Care Management Matters April 2014 by Care Choices Ltd

CMM CAREMANAGEMENTMATTERS

APRIL 2014 £4.00

IMPLEMENTING THE CARE BILL The importance of leadership

Better care for frail older people Deloitte’s new report

Business Clinic Are there opportunities in the Irish market?

Spotlight on… Assistive technology

Includes 4-page Skills Academy insert: Focus on Leadership, Recruitment and Retention: Using Values-Based Approaches in Social Care

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in this issue

IN THIS ISSUE regulars 05

editor s welcome

Is it just me...? Editor in Chief Robert Chamberlain examines a new report on integrating health and social care via relationships and culture.

News

In Focus

Property News

Local Authority and Planning News

Corporate News

60 seconds with...

Richard Hawes, Care Director at Orders of St John Care Trust.

Business Clinic Our panel consider whether there are opportunities or too many risks in the Irish market.

Spotlight on... Assistive technology

features

A selection of assistive technology and nurse-call systems are proﬁled.

Conferences

David Roe explores the need to identify and highlight the implications of risks to business to ensure market sustainability.

CMM reviews the recent CMM Insight conference on the future of learning disability care.

What s On?

Straight Talk

Financial and well-being risk monitoring in social care

Better care for frail older people CMM presents a summary of this new report by Deloitte Centre for Health Solutions which looks at the challenges to caring more eﬀectively for increasing numbers of frail older people.

Stewart Wallace gives his opinions on how the sector can move on from the Winterbourne View abuses.

What progress has been made to move those inappropriately placed in long-stay hospitals ahead of the June 2014 deadline? CMM investigates.

From long-stay to the community - the deadline looms

The Care Bill: why leadership will be essential in making it work Debbie Sorkin reports on what s to be expected from the forthcoming Care Bill and the role of leadership in making it happen.

With a Care Bill just around the corner, I m sure many of you are thinking about the impact it could have on your operations and how to implement the forthcoming changes. Debbie Sorkin looks at the Bill on page 32 and shares her thoughts on the importance of preparation and leadership in ensuring everyone is aware of the implications. A new report from Deloitte Centre for Health Solutions has analysed the challenges in caring for increasing numbers of frail older people. CMM summarises the report and oﬀers details of how you can read it in full on page 20. Our CMM Insight conference at the end of February brought together many leading names in learning disability services to discuss and debate challenges and best practice in the sector. Margaret Flynn s moving presentation on the abuse of Winterbourne View was particularly well-received. She discussed how progress towards moving individuals with a learning disability out of inappropriate long stay provision and back into their local communities was disappointingly slow . After the horriﬁc abuse at Winterbourne View exposed by the BBC s Panorama programme, a deadline of June 2014 was set to move people inappropriately place, back into their communities. With that deadline just around the corner, progress hasn t been as quick as hoped. That s not to say there isn t good practice and ways providers can help make it happen. On page 28, CMM looks into what is happening, how providers can play their part and existing good practice in the sector. On that note, we also have Stewart Wallace delivering our Straight Talk feature on page 46 looking at how the sector can put the caring back into care. Finally, for those of you unable to attend Insight, we have summarised the main presentations and workshops on page 44. I found the event very interesting and the quality of speaker and delegates made for many valuable conversations. I look forward to seeing everyone again next year to move the conversations forward. Emma Morriss Editor

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CMM APRIL 2014 ¦ 3

contributors

CMM CAREMANAGEMENTMATTERS

editorial panel Des Kelly OBE,

Mike Padgham,

Executive Director, National Care Forum

Chair, UKHCA

Professor Martin Green OBE,

David L Jones,

Chief Executive, Care England

Partner, Deloitte

Andrew Sidwell,

Paul Ridout,

Partner, GVA

Partner, Ridouts LLP

Andrew Barnsley,

Zoe Farrell,

Managing Partner, Nexus Corporate Finance LLP

Training Development Director, Catalyst for Care

April 2014

EDITORIAL AND PRODUCTION editor@caremanagementmatters.co.uk Editor in Chief: Robert Chamberlain Editor: Emma Morriss News Editor: Des Kelly Deputy Editor: Heather Day Design and Production: Lisa Werthmann, Jamie Harvey, Nick Cade & Holly Cornell ADVERTISING sales@caremanagementmatters.co.uk 01223 207770 Advertisement Manager: Tracey Diplock tracey.diplock@carechoices.co.uk National Sales Manager: Paul Leahy paul.leahy@carechoices.co.uk SUBSCRIPTIONS info@caremanagementmatters.co.uk To request your free copy of CMM call 01223 207770 www.caremanagementmatters.co.uk Care Management Matters is published by Care Choices Ltd who cannot be held responsible for views expressed by contributors. Care Management Matters ÂŠ Care Choices Ltd 2014 ISBN: 978-1-909048-93-5 CCL REF NO: CMM 11.2

contributors Austin Hickey, Senior Manager, BDO Ireland Beverley Dawkins OBE, Special Adviser, Mencap Bill Mumford, Director, Winterbourne View, Joint Improvement Programme and Chair TLAP s National Market Development Forum David Roe, Consultant, LaingBuisson. Debbie Sorkin, Chief Executive, National Skills Academy for Social Care Deborah Joynt, Associate, Knight Frank LLP

Publications

Gary Watson, Director and Head of Agency, Jones Lang LaSalle Healthcare Jackie Astill, Head of Quality and Specialist Services, Eden Supported Living

CMM magazine is officially part of the membership entitlement of:

Karen Taylor, Director, Deloitte UK Centre for Health Solutions Michael McGlynn, NHI Communications and Research Officer, Nursing Homes Ireland Richard Hawes, Care Director, Orders of St John Care Trust (OSJCT)

ABC certified (Jan 2012 - Dec 2012) Total average net circulation per issue 16,302

4 ÂŚ CMM APRIL 2014

Stewart Wallace, Strategic Director, CareTech Community Services Tadhg Daly, Chief Executive Officer, Nursing Homes Ireland

is it just me...?

Is it just me...? Editor in Chief, Robert Chamberlain examines a new report on the reality of integrating health and social care via relationships and culture. One Person, One Team, One System is a new report by Sir John Oldham for the Independent Commission on Whole Person Care for the Labour Party. It examines how integration of health and social care services can become a reality, not through system change but through relationships and culture. It states that, ‘Across the developed world, health and care systems face the problem that what they have to offer does not fit with the main needs of the population they serve. We face the same problem, which has arisen because our patterns of need have changed much faster than the systems have been able to change. Need has changed because of the success of health systems and social, environmental, and economic factors.’ We all know the demographic pressures causing this and the comorbidities of the ageing population on a system that was developed in 1948 in the case of the NHS and a social care system that has faced cut after cut to funding and relies heavily on unpaid family carers.

RELATIONSHIPS AND CULTURE The report is clear that people need their care to be looked at holistically. Where people are treated as one person, with multiple needs that are attended to as a whole, by people acting as a team. It argues that the current system focuses on different needs with professionals

focused on different specialities. Where things have needed to join up and work together, recent reforms have ‘fragmented the services for people, taking us in the opposite direction’. Its message is One Person supported by people acting as One Team from organisations behaving as One System. But how can this be achieved with an antiquated NHS and a funding-starved social care system that aren’t geared up to work together? This is where Sir John Oldham and the Commission are clear on the power of people, culture and relationships. It wouldn’t be by major structural reform which, although needed at some point, would more than likely mean pushing the current NHS and care system over the edge given the recent reforms. It proposes that ‘relationships and culture trump structures’. That focus should no longer be on structures but the relationships among them, the people who work in them and what they do. They argue that, ‘this is the essence of care and what really matters. These changes may not be as tangible and headline grabbing as scrapping and creating organisations. Arguably they are, taken together, more radical.’ The report’s 46 recommendations ‘tackle deeply ingrained practices and biases within the system. They are issues that have been impervious to the many reforms of the NHS, but have also often

meant little change to the day to day experience of people using health and care services despite the large scale of a reform process.’ At its heart, the system needs services that put the person, not the institution at the centre. Policies that focus on helping people stay well, manage their illnesses and promote their independence. Payments to different providers of care that are aligned to encourage them to put people’s interests first; a health and social care system that works in partnership for their communities, without expensive and distracting structural reorganisations. Multi-disciplinary working should be the norm with shared decision-making being the default for all professionals and a commissioning requirement.

RHETORIC AND REALITY This report makes absolute sense and its recommendations should be the basis of a blueprint to shape the future to combine the health and social care sectors. However, I fear that the Coalition may play down the report as it comes from the Labour Party. Should the election result in a new Labour Government, we will need to see sufficient funding to perform such radical change. Let’s hope that politics doesn’t get in the way. If you would like to comment please email robert.chamberlain@caremanagementmatters.co.uk

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news

NEWS

APPOINTMENTS APPOINTMENTS

• Planning • Local authority • Corporate News editor - Des Kelly Crisis in Care A damning report from Age UK reveals that spend on social care services for older people has dropped by at least £769 million since 2010. The report Care in Crisis 2014 reveals the disastrous depths that the crisis in care has reached and its distressing human cost. It shows real problems with social care and support for older people in England. Despite rising demand, the amount spent on social care services for older people has dropped by a massive £1.2 billion (15.4%) since 2010. Since then, to help compensate for substantial wider cuts in local government budgets, £438

million was transferred from the NHS budget to local authorities. However, this still leaves a shortfall of £769 million, even if every penny was spent on social care, which is unclear. Taking into account trends over the last decade, the scale of the crisis in care becomes clear. Even before the deep cuts in government funding for social care between 2010/11 and 2013/14, funding for older people’s social care had been broadly stagnant since 2005. Yet the number of people aged 85 and over, the group who are most likely to need care, has risen by 30% between 2005 and 2014 (from 986,000

to 1,280,000). Age UK blames the squeeze on funding which has forced councils to reduce budgets by 15% over the past three years to £6.6billion. Caroline Abrahams, Charity Director at Age UK said, ‘The figures we have uncovered in this report are catastrophic. Older people who need help and are now not getting it are being placed at significant risk and families who care for loved ones are experiencing intolerable strain.’ Age UK is calling on the Government to use the Budget to invest in the social care system so it can deliver the care and support that older people need.

Is paperwork preventing proper care? Is an overload of paperwork preventing care home staff from looking after residents properly? Care homes regularly have to complete more than 100 separate items of paperwork, often duplicating the same information, a study from the Joseph Rowntree Foundation has found. Researchers visited care homes and spoke to staff who felt they were judged more on their ability to produce paperwork than deliver care. The research recommends that the sector rethinks its priorities

and makes changes to the way it deals with administration so that residents can be given more compassionate, personalised care. The balance between prevention of poor care and promotion of good care is ‘out of kilter’, the report argues. It goes on to say that, fuelled by fear and insecurity, care homes spend too much time attempting to cover themselves against blame or litigation, often at the expense of spending time with residents. As a result, staff can lose their sense

of vocation. The report suggests that paperwork has limited the ability to measure the quality of interactions between staff and residents. These day-to-day interactions should be at the heart of care home inspections, which should give real weight to resident participation, choice, dignity and respect. Instead of being an addition to care quality, paperwork can lead to ‘subtractions’ – literally taking away from the delivery or management of care.

FOUR SEASONS APPOINTMENT Peter Dixon has been appointed to the Board of Four Seasons Health Care as a Non-Executive Director. Peter Dixon is Chief Executive Officer of Phoenix Energy Holdings SU SAYER STEPS DOWN After 40 years of leading United Response, Su Sayer CBE has decided to step down as Chief Executive. She will take on a new part-time role as Founder Director. CQC APPOINTMENT Paediatrician Dr Kim Holt has been appointed by the Care Quality Commission (CQC) as a professional adviser on issues relating to whistleblowing. NCPC S NEW CHIEF EXECUTIVE The National Council for Palliative Care (NCPC) has announced the appointment of Claire Henry as its new Chief Executive. She will succeed Eve Richardson who is stepping down from the charity at the end of March 2014. Claire Henry is currently Head of Programmes for Long Term Conditions and End of Life Care at NHS Improving Quality and was formerly Director of the National End of Life Care Programme. SHAW HEALTHCARE MANAGER Amanda Willetts has been promoted to Manager at Shaw Healthcare s specialist support service in Worcester. NEW HEAD OF FUNDRAISING Madeleine Fletcher has taken up the post of Head of Fundraising at The Walton Centre NHS Foundation Trust a specialist neuroscience trust EAGLE WOOD APPOINTMENT The Eagle Wood Neurological Care Centre has appointed experienced healthcare manager Dara Ní Ghadhra as General Manager.

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CMM APRIL 2014 ¦ 7

in focus / news

In Focus: Exploitation

Fight against dementia

in the care sector to be investigated

The UK continues to lead the world in the fight against dementia with a £90 million package to improve the diagnosis of dementia and care. The World Dementia Envoy has been appointed to raise funds for research towards a cure and leading British businesses have also signed up to the cause with over 190,000 staff at M&S, Argos, Homebase, Lloyds Bank and Lloyds Pharmacy agreeing to learn to support customers who have dementia. NHS England will invest £90 million in diagnosing two thirds of people with dementia by March 2015. In some local areas it takes up to 25 weeks to carry out diagnostic assessments whereas in some areas the wait is as little as six weeks. From April, every

WHAT’S THE STORY? Labour leader, Ed Miliband, has asked Baroness Kingsmill to lead a review ‘to better understand and tackle exploitation in the care sector’. The call for evidence says, ‘Social care workers carry out some of the most important work in society, caring for the sick, elderly and the disabled. Yet long-term problems within the sector have led to the work they do being undervalued. As well as the work being physically and emotionally demanding and often undertaken in unsocial hours, there is strong evidence of exploitation in the care sector.’ • 150,000 to 220,000 care workers are paid less than the National Minimum Wage; • 300,000 care workers are on zero-hours contracts; • staff are often not paid for travelling between (increasingly short) appointments, exacerbating problems of low pay and zero hours contracts.

HOW WILL THE REVIEW COLLECT EVIDENCE? In addition to a call for evidence, Baroness Kingsmill is consulting with employees, trade unions, provider associations, think tanks, local authorities and charities in the care sector. Specific areas of interest include the structure of the industry and the workforce, nature of working conditions, professional standards and career progression.

WHAT HAPPENS NEXT? You can submit evidence to the Kingsmill Review of exploitation in the care sector by using the online submission form on www. yourbritain.org.uk or by email at: yourbritain@labour.org.uk with the subject heading ‘Submission to the Kingsmill Review’. The Kingsmill Review will make policy recommendations to tackle these issues with a specific focus on how to improve working conditions without raising the costs or reducing the availability of care.

person over 75 will have a named accountable GP and the most vulnerable 2% in each practice will receive an enhanced service including same day telephone consultations and proactive case management. People diagnosed with dementia and their carers will also be able to sign up to a new service on the NHS Choices website to get essential help and advice in the early stages of their condition. April 2015, councils and the NHS will get £3.8 billion in the Better Care Fund and it is expected that local areas will use some of this to improve care for people with dementia, such as providing access to dementia advisors, reminiscence services and counselling.

Improving Lives To support the work of the Winterbourne View Joint Improvement Programme (WVJIP), the Improving Lives programme has been established. Improving Lives will assess the quality of care currently being provided to people with learning disabilities or autism and additional complex needs. A key aim of Improving Lives is to identify and embed good practice. Improving Lives is run jointly by NHS England, Association of Directors of Adult Social Services, Local Government Association and the Care Quality Commission,

as part of the WVJIP. Working in partnership with family carers (who will be represented on the Improving Lives steering group), local commissioners and providers, its focus includes: reviewing the care currently provided to former residents of Winterbourne View and other individuals; reviewing the care provided in a sample of NHS and Independent Sector services; and assessing the quality of individual patient reviews that have already been completed by NHS England and Clinical Commissioner Groups in line with the Concordat commitments.

Care reform implementation 3% NMW rise proposed The Department for Health, Local Government Association and Association of Directors of Adult Social Services have launched a dedicated website to explain how the £2.7 million

implementation fund will be invested. A ‘getting started’ guide has been produced along with a set of ‘must knows’. www.local.gov. uk/care-support-reform

The National Minimum Wage (NMW) should rise by more than inflation from £6.31 to £6.50 an hour in October, according to a recommendation by the Low

Pay Commission. If the 3% increase is approved by ministers, it would be the first time for six years that the rise has been higher than inflation.

Dementia and nutrition – the proof A new report calls for stakeholders to recognise nutrition as an important factor for the well-being of people with dementia, finding that 20% to 45% of those with dementia experience clinically significant weight loss over one 8 ¦ CMM APRIL 2014

year. Commissioned by Alzheimer’s Disease International and Compass Group, the report reviews dietary factors across the life-course that might increase or decrease the risk of onset of dementia in later life. It also details what actions could

be taken to improve the nutrition of people with dementia both through diet and external factors, such as modifying the mealtime environment and supporting and training carers. The report recommends that

nutritional standards need to be adopted and that more research needs to be conducted into the effective components of diets that might prevent dementia and the progression of mild cognitive impairment.

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property news

New care home in Wimbledon New Christchurch care home A new purpose designed care home is going to be built in Victoria Drive, Wimbledon. The new home with 77 en-suite bedrooms is to be built on the site of the former Park Lodge Care Home and operated by Four Seasons Health Care. The planning application for the new home was submitted early last year and planning permission was granted in August. Site clearance for

construction will start when the 53 residents of Park Lodge have been relocated to their new homes, which is expected to take several weeks. Park Lodge was constructed more than 40 years ago and the environment and facilities do not meet Four Seasons’ requirements for a care home for the future. The layout of the building means that it is not a practical proposition to upgrade it.

HPC uphill challenge HPC Director Ian Wilkie is organising a 10k charity run which is raising thousands of pounds in aid of Alzheimer Scotland. Together with sons Craig and Elliot, nephews Jamie and Grant and other friends, the group will take on the run up and round Edinburgh’s famous extinct volcano Arthur’s Seat. Ian commented, ‘Our family

lost my Dad, Alistair, last year as a result of complications associated with vascular dementia. We wanted to mark the anniversary in a positive way and so have arranged the challenge for 12th April this year.’ Running in aid of Alzheimer Scotland, Ian and his family want to help fund the dementia support services. www.justgiving.com/TheHill

A new private luxury care home, Homefield Grange, specialising in nursing, residential and dementia care, has opened near Christchurch. The

modern facilities offer fivestar accommodation for up to 64 residents and are owned and managed by the Maria Mallaband Care Group.

Nottingham care home creates 50 jobs The opening of a Nottingham care home funded by Yorkshire Bank has created 50 new jobs and set new standards for the industry locally. Acorn House, which is owned by Jay Patel, opened in December

2013 with the support of a sevenfigure funding package from Yorkshire Bank. The 64-bed purpose-built home is located in the Carrington area of the city and was built by LNT Construction.

£15m retirement community Caterplus has opened Dreywood Court, a new £15 million retirement community offering nearly 100 homes. Some of the homes at Dreywood Court, which is part

of the East Thames Group are available for shared ownership. Dreywood Court also offers communal facilities including an onsite restaurant, catered by Caterplus.

specialist property agents GROUP ACQUISITION – NEW DIRECTIONS SPECIALIST CARE G SOLD SOLD BY DC CARE, JANUARY 2014 TO PRIORY GROUP

Craegmoor, part of the Priory Group of Companies, has enhanced its portfolio of care services with the acquisition of New Directions, a company providing specialist residential care and Supported Community Living for individuals with Prader-Willi Syndrome (PWS). New Directions operates five homes, with a total of 36 beds, in the Hastings area.

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property news

Creative Support acquires Delos Community Northamptonshire provider Delos Community has been purchased by Creative Support. Delos provides residential care, community outreach, supported living and innovative day services for people with a learning disability. Creative Support is a registered charitable provider of social housing and currently delivers social care services for people with mental health

needs, learning disabilities and other needs across 57 local authorities. Delos and Creative Support share the same values and ethics with a firm commitment to a person-centred approach, coproduction and social inclusion. The combined organisation now employs 5,000 staff to support around 6,000 people across England, with annual turnover of over £100 million.

Chester Healthcare development The Healthcare team at Jones Lang LaSalle has successfully forward-funded a modern, purpose-built health centre in Chester city centre for £18.5million with Primary Health Properties PLC (PHP). The landmark building at Gorse Stacks on Delamere Street will comprise a high quality

NHS integrated resource centre to be known as The Fountains, accommodating various NHS facilities, a pharmacy and four GP practises who are relocating from existing premises in Chester. The medical centre will be fully let, on a single lease for 25 years, agreed by West Cheshire Health Consortium and the NHS.

Recovery in elderly care A new report by business and financial adviser Grant Thornton UK LLP suggests the UK’s private residential elderly care sector is showing signs of renewed financial health, following a prolonged period of instability. The review of the sector identifies a number of factors signalling both stability and cautious optimism for care home operators. These include an overall net increase in residential demand, coupled with a recent improvement in occupancy rates; stabilisation of operating costs – namely with regard to employment costs – and improvements in Debt / EBITDA lending parameters to more normalised levels of x4 to 6, versus the ‘pre-credit crunch’ period when leverage reached x14. Grant Thornton’s report predicts an overall improvement in the sector’s longer-term prospects, underpinned by an increasingly elderly demographic, the long-term transfer of residents

from local authority homes to independent care homes and earlier credit pressures having restricted new builds, thereby assisting current occupancy levels. The report, however, expresses a degree of caution over the sector’s near-term outlook. It notes that highly leveraged operators, and particularly those with compliance issues operating from older properties, are still likely to face challenges potentially leading to further business failures. Regionally, the report also identifies a growing disparity in business conditions around the UK, with London and the South East remaining the most buoyant markets on account of localised affluence and resident’s ability to self-pay. The North East, Yorkshire and Humberside are noted as some of the most challenging regions, on account of local economic factors, over capacity and lower fees, coupled with lower occupancy rates and aging properties in these regions.

CMM APRIL 2014 ¦ 11

local authority and planning news

Abbeyfield’s plans in Tonbridge The Abbeyfield Kent Society has submitted plans to build a care home and extra care scheme to replace Woodgate residential home in Tonbridge. Planning permission has been submitted for a threestory 101 bed care home which will include a nursing floor, as well as an extra care

scheme of 52 one and two bed apartments. The care home will be built on a site next to the existing Woodgate care home and once complete, current residents will be moved across to the new home. This will then allow for the extra care scheme to be built, causing minimal

disruption to residents. The extra care scheme will have Caring Companions, the Abbeyfield Kent Society’s domiciliary team onsite. Building work is due to start during the autumn of 2014 and the first phase is scheduled to be completed in 2015.

Midas starts work for Anchor Work has started on a £37 million retirement village in Hampshire. The new Hampshire Lakes site near Yateley is being developed for Anchor by Midas Construction, which won the £16 million contract to build the first phase of the purpose-built, continuing-care village. The development will include over 100 assisted living, village apartments and a 36 bed care home. The mixture of housing options is designed to promote independent living whilst also

ensuring residents can access the right level of support should their needs change. Hampshire Lakes retirement village was designed and created by English Care Village Partnerships, working with Anchor. Facilities within the complex will include a restaurant, deli, juice bar, library, wellness centre and spa, fully equipped gym, craft room and treatment rooms, all sited within an idyllic lakeside setting in the Hampshire countryside.

Anchor and Midas Construction have also started work on a new £8.4 million care home in Southampton, Hampshire. Mayflower Court will be a 72 bed care home over four floors which will also include a café, craft room and hair and beauty salon. The home will also provide specialist care for people living with dementia. Midas won the contract to build the development for Anchor and Mayflower Court will open in the spring of 2015.

Care village for Didsbury Morris Feinmann Home is to build a new purpose built, state of the art £11 million Jewish care village on its existing site in Didsbury. The new complex will be built on the award winning “Belong village” model,

offering a mix of 24 hour care in six extended family sized households, each with 12 en suite rooms, 11 independent living apartments and a vibrant village centre, including kosher deli bistro, hair salon and exercise studio.

The new Morris Feinmann will be developed and managed by Belong Villages, part of the CLS Care Services Group. It is planned that the new Morris Feinmann Belong Village will be ready for occupation by 2015.

New extra care scheme for Poole Poole Housing Partnership (PHP) and Borough of Poole have been successful in their bid to build a 54-unit extra care development at Trinidad House. The proposed scheme will be financed through £1.7 million of

funding from the Government, plus a commitment of £5.5 million capital funding from the Housing Revenue Account. PHP is meeting with current residents to discuss how the scheme will affect them individually.

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It is hoped the proposals will develop over time following consultation with residents about how they would like the site to look and feel. Works are scheduled to start in Summer/Autumn 2014.

The Fremantle Trust has launched its new flagship care and nursing home, Fremantle Court in Aylesbury. Fremantle Court, built by Castleoak on behalf of Care Places Fund, will provide tailored care for people with a range of care needs including nursing care and dementia. Fremantle Court is the Trust’s latest premium, innovatively designed 90-place home.

New extra care for Calderdale Calderdale Council has agreed to contribute £500,000 towards a new extra care development in the area. The scheme has already been awarded funding from the Department of Health and a grant application has been made to the Homes and Communities Agency.

Cotswolds care village recommended Plans have been recommended for approval by Cotswold District Council for a care village in Stow, although Stow Town Council opposes it. The application by English Care Villages Partnership – ECVP (Stow) is for 65 assisted living units, 27 close care units and a 24 bed care home.

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corporate news

Healthcare attracts funds The specialist investment sector is witnessing an increase in activity from institutional funds, seeking and finding value in healthcare, hotels and student property, as prime yields harden to 2007 levels, according to Knight Frank LLP. The ‘defensive’ sectors are providing a safe haven for institutional equity, preserving value and leading to an increase in demand and confidence in the wider economy. Gilt and bond yields continue to remain low and there continues to be an arbitrage between fixed income and property yields. The Healthcare market has a positive outlook for the year ahead.

• The demand for the acquisitions of high quality purpose built care homes and new development opportunities is continuing to outstrip supply. • There is a greater level of fluidity in the debt markets for the acquisition of existing care facilities, with transactions of middle tier stock increasing. • In 2014 Knight Frank predicts a shift towards integrated investment models, a continuation of international capital into the UK, yield compression, new operators and funds entering the market, sale and leaseback occurring in the midcap market and also excellent forward fund opportunities.

Shaw Healthcare wins Cardiff-based Shaw healthcare, has won a national finance industry accolade in recognition of the excellence of one of its finance teams. Shaw’s income and

credit control section was named In-house Collection Team of the Year (Consumer) by the Institute of Credit Management (ICM) at a prestigious London ceremony.

Investor for New Century Care New Century Care (NCC) has announced a new cornerstone investor of its business, US hedge fund, Anchorage Capital Group LLC (ACG). ACG will work alongside NCC’s founder, Paul Warren, who will retain a significant stake in the company, to support the growth and development of the business. NCC’s senior management team has spent a number of months with ACG as they reviewed the operations. Working closely with NCC’s management, ACG will look to increase the high standards of care its residents receive and to improve the quality of lives of those under its care.

Heritage buys food franchise Heritage Healthcare owners Glenn and Sally Pickersgill have acquired an Oakhouse Food franchise, which delivers high quality, value for money meals and groceries across the North. The new business, which

Learning through Work A series of pocket-sized booklets ts that develop lls in the adult communication and number skills social care workplace. Designed to deliver bitesized chunks nks of e work, they learning as part in day-to-day care focus on routine, but vital tasks in adult social nd working care. Including keeping records and out medication administration.

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NCC, supported by ACG, will begin the process of increasing the existing high standards of care by reviewing how best to improve its homes. NCC operates 27 care homes and owns the freehold interest in all of its properties, with 1,279 registered beds, located in the South East, North Yorkshire and West Yorkshire. Andrew Barnsley, Managing Partner of Nexus Corporate Finance, advised New Century Care on the investment by ACG. Andrew introduced NCC to ACG and worked with the company and its shareholders to facilitate, negotiate and advise on all aspects of the transaction.

delivers nutritious frozen meals, desserts and groceries throughout Northumberland, Tyne & Wear, County Durham, Cleveland, North Yorkshire, and East Riding of Yorkshire, complements Heritage Healthcare’s domiciliary care services.

corporate news

McCarthy & Stone half year results McCarthy & Stone has reported its trading for the half year ended 28th February 2014. The company anticipates announcing full results for the half year on 31st March 2014. In the latest full financial year ending 31st August 2013, McCarthy & Stone confirmed 1,527 unit sales, a 21% growth in revenue to ÂŁ310.8 million and posted a 15% increase in EBITDA to ÂŁ46 million. At the six month point of this financial year, the company has reported:

â&#x20AC;˘ A 30% increase in legal completions to 659 units, compared to this point in 2013. â&#x20AC;˘ Overall half year revenues up by approximately 50% to approximately ÂŁ150 million. â&#x20AC;˘ Continued strong sales growth, with forward sales into the second half standing 30% ahead of prior year at circa ÂŁ133 million. â&#x20AC;˘ Since September 2013, the company has legally agreed to buy 34 new development sites, totalling more than 1,100

units. The company now has a sizeable land bank under its control, equating to circa 8,500 units. â&#x20AC;˘ Net debt at 28th February of ÂŁ95 million following refinancing, down from ÂŁ431 million at end of February 2013. â&#x20AC;˘ A new board in place, including former Barratt director, Clive Fenton, who has joined as CEO. McCarthy & Stone has also

announced that it is undertaking an organisational review, with the goal of transforming the business and achieving long-term growth. It will consider the right structures, systems and processes to create a more profitable, scalable and effective business. Change is expected to impact a number of individual roles, primarily in its head office, and a more limited number across the companyâ&#x20AC;&#x2122;s five regional offices. All affected employees will be consulted.

Movement on the HC-One Sale Barchester â&#x20AC;&#x2DC;Best Big Companyâ&#x20AC;&#x2122; According to the Financial Time the sale of HC-One and NHP is moving forward. The paper reports that, â&#x20AC;&#x2DC;The financial backers of HC-One, which was formed as a management company to run about a third of the estate managed by Southern Cross, has shortlisted five bidders to buy the 241-home

portfolio, with a deal in excess of ÂŁ500 million expected by the end of March. Potential buyers include Patron Capital, Duke Street, Four Seasons, Formation Healthcare, Fondia Investment Management, according to sources close to the Financial Times. Deutsche Bank is running the sales process.â&#x20AC;&#x2122;

Barchester Healthcare appears in the Sunday Times â&#x20AC;&#x2DC;25 Best Big Companies to Work for list 2014â&#x20AC;&#x2122; for the sixth time. It is the only care provider in the listing. The company employs more than 17,000 people and provides high-quality personalised care for more than 10,000 people in over 200

locations across the UK. The breakdown of the results shows Barchester in 23rd place overall with particularly strong scores in personal growth, where the company was ranked 12th. This growth is driven by Barchesterâ&#x20AC;&#x2122;s in-house business school, which offers a huge choice of learning and development opportunities.

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p7-15 News.indd 16

13/03/2014 11:01

FINANCIAL AND WELL-BEING RISK MONITORING IN SOCIAL CARE David Roe explores how providers should work more closely with local authorities and the Care Quality Commission, to identify and highlight the implications of business risks, to help ensure the sustainability of the market.

Local authorities are not paying the true cost of care, they need to make further substantial budget reductions and there is no sign of the Government providing extra social care funding to ensure this happens. This increases the risks of more widespread ﬁnancial failure of providers, lower quality care, poorer outcomes and well-being for individuals. There is, therefore, an urgent need for local authorities, as well as NHS commissioners to identify better actual costs of care, understand the relationships between cost

and quality, and ensure that the cuts they make do not result in inadequate quality, undermine the well-being of those being supported, directly result in financial failure, or jeopardise the sufficiency of good quality supply in the marketplace. However, they are not currently wellequipped to do so, and the Government’s proposals for Oversight in Social Care, debated in CMM October 2013, will only address some of these considerations, and then only for the largest, ‘difficult to replace’,

CMM APRIL 2014 ¦ 17

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providers. Social care has a proliferation of small and medium providers, and it should not be assumed that financial failure will only affect a few, that can readily be replaced by larger, more financially robust providers. It may not be financially attractive to do so, or the larger providers may be constrained in their rescue role by their own deteriorating financial circumstances. It is no longer sufficient to address only the consequences of financial failure. It is necessary, and should be possible, to identify risks at an earlier stage, so that remedial actions can be taken before financial failure or deterioration in quality and outcomes. In particular, a range of predictive indicators, financial and quality measures and tools could be introduced to identify the drivers of quality and link quality and cost. To make this work, providers would need to conduct selfassessment of risks, with additional involvement of the Care Quality Commission (CQC), working closely with the local authorities.

PREDICTIVE BUSINESS AND FINANCIAL INDICATORS In order to better predict financial failure, there is a need to complement generic analysis of historic financial accounts with the potential impact of current and future developments, trends and risks specific to the sector. This needs to include: • Mix and profitability of self-funded versus local authority business. As many providers move away from increasingly unprofitable local authority business, the risks for those still reliant mainly on local authority placements are increasing significantly, as are the

18 ¦ CMM APRIL 2014

•

risks for supply shortages in the marketplace; this is particularly acute in the North, where there are far fewer self-funders than in the South East, and where many leading providers are no longer willing to invest further. Structural financial risks such as those associated with OpCo/PropCo separation of property portfolios and leasing agreements. Collaborative arrangements between support providers, housing associations, private landlords etc. that can carry occupancy risk. Consider who is responsible, who suffers the financial risk and how this is mitigated. There is a need to monitor levels of existing vacancies or voids and their impact on profitability and viability. For learning disability services, profile the mix of residential care and supported living business for a good indication of the relative risk profiles, particularly as residential care now tends to be less favoured and inadequately funded by the local authorities. Profiling the quality of properties may also be useful, particularly in respect of care homes for older people.

THE COST OF QUALITY AND QUALITY RISKS There is endless debate about what it costs to provide good quality care, but very few clear answers. Useful predictive indicators of quality deterioration can be expressed in terms of costs or operational performance: • Sustainable cost levels. A critical question regarding costs is whether, in cases where these are being constrained, the amounts paid are sustainable for

•

the future to deliver adequate quality of services. Rates of pay for staff are of key importance, as highlighted in the recent United Kingdom Home Care Association Briefing, A minimum price for Homecare. Low rates of pay also tend to lead to higher staff absenteeism and turnover, which means lower continuity and quality of care, as well as higher costs from using agency staff and/or recruitment and training costs. Very tight financial conditions, with low fees, also mean that staffing levels are often reduced, and support (ratio) levels are cut back. Important investment in, for example, training and development for staff are, in consequence, curtailed. Individual provider National Minimum Data Set data on salaries and staff turnover etc. should be of use to help measure at least some of the above, provided that it is upto-date and reliable. Staff satisfaction and culture are also key determinants of quality, and can and should be measured and analysed, as these often point to inadequacies in management and leadership.

In fact, there can often be a ‘vicious circle’, and accelerating deterioration in quality which sets in. This might be triggered by ﬁnancial constraints, loss of a manager or other management issues in any service, so cause and effect needs to be properly identiﬁed. Arguably, tracking resource inputs and their adequacy, covering levels of support and the cost of quality, as well as understanding cause and effect and the drivers of quality, and measuring these, should form a key part of the new quality ratings to be introduced by CQC, as well as a useful early warning system for providers, local authorities and CQC.

Ä UHUJPHS HUK ^LSS ILPUN YPZR TVUP[VYPUN PU ZVJPHS JHYL Simply measuring outcomes, although crucially important, is insufﬁcient to understand how people need to be supported well, staff attitudes and behaviours required, key aspects of operational processes and management structures needed. Providers and commissioners need to understand how services are progressing towards excellence, what they need to address and how to achieve it.

QUALITY, LEVELS OF SUPPORT AND INDIVIDUAL WELL-BEING RISK As the hours of support to which people are entitled are progressively being cut back, there also needs to be a better mechanism for highlighting the adverse implications on outcomes and the well-being of individuals. This is a big topic, requiring a root and branch improvement to needs analysis and care planning, for example, to better consider investment in building on capabilities, rather than simply sustaining dependence. There should be a responsibility to highlight shortages in levels of support provided, against those required, and distinguish whether these arise from a deficiency in what is commissioned, or a shortfall in staffing or support that is actually delivered. As local authorities are increasingly moving towards the use of personal budgets, it is also important to recognise that there has been a gradual separation of levels of budget from a defined number of hours of support they can pay for. This is largely because personal budgets should be capable of being spent as individuals wish, on a mix of professional and community support to suit them. These developments are very appropriate, but the danger is that levels of budget set are no longer calibrated based on

levels of support required, and that there is insufficient basis and evidence for redress when budgets are cut. This could be addressed if personal budget formulation first identified the nature and amount of initial investment and support required, before determining, with the individual and family, how it could be provided costeffectively, given support and resources available. Reporting inadequacies in support should provide an analysis of the specific areas where this exists (e.g. personal care, domestic support, to go out in the community, to work etc.). This then needs to be coupled with reporting of resulting outcomes and measuring well-being, within a consistent, overall framework, across social care, matching support or the lack of it with the consequences in terms of outcomes. Whilst this sounds like a very major challenge, it should be possible to derive a relatively straightforward framework to make real progress in this area.

RESOURCE IMPLICATIONS Clearly CQC, local authorities and providers are all highly resource constrained, in considering extensions to their measurement and monitoring roles. Arguably, keeping a handle on many aspects of what we are talking about, in terms of measures and indicators, should form a key part of providers’ sound management of their services. If this can be shared with CQC, this will enhance their understanding, and better point to areas for improvement, as well as constraints. The challenge will then be to communicate results and issues with the local authorities, whilst being conscious of conﬁdentiality issues, relating to individual well-being data

and financial sensitivities. Whilst better identifying the levers to pull to improve quality will help now, and pinpointing all these risks will focus government attention on the key areas to address and scale of under-funding, this will not, in itself, solve these severe problems. To do that also requires a combination of much more investment in prevention and building on individual capabilities, major re-engineering of personalised support to provide increased and more cost-effective community support (where practicable), working in an integrated, better coordinated, more effective and efficient manner with health services, as well as still, inevitably, substantially more funding for social care. Despite the severe, immediate financial constraints, central and local government need to have the courage to support greater investment in prevention and building on individual capabilities and assets now, with the expectation that much of this can, if implementation is well-managed, reap rewards in terms of relatively lower support levels and costs in the near future. In other words, not try to manage everything down within the current year budget, but take, say, a three or four year view to 2018. This should result in a much lower and more sustainable level of financial support being achieved than otherwise would have been the case, within the next comprehensive spending review timescales. CMM David Roe is a consultant with LaingBuisson. david.roe@btconnect.com More information on this subject is available in the thought-piece Financial and Well-being Risk Monitoring in Social Care produced by Laing Buisson. www.laingbuisson.co.uk/ marketreports/freereports

CMM APRIL 2014 ¦ 19

BETTER CARE for frail older people A new report from Deloitte Centre for Health Solutions has analysed the challenges in caring more effectively for increasing numbers of frail older people. CMM summarises the report with details of how to access the full version. 20 ÂŚ CMM APRIL 2014

CHALLENGES FACING THE SECTOR The National Health Service’s greatest success has become its most daunting challenge. People are living longer but increasingly with one or more health conditions putting the current health and social care delivery model under unsustainable pressure as demand and costs escalate and quality is compromised. Over the past 30 years, life expectancy has risen by 10 per cent and the likelihood of death before the age of 65 has reduced by a third. Health and social care spending on people aged 65 and over, with at least one long-term condition, is

increasing and is currently at least £30 billion a year (£15 billion on those over 75). However, the last two years have seen many high proﬁle national reviews and reports that have highlighted serious concerns about the care provided to frail older people. The most deﬁning of these is the Francis report into failings at the Mid Staffordshire NHS Foundation Trust, whose repercussions have reverberated across the health and social care system. There is a broad political and managerial consensus on many of the systemic changes that are needed, including integrating health and social care, and reform to the chronically underfunded social care system.

BARRIERS TO BETTER SERVICES Integration and reform of social care funding have been mooted by successive governments for over 30 years, with limited success. Many of the changes now being proposed require legislation, structural and organisational reform. Implementation is likely to take between ﬁve and ten years and will require sustained and consistent leadership in order to succeed. In the meantime there are actions that can be taken to improve the efﬁciency and effectiveness of services. A key barrier to integrating or improving services is the fact that funding

J CMM APRIL 2014 ¦ 21

better care for frail older people

streams for health and social care are separate. This presents a particular problem in financing the complex needs of frail older people since those needs increasingly span the boundary between the two systems. Real-term funding for healthcare has been almost flat against a background of increasing demand for services of around four per cent per annum, driven largely by the ageing population. At the same time, intense pressure on social care budgets has resulted in a nine per cent decline in the number of older people receiving support between 2001 to 11 and 2012 to 13. This is putting further pressure on NHS services and is leading to funding gaps in both health and social care. These gaps mean that the desire of frail older people to remain in their own homes is often undermined. A further systemic barrier is the fragmented model of care delivery which remains focused on institutional, episodic care and siloed pathways into primary, hospital and social care. Efficient care is undermined further by the lack of shared access to patient information. This is exacerbated by the difficulty in accessing health and social care services out of hours. Consequently, increasing numbers of frail older people find themselves in hospital as the default position, with frequent emergency admissions to hospital and longer lengths of stay than medically indicated. Indeed, the majority of emergency bed days in the NHS are currently occupied by frail older people.

COMPLEX NEEDS Older people’s complex requirements mean that they are likely to come into contact with the majority of staff groups and provider organisations across health and social care. Yet the staff who spend most time caring for frail older people receive the least training and remuneration. • Low skilled homecare workers, care home staff and healthcare assistants provide the most contact hours, but have limited training or supervision and the lowest pay rates. • There is a mismatch between the

22 ¦ CMM APRIL 2014

training and location of healthcare staff and the needs of frail older people; with training and majority of care traditionally centred on single episodes of care in hospitals. • The role of the general practice is the key to continuity and access but faces increasing capacity constraints and, despite limited training in the complexities of multiple conditions, the workload in caring for the over 75s is three times that of caring for the 45 to 64 age group and is very challenging. Many health conditions experienced by older people have a causal link to, or are exacerbated by, housing conditions. Currently nearly half of all people aged 75 and over live alone, often socially isolated, which can cause chronic loneliness and lead to an increase in physical and mental illness. Around one in three households where the oldest person is over 75 live in housing which has failed the ofﬁcial decent homes standard. A move from unsuitable housing into extra care housing can help maintain their independence for longer; however, availability of such housing is low. Frail older people with dementia (around one in six over 80 and one in three over 95) are more likely to need some form of residential care, but availability of suitable, affordable accommodation is often poor.

SOLUTIONS TO CHALLENGE THE STATUS QUO Improving the experience and outcomes for frail older people requires improvements on three fronts: physical and mental healthcare, social care and place of care. Information is the key to improving all three elements and enabling providers to plan and manage care more effectively. The primary care record, maintained by GPs, is a valuable source of information but, as noted, is currently difﬁcult to access for other health and social care providers. Likewise, hospitals have detailed patient notes but these are still

largely paper-based and not linked to the primary care record. Action to link hospital and primary care data is underway, but plans to provide a fully integrated interoperable healthcare record is unlikely before 2018. Meanwhile, access to information is essential for frail older people given the multiple medical and social care interventions, including multiple medications. Information is also important for commissioners who need a clear understanding of the health and social care needs and pattern of use of services so that interventions that will help keep people out of hospital, including at a point of crisis, are available when needed. To shift the balance of care to the community, investment in primary and community healthcare services is needed. Deloitte’s work on Any Town for NHS England provides further suggestions on how commissioners might achieve improvements in outcomes and ﬁnancial balance for their whole population, including speciﬁc initiatives targeting older people. This means redirecting some of the resources spent on caring for frail older people from the more expensive hospital settings to primary and community care. It also means investing in better quality homecare and extra care facilities. Technology-enabled care such as telemedicine can play an important role in preventing or delaying the need for more institutional care. However commissioners and providers need to co-operate to ensure that the incentives are aligned, including developing new reimbursement models. They also need to ensure that the technologies are understood by and valued by patients and are used to re-design services around the patient.

INTEGRATION The Kings Fund and Nufﬁeld Trust, among others, have published extensive research making the case for integration and for redirecting resources to provide better, more cost-effective care in the community and primary care. While the research provides a compelling case for

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better care for frail older people

24 ¦ CMM APRIL 2014

new models of care, the evidence base shows improvements in quality rather than reductions in costs. Consequently, adoption of these new models, albeit improving, is still low. The Government’s Better Care Fund of £3.8 billion a year from 2015 is an important initiative which has the power to galvanise joint-working but which will need to be implemented carefully if it is to realise its full potential. The NHS and social care need to start to work differently now, including accepting joint responsibility for organising services around the individual and adopting new contracting and funding models that support the provision of seven day services. Joint-working requires strong and consistent leadership, clinical involvement and clear governance and ﬁnance arrangements. It also needs multidisciplinary teams of appropriately trained staff to work in partnership with the voluntary and private sectors. Steps that should be taken in the short term at the local health economy level include: • adopting population health management, case ﬁnding and a register of frail older people; • implementing targeted prevention and early intervention strategies; • establishing a single point of access and appointing a care

co-ordinator for everyone with a diagnosis of frailty; • providing annual frailty checks, and priority access, rapid assessment and diagnosis for everyone over 75; • involving people in their own care through personalised care planning and self- management support services. There are also speciﬁc actions needed to make each place of care ﬁt for purpose including: • improving people’s living conditions through the provision of personal or capitated budgets which can then be used to fund repairs, adaptations and/or buy homecare or support a move to extra care housing; • inspecting, registering and accrediting nursing and care homes, to demonstrate their compliance with quality standards, including access to effective medical care; • implementing a hospital frailty pathway, based on the recommendations in the Silver Book – an intercollegiate guide on providing quality care for frail older people with urgent and emergency care needs.

TIME FOR ACTION Caring for the increasing number of frail older people with multiple health conditions is extremely complex. It requires an urgent and

radical shift in the current approach to care aimed at organising services around the patient and delivering the right services in the right place at the right time. The challenges of caring for an ageing population require health and social care commissioners and providers to work together, and with other partners in the private and voluntary sectors, to develop new care pathways. The focus should be on promoting home care, avoiding escalation of care needs and promoting a return to home care. In addition, commissioners need to use their contracting levers to require improvements in each place of care. Above all, while integration of commissioning and service provision may be desirable in the longer term, in the immediate term better care for frail older people requires all health and social care staff to be willing to work differently. CMM This is the Executive Summary of Better Care for Frail Older People – Working Differently to Improve Care. The full report is available from www.deloitte.co.uk/ centreforhealthsolutions and includes information on improving the place of care through new approaches and innovation across health and care services. With thanks to Deloitte UK Centre for Health Solutions.

Focus on Leadership, Recruitment and Retention: Using Values-Based Approaches in Social Care Welcome to the National Skills Academy for Social Care’s Leadership Section Welcome to our latest issue. As Camilla Cavendish noted in her independent Review into training and support of front-line social care workers: “To get the right quality of care, it is vital that the right people are recruited to caring roles.” If we’re really going to transform social care, everyone – employers, people using services, relatives, unpaid carers and commissioners – needs to have faith that we have the right people in post, doing the right things, in the right way. Since then, events at Orchid View and other well-publicised cases have shown what can happen when you recruit for the wrong values and allow dysfunctional organisational cultures to take hold. CQC has placed values at the centre of their proposed new inspection regime: in ‘A Fresh Start’, which announced plans on how the regime would work, “Checking that providers have the right values and motives, as well as ability and experience” was amongst the top ten priorities for the Commission. But how do you demonstrate and embed the right values, if you are a small provider with little access to expert HR advice, or a large employer with multiple sites and continuous recruitment rounds? One way to do this is to recruit people with the right values at the start. In July 2013, the Skills Academy, working in partnership with Skills for Care and MacIntyre, launched an online values-based recruitment toolkit, aiming to test the support in the sector for this approach, and to make it accessible for front-line roles and SMEs. The toolkit includes: • An introduction to values in social care and why they are so important • Guidance in plain English on how employers can recruit and select for social care values • Examples of job advertisements and interview questions, to help employers unused to this approach • An online Personality Profiling tool which employers can use with candidates • Signposting to the Leadership Qualities Framework with an explanation of how it can help in recruiting for values • Signposting to information on Finders Keepers, the Skills for Care retention toolkit; Common and Managers’

Debbie Sorkin, Chief Executive of the National Skills Academy for Social Care, reports on findings so far on the pilot for a values-based recruitment toolkit, which aims to make it easier for all employers to recruit staff with the right social care values. Induction Standards; and otherr sources of information. Employers can select the ones that are useful to them at any particular time. We are also trialling the personality profiling tool with 100 employers of different types, around the country. The tool asks candidates to complete a short questionnaire, which generates a report for employers that they can then use to focus on particular areas or questions when interviewing. The response so far has been extremely gratifying. Overleaf, employers, commissioners and others involved in the pilot set out what it has meant for them to be involved. The website has received almost 23,000 visits over the past six months, and we have had highly positive feedback from those taking part. Moreover, the level of visits has remained steady throughout the period, with around 3,000 visits a month; a testament to the popularity of the site and the usefulness of its content. The interview questions and Common Induction Standards appear to be particular favourites with employers. There is a waiting list of employers hoping to have an opportunity to use the profiling tool, and those that have done so have been hugely enthusiastic, with comments ranging from “I think it’s really good – the support is excellent” to “it has helped us deliver a more robust recruitment programme.” The features overleaf give more detail about how the toolkit is being used in practice, for current as well as for new staff, and sets out next steps following the evaluation of the pilot. But we know already that values-based recruitment has found a ready acceptance amongst employers, and we are already planning for it to become an intrinsic part of the Skills Academy’s leadership offer. For more information about the toolkit, go to https:// www.nsasocialcare.co.uk/values-based-recruitmenttoolkit, or contact mark.poland@nsasocialcare.co.uk 1: Cavendish Review, July 2013-us/leadership-qualities-framework 2: https://www.nsasocialcare.co.uk/registered-managers

Bringing greater consistency and quality to recruitment in adult social care Dr Glen Mason, Director of Social Care Leadership and Performance, Department of Health We all recognise that adult social care is a vital service for many older and disabled people. A caring, skilled and valued adult social care workforce has a key role to play in delivering quality care and support to the most vulnerable people in society. Unfortunately we are also only too aware of the consequences when care is poor. It is almost a year since the Government published its response to the Francis report into Mid Staffordshire. Much progress has been made since then, but we should never forget the lessons that came out of this report. The Government is therefore committed to bringing greater consistency and quality to recruitment, training, supervision and management of care workers in adult social care, enabling them to place compassionate care at the heart of their work. We are acutely aware of the role that sensitivity and compassion of care workers plays in service users’ experience and need to ensure the care workforce is properly prepared to provide the quality of care those in need deserve. As Camilla Cavendish said: “The best organisations in health and social care recruit people for their values and commitment to caring: they invest in rigorous training and development and ensure that this translates into everyday practice; they build teams which value all members of staff; led by empowered first line managers”

Over recent months we have made real progress in placing dignity and respect at the centre of our workforce policies. One of the important initiatives has been to develop the Values-Based Recruitment Toolkit with Skills for Care, the National Skills Academy and MacIntyre. The toolkit, launched by the Minister for Care Services, will run for a pilot period of 12 months, followed by evaluation and report in summer 2014. As a result of the pilot, I am keen to understand more about the ‘difference’ a values based approach can make within the care sector. Understanding the appetite among employers for this approach will be central to future success. Early indications suggest interest among employers has been encouraging, with large support for the pilot. Interim evaluation shows evidence of demand and positive feedback, with some employers who reviewed their recruitment practices, expressing interest in what will follow after the pilot. There is also evidence the toolkit is also being used for wider applications including induction, supervision, appraisal and management training, suggesting an impact on existing staff, and those new to the sector. Finally I am also very interested in the toolkit’s impact on the many small and medium sized employers that do not have access to HR resources. We hope that the toolkit will provide support to smaller employers to recruit the right people with appropriate social care values.

Valuing our workforce – innovative recruitment and retention Sharon Allen, Chief Executive, Skills for Care One million. That figure is one I focus on constantly because it is the number of new job roles our National Minimum Data Set for Social Care tells us we could need to fill by 2025. Our sector would need around 800,000 people to fill those roles, which is why innovative recruitment and retention initiatives like the Value Based Recruitment Toolkit (VBRT) are going to be vital over the next decade or so. As well as being the product of a partnership, the VBRT was developed through extensive consultation with employers, and we believe we have produced a toolkit that will help us not only identify suitable candidates for rewarding careers in adult social care, but keep them. The whole concept is based around the idea that there certain values and behaviours needed to be an effective care worker including, dignity, integrity, respect, kindness and responsibility. If you don’t think this matters, think about examples in the media where abuse has occurred because those core values were missing. As a former CEO of a major care provider I know only too well how difficult it can be to sit across from someone and try to ascertain whether or not they have those values. What we do is far too serious to just rely on hunch or instinct. So we went right back to basics, pulling together what we

thought would be useful tools for employers to test if the person has the sort of values an organisation is looking for. In addition to the job advertisements, suggested interview questions, and the Online Personality Profiling Questionnaire, we have worked with our UK partners in the Sector Skills Council to develop ‘A Question of Care – A Career for You’ which people can use to self-assess whether care is the right sector for them and employers can also use as part of their recruitment process. To my mind, if other sectors use these sorts of techniques, why shouldn’t a sector that provides care and support to people in our communities with a wide range of needs? We also recognise there are around 200,000 Individual Employers which is why we produced a toolkit to support them to find Personal Assistants to meet their care and support needs: ‘Employing Personal Assistants’. These can be used alongside the Skills Academy’s Leadership Qualities Framework and Skills for Care’s ‘Finders Keepers’ toolkit. The Value Based Recruitment Toolkit pilot will complete in July this year. We are pleased that the evaluation feedback so far is that it’s a useful addition to an employer’s armoury as we focus on finding not just warm bodies but quality people, with the values we need, who will stay with us.

Value-Based Recruitment Toolkit: an update on the evaluation Jacqui Goode, Independent Consultant , VBRT evaluator A pilot of the National Skills Academy Value-Based Recruitment Toolkit (VBRT) has been operating since August 2013. 100 social care employers are engaged in piloting the various components included in the toolkit, these include examples of value based job adverts and interview questions, the Leadership Qualities Framework and an on-line valuebased psychometric profiling questionnaire (Profiles4Care). The aim is that the components, working together as part of an employer’s overall recruitment and selection process, will enable organisations to better identify an individual candidate’s personal value-base before they are recruited and enter the workplace. I have been commissioned by the National Skills Academy, and the VBRT Steering Group, to conduct an independent evaluation of the pilot. In particular, I am seeking feedback from employers on their experience of the toolkit’s process and its effectiveness in supporting employers to recruit staff with the right values for social care at the outset, and to improve the retention of suitable staff. Longer term evaluation will aim to understand the toolkit’s impact on the quality of service delivery and ultimately the experience of people who use social care services. Findings so far highlight that interest in the VBRT is being sustained, with increased interest in the toolkit and 100 additional employers on the waiting list. At the early stage

of the pilot employers were not very aware of the other VBRT components. However, since then, the use of other components has increased and there is now evidence that employers are using the full complement of VBRT resources. Employers report that, in the main, an average of 88% of recruiting activity is to front-line worker roles and 48% to front-line supervisor roles. Whilst participants are using the profiling tool for recruitment, the intended purpose of the pilot, many are using it with existing staff in supervision (45.5%) and to support staff appraisals (nearly 37%). Managers and staff are positive about its use in these settings and see benefits in using it to identify staff development needs and to support training activity. Candidates who have experienced the VBRT process say they feel ‘more professional’ as a result. And all employers report that they feel confident they are recruiting the right people with the right skills and values at the outset, however feel it is too soon into the pilot to provide evidence at this stage. In summary, just-over half way through the pilot, the findings are very positive, with a number of employers changing their recruitment process by using all or most of the resources in the VBRT, and emerging good practice is evident. I will observe ongoing developments with interest and hope to be able to share good practice in the evaluation’s final report.

Learning from the world’s largest Social Care market Neil Eastwood, Founder, Sticky People Ltd The Values Based Recruitment Toolkit is helping social care employers in the UK to get the best people in their organisations. But have you ever considered how providers in other parts of the world are tackling the same recruitment challenges that we face? The world’s largest care market, the United States, is a good place to start. In 2005, a national poll of care providers cited finding quality staff as their biggest challenge. Several initiatives were launched to address this. Firstly, PeopleClues, a behavioural assessments provider, was selected to create a benchmark of the ‘perfect care worker’ by mapping the personalities of thousands of care staff, and comparing results with their managers’ ratings of their suitability, honesty, temperament and reliability. Subsequently this benchmarking assessment tool has been used by US providers to improve quality, address safeguarding risk, reduce staff turnover and differentiate their businesses. Hundreds of thousands of care candidates have been screened prior to interview, and 19 more care job benchmarks created, including Care Manager and Support Worker. In 2013 the PeopleClues tool (branded here as Staff-Sure), completed UK trials and was accredited by the British Psychological Society. It is gathering momentum with UK providers and shares the objectives of the National Skills Academy for Social Care and its partners’ initiative.

Better screening is only part of the story - the US providers also needed to recruit more quality applicants. Just as in the UK, they found relying solely on traditional methods such as online job boards and local paper ads only targeted active job seekers which may include those desperate for any job, with little commitment to care. Further research revealed that the best care workers often had past experience of family caring, so employers tested new job adverts to attract such candidates. They also extended their search to target the ‘passive’ job market - those potential excellent care staff who had never considered the sector. US providers discovered pools of these candidates existed in every community, for example active retirees, church-goers, friends and family of their existing and past clients and local hospice supporters. Activating this hidden source of potential is low-cost, but takes effort. It means getting out there, building relationships with the local community, and enrolling stakeholders, including those using services, in the search. By engaging with their communities, our US colleagues found they gradually released a steady flow of well-suited candidates whilst increasing their local profile. Borrowing best practice techniques, such as these, which have been proven to work in other markets, can offer a low risk way of improving our social care system. As the Americans would say… “it’s a no-brainer!”

The importance of values based recruitment in live-in care Dominique Kent, Director of Operations at The Good Care Group

At the heart of quality home care are professional carers who are highly trained and equipped with the knowledge and skills to deliver a service that is highly personalised, flexible and offers a continuity of care. Providing live-in care can be emotionally, intellectually and practically challenging, even for the most experienced carers. Equally, for home care providers the issues that exist with leading, managing, engaging, effectively communicating and enabling development pathways remotely can have a significant impact on the retention of carers and therefore continuity of care. We recognised this impact and in order to improve this, we wanted to ensure we had the right people working for us in the first place. We started by undertaking a review of our competency framework and ensuring we really understood what the ‘make-up’ of a great live-in carer is. Essentially, we wanted to make sure our competencies ran through the whole process. Our initial competencies had been created ‘top/ down’. We turned this on its head and by taking a ‘bottom/ up’ approach we sought to really understand what to look for when recruiting our carers. We undertook a review of our care team to truly understand what contributed to their success as a live-in carer. This was achieved through the completion of psychometric personality assessments, followed by in-depth interviews with a number of professional carers, high performing/exemplars, senior carers and Regional Care Managers. We then used

this information to create entry level competencies, and distinguishing competencies which we have embedded into our recruitment, selection and performance management frameworks. The use of psychometric profiling enables a safer and more balanced view of an applicant’s suitability to provide live-in care and highlights issues to explore. That said, profiling cannot be used in isolation and must form part of a robust overall recruitment process. These profiles are then used alongside client profiles that encompass personality and preferences as well as social, lifestyle and medical care needs. They are used to match carers with potential clients and their needs, recognising that live-in home care is more successful when carer and client enjoy a respectful, harmonious relationship. By improving the matching process, we are able to provide a stronger foundation for that relationship and achieve continuity of care. Since the introduction of the new process and alongside improved management practices, long term sickness, conduct issues and personal reasons have seen a significant downward trend in being reasons carers leave us. It has contributed to increased carer satisfaction – an employee survey in 2013 found that 85% of professional carers say they ‘usually’, or ‘always’ felt satisfied working for The Good Care Group and average monthly carer turnover has reduced by 30% from 2012.

Demonstrating the power of good recruitment practice Christopher Duff, Workforce Director, MacIntyre

MacIntyre provides support to over 1100 children and adults with learning disabilities and their families. We provide diverse and locally connected services, flexible and personalised solutions to encourage independent lives for those we support. We are known for the investment that we put into our recruitment process. MacIntyre has long been committed to employing the best people to support those with a learning disability. MacIntyre is also committed to the ‘resilience’ of the social care workforce. We believe in the power of effective recruitment and we believe that the Values Based Recruitment Toolkit (VBRT) is clearly going to help many organisations demonstrate the power of good recruitment practice. That is why we partnered with the National Skills Academy, the Department of Health and Skills for Care to help develop the VBRT as a new approach for the whole sector. We are convinced that the VBRT signals the start of a huge and positive change process to happen across the care sector. This may sound a little extravagant on first reading, but let me explain. The sector has long had to balance the demand for quality in our working practice and the costs of delivering complex services. The key to achieving that balance are the frontline staff, the unsung heroes who day in and day out dedicate themselves to the people they support.

An essential aspect of MacIntyre’s workforce priorities is that people we support experience our values through the behaviours of our staff; the quality of the interaction between a person receiving a service and an individual employee. We call these facilitation skills. MacIntyre has developed its own recruitment methodology to help realise those behaviours in practice. We try to recruit people who are open to learning and predisposed to work in a facilitative way. We have developed an ideal personality profile and competency frameworks, and use a personality based on the behaviours of our ‘best’ frontline workers. This methodology has helped embed a culture of reflection and an evidence based approach. We have found that fewer staff leave in their probation period, recruits are more willing to engage in learning, a high proportion are promoted or stay with MacIntyre in other roles and there are fewer performance management issues. We are currently supporting 19 other care and disability organisations to use our approach. Investing in the recruitment process has brought a real qualitative and financial return for our money. One of the ways our approach is cost effective is through lower turnover of staff. The other benefits are through consistency of staffing for those who need it, flexibility of working practice and the ability and enthusiasm to strive for new, innovative approaches.

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THE LEADING PUBLISHER OF CARE INFORMATION WITH TWENTY YEARS’ EXPERIENCE IN THE SECTOR

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RICHARD HAWES Richard Hawes is the new Care Director at the Orders of St John Care Trust (OSJCT).

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I joined OSJCT at the end of January having worked in the statutory, commercial and not-for-proﬁt care sectors. I came to care following a career change. I started as a healthcare assistant, studied to be a Mental Health Nurse and went on to complete a Post-Graduate Diploma in Health Studies and a Community Psychiatric Nursing qualiﬁcation. In 2005, after holding various management posts, I took my Masters in Business Administration. Having worked in the NHS for many years, I then moved to work for a quality national care home provider, commencing as a home manager and eventually managing the south coast services as the Regional Operations Director. Six years ago, I decided to move into the charity sector and became the Director of Care Services for a charity based on the south coast providing residential, nursing and dementia care for older people.

WHAT ARE YOUR PLANS? The Orders of St John Care Trust provides high quality personcentred care for older people from any background. Our aspiration is to be the leading not-for-proﬁt provider of care for older people. My role will be about building on the great services we currently oﬀer our residents and to have a service where people come to our care homes to continue living in a positive, life-enhancing way. I will be working to develop a dementia strategy, which will recognise the current excellent provision of dementia care, in addition to further developing the partnership and employment of

the Admiral Nursing service; I will also be looking at opportunities to develop new methods of supporting those living with dementia. The role is also responsible for care policy and audit functions. I will be keeping our focus on supporting staﬀ to maintain and improve our higher than national average compliance rate; also looking at where the life of the resident can be enhanced by listening to feedback from those who use our services and the staﬀ and volunteers supporting them.

WHAT S THE BIGGEST PRESSURE YOU FACE? Some of the biggest pressures will be preparing for the changes and challenges that will result from the Care Bill. Developing our systems and policy in line with the proposals from the Care Quality Commission for new ways of regulating and inspecting adult social care services later in 2014, the return of a rating system has the potential to oﬀer providers the opportunity to demonstrate their excellence. It should also provide the public with help and assistance to recognise good or excellent services.

TELL US ABOUT YOU Those who know me well would expect me to have something to say about motorsport here, so here goes: in 2013, I came ﬁrst in the Welsh National Rally on a motorcycle, and I have been an avid Land Rover fanatic for some years, having both raced Land Rovers and driven them to remote parts of the world including the Arctic Circle and across the Alps between France and Italy. CMM

CMM APRIL 2014 ¦ 25

business clinic

IRELAND ‒ RISK OR REWARD? A new report from BDO in Ireland has examined the long-term residential care sector and set out a required strategy for the future. Despite the challenges are there opportunities too? Health’s Ageing Crisis: Time for Action – A Future Strategy for Ireland’s Long-Term Residential Care Sector is a call for action report prepared by BDO in Ireland for Nursing Homes Ireland. It highlights that there is an impending crisis in residential care provision for older people due to, ‘the Government’s current short-term approach with respect to policy and funding for the residential care needs of our ageing population [which] will, if continued, result in a much higher social and economic cost in coming years.’

OVERVIEW OF THE SECTOR Ireland, like the majority of the developed world, has a growing, ageing population requiring long-term residential care. This is placing signiﬁcant strain on the Irish nursing home sector and increasing pressure across the wider healthcare service. Demand for nursing home beds is exceeding supply in parts of the country and the gap between supply and

develop the beds now required to meet current and future care needs represents a more effective use of limited resources.’

POLICY The Fair Deal scheme in Ireland provides financial support to those in need of nursing home care. Financial support is provided based on ability to pay and takes two forms; straightforward financial assistance, is ‘State Support’ and the option to defer part of the applicant’s contribution via the ‘Nursing Home Loan’. Applicants are assessed on their care needs and finances and contribute 80 per cent of their assessable income and 7.5 per cent of the value of any assets per annum. However, the first €36,000 of assets is disregarded and their principal residence will only be included in the financial assessment for the first three years they are in care. Although there are no official figures it is thought that over 80 per cent of all residents are funded

Uncertainties need addressing ﬁrst

Opportunities need tailored approaches

Deborah Joynt Associate Knight Frank LLP

Gary Watson Director and Head of Agency Jones Lang LaSalle

Social care in Ireland is fast approaching tipping point. The factors contributing to the ever worsening situation are all very familiar ‒ ageing population, state funding issues, pressure on stock to meet Standard 25 by 2015, lacking provision of new facilities, Government s promotion of homecare, bed-blocking, etc. The BDO research arguably makes for grim reading. The upshot is loud and clear, a national strategy setting out exactly how the elderly are going to be cared for, is now essential. In our opinion, a signiﬁcant part of this strategy will be improving existing stock to comply with Section 25 and, of course, the provision of new build future proof care homes. England went through a similar process in the early 2000s where a number of older style non-compliant converted homes closed down. This, in a sense, was what the market needed, getting rid of the older stock and making way for better quality

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demand is ‘rapidly widening’. This is equated in the report as a shortfall of ‘approximately 8,000 beds or 100 new nursing homes by 2021’. With a typical development taking three years to complete, there is a real urgency to increase provision. Homes are run by the public, private and third or voluntary sector, stock is ageing across all provision and there is a looming environmental standards deadline to meet by 2015. It is estimated in the report that 90 per cent of existing long-stay public beds will not meet the standards in time and in the public sector alone €834 million is needed to bring stock in line with the standards. Added to this the State has an objective to deliver 20% of overall nursing home provision which will require a further investment of €850 million. The report argues that it is ‘unlikely’ this investment will be achieved and questions whether it is appropriate use of ‘scarce public resources’. It suggests that ‘encouraging and supporting the private and voluntary sector to

new build accommodation. This is where an opportunity would lie for an experienced English operator. However, bearing in mind that the above problems have not just sprung up overnight, if there was a decent opportunity here, surely those operators well-established within Northern Ireland would have made the transition down South? They are watching the South very closely, as they are in a favourable position to move quickly, but only when the reward significantly outweighs the risk and market conditions are right . Also forward-thinking Irish operators have approached UK investors recently but found it very difficult to raise cash, if at all. Until the strategic uncertainties are addressed and a clear programme identified, I think there will be little or no movement from English operators to invest, or indeed Irish investors in UK healthcare begin to reinvest in their home market.

In Ireland health and social care are integrated through provision, regulation and ﬁnancing. There is no formal residential care model only nursing (incorporating social care under a nurse-led model). The introduction of the Health Act 2007 gave rise to the Health and Information Quality Authority. Under its remit public, private and voluntary sector services operating from designated centres are regulated by the same standards. Private had been regulated since 1993. The standards gave centres six years to comply with [primarily] increased environmental standards. This is due to expire in 2015, with serious implications. The ageing demographic needs appropriate planning and service delivery regardless of ideology or tenure of provision. The Government introduced Fair Deal, the main source of funding for up to 80% of admissions. Redirection of funds to other non-regulated and lower acuity models like home care would

appear as short-term risks to nursing operators but undeliverable in the longer term due to the demand drivers. Modification to Fair Deal may be required to increase individuals contributions. Since the financial crash, Ireland has been able to re-base its domestic and international competitiveness. Whilst there remains further scope for budgetary compliance and the economy is not out of the woods yet, there is evidence and sentiment that it s recovering. The sector has suffered from a lack of liquidity to finance new services. Whilst funding is returning, there is demand for additional financing options to ensure competitiveness for project promoters. Are there opportunities for UK operators? Yes. However, it s a market with specific characteristics needing a tailored approach and locallycustomised offerings recognising the market s social, financial and regulatory requirements.

business clinic

under Fair Deal with only four or five homes operating outside of it and reliant on purely self-funders. The average weekly Fair Deal rate for private and voluntary nursing homes, at January 2014, is €890 and the most recently published for public homes, from March 2011, states the average cost of care is €1,245. Although everyone is eligible for Fair Deal some opt to self-fund if there are delays in getting Fair Deal approved; they require a bed urgently and are unable to access one or they are sufficiently wealthy that the Fair Deal is not financially attractive. In these cases it may be more attractive to pay directly and reclaim tax relief on amounts paid. It is possible to claim tax relief on nursing home expenditure. Although everyone is, in essence, eligible for Fair Deal, the report highlights that, due to financial constraints, the Government is diverting funding to alternative homecare packages and community facilities. The report claims that this short-term approach will increase waiting times and cost more to the State as more people end up in acute settings unnecessarily. As the report explains, ‘The net weekly cost to the Exchequer of private nursing home care is averaged at €750 (excluding the resident’s contribution)

per resident versus a weekly cost of around €6,000 or higher in the acute hospital sector…The cost savings and beneﬁts to the Exchequer, on an annualised basis, are enormous, estimated at €273 million.’ Added to this, despite a drive to keep people in their own homes for a long as possible, in Ireland homecare is unregulated and doesn’t have national quality standards like nursing home care.

THE REALITY The report states that, ‘the level of private sector investment now required to provide the number of new nursing home beds urgently sought by our ageing population will not happen unless greater clarity is provided in relation to the long-term funding and ﬁnancing of nursing home care. The State as a monopolistic buyer of services in the sector has a fundamental role in establishing clear and sustainable policies which can provide greater certainty for funders and operators alike.’ Nursing Homes Ireland added to this, ‘Uncertainty around the ﬁnancing of longterm care under the Fair Deal scheme and the absence of a formal cost model threatens

sustainability of current provision and continues to temper investor sentiment, acting as a barrier to investing in the nursing home sector. ‘Signiﬁcant capital investment is now urgently required. The political expediency associated with cutting ﬁnancial support for the Nursing Home Support Scheme (Fair Deal) runs the risk of real long-term damage to Ireland’s capacity to care for our growing ageing population. ‘Older persons must be afforded opportunity to access nursing home care in a timely manner and failure to ensure this will have serious consequences for their health and wellbeing. Furthermore, a key weakness in terms of the provision of the entire range of older people services in Ireland is the absence of regulation of or national quality standards for assurance in other older care settings, primarily homecare.’

Over to the experts... Given there is a real issue around supply and quality stock, are there opportunities for experienced English operators to invest in the Irish sector? Or are the policy uncertainties and funding issues too much of a barrier? What does the panel think?

Government’s approach undermines sector Tadhg Daly Chief Executive Oﬃcer Nursing Homes Ireland The Government s short-term approach to policy and funding continues to undermine the sector. Recent decisions to divert funding for nursing home care from Fair Deal to home care and other community packages are counterproductive and create uncertainty. The State has signiﬁcantly reduced the resources to enable those requiring nursing home care to avail of it. Its €35 million cut of the Fair Deal budget will see almost 1,000 fewer persons supported in nursing homes. From a capital and operational funding perspective, the Government is not encouraging and supporting the sector to develop the bed capacity needed to meet current and future requirements. A clear role for nursing homes, in the context of a new and emerging continuum of care model, should form a key element of future strategy in Ireland. Barriers to investing in the nursing home sector due to uncertainty around Fair Deal and the absence

of a formal cost model continue to erode the capacity to plan. Older persons must be aﬀorded opportunity to access nursing home care in a timely manner and failure to ensure this will have serious consequences for them. Government policy and funding must provide a sustainable basis for the delivery of high quality nursing home care and allow for on-going investment in new capacity and service development. This is not happening currