House organisations. We are now at the stage where Nightingale’s capacity is around 200. we are going to commit those resources.” Hammerson House was 85 but the charity has dated design of Hammerson House holding the North London side of the partnership back. Nightingale House narrowly missed being an overall ‘Outstanding’ rating after its most inspection. The 200-bed facility has been awarded ‘beacon’ status for its end of life care by the Gold Standard Framework and aspires to win national recognition as a ‘teaching care home’.

been winding-down the Barnet facility prior to

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I said I found it a little startling that a social care provider could plan and proceed with a redevelopment of this scale without having to take on bank debt or approach other financial institutions to take on debt, but Ms Simmons confirmed this to be so. “It’s great that Nightingale can put in the £20m which is made up of past donations,” Ms Simmons said. “We are also fortunate that our invested reserves have done very well since the Brexit vote and we have to thank our investment managers for their excellent stewardship. “Because we have a fantastic reputation of high quality care, we do attract a reasonable

percentage of self-funders and there is no doubt that that helps with a sustainable funding model. But it’s not something we target – we don’t aim to get self-funders that’s what we’re about as a charity, but we still rely on donations to fill a gap, even with a high percentage of self-funders, because local authorities don’t pay anywhere near the cost of the care we provide. “And we’re fortunate in the having the huge contribution made by our volunteers – we just couldn’t pay for that. If we weren’t a charity would we attract the same number of volunteers? I don’t know. “But public funding of social care isn’t going to get better anytime soon as far as anyone can see, and it could well get worse, so we

Care Homes Sold DEVON

LANCASHIRE

Name: Somerforde, Newton Abbot Registration: 24 elderly Seller: Somerforde Ltd Asking price: £1.8m Agent: Christie & Co Tel: 07764 241310

Name: Hulton, Nelson Registration: 34 elderly residential Asking price: £625,000 Agent: Christie & Co Tel: 0161 833 6906

EAST SUSSEX Name: Hartfield House, Eastbourne Registration: 20 elderly residential Agent: Christie & Co Tel: 01622 656000

Name: Pilling NH, (Closed), Preston Registration: 29 elderly Asking price: £400,000 Agent: Christie & Co Tel: 0161 833 6906 Name: Watson House, Blackpool Registration: 9 residential Asking price: £90,000 Agent: Christie & Co Tel: 0161 833 6906

KENT Name: Temple Ewell NH, Dover Registration: 44 elderly Buyer: Mr M. Kunvarji Agent: Capital Care Tel: 01795 521025 Information appearing in “Care Homes Sold” is published in good faith that the information is accurate and cleared for publication. The onus for accuracy is on the property agent. Caring Times will not publish, in a subsequent issue, corrections or alterations to information supplied. Agents, please note that items cannot be withdrawn once the copy deadline has passed. We advise readers to confirm any details with the property agent concerned.

11

NORTHAMPTONSHIRE Name: Cliftonville, Rushton Registration: 20 elderly dementia Buyer: Kingley Care Partnership Seller: Anthony Lampitt Agent: Christie & Co Tel: 0121 456 1222 SCOTLAND Name: Hutton Park,Largs Buyer: Lifeways Community Care Ltd Registration: 37 residential Agent: Christie & Co Tel: 0131 557 6666 STAFFORDSHIRE Name: Former children’s home, Stoke on Trent Buyer: Lifeways Community Care Ltd Seller: Paul Glynn Asking price: £395,000 Agent: Christie & Co Tel: 0121 456 1222

have to look to be sustainable. I don’t understand how private care homes make money and provide good care, and with the Living Wage coming in, some of those homes are just closing down. How is that going to impact on the charity sector? It will be very interesting to see. “If private providers, who provide the bulk of the care, stop building in local authority areas and only build in the south, that will have an impact on charitable providers. I think government has a short term view and seeing all the work Care England has done to inform government of what they need to know in order to make the right decisions, and yet nothing happens, suggests there’s not much more anyone can do.” CT

Runwood acquires three homes in Northern Ireland Essex-based Runwood Homes has acquired three care homes in Northern Ireland: Ashbrooke in Enniskillen, Ard Mhacha in Armagh and Geanann in Dungannon. The three facilities care homes are registered to provide 192 places for the care of older people with varying care needs. These latest acquisitions bring

Runwood Homes’ portfolio of nursing and residential beds in Northern Ireland to 812 beds across the province. Later this year this will increase to almost 900 beds with the completion of a new care facility in Glengormley in Belfast. The group now operates 83 care homes across the UK.

Two more homes for Target Target Healthcare REIT has completed the acquisition of two modern, purpose built care homes located in Dundee, Scotland and Sandiacre, Derbyshire for about £14m including acquisition costs. The properties comprise a total of 151 bedrooms with full en-suite bathrooms including wetrooms and opened in 2007 and 2015. A refurbishment programme on the older property will be completed imminently with both properties

due to reach operational maturity by the year’s end. The homes will continue to be operated by the incumbent operator, Hudson Healthcare who will become Target’s 14th tenant, thereby further diversifying the group’s tenant base. The homes are subject to 35-year leases with RPI-linked cap and collar. The net initial yield on the transaction is broadly consistent with the overall average of the group’s portfolio.

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DEMENT I A CONGRESS

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