Savings, Solutions, and Sustainability Issue 4

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Welcome from Care England

Richard Ayres, Social Care Advisor at Care England, reflects on the depth of sector insight provided by Savings, Solutions, and Sustainability over the last 12 months.

Money saving updates

Richard Ayres, outlines four ways of achieving significant savings or return on investments to solve some of the challenges you may be facing.

Under the spotlight with Naiomi Beaumont Swindlehurst

Naiomi Beaumont Swindlehurst, Raw Materials and Research and Development Expert at Alsico, talks about the need to cater for people experiencing the menopause.

Homemade Circus: Enhancing care home activities for free

Bridie Tyler, Digital Communications Associate at Upswing, and Marine Begault, hired as an independent evaluator, share details about the project’s free digital toolkit for providers.

Member spotlight: Stow Healthcare

Ruth French, Operations Director at Stow Healthcare, discusses the work behind recent recruitment success stories and previews plans to ensure that retention also plays its part.

Navigating new food waste legislation in England

Vinay Jalla, Marketing Manager at Keenan

Recycling, reveals how to ensure compliance with the incoming legislation and take advantage of the numerous business opportunities.

How to… Amplify your presence and drive occupancy

Tobi Alli-Usman, Founder and Managing Director at Prosperwell, explains how to avoid six common mistakes and ensure your care home is attractive for prospective residents.

Transforming dysphagia care: Improving outcomes with specialist training

Preston Walker and James Ball, Co-Founders of OHK, express how collaborative sector partnerships have led to the delivery of dysphagia support and management training.

Legal matters

Anna Fee, Senior Associate (Dispute Resolution – Health and Social Care) at RWK Goodman, considers the Care Quality Commission’s (CQC’s) environmental sustainability expectations.

Demystifying insurance: Making it work for your business

Jason Brown, Head of Care at Towergate Insurance, emphasises the value of having sufficient cover to suit the needs of your business.

Members' voice: Your questions answered Charlotte Lezard, Policy and External Affairs Lead at Care England, answers your questions on the CQC, local authority contracts, research opportunities, and more.

CONTRIBUTORS

Richard Ayres

Social Care Advisor, Care England @Care England

Naiomi Beaumont Swindlehurst

Raw Materials and Research and Development Expert, Alsico Search ‘alsico UK’

Bridie Tyler

Digital Communications Associate, Upswing @upswingaerial

Marine Begault

Independent evaluator of the Homemade Circus project

Ruth French

Operations Director, Stow Healthcare @StowHealthcare

Vinay Jalla

Marketing Manager, Keenan Recycling @keenanrecycling

Tobi Alli-Usman

Founder and Managing Director, Prosperwell @ProsperwellTeam

James Ball Co-Founder, OHK Search 'OHK’

Preston Walker Co-Founder, OHK Search 'OHK’

Anna Fee

Senior Associate (Dispute Resolution –Health and Social Care), RWK Goodman @rwkgoodman

Jason Brown Head of Care, Towergate Insurance Search ‘Jason Brown Towergate’

Charlotte Lezard

Policy and External Affairs Lead, Care England @CareEngland

EDITORIAL

editor@caremanagementmatters.co.uk

Lead Editor: Henry Thornton

Content Editor: Aislinn Thompson

PRODUCTION

Designer: Rebecca Mendil Director: Lisa Werthmann

Studio Manager: Jamie Harvey

ADVERTISING

Advertising Manager: Aaron Barber aaron.barber@caremanagementmatters.co.uk

WELCOME FROM CARE ENGLAND

In this new edition of Savings, Solutions, and Sustainability, Richard Ayres, Social Care Advisor at Care England, reflects on the depth of sector insight provided by the magazine to date.

Welcome to our fourth edition of Savings, Solutions, and Sustainability. We are very proud of all our contributors as this edition completes our first year of helping you to reduce costs, solve problems, and sustain the future of adult social care in England. A special thanks to all of those who have taken part in providing and funding 192 pages of invaluable support to providers across the country.

We understand the constant challenges you may be facing; and we know that a new Government may take time to make positive changes to our sector. We also know that this time will add further pressure on you and drive more uncertainty for care businesses of all sizes and structures for the foreseeable future.

Therefore, our aim is to continue to bring you our free publication to ensure we are sharing solutions to help every care service in England to reduce costs, solve problems, and sustain services.

Whether you need help and support today, tomorrow, or in the future, this publication houses solutions from right across the sector for all providers: large, small, independent or groups, charities, not-for-profit, and for-profit

organisations. Its only agenda is to help sustain adult social care. If you would like to be involved or have something to contribute, contact the magazine’s publisher, Care Management Matters, using the details opposite.

In the last year, we have introduced a range of solutions to many of the problems faced by providers, covering recruitment and retention, energy, digital transformation, and the Care Quality Commission’s (CQC’s) single assessment framework, through to legal concerns, employee wellbeing, outsourcing, marketing, and research.

In addition, we have taken a deep dive into how switching to decaffeinated drinks can reduce toileting-related falls by over 35%, offered foot health support which can save lives, provided financial and environmental savings relating to personal care delivery, demystified insurance, and provided solutions from 13 contributors about how to transform a care service, refinance, redevelop, or exit the market with maximum value.

We have also answered your questions, pointing to solutions, advice, resources, and guidance to improve service provision.

Across the four publications, we have revealed 19 ways you can recover money, maximise care fees, lower staff time and costs, deliver personal care for less, and reduce the costs of services including energy, water, and consumables. Combined, these solutions could save you up to tens of thousands of pounds annually.

There have been 16 features examining the problems facing the sector in depth and suggesting real and practical evidencebased solutions to solve them. Several return on investment opportunities have been outlined, coupled with numerous free activities and free digital solutions to enhance care service delivery, prepare for CQC inspections, and manage environmental, social, and governance reviews.

We have championed providers who have turned around failing services from loss making into profitability, shared strategies for expanding and growing a business in a challenging market, explained how efficiency can easily be achieved through focus, rigour, and attention to detail, and highlighted how participating in research is key to solving some of the problems you may be facing. Moreover, in each edition, we point to key sector events aimed at supporting you to find solutions from across a network of hundreds of service providers and conference speakers.

Of course, Savings, Solutions, and Sustainability is just one way Care England supports the sector. We have multiple discounts and offers online, provide access to national tenders for social care, and publish a range of essential and topical resources and guidance, plus webinars and networking groups.

Richard Ayres is a Social Care Advisor at Care England. Email: rayres@careengland.org.uk @CareEngland

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MONEY SAVING UPDATES

At times, we need to spend a little to make savings. The following money saving updates outline four ways of achieving significant savings or return on investments to solve some of the most critical challenges you may be facing. In this edition, topics covered include rising water bills, increasing occupancy, and incoming employment law changes.

Magic Hour Creatives

Tackle rising water bills

Over the next four years, the care sector will see water bills increase by 90%. Graham Mann, Director at water cost reduction company, SwitchWaterSupplier.com, knows a lot about water. Graham has 35 years of knowledge and expertise and is recognised as a leading water industry expert.

Graham and his team have been reducing water bills in the care sector for years, with savings and refunds delivered to one care company of over £500,000. Another residential client made £50,000 of savings when switching water companies and received a £40,000 refund due to overcharges from its previous water supplier.

Savings can be made by switching water companies, bill reviews, new connections, and service issues. Most care providers have no idea that they are overpaying for their water or know what to do about it.

To see how much you could save, visit SwitchWaterSupplier.com or request a free water audit. Alternatively, Call 0330 055 2532 or email graham.mann@switchwatersupplier.com

Increase occupancy and help prevent transfer trauma

Utilising virtual tours to market care homes enhances operational efficiency and resident experience.

Magic Hour Creatives virtual tours display care homes in their best light, with vivid and realistic imagery that highlights the facility's amenities, comfort, and atmosphere. This immersive approach can attract prospective residents and their families by providing a detailed, engaging view of the home without the need for an initial physical visit.

When families are reassured through virtual tours, they are more likely to commit to a decision faster and with greater confidence. Care homes can allocate their resources more efficiently, reducing the need for multiple physical tours and freeing up staff time to focus on providing care.

The decision to move a family member into a care home is often fraught with emotional stress and uncertainty, so the reduction of anxiety for families and prospective residents considering care options is key. Virtual tours offer a transparent preview of the environment, helping families to feel more at ease and confident in their choice.

By allowing prospective residents to explore the facility remotely, they can revisit specific areas multiple times which helps them become familiar with the surroundings. This helps reduce the fear of the unknown – making the transition to the care home smoother and helping prevent relocation stress syndrome. Ultimately, virtual tours not only enhance marketing efforts but also foster trust and satisfaction among families, leading to higher occupancy and improved resource allocation. To view an example, scan the following QR code.

Richard Ayres, Care England. Email: rayres@careengland.org.uk Continued →

To find out more, email aimee@magichourcreatives.com and quote ‘CAREENGLAND’ to receive a 10% discount if you are interested in creating a virtual tour of your facility. Valid until 31st October 2024.

Care Home Life

Cleaning delivered efficiently

Cleaning a care home is an everyday activity that demands an investment of both time and resources. But how you approach it can have a big impact on revenue and profits.

Productivity is the measure of how efficiently resources like time, money, and effort are used to produce the desired outcome. Care Home Life knows how to up productivity when it comes to cleaning protocols, to save precious hours and effort, reduce waste, and get far better results and make a positive impact on your people, planet, and pocket.

Firstly, organise and plan out the day for staff involved in any cleaning protocols, making sure everyone knows how to keep on top of those all-important daily tasks by using a physical checklist, giving focus and stopping any unnecessary repetition by visibly seeing a tick against each job done.

Regular product training saves time and prevents health hazards. Knowing how to use products correctly means hygiene is improved and waste is eliminated, saving money and reducing environmental impact. In addition, trusted brands that employees recognise should demonstrate how to use their products properly.

Secondly, helping staff to be as efficient as possible speeds up processes and using products correctly requires less effort. Introducing a streamlined range of effective cleaning chemicals is key to saving time and money as well as helping to create cleaner, safer, and healthier environments.

Professional dosing systems across housekeeping, laundry, and kitchens will reduce waste, chemical consumption, environmental impact, and Control of Substances Hazardous to Health (COSHH) risk, whilst increasing cleanliness and aiding infection prevention and control.

Imagine the knock-on effect of saving an employee one hour a day thanks to sufficient training, planning, and using effective products for a first-pass result. This equates to 30 hours less per month spent on unnecessary cleaning tasks, saving £23,000 per year.

To find out how much your home could save, and to try CareHomeLife’s cost-savings calculator, call 01772 425310, or email info@carehomelife.co.uk.

Prepare for employment law changes

The new Government has pledged to bring huge changes to workers’ rights. The scale and speed of change will be enormous, having a significant impact on all UK employers. Labour plans over 30 employment law reforms and has described current laws as not fit for the modern economy.

There are some highlights that managers and business owners need to start planning for now, including:

• A ‘day one’ right for employees to claim unfair dismissal.

• The Fair Work Agency, to support workers in areas such as holiday pay and sick pay.

• Banning exploitative zero-hours contracts and ending one-sided flexibility, ensuring that all jobs provide a baseline level of security and predictability.

Citation helps to keep your organisation compliant with employment legislation. With Citation’s help, your organisation is 16 times less likely to face an employment tribunal claim.

In addition, when businesses work with Citation:

• 85% save valuable time.

• 87% say they get great value for money.

• 92% have more peace of mind.

• 85% have a happier, healthier, and more productive workplace.

If you sign up with Citation (and quote ‘Care England magazine’) before the end of October 2024, you will receive three months’ free service, in addition to preferential member rates (terms and conditions apply).

Call 0345 844 1111 to find out more. You can also access to Citation’s free HR and employment law advice line by calling 0161 504 0843 or emailing appointmentswithjonathan@citation.co.uk

REDUCE YOUR OPERATING COSTS!

Opeque will identify potential savings and recommendations for how you can realise:

• Precise control of engineering and building services to reduce costs:

Plant room, water tanks, hot and cold distribution, heating and ventilating, lighting

• Laundry services to achieve hygienic standards HTM01-04 compliant:

Optimum processing of bed linen, towels, staff uniforms and residents clothing

• Health and Safety standards for your residents, staff and the building(s):

HSG220 is the recognised guidance for implementation in CARE HOMES

ACoP L8 and HTM04-01compliance to ensure Legionella control

Public Health England COVID -19 guidance on PPE and operational procedures

• Sustainability, carbon footprinting to achieve a ‘net zero’ emissions strategy

Opeque can assist in reducing energy bills, complying with legislation, managing health and safety and achieving a sustainable operation.

Applying industrial engineering principles, we address productivity, resource efficiency, quality control, health and safety and asset management, bringing people, utilities,

equipment, and buildings together to realise product excellence.

We have worked with many care homes to provide laundry services and water hygiene and it is from these close relationships that we believe we can further assist your care home to reduce operating costs.

Opeque Care Home Approach (OCHA) Survey

Scan the QR code to visit our online survey.

Q&A UNDER THE SPOTLIGHT

Care England speaks to Naiomi Beaumont Swindlehurst, Raw Materials and Research and Development Expert at Alsico, about the need for catering to people experiencing the menopause in the care sector. In particular, Naiomi explains the key considerations for decision makers when selecting uniforms to accommodate these team members.

with Naiomi Beaumont Swindlehurst

Care England: Are uniforms that cater to people experiencing the menopause a top priority for the care sector in 2024?

Naiomi Beaumont Swindlehurst: The care industry has historically been underfunded, which meant there has been a significant lack of investment across the sector. With tight budgets to contend with, most decisions taken have been dictated by cost and often uniform has not been so far up the list of priorities.

The COVID-19 pandemic was a real turning point for the sector. At this time, the care industry was finally recognised for the essential service it provides and as a result, there has certainly been an increase in investment across the sector as a whole, especially in its people. This investment has led to more support and training for care workers, as well as reviewing resources and processes, including uniform selection.

Where many care home groups are now assessing the suitability of their uniforms to ensure that all

care workers can carry out their roles effectively and comfortably, there is a big opportunity for menopause symptoms to be considered in this review.

CE: Are there specific uniforms that decision makers should be assessing that cater best to menopause symptoms?

NBS: There are many steps that decision makers can take when selecting uniforms to support employees experiencing both the physical and psychological symptoms of menopause. However, it is important to ensure that wearers going through the menopause do not become identifiable by the garments they are wearing because this eliminates that individual’s right to privacy around their needs. In fact, the benefits of a uniform designed with menopause in mind can often be felt by any team member working in care homes.

‘Hot flushes’ are the most commonly cited symptom of

menopause, with eight in 10 people experiencing them. They are often described as a sudden feeling of warmth in the upper body, particularly the face, neck and chest, accompanied by sweating. There are a number of design elements that can be incorporated into garment development to mitigate these sensations.

Garments should be made from fabrics which incorporate natural or regenerated fibres, such as cotton or Lyocell, or synthetic fibres that have been specially engineered to have a wicking effect. This will help to manage the absorption and evaporation of moisture for the wearer.

Getting the right fit is also a key element in ensuring uniforms are suitable for people experiencing menopause symptoms. Decision makers should try to avoid tight-fitting, rigid uniforms, which can be uncomfortable and do not facilitate air circulation. Instead, garments should be made of fabrics that offer enough stretch to allow air to circulate through

them. Ventilation under the arms and open necklines will help to increase airflow and, therefore, keep wearers cooler too.

Whilst these fabrics and fits cater to people experiencing menopause, increased stretch and comfort will no doubt be welcomed by care workers who are not menopausal too. Care work is physically demanding, and care environments are often kept at higher temperatures than typical working environments. Therefore, uniforms that are designed to offer a full range of movement and make warmer environments more comfortable to work in are likely to benefit all wearers.

Another important consideration when selecting a uniform that caters to people experiencing the menopause is wash requirements. Increased sweating often associated with the menopause may result in carers wanting to wash their uniforms more frequently, possibly between each use. Therefore, garments need to be able to withstand high temperature washing, at least 60 degrees, and be suitable for tumble drying to reduce the turnaround time between each wash.

Finally, I often get asked about what colours are most suitable for wearers experiencing menopause symptoms. Whilst it is true that lighter colours reflect heat and darker colours absorb it, the difference to body temperature as a result of the colour of a garment is minimal. For many, darker colours will make them more comfortable, as perspiration is not as visible, and most people tend to feel these are more flattering.

CE: What developments would you like to see in the care sector over the coming years to better provide for team members experiencing the menopause?

NBS: Going forward, I would like to see menopause being considered as standard when decisions are being made in the sector, especially when it comes to uniform provision. The care industry is already making great progress towards this.

In recent months, the conversation around menopause and what the sector can do to make people going through menopause more comfortable has definitely been more visible.

What has previously been a rather taboo subject is now firmly on the agenda. In future, it would be great to see that work is being done to support people experiencing menopause without being on the agenda at all, as it is just a given that it is what needs to be done.

There is not a one-size-fits-all approach to cater for menopause, as there is a vast difference in symptoms and experiences from person to person, so it is really important that the voices of people who have experience with it are heard, in order to progress. Alsico is currently partnering with Care England to host an event on the 9th October at the Care Show in Birmingham. This will bring carers who have been affected by menopause together to discuss their own experiences, those of their teams, and how the industry needs to adapt to cater for these experiences, in relation to both uniform and the industry as a whole. These collaborative events are crucial to keep decision makers across the sector up to date on real people’s experiences and how support needs to be tailored accordingly.

Naiomi Beaumont Swindlehurst is the Raw Materials and Research and Development Expert at Alsico. Email: sales@alsico.co.uk Search ‘alsico UK’

Upswing's Homemade Circus project offers a refreshing approach for care providers seeking innovative, cost-effective ways to enhance the lives of residents and staff. In this feature, Bridie Tyler, Digital Communications Associate at Upswing, and Marine Begault, who was hired as an independent evaluator of the project, explain how the organisation has distilled its expertise into an easy-to-use digital toolkit, available for free to all care providers across England.

The Homemade Circus digital toolkit, born from a two-year project funded by City Bridge Trust and The Rayne Foundation, represents a significant leap forward in activity provision for care homes. This comprehensive resource equips care staff with the skills and confidence to lead inspiring circus activity sessions, tailored to the individual needs of their residents.

The project

Homemade Circus was designed to extend the reach of our previous circus projects in care homes. This programme of work focused on creating a sustainable and accessible model that could continue to benefit people living and working in care homes long after the initial workshops ended.

Over two years, we worked with 15 care homes across London and the South East of England, engaging with over 450 staff members and 621 residents and family members. Our project team, consisting of eight trained circus workshop facilitators, delivered a series of workshops and staff training in care homes, demonstrating how to use various pieces of circus equipment and lead activities with residents.

A key aspect of the project was the training provided to care home staff. This training went beyond simply teaching circus skills; it focused on empowering staff to adapt activities for residents with varying abilities, integrate circus elements into daily care routines, and understand the therapeutic benefits of these activities.

The culmination of this project is the digital toolkit, designed to make the Homemade Circus approach accessible to care homes nationwide. By creating this resource, our aim was to ensure that the benefits of circus

activities can continue to be realised in care settings, even without the direct involvement of circus professionals.

Introducing circus to care homes

The Homemade Circus approach has demonstrated significant benefits for both residents and staff in care home settings. These benefits span physical and mental health improvements for residents, as well as increased job satisfaction and wellbeing in staff.

Circus activities work remarkably well in care homes due to their inherent playfulness and spirit of exploration. The equipment itself – bright, colourful, lightweight, and tactile – instantly creates an inviting atmosphere. These unique elements bring a sense of joy and discovery to care settings, encouraging participants to embrace a childlike sense of curiosity.

In this environment, making mistakes isn't just acceptable – it's celebrated as part of the learning process. Whether it's balancing a peacock feather or tossing a juggling ball, learning these new skills together creates shared experiences that break down barriers between staff and residents.

Impact on wellbeing

For residents, the circus activities have shown remarkable improvements in physical wellbeing. The multi-sensory nature of the activities, combined with the novelty of circus equipment, encourages movement and engagement in ways that traditional care home activities often struggle to achieve. Residents have demonstrated increased mobility, improved hand-eye co-ordination, and enhanced dexterity.

Continued →

One care assistant shared a striking example of physical improvement: ‘Peter wasn't like that before. He was very quiet and silent. But last week, we all noticed that Peter was very active, and he was laughing and smiling throughout the activity. Even this week, he spoke to the members and the circus team... he waved his hands, gave me a handshake, and called me by my name.’

The sessions begin gently, with seated activities that meet residents at their current mobility levels, allowing them to gradually build strength and confidence. Another report highlighted how residents' accuracy and agility with beach balls had advanced dramatically since the first session, with participants who initially showed limited engagement learning to adapt their techniques, such as squeezing rather than catching the ball, standing up to throw and catch the ball with one hand and increasing the throwing distance as the activity went on.

Social connections

Beyond physical benefits, the Homemade Circus activities have shown significant positive impacts on residents' mental health and social connections. The group nature of many activities brings together residents who might not typically interact, fostering a sense of community within the care home. This has led to reduced feelings of loneliness and isolation among residents.

An observer noted after one of the sessions, ‘At the beginning residents are in their own bubbles, slower to engage and connect. Once warmed up with the beach balls they start to look up and across the circle, they sit up in their chairs, anticipating the ball and connecting with other residents through eye contact and facial expressions.’

By the end of the sessions, residents appeared more present, aware of each other and the space, and noticeably calmer. As one resident expressed upon leaving a session, ‘I was feeling lonely before but now I'm feeling a million-dollar happy.’

The cognitive stimulation and holistic benefits provided by learning new skills cannot be understated. Residents described feeling ‘Alive!’ and that the activities took them ‘away to a dreamworld’.

Job satisfaction

For staff, the benefits of the Homemade Circus approach have been equally impactful. The project has led to increased job satisfaction, as staff members find new ways to connect with residents and break out of routine care patterns.

Additionally, learning these new skills has given staff a sense of ownership and creativity in their work. This renewed sense of purpose and autonomy addresses a significant challenge in the care sector,

where staff can often feel constrained by rigid routines and limited resources.

A care assistant shared, ‘It's just so much fun. I always say to people – I can do a 12-hour shift on that day... It gives you that excitement, you have so much extra oxygen. You just feel so good that you can cope working later because you just feel that excitement in you. So, so much creativity.’

Another staff member noted, ‘The first session was just magical. It just really stuck in my head. It is not about the session itself... I never thought that I could do so many things with a ball or a hat or a simple scarf. It's like now when we get bored, you just take anything and you can just dance around, make some fun things with it. I never thought I could just create something out of nothing.’

Importantly, staff wellbeing has also been positively impacted. Homemade Circus focuses on play and exploration, fostering a sense of freedom and presence. As one staff member expressed, ‘Sometimes you come to work, and you feel a bit down and low. But all these activities and the engagement, suddenly it boosts you, and you forget. The contact we have, the bonding, the connection. It does impact on our wellbeing. It boosts the moods. The laughter, the talking, the jokes.’

The digital toolkit

The Homemade Circus digital toolkit is the result of careful observation, practical experience, and collaborative effort. Throughout the two-year project, our team documented the most effective activities, resident responses, and staff feedback from our work in care homes. This hands-on experience was invaluable in shaping the content of the toolkit.

Initially, a handbook was produced, but feedback indicated that care staff needed more visual guidance. This led to the creation of instructional videos, filmed in actual care home environments with staff and residents where possible. The training mirrors our workshop progression – introducing the equipment, demonstrating basic techniques, and showing adaptations for different abilities.

It also guides users on engaging bed-bound residents, those with limited mobility, dementia or sensory impairments, as well as involving family members in activities. Moreover, the activities incorporated into the toolkit align with the Care Quality Commission’s (CQC’s) guidelines for meaningful engagement and person-centred care, not only ensuring regulatory compliance but also potentially reducing reliance on medication and decreasing the frequency of health interventions.

The creation process involved close collaboration with care home staff and residents to ensure the toolkit would be genuinely useful and accessible. Activities were refined and adapted based on

real-world implementation, ensuring they could be easily replicated in various care home settings.

Extensive consideration went into selecting a broad spectrum of inclusive and accessible activities, from group to one-on-one sessions, seated to standing, and even those that can be taken bedside. Each video and accompanying resource in the toolkit has been designed with the end-user in mind. Clear, step-by-step instructions, tips for adaptation, and safety considerations are all included to give care staff the confidence to implement these activities independently.

The decision to create a digital toolkit was driven by the desire to make Homemade Circus accessible to as many care homes as possible. By providing free, online resources, we aim to overcome geographical and financial barriers that might prevent care homes from accessing this new approach to activities.

Cost-effective solution

Amid ongoing pressures to optimise care while managing expenses, the Homemade Circus digital toolkit offers a remarkably cost-effective solution for enhancing activity provision. Its free availability means that the only real investment required is staff time – an investment that results in measurable enhancements to resident wellbeing, staff satisfaction, and potentially CQC ratings.

The toolkit includes:

• 12 videos and session plans for 10 different pieces of circus equipment.

• Downloadable information sheets and activity plans.

• Links to playlists and circus equipment suppliers.

• Briefing notes on health and safety considerations.

• Guidance on room setup and recommendations for before, during, and after workshops.

Case study: Windmill Care Home's experience

Windmill Care Home in Brixton, an Excelcare home that participated in the project, provides a compelling example of the impact of Homemade Circus. The care home received four weekly sessions which included staff training, resident workshops, and one-on-one sessions, as well as a final ‘Circus party’. The in-depth interactions allowed staff to truly engage with the project and adapt content to their specific needs.

Key observations from Windmill Care Home:

1. Presence and engagement: Activities encouraged participants to be fully present.

One resident spent considerable time carefully observing the colour of her hand through a juggling scarf, demonstrating deep engagement with the sensory experience.

2. Collaboration and equality: The activities fostered collaboration between staff and residents. A workshop facilitator noted, ‘The key term here is, to collaborate. The language used to describe these interactions signifies equality in the relationship.’

3. Joy in observation: Care staff found joy not only in participating but in watching residents engage. A Lifestyle Co-ordinator shared, ‘Even when I was watching it, I was still very happy because I was watching the residents and the staff enjoy themselves.’

4. Building connections: The activities helped build connections across the home. One observer noted, ‘There is a clear shift in awareness of space and each other that occurs through using the equipment and doing the activities.’

5. Role reversal: In one session, a resident gently tickled a staff member's face with a peacock feather, asking, ‘Do you like this? Is this okay?’ This role reversal demonstrated the potential for reciprocal care and connection.

Lasting benefits

As care providers continue to navigate the challenges of delivering high-quality, person-centred care, innovative solutions like Homemade Circus serve as a catalyst for positive change.

Making use of cost-effective and accessible resources has the potential to significantly enhance the quality of life for both residents and staff, free up budget allocations to other areas of need, and still offer high-quality, engaging activities for residents that align well with CQC requirements for meaningful activities and person-centred care.

Moreover, innovative activity programmes like Homemade Circus can be a unique selling point for care homes, potentially attracting new residents and their families. The engaging nature of these activities can also encourage more family visits, fostering a vibrant community atmosphere within the care home.

By investing time in implementing circus activities, care providers can create environments where both residents and staff can thrive, laugh, and discover new potentials, all while improving their bottom line.

For more information and to access the digital toolkit, visit the Homemade Circus website here.

Bridie Tyler is a Digital Communications Associate at Upswing and Marine Begault was hired as an independent evaluator of Upswing's Homemade Circus project. Email: info@upswing.org.uk @upswingaerial

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MEMBER SPOTLIGHT

Stow Healthcare

In each issue of Savings, Solutions, and Sustainability, we hear directly from our members about solutions that have worked for them. Whether it is a new tech solution, a workforce management tool, or partnerships to strengthen operations, this feature showcases solutions and encourages you to think differently and try new practices. In this issue, we hear from Ruth French, Operations Director at Stow Healthcare, who discusses the work behind recent recruitment success stories and shares plans to ensure that retention also plays its part.

Stow Healthcare comprises eight nursing and residential homes covering Suffolk, Norfolk, and Essex. Family owned and run, it is best known for taking on homes with a troubled past and turning them into ‘Outstanding’ rated homes.

At Stow Healthcare, we have had a huge focus on attracting the right people to join our company in the last two years. Post pandemic, in common with many in social care, we saw some of our team choosing to exit the sector, many exhausted by the battle they had been fighting.

The scale of the problem is clear. Social care reported an 8.3% vacancy rate for 2023/24, which increased hugely during the pandemic (from pre-pandemic levels of 7%) and was reduced only due to overseas recruitment. The impact of the brakes that the last government put on overseas recruitment by preventing overseas care workers from bringing their dependants to the UK is already being felt.

Finding a new approach

Treating recruitment with the professionalism it deserved was the starting point. For too long, we had left

recruitment up to our care home managers, expecting them, on top of their heavy workload, to spot CVs coming through, screen them, and plan interviews. It simply wasn’t working any longer and a new approach was needed.

At Stow Healthcare, operating eight homes has given us a level of scale now where we can think more strategically about some aspects of recruitment. Hiring someone whose sole job it is to source, pre-screen, and book candidates for an interview has been a game-changer. Our vacancy rate has dropped from 7.4% to 1.4% in 12 months.

The impact of reducing our reliance on agency staff has been huge too. Agency staff costs were equivalent to 9.4% of our annual income in 2022/23, but have since come down to 3.5% in 2023/24, and are due to reduce to 2% in the current financial year. Our recruitment manager has paid for themself 12 times over. Even in a smaller company where recruitment is an issue, we would be surprised if this move did not pay for itself.

Growing our own

As providers, we need to look at every tool in our toolbox to recruit effectively and grow our own. The truth is, we could get a lot better at this. Take nursing in social care; universities are crying out for placements for student nurses and find it very tough to establish relationships with nursing homes who will support them. This is our golden opportunity to encourage student nurses through our doors for the first time, and at Stow Healthcare, we have embraced the opportunities.

At one home alone, over 800 nursing practice hours were offered to students, impressing the integrated care board (ICB) so much that they secretly nominated the home for a Chief Nurse Adult Social Care Gold Award, which they were delighted to receive! Beyond the many student nurse placements, a variety of opportunities have been offered to dietitians, paramedics, and physiotherapists, few of whom would end up working in our homes, but will certainly understand social care better as a result (and can benefit people in our care greatly whilst they are there).

However, surely one of the best indicators of the success of student placements is when those students choose to return to you for their permanent job as a registered nurse. We

were delighted when this became our reality in 2023, with a mature graduate returning to become a preceptee nurse with us – and she is flourishing!

Student placements must be part of the puzzle, but growing your own goes deeper than that. We can look at it in a few ways –supporting our team with qualifications to deepen and expand their knowledge; underpinning growth and development to take on new responsibilities; and even

looking at opportunities to enhance skills thematically. Many of these options cost us nothing, or at least save us huge amounts of money in the longer term.

The value of knowledge sharing

One of the simplest ideas has been the evolution of our role-specific Development Days, where we bring staff from our sister homes together to share knowledge, undertake training together, and just have the chance to swap experiences. We do this annually for our activity teams, and the feedback is brilliant.

This year, we combined external training on how to maximise our giant interactive tablets with internal coaching on how to shape case studies of ‘Outstanding’ care. Coupled with great idea swaps on activities and fundraising, it was a really uplifting day. We will be expanding this to other job roles, especially those such as maintenance which can be isolating.

Growing your own feels key when it comes to strong and consistent management. Half of our home managers were previously deputies in our company (sometimes at other homes). But we can

never just assume people are ready for a promotion. Instead, we have to prepare them for these roles.

Role-specific Development Days are a key part of our offering, with input from senior colleagues across our homes as well as external leadership coaching. This combined approach builds a support network for the teams, and this is so important for people in management roles. We call our homes ‘sister homes’ and the familial bonds help all of our homes to succeed – one is not pitted against the other.

Finding a long-term solution

Internal development has been critical for us at Stow Healthcare. Since we became sponsors of overseas workers 18 months ago, around half of our vacancies have been filled by overseas staff. Prior to the change in migration law, some also brought dependants and many of those dependants are also working for us –what a bonus!

We have recruited a mixture of carers and internationally educated nurses with a 100% success rate. This is in terms of all staff still being in their roles and performing well. All nurses are registered with the Nursing & Midwifery Council and can operate effectively.

Migration however is not the sole answer to resolving the perennial staffing crisis in social care. Ethical international recruitment takes time and resources, and we appreciate not every company will have the capacity to undertake it.

Nurturing the next generation

Answers can also lie closer to home though. We are always amazed when we speak to local college students completing their health and social care qualifications – so few have ever considered working in the care home just down the road. Careers fairs from our experience have been disheartening – parents ushering their children past social care stands on the way to the ‘safety’ of the NHS.

Taking time to speak to a captive audience in a classroom is wholly different and, in our experience, has seen us recruit

much more effectively. Investing your time in this way and building relationships with teaching staff can be very helpful – we have even supported a local sixth form college with the development of their infection control module.

Retaining talent

Whilst recruitment processes are working smoothly, and this has had a positive impact on finances, our next area for improvement must be retention. There is no point being brilliant at recruitment and attracting the best to your company without incentivising them to stay for the longer term. Recruiting staff and inducting them properly is vastly expensive, so at Stow Healthcare our next big focus is on retention and reduction of staff turnover.

We have introduced measures that we hope will attract and retain staff such as paying the Real Living Wage, giving team members an extra day off for their birthday, generous starting bonuses, and enhancing pay when staff gain a qualification.

We cannot rest on our laurels though. In a sector where turnover of our care staff was over 36% last year, we all need to be looking at innovative solutions that support staff to stay with us, and to avoid the constant churn that is so disruptive to social care (especially when training has to be started all over again).

Partly, the answer must lie in making sure we get better at recruiting the right people – those with the values we need, those who are more suited to working in the care sector, those who we know stay longer, and those who offer the reliability that is so critical for our sector. The other part of this answer lies in the ongoing support package for staff – something that is only increasing.

What is clear, as we employ more of Generation Z, is that work satisfaction is not all about pay, but is much more focused on being treated with empathy, feeling heard, and receiving appropriate mental health support. Adapting to the needs of different generations is going to be an important part of our ability to attract the next generation into social care.

Ruth French is Operations Director at Stow Healthcare. Email: enquiries@stowhealthcare.co.uk @StowHealthcare

Navigating new food waste legislation in England

On 31st March 2025, new legislation will come into effect requiring businesses to separate food waste from other wastes and present it separately for collection. Vinay Jalla, Marketing Manager at Keenan Recycling, shares how to ensure compliance and take advantage of the numerous business opportunities.

The care industry is already bound by waste legislation, including the Environmental Protection Act 1990 and Hazardous Waste Regulations 2005, placing a statutory duty of care on waste management and the classification, handling, and disposal of all hazardous waste.

As per new Government legislation, all non-household municipal premises in England, excluding micro-firms (businesses with fewer than 10 full-time equivalent employees), will be required to comply with the following regulations by 31st March 2025:

• Separate food waste collections: You must arrange for separate collection of your food waste, diverting it from general waste streams.

• Compliant waste presentation: Food waste must be presented in a manner that adheres to the new legislation.

Micro-firms will have extra time to bring in the new requirements for food waste – they must comply by 31st March 2027.

According to the new legislation, the following materials will be included in the food waste stream:

• All food intended for human or household pet consumption, regardless of whether it has any nutritional value.

• Biodegradable material resulting from the processing or preparation of food, including inedible food parts such as bones, eggshells, fruit

and vegetable skins, tea bags, and coffee grounds.

Our research has found that 64% of UK care homes are not currently aware of this legislation and a further 48% do not currently consider food waste to be a core priority. This is despite each care home spending on average £50,862 annually to send food waste to landfill rather than using a food waste recycling service provider. Failure to comply with this landmark legislation could see care homes facing fixed-penalty fines of £300 upwards.

Food waste recycling might initially appear to

be another costly activity to implement. But, if done correctly, it has the potential to make financial savings using data generated from diverting waste from landfill and incineration. Tracking the cost of food purchased and subsequently wasted may help you to measure costs that could be re-allocated to food waste recycling.

Understanding the legislation

The new legislation requires all businesses, the public sector, and third-sector organisations in England to separate recyclable materials like most householders do now. Under the new law, food cannot be sent to landfill or incineration; it must be sent for recycling.

The two methods that can be used are composting or anaerobic digestion. Macerators (units which chop and flush food down drains using high volumes of water) or liquidising digesters will be banned completely.

The rationale behind this ban is rooted in the adverse environmental effects of these systems. Drying or dewatering systems will still be permitted – these can reduce the volume of your food waste when it comes to collection.

These regulations are designed to improve the quality and quantity of waste collections across England, most notably by mandating that food waste is separated out and collected separately when any non-domestic property generates waste food. This includes all businesses, prisons, hospitals, care homes, office blocks, independent schools and colleges, garages, and transport hubs.

Commercial food waste legislation has been in place in Scotland since 2014, and the legislation was introduced in Wales in April 2024. In England, businesses generating more than 5kg of food waste every week will likely have to comply with the new regulations. By staying informed

and acting now, your business can set a positive example and be at the forefront of environmentally friendly food waste management.

What does this mean for businesses?

The main investments your business will need to make to ensure compliance with the new legislation will be setting up the correct procedures to easily separate food waste from general waste and organising a separate collection service for food waste. This may involve investing in additional bins, containers, or other infrastructure to facilitate separate food waste collection.

Your return on investment in this instance should be that taking food waste out of general waste collection should reduce your general waste collection costs. Food waste is heavy and can mean you pay more for your general waste collection bins. Food waste collections can be as low as just £5 per bin.

You may be worried about the cost of purchasing new bins and storage for food waste. However, this fee is usually included within the cost of working with a waste recycling service provider, should you wish to engage with one, meaning that you do not necessarily need to invest your own time and money into purchasing new resources independently.

Using specialised food waste bins can also support with providing good hygiene standards. These bins allow food waste to be properly stored ahead of recycling, which deters pests and helps to ensure robust hygiene standards are maintained. This minimises the risk of incurring fines or problems resulting from poor hygiene.

We recently held a roundtable with professionals operating within the care, hospitality, and food retail sectors to discuss the opportunities, challenges, and blockers to recycling food waste. Chris Dean, Procurement Director at Signature Senior Lifestyle,

said, ‘We have to be particularly careful with food waste because it has to be kept safely outside due to rats. We have even bought our own metal food bins as rats can chew through thick plastic normally provided, which can otherwise lead to a massive pest control issue.

‘Ensuring we have the right containers to make it simple for staff, while also remaining compliant with both hygiene and food waste laws, has been key to getting our sites onboard when rolling out our food waste recycling system.’

It will also be crucial for you to implement robust monitoring and review processes to ensure that any new measures you introduce to ensure compliance are upheld. Periodic reviews will help to maintain legal standards and address any issues promptly.

Taking action

As well as familiarising yourself with the latest Government policy, the most important thing you can do to prepare for the new legislation is to assess your current waste management practices. This will help you to understand what wastes you produce, what quantities they are produced in, and how they are disposed of. It will also help you to determine the necessary adjustments you need to make to meet the new legislative requirements. A waste recycling service provider may be able to conduct this assessment on your behalf, identifying areas for improvement and providing tailored recommendations to reduce your food waste.

With a clear understanding of your current food usage, you can minimise food waste generation through portion control and food donation programmes, for example. Moreover, food waste reporting can help to identify process inefficiencies.

Are you consistently overordering produce? Do you have issues with storage or handling

practices? These insights allow you to streamline operations, improve shelf-life management, and implement better stock rotation strategies.

In addition, your business may benefit from an employee training programme offering education sessions to help your colleagues understand and implement best practices for food waste management. Topics may include the importance of recycling, segregation protocols, and proper waste disposal techniques.

Environmental benefits

When food waste is mixed with general waste, it is often landfilled or incinerated, effectively wasting the food twice. Furthermore, when food waste decomposes in landfills, it produces methane. This greenhouse gas is approximately 28 times more potent than carbon dioxide in its potential to cause global warming.

By separating food waste, you can significantly reduce the volume of waste sent to landfills and decrease methane emissions. This results in a smaller carbon footprint and a positive impact on climate change mitigation efforts.

Care providers should capitalise on the hidden value of waste, turning it into renewable energy through a process called anaerobic digestion. This innovative procedure involves breaking down organic matter in an oxygen-free environment, transforming food waste into biogas and nutrient-rich biofertiliser.

The biogas produced can be harnessed for various purposes, including electricity generation, heating, or as biofuel for transport. This resource efficiency minimises waste, contributes to the UK’s renewable energy targets, and reduces our reliance on fossil fuels. Just one caddy of food waste can generate power to a home for almost one hour and

nine recycled banana peels can fully charge a laptop.

Business advantages

One of the key barriers to using a dedicated food waste recycling service provider is apprehension about the costs of initial investments. However, our research suggests that care providers are missing out on savings of up to £7,000 a year in the mid-long term. Despite this, only a third (36%) of care homes say that they recycle food waste to minimise financial losses and only a third (34%) recycle food waste to avoid costly fines.

During our recent roundtable discussion, we uncovered that many businesses that have adopted food waste recycling have seen a positive impact on the bottom line due to more informed procurement processes.

Chris Dean, Procurement Director at Signature Senior Lifestyle, said, ‘A simple trick we found was to get each of our sites to log any waste food from overproduction and get it signed off by their manager each week. This alone reduced our food production waste by 5% which was a significant saving.’

In addition, taking proactive steps to do the right thing for the environment by recycling food waste is a key part of improving your sustainability credentials as a business. From a regulatory perspective, the Care Quality Commission’s new single assessment framework calls upon care providers to reduce any negative impact of their activities on the environment and support others to do the same.

You may also benefit from an improved brand reputation by adopting sustainable food waste management practices. Committing to the environment resonates with environmentally conscious consumers, who are increasingly

seeking responsible companies.

Research from the Social Care Sustainability Alliance argues that to remain competitive as a care provider, you must not only adopt environmentally sustainable practices but ensure that you also communicate this to your potential customers.

Our research echoes this, finding that almost half (44%) of care providers said they recycle food waste as a response to public sentiment and consumer demand. A further third (32%) of respondents cited that recycling food waste helps them adhere to hygiene standards.

Additional support

Keenan Recycling is the largest food waste collection business in the UK. We have helped many businesses before in Scotland and Wales comply when regulations changed in those countries.

As such, we are an experienced and dependable partner in sustainable food waste management, offering sensible, compliant solutions to help you navigate the changes being introduced by the Government. Collaborating with Keenan Recycling will ensure your business has the best solution in place for your food waste management. Following public consultation on the new legislation, Government has communicated that it plans to further consider the features and benefits of cost reduction options for all non-household municipal premises.

Government explains that it will do this by working with stakeholders to better understand how these options can help limit the costs that businesses face to recycle. Furthermore, where appropriate, Government has stipulated that it will explore the possibility of providing guidance on these options as part of the implementation of the new legislation.

Vinay Jalla is Marketing Manager at Keenan Recycling. Email: enquiries@keenanrecycling.co.uk @keenanrecycling

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HOW TO... AMPLIFY YOUR PRESENCE AND DRIVE OCCUPANCY

You may be facing marketing pitfalls that are hindering your ability to attract new residents. Here, Tobi Alli-Usman, Founder & Managing Director at Prosperwell, explains how to avoid six common mistakes and ensure your care home remains a top choice for people seeking care and support.

Neglecting digital marketing

Neglecting digital marketing can be a costly oversight. Whilst you may still rely heavily on traditional marketing methods like leaflet drops, newspaper ads, and word-of-mouth referrals they simply cannot compete with the reach and precision of digital marketing.

Imagine you are a family member seeking the best care for your loved one. The first thing you are likely to do is conduct a Google search. If your care home does not appear in the search results, you have already lost a potential client.

Digital marketing, particularly through platforms like Google Ads, allows you to target individuals actively searching for your services. This is known as intent marketing, where your ads are shown to people precisely when they need your services.

Additionally, leveraging digital marketing tools like email campaigns and social media advertising can significantly boost your outreach efforts. Posting engaging content on social media platforms like Facebook can help

you to engage with the community, build trust and enhance your visibility.

By embracing modern digital strategies, you can reach a wider audience, improve engagement, and ultimately build your occupancy, ensuring you remain competitive in a rapidly evolving market.

Conduct a thorough review of your current marketing efforts, their effectiveness, and look to bring in a team or individuals that have a track record for driving success using digital marketing, and who understand the specific nuances of the care sector.

Unclear objectives

Another significant mistake you may be making is not having clear, well-defined objectives. Many believe they have clear goals, but there is a difference between having a vague intention and a specific, actionable objective.

A clear objective is specific, measurable, achievable, relevant, and time-bound (SMART). For example, ‘Increase occupancy’ is a vague

goal. A clear objective would be, ‘Increase occupancy by 15% within the next six months by attracting 10 new private clients.’ This objective is SMART.

Imagine setting off on a road trip without a map or a destination in mind. You might enjoy the drive for a while, but ultimately, you will end up lost and frustrated. This is similar to how marketing works without clear objectives. By setting clear and realistic objectives, you can tailor your marketing strategies to meet specific goals and targets. An objective involving brand awareness will have a different set of strategies to building occupancy with private clients. One may involve releasing content through newspapers and radio, for example, and the other targeting people actively searching for care within their local area.

Ultimately, having clear objectives allows you to track your progress and adjust your strategies based on what works. Define your marketing goals clearly and create a roadmap to achieve them. Regularly review and adjust your strategies based on performance data.

Inadequate results tracking

Something we commonly find in the care sector is providers failing to adequately track and analyse the results of their marketing.

Imagine investing time and money into various marketing campaigns but not knowing which efforts are driving enquiries and admissions. This lack of insight can lead to wasted resources and missed opportunities.

Without proper tracking mechanisms, you cannot accurately measure the return on investment (ROI) of your marketing activities. For example, you might run online ads and see an uptick in website traffic, but without detailed analytics, you will not know which ads brought in potential clients and which were ineffective.

It is not enough to know your website visitors or enquiries. You need to understand how many were relevant, how long they spent on your website, and which sources your enquiries or website visitors came from.

Even for offline marketing, tracking and analytics are crucial. Unique phone numbers or QR codes on leaflets and newspaper ads can

track responses. Dedicated landing pages for different print ads help monitor which sources drive the most traffic.

Implement robust tracking and analytics tools to measure the effectiveness of your marketing campaigns, both online and offline, and make data-driven decisions.

Ineffective follow-up

A common challenge we have observed in the care sector is some providers having an inefficient follow-up process, where staff are either too busy to follow up on new care enquiries or lack the training or confidence to do so effectively.

While you may generate interest in your home, it is the follow-up that determines whether an enquiry turns into a resident. An effective sales process means providing people with the best chance to make informed decisions for themselves, their friends, or family members.

In a sector where decisions can be made during stressful and emotional moments, care-seekers are looking for reassurance and promptness. A lack of personalised communication, or even forgetting to follow up altogether, will severely impact the success of your marketing efforts.

Build the confidence of all the members in your team by giving them training in call handling and sales, and if you find they are too busy to find the time, establish a systematic follow-up process using CRM tools to automate crucial stages in your sales process.

Mismanaging strengths

Successful care providers understand the importance of having staff who are not only skilled but also have the right mindset and understanding of their roles within the business. For instance, assessing and leveraging employees' individual strengths is crucial. This includes having dedicated personnel who excel in handling prospective clients on the phone.

It is not just about having someone answer calls, but about ensuring that the person managing these interactions understands the nuances of care and how to blend empathy, communication skills, and a thorough understanding of your care home's offering. Similarly, when it comes to marketing, it is not enough to delegate this responsibility to just anyone. The person or team overseeing marketing should ideally have a track record for producing results and doing so in the care sector to ensure they understand its nuances.

By ensuring that employees or teams working with you are well suited to their roles and equipped with the necessary skills and knowledge, you can expect to enhance your marketing effectiveness and see more success in building occupancy.

Poor website optimisation

Many care home websites miss the fundamentals needed to convert enquiries efficiently. A website is often the first point of contact between potential clients and your care home, and overlooking the importance of a user-friendly, informative site can result in many lost opportunities.

If a family comes across your website but finds it difficult to navigate, with slow loading times and a lack of clear information about the services you offer, they are more likely to get frustrated and leave without engaging with your business. Include strong calls to action (CTAs), such as clear brochure downloads, forms, phone numbers, or live chat options, so visitors know how to proceed and ensure it is mobile-friendly and easy to navigate.

Further support

Avoiding these common mistakes can make a substantial difference in building and maintaining occupancy in care homes. By embracing digital marketing, setting clear objectives, tracking results, following up effectively, managing your team’s strengths, and optimising your website, you can ensure your marketing efforts, goals, and targets have a better chance of being met successfully and sustained.

For practical insights and solutions to the sales and marketing challenges you may be facing, join Care England and Prosperwell's Care Sector Lunch and Learn sessions. Starting in October, these free online sessions, held on the first Wednesday of every month during lunch hour, will provide a valuable resource for anyone looking to grow their care business and improve their strategies. Find out how to register on the Prosperwell website here

Tobi Alli-Usman is the Founder & Managing Director at Prosperwell. Email: team@prosperwell.co.uk @ProsperwellTeam

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DYSPHAGIA CARE Transforming

Improving outcomes with specialist training

Dysphagia is the medical term for difficulty swallowing and it affects millions of individuals worldwide, significantly impacting their quality of life. In this feature, Preston Walker and James Ball, Co-Founders of OHK, share how collaborative sector partnerships have led to the delivery of dysphagia support and management training, essential for care providers to meet the needs of impacted care home residents.

Around four million people in the UK are affected by dysphagia, with care home residents and hospitalised patients significantly impacted by the condition. Prevalence rates in care homes are estimated at 50% to 75%, and approximately 10% of acutely hospitalised patients experience dysphagia. Health Education England also states that dysphagia prevalence in the general population ranges from 2.3% to 16%, with higher rates among older individuals. With such high prevalence rates, it is understandably surprising that there has historically been a lack of resources available for providers looking to understand how to best manage dysphagia and support those living with the condition. Despite this, in recent years we have seen much more pressure being applied from both the public and private sectors on how we can improve this area of social care.

For example, at OHK, we have been part of numerous pilot studies and partnerships across the UK that have seen whole care and catering teams taking on specialised eating, drinking, and swallowing (EDS) competencies training as well as learning more about the International Dysphagia Diets Standardisation Initiative (IDDSI) – a global framework for clinically recommended drink and food textures to help people with dysphagia live better lives.

Common complications

Dysphagia can lead to several severe complications, highlighting the importance of quality management and care. One major issue is malnutrition and dehydration. Individuals with dysphagia may avoid eating and drinking due to fear of choking, physical impairment, dislike of available options, avoidance of usual

opportunities, and lack of support, all of which can result in an insufficient intake of essential nutrients and fluids and be detrimental to wellbeing.

Another serious complication is aspiration pneumonia, which occurs when food, liquid, or saliva passes into the lungs instead of making its way into the stomach, leading to severe chest infections and other respiratory issues.

Additionally, individuals with dysphagia are at a much higher risk of choking, where the airway becomes completely blocked, leading to potential brain damage within minutes and death in seven to 10 minutes. Social interaction is also profoundly affected, as dysphagia can diminish a person's

confidence and ability to engage in activities related to eating and drinking, causing isolation and leading to loneliness.

Since personal identity and social cohesion are closely linked to dining experiences, dysphagia can be highly disruptive to these interactions, leading to perceived or actual negative responses from the wider social group and affecting engagement in this usually enjoyable, and vital, aspect of life.

By developing team knowledge and skills competencies to recognise the symptoms of dysphagia and understand the best next steps for referral or creating effective management strategies, care teams can actively support and significantly improve the quality of life of people living with dysphagia.

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Management challenges

Dysphagia management in the UK health and social care sector faces significant challenges, including a lack of specialised healthcare staff and variability in diagnostic practices. Addressing these challenges is crucial for improving resident outcomes, the quality of care provided, and ultimately, CQC ratings.

This is where OHK identified the biggest need – comprehensive, flexible, and accessible training solutions for healthcare professionals. In 2018, we were approached by a lead speech and language therapist at East Sussex Healthcare NHS Trust (ESHT), following a 'never' event occurring at the time, alongside several near misses.

The root cause of these incidents was traced back to insufficient education and staff awareness of the impact and complications from not following safer swallowing recommendations. Teaming up with ESHT, we started to develop an immersive eLearning programme, which fell within the timeframe that the interprofessional dysphagia competencies were being revised.

The Eating, Drinking, Swallowing Competency Framework (EDSCF) was the output of this work, which was developed by experts from The Royal College of Speech and Language Therapists, Royal College of Nursing, Royal College of Physicians, British Dietetic Association, private and voluntary healthcare sector, the interdisciplinary team, and the wider profession. We ensured that we mapped our training resources to this new framework, guaranteeing a timely, comprehensive, and impactful training solution.

Case study: Evidence from ESHTendorsed adoption of EDS training

Establishing EDS competencies within organisations involves identifying the specific knowledge and skill sets required for each role within care and catering teams, as outlined in the EDSCF. This ensures that every team member, from carers and nurses to caterers and managers, possesses the necessary competencies to support residents effectively.

Fundamental to this is adherence to the IDDSI framework, which details the exact methods for preparing high-quality, nutritious meals and drinks tailored to residents’ specific swallowing needs. With such a varied, rota-based workforce, that unfortunately suffers a high turnover rate three times higher than the national average, it is difficult for providers to keep on top of cascading the latest guidance, compliance changes, and general skillset training. Clear objectives and straightforward

management protocols are essential for maintaining these standards over time.

Implementing EDS competencies at scale has been successfully demonstrated by the original ESHT pilot, which was soon followed by others, due to the success seen by various regions and care settings across the UK and with adoption globally too.

The pilot with ESHT was seen as a huge success. Specifically, an initial drop in incidents of 85% was recorded, with a year-on-year reduction of 33% in incidents on the unit until the end of 2022. Since the introduction of this training, there has been just one incident in 2023 and no ‘never’ events or near misses. A person-centred value that cannot be underestimated.

In addition, 86% of staff stated that the catering for dysphagia diets course helped them in their work due to improved knowledge, positively impacting quality of life, food safety, and the choice offered. Staff now have a deeper understanding of the challenges faced by people with dysphagia, enabling more compassionate and effective support, resulting in a meaningful impact on their lives.

Dysphagia eLearning has simplified the identification of difficulties and boosted staff confidence in recognising signs and symptoms, resulting in fewer inappropriate referrals and earlier resident interventions in acute sites. In community settings, where training has been adopted, referral rates have increased in line with improved staff confidence and understanding, aligning with the national agenda for transforming community services and reducing hospital admissions.

The eLearning can be adapted for a flexible, blended learning approach, accommodating online, live stream, and face-to-face options. Levels 1 and 2 of the EDS modules developed by OHK are now mandated as essential training for clinical staff at ESHT, while Level 3 is offered in specific roles for those implementing interim care plans to individuals awaiting a full dysphagia assessment.

Engaging the public and private sectors

Other organisations were quick to pick up on the success of the training roll out in ESHT. Examples include South Tyneside NHS Trust, the States of Guernsey, Ayrshire and Arran NHS Trust, along with private settings like Norse Group and Belong Villages. Between 2,000 and 6,000 staff from each organisation, across a wide spectrum of care, catering, and management roles, enrolled and completed EDS

and IDDSI-specific training schemes. Integration of EDS training and systems has significantly benefitted these care facilities and their residents.

Following an EDS training pilot in South Tyneside NHS community settings, 74% of participants reported they would change the way they work due to completing the programme, with 34% stating they were more confident in knowing how to refer residents for assessments.

Similarly, the States of Guernsey implementation report showed that both the kitchen services and an acute stroke ward demonstrated improvement in the production of foods for the IDDSI framework, and in the understanding and confidence of all staff to support patients with dysphagia.

The post-pilot audit report highlighted improvements in staff efficiencies, consistency in service delivery, effective and speedy problemsolving, and enhanced due diligence processes. For example, all chefs undertaking IDDSI level-specific food training responded ‘Very Confident’ or ‘Extremely confident’ for all IDDSI food production levels.

Private settings Norse Group and Belong Villages have also seen improvements following engagement with IDDSI and EDS-specific training programmes. Norse Group noted that 84% of attendees to the onboarding sessions felt they left with a ‘Good’ or ‘Strong’ understanding of supporting people with EDS difficulties. Belong Villages attested to the training’s efficacy in improving confidence in compliance and quality practices.

Together with Norse Group, we identified a need to increase the knowledge and skills of supporting people with EDS difficulties across the organisation’s care settings in Norfolk. In the case of Belong Villages, we worked alongside the organisation to develop a bespoke package of training support that continues to fully meet its needs from both an industry regulatory perspective and a quality assurance standpoint.

What is apparent from the positive outcomes of these activations, is that to enhance people living with dysphagia’s daily experiences and ensure high standards of care, it is essential to not only engage multi-disciplinary teams (MDTs) and get them talking the same language, but to embed comprehensive knowledge of EDS and how to implement this in real-life cases.

Comprehensive training is essential

A well-trained workforce is essential for supporting the cohesion of the MDTs in varied settings with complex

needs. From the partnerships forged with OHK, it has been clear that a comprehensive integration of EDS and IDDSI competencies training ensures that all staff members are knowledgeable and skilled in identifying and managing dysphagia effectively.

The positive effects of implementing ‘whole team’ training in EDS competencies has been clearly evidenced as:

• Reducing incidents related to clinical recommendations.

• Greater compliance with IDDSI.

• A more confident workforce.

• High-quality referrals and a reduction in unnecessary Speech and Language Therapist referrals.

• A leadership approach where responsibilities and positive actions are promoted.

• Improved quality of care and life for people living with dysphagia.

Dysphagia management is a critical component of health and social care that requires focused attention and co-ordinated efforts. By implementing robust training solutions and adhering to best practice frameworks, healthcare providers can significantly improve patient outcomes, achieve cost savings, and meet regulatory compliance standards.

Enhanced education and training, standardised diagnostic protocols, and robust patient support systems are essential for addressing the challenges of dysphagia management and are achievable through better education and training. For more information on upskilling teams and meeting regulatory best practice with specialised, cost-effective dysphagia and IDDSI eLearning and support, visit the OHK website.

Preston Walker and James Ball are Co-Founders of OHK. Email: info@oakhouse-kitchen.com

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Empowering the care sector with employee wellbeing

Around 450,000 care workers left their jobs between 2023/24, exceeding the national average nearly three-fold. Care England, in partnership with Vivup, shares a new solution to ease workforce pressures by increasing wellbeing.

Leading employee wellbeing benefit provider to the public and private sectors, Vivup, delivers an Employee Assistance and Wellbeing Programme (EAP) to support social care staff in partnership with Care England. Social care staff face a range of pressures impacting their wellbeing, leading to reduced job performance, morale, quality of life, and contributing to excessive staff turnover.

EAPs can help retain staff

Care England is proud to offer the UK’s only clinically accredited in-house EAP from Vivup. From dealing with loss to managing mounting workplace pressures, social care staff can utilise the EAP 24/7 for any personal or professional issue. Along with 24/7 telephone support, the EAP solution allows you to offer your staff access to:

• Discounts worth up to £1,500 per year for an average care worker.

• Eight sessions of face to face, telephone, and virtual counselling (per issue).

• Unlimited in-the-moment support.

• Online GP service to save the dreaded 8.00am call for an appointment.

• Medical second opinion via HealthHero.

• A comprehensive wellbeing and health management platform examining elements contributing to a person’s mental, physical, and financial wellbeing.

• Menopause support.

• Bereavement support.

• Citizens Advice trained specialists to support practical issues such as financial wellbeing, legal information, older people’s care, childcare, tax guidance, and more.

• Cognitive Behavioural Therapy (CBT) workbooks.

• Financial wellbeing support (including 24/7 debt support).

• Domestic abuse app and resources.

You can also offer additional financial assistance to your staff using the EAP’s Lifestyle Savings. With 750+ discounts and savings across the UK’s major retailers, supermarkets, entertainment, and much more, employees can save an average of £1,600 per annum –equivalent to a 6.5% pay rise.* This comprehensive support solution is available for as little as £4.92 per employee per year (subject to a minimum charge of between £835 to £1,335 per annum)*.

Why should you have wellbeing support?

High levels of daily stress, anxiety, and exhaustion are of concern for the workforce. Burnout, caused by excessive and prolonged workplace stress, could cause employees to disengage from their role.

Grief is also a key challenge for care sector workers who build long-term relationships with the people they care for, and research has found grief reactions in staff ‘reflect many of the core grief symptoms reported by bereaved family caregivers’. With bereaved employees who feel alone at work being 56% more likely to resign and drive high staff turnover levels, offering support is vital. By putting wellbeing at the core of a care worker strategy and providing unlimited in-themoment support, you can arm your staff with the tools they need to increase personal resilience and sustain the delivery of the highest standards of care.

Ready to learn more?

Discover how Care England and Vivup’s EAP could benefit your organisation’s recruitment and retention strategies by visiting the Vivup website.

Tristan Rigby is Head of Wellbeing at Vivup.

Email: tristan.rigby@vivup.co.uk @wearevivup

*Based on average discount % and Office for National Statistics (ONS) living costs. Saving or offers are accurate at time of publication. Subject to availability. Terms and conditions apply for all third parties. Prescription costs apply. 24/7 access to the online GP app but telephone/video consultations are 8.00am to 10.00pm, seven days a week, excluding bank holidays.

LEGAL MATTERS Environmental sustainability and CQC implications

Care providers are quickly becoming familiar with the phrase ‘Environmental, Social, Governance’ (‘ESG’) and for good reason. Anna Fee, Senior Associate (Dispute Resolution – Health and Social Care) at RWK Goodman, considers the ‘E’ in ESG and the Care Quality Commission’s (CQC’s) expectations in relation to environmental sustainability

Under the CQC’s single assessment framework (SAF), the CQC is now assessing environmental sustainability in NHS trusts and integrated care system assessments. Adult social care (ASC) providers are not yet being assessed on environmental sustainability, but they will start being assessed from the second year of the SAF’s roll out. In order to prepare for the CQC’s environmental sustainability assessment, ASC providers should start considering their ESG strategies now.

The CQC on ESG

in the care sector.

The CQC’s SAF includes a quality statement on environmental sustainability which providers must demonstrate compliance with. The quality statement falls under the ‘Well-led’ key question and states, ‘We understand any negative impact of our activities on the environment, and we strive to make a positive contribution in reducing it and support people to do the same.’

Under this quality statement, the CQC will consider the steps that providers have taken to become more environmentally sustainable. As part of its assessment, the CQC will consider how well:

• Leaders understand that climate change is a significant threat to the health of service users, staff and the wider population.

• Leaders empower staff to understand sustainable healthcare and how to reduce the environmental impact of healthcare activity.

• Leaders encourage a shared goal of high-quality, low-carbon care with a focus on health promotion and prevention. For example, how a reduction in air pollution will lead to significant reductions in coronary heart disease, stroke, and lung cancer.

• Leaders take action to ensure their settings are low carbon, energy efficient, and use renewable energy sources where possible.

• Leaders take active steps towards ensuring the principles of net zero care are embedded in planning and delivery of care.

Regulation 17: Good governance

The environmental sustainability quality statement links to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. To meet Regulation 17, providers must have effective governance systems and processes in place. Having a robust ESG strategy in place is one of the ways to help demonstrate that a service is well led and compliant with Regulation 17. Whilst developing an ESG strategy might seem like a daunting prospect, it can be developed over time and there are a number of online resources that providers can refer to for guidance. Care England also has its free Strategic Management Audit Repository Tool (SMART) to help providers plan, prepare, and report against social ambitions and Government environmental targets.

Outside

of ESG matters, if your service is experiencing any issues with the CQC, it can be helpful to seek specialist legal advice.

ESG support from RWK Goodman

RWK Goodman supports providers with estate management and in particular, with managing energy efficiency, carbon neutrality, and how to take advantage of technology. We have recently undertaken a number of estate reviews for clients looking at ways to diversify (for income and cost saving measures) by looking at alternative energy generation and energy efficiency measures.

RWK Goodman will be co-hosting a series of podcasts with Care England regarding ESG matters over the next few months and further information regarding this will soon be published on both organisations' websites.

Outside of ESG matters, if your service is experiencing any issues with the CQC, it can be helpful to seek specialist legal advice. Our lawyers at RWK Goodman can assist with this. For further information, call 020 3006 9727 or visit our website.

Anna Fee is a Senior Associate (Dispute Resolution – Health and Social Care) at RWK Goodman. Email: anna.fee@rwkgoodman.com @rwkgoodman

Making it work for your business

Having an insurance policy in place is one of the most important parts of running a care business, but it is often accompanied by much confusion. In this feature, Jason Brown, Head of Care at Towergate Insurance, emphasises the value of having sufficient cover to suit the needs of your business.

Here at Towergate Insurance, we have created a guide to walk you through what you need to be aware of when it comes to insurance. As Care England’s preferred insurance provider, we want to make choosing the right policy for you and your care business as easy as possible.

Beware of underinsuring your care home

With the increasing cost of labour and materials globally, it is vital that you ensure your buildings are sufficiently insured. It is solely the policyholder's responsibility to ensure that the property is covered correctly.

In order to do so, you are encouraged to have valuation surveys undertaken at least every three years. These valuation surveys will be able to consider any changes in the market that may have affected rebuild costs.

Why has my valuation gone up?

Several different factors have contributed to the increase in the cost of raw materials and construction charges. For example, Brexit has led to a shortfall of 330,000 people in the UK labour force, meaning that the cost of labour has now increased by 30%. As well as an increase in labour, the cost of construction materials including cement, timber, and steel increased by 60%.

Additionally, we are still feeling the impact of the COVID-19 pandemic. Individuals and businesses are still experiencing a shortage of labour and a reduction in the supply of certain building

materials resulting in an increase in costs.

Environmental factors have also contributed such as the roll out of new low emission zones that issue congestion charges and the banning of materials previously used in construction. The war in Ukraine is also impacting what materials UK businesses can get access to.

What

risks do I face if I am underinsured?

Most commercial property insurance policies in the UK include what’s known as an ‘Average clause’. Essentially, this means if you have not paid the correct premium for your property, the claim paid will be reduced by the same percentage you are underinsured by.

For example, in the event of a claim, if you have underinsured your property by 50%, the claim will be reduced by 50%. This average clause is included by insurers and underwriters to deter policyholders from deliberately underinsuring. As you can imagine, this can lead to disastrous consequences should your care home suffer damage.

To prevent this, it is worth factoring in funds in your annual business budget to pay for getting an official survey of the property done. Getting regular valuations by a professional company will help ensure that the building sums insured are correct. This will mean you can focus on running your business with the knowledge that your insurance is sufficient for your business needs in the event that you need it.

It is also worth remembering

Continued →

that in the event of a claim, the cost of the valuation will pay for itself when you receive the correct payment instead of a percentage of it. Some insurers even reward businesses that strive to keep as accurate building sums insured as possible, by applying an ‘Average waiver clause’ that means should you need to make a claim and somehow find you are underinsured, the insurer will not apply the average clause.

By making sure that your policies and procedures are up to date, you should find it far easier to evidence that you have been acting with reasonable care.

Please note, your building sums insured should be based on the reinstatement cost rather than the market value and if your property has features, restricted access, or is a listed building, this could further impact the rebuild cost too.

‘It will never happen to me’

It is easy to think that it is unlikely to happen to you but these disasters do happen, especially now when the number of properties that are underinsured is rising. The following examples demonstrate how an innocent undervaluation can lead to paying a high price.

Partial loss

A portable CD player experienced an electrical fault that resulted in a fire, causing £25,000 in damage to a care home. It turned out that the care home operator was only insured for £10,000 in contents cover, when the loss adjuster calculated the actual value of the contents to be 10 times that, at £100,000. Moreover, the claims settlement was reduced by the percentage the care home was underinsured, resulting in the policyholder receiving only £2,500 – just 10% of the total cost of the damage.

Total loss

A care home with a buildings sum insured of £1m suffered a fire that burned the entire home to the ground. The loss adjuster calculated that the real value of the buildings sum insured was actually £2m, meaning that the building was underinsured by half. The average clause in the policy meant that the policyholder received a payout reduction of 50% of the £2m total loss at just £1m, meaning they had to fund the remaining £1m of the rebuild works themselves.

The importance of keeping up-to-date records

Should a claim arise, you may have to provide evidence to support your claim, including potentially in a court of law. By making sure that your policies and procedures are up to date, you should find it far easier to evidence that you have been acting with reasonable care.

Records such as risk assessments, staff training, and care plans can allow you to show you have been complying with the latest guidelines. It is worth noting that even defending claims can come at a cost. For example, paying for solicitor’s fees and court fees.

How can I get the best value policy?

As you may recall during the pandemic, nearly all insurers within the social care market closed their doors to new business risks and some even walked away from their existing clients, unable to offer ongoing renewal terms. In the last year, we have started to see a recovery with some insurers reconsidering their risk appetite and offering new quotations for well managed risks.

The question is, what can you do to make your organisation attractive to an insurer? You may find that you are already doing some of these things without even realising that it can help you find the right insurance policy for you.

These include:

• Obtaining a CQC rating – this gives the insurance provider an in-depth look at how your business operates. Ideally insurers want ‘Good’ or ‘Outstanding’ rated care homes but should you receive a ‘Requires improvement’ rating, we can still provide cover if you can provide evidence of a detailed and up-to-date action plan. If you have a ‘Inadequate’ rating, we may be able to obtain a quote if the property is part of a larger portfolio on referral. We reward any care homes that receive ‘Outstanding’ with a premium discount.

• Being proactive about reducing claims – you should also provide a thorough history of your claims background which plays an important role in deciding whether an insurer will offer cover at all. If you have a good claims history, insurers may take this into consideration when it comes to calculating your premium. On the other hand, if you have made claims in the past, insurers will want to see that you have put adequate measurements in place to prevent the situation reoccurring.

• Trusting your broker – when it comes to speaking to your broker ahead of your business renewal, there is no such thing as too much information. Keeping your broker abreast with any changes as they arise throughout the year will allow you to develop trust.

• Mentioning your Care England membership – this industry-recognised membership should help

to demonstrate to insurers that your business is committed to operating at a high standard.

• Having a strong online presence – when we are researching your care home, we will look at your website to see how you stand out from competitors, how you are reviewed by service users and their families, and if all the relevant information regarding your care home is published and accessible. Make sure that your website is up to date and showcases your care home effectively to both your customers and your broker. For more information about marketing your business, see page 28.

When should I start thinking about renewals?

We recommend that you contact your broker roughly 90 days before the renewal date to allow ample time to provide sufficient updates and make any necessary policy changes.

If you intend to shop around for other quotes, you can expect to be asked:

• Business activities undertaken.

• Risk management procedures.

• Recruitment policies.

• Full details on construction details of care homes.

• Directors’ history regarding any past bankruptcies and or convictions.

You can also expect your broker to ask about any changes to sums insured, conducting a claims review, and your current CQC rating.

What makes Towergate different?

Unlike some insurance brokers, we offer 24 months of indemnity as standard while others have only 12 months. This means that if your care home is burnt to the ground and you need to rebuild it, you only have 12 months to clear the site, get planning permission, rebuild, re-open, and most importantly, get the same number of residents you had prior to the incident, otherwise your loss of revenue cover will cease.

We believe that this is too tight a deadline, during what is already a highly stressful period. As one of the longest standing brokers in the care sector, we believe a 24-month period will give you enough time to get back up and running, ensuring that we cover the costs for the completion of most, if not all works. For larger care

homes, we offer an indemnity period of 36 months.

Cyber protection for your care home

Care sector businesses continue to be subject to ever-increasing regulations and requirements that are having a significant impact on how they operate. When GDPR came into effect in 2018, sector organisations were given much stricter guidelines than others on the collection, processing, and storage of personal data.

Due to the sensitive nature of personal data on record at care homes, including ‘Personal Identifiable Information’ (PII), this is highly valuable for cyber criminals as it may be utilised for identity theft, fraudulent activities, or malicious intent.

Many sector businesses operate with modest cyber security budgets and use potentially outdated IT systems, leaving many vulnerable targets for cyber criminals. However, it is crucial that appropriate measures are implemented to ensure all data is handled securely.

You can increase cyber security in your care home by implementing strong passwords, multi-factor authentication, control access, encryption codes, staff training, and secure online back-ups, to name a few.

Why are we the preferred insurance supplier of Care England?

Towergate Insurance has been working in the sector since 1982 and still has clients who have been with us since the beginning. As well as supporting clients for over 40 years, we have strong partnerships with Care England who we have been working with for over 10 years.

We have a dedicated team working exclusively with social care businesses, meaning it understands the issues being faced by care providers. Working across multiple offices, we also engage with our local communities and support the work of regional care associations and charities.

Our care home and domiciliary care policies have been created to benefit care providers, rather than to minimise insurer claims and are continually evolving to meet the sector’s needs. From a start-up domiciliary care agency to a large care home group, Towergate has the expertise to support your business.

For more information on how we can assist with finding sufficient cover for your business, call 0330 123 5154, email newcare@towergate.co.uk or visit our website.

Jason Brown is Head of Care at Towergate Insurance. Email: jason.brown@towergate.co.uk Search ‘Jason Brown Towergate’

Towergate and Towergate Insurance are trading names of Advisory Insurance Brokers Limited. Registered in England No.4043759. Registered Address: 2 Minster Court, Mincing Lane, London, EC3R 7PD. Authorised and regulated by the Financial Conduct Authority. (Ref: 313250)

This one-day conference in London will inspire and educate, equipping you with the tools, knowledge and network needed to deliver outstanding dementia care.

This event offers a 360-degree view of social care with CPD accredited educational sessions that are led by experts who will be sharing their practices.

Join care suppliers, industry experts and like-minded care professionals, in Surrey, to discover innovative products and services as well as the latest updates within the sector.

Join Nightingale Hammerson, in London, who are leading experts in residential, nursing, dementia and palliative care, as they explore the future of care and the importance of research in care homes.

The Occupational Therapy Show returns in Birmingham to provide you with the most up-to-date information and resources to enhance your service and improve lives.

This event in London, includes two days of insightful content, CPD training, networking, and entertainment, featuring industry leaders and 150+ exhibitors.

Over 200 delegates will attend CIF 2024 and take part in focused buyer and supplier one-to-one meetings, networking sessions and attend our extravagant CIF Black Tie Festive Gala Dinner at the Crowne Plaza Hotel.

Join

Westminster for a day filled with

MEMBERS' VOICE

Your questions answered ??

At Care England, we are always eager to hear from our members and we strive to answer any questions and queries our members may have. In this edition of Savings, Solutions, and Sustainability, Charlotte Lezard, Policy and External Affairs Lead at Care England, answers your questions on the Care Quality Commission (CQC), local authority contracts, research opportunities, and more.

Q: Regarding the new CQC assessment process and given the level of digital transformation across the sector, are we expected to be moving toward digital technologies to evidence our work, or are paper records considered equally?

Charlotte Lezard: Paper records are still acceptable, but fully paper-based records have received criticism from the CQC, which is a disadvantage to a service when they are inspected. The CQC considers digital record systems under its ‘Well-led’ key question, specifically under the quality statement for governance, management, and sustainability. The CQC expects you to demonstrate compliance with the Data Security and Protection Toolkit or equivalent. It does not assess the standard or technical functioning, or capabilities of the systems themselves. The sector is moving towards digital care records, and we would encourage you to look at electronic technologies.

Q: Can you explain how a new CQC assessment outcome can be challenged where a new quality statement is reading as ‘Good’ and the old report was ‘Requires improvement’ (RI), but the overall report remains RI?

CL: The CQC has changed its approach since the single assessment framework came into place, whereby the CQC now ensures it reviews all quality statements under

a key question previously rated ‘Requires improvement’ or ‘Inadequate’. If your service has been inspected and this was not the case, contact a member of our team at info@careengland.org.uk.

More broadly, to challenge an outcome, you can begin a factual accuracy process with the CQC. As there is no word limit, it can be an opportunity to be very detailed and raise concerns about fairness, not just factual accuracy. It is also a chance to engage with legal help, which could provide more nuanced legal arguments that may be referred to at a later stage. However, you only have 10 days after receiving the draft report to make a submission.

The factual accuracy process allows you to correct any inaccuracies or misinterpretations in the report. It is important to provide evidence and documentation to support your claims. Additionally, maintaining a record of all communications and submissions during this process is crucial for future reference.

Q: We are seeking new local authority contract opportunities to expand our services, generate further income streams, and open new locations. How can we ensure we are connected to future tender opportunities?

CL: Care England has a free tender and contract opportunities page for adult social care and seeks to Continued

upload all new tenders and contracts nationally for adult social care and related areas. We always suggest that you register with the various portals and local authorities they are interested in working with to ensure they are made aware of upcoming tenders. However, our portal is updated three times weekly with NHS and local authority tenders and contracts and is free for all providers.

Registering with local authority and integrated care board portals will ensure that you receive notifications about new tender opportunities. Additionally, networking with other providers and attending industry events, provider forums, and engagement meetings can provide valuable insights into upcoming opportunities. Joining a care provider association can also help you stay informed about new sector developments and opportunities.

Q: I have been told that we require a TV licence in our care homes. Is this correct?

CL: This is something we have heard from a lot of providers, so we commissioned Anthony Collins Solicitors to provide guidance on Motion Picture Licensing Company Licensing Arrangements. More information is available on the Care England website. In summary:

• You will not require a licence if a resident watches TV/films or a group of residents watch TV/films together in a communal lounge.

• You will likely require a licence if you organise a TV/ film screening as a group activity.

• You will likely require a licence if you market your home/s as offering dedicated cinema facilities.

Understanding the licensing requirements is crucial to ensure compliance and avoid potential fines or legal issues. Legal professionals can provide clarity and help navigate the licensing process. It is also important to understand that many of the streaming platforms such as Netflix, Amazon, Disney, and Spotify are not licensed for business streaming and you could be breaching the licence requirements if you use these platforms in your services.

Q: We are keen to improve our services by being part of innovative practice. How can I get involved in care home research?

CL: One way is by contacting your local ENRICH care home research community. ENRICH brings together care home staff, residents, and their families with researchers. It provides a toolkit of resources to help care homes make the most of research as well as researchers to set up and run studies effectively and collaboratively in care homes. Once you are signed up, you will be contacted with opportunities that are right for your service.

Signing up does not mean you have to participate; it just means you will receive opportunities. A list of local networks can be found here.

Participating in research can provide numerous benefits, including contributing to the advancement of care practices, accessing the latest innovations and improvements in care, and collaborating with other professionals in the field. Engaging in research can also enhance the reputation of your care home and demonstrate a commitment to continuous improvement and high-quality care. The research can be either partly or fully funded.

Q: What are the key benefits of moving to digital care records for our service?

CL: Transitioning to digital care records offers several key benefits:

• Enhanced efficiency: Digital records streamline documentation processes, reducing the time and effort required to update and maintain records. This allows you to focus more on delivering quality care.

• Improved accuracy: Digital systems minimise the risk of errors associated with manual data entry and ensure that information is accurate and up to date.

• Better accessibility: Digital records can be accessed quickly and easily by authorised personnel, facilitating better communication and co-ordination among care teams.

• Compliance and auditing: Digital systems support compliance with regulatory requirements and make it easier to conduct audits and reviews. They provide a clear and organised record of all care activities.

• Data security: Digital systems can offer enhanced security measures to protect sensitive information, ensuring that data is stored securely and only accessible to authorised individuals.

• Integration with other systems: Digital care records can be integrated with other health and social care systems, allowing for more comprehensive and co-ordinated care.

Overall, moving to digital care records can significantly improve the quality and efficiency of care, enhance compliance and data security, and support better outcomes for residents.

Charlotte Lezard is Policy and External Affairs Lead at Care England. @CareEngland

Proud to have supported almost care workers with over Support us to help even more

1 0 . 5 T H O U S A N D 10.5 THOUSAND

£ 5 . 9 M I L L I O N

I N G R A N T S A N D S U P P O R T £5.9 MILLION IN GRANTS AND SUPPORT

SINCE 1824 &

SCAN HERE TO FIND OUT MORE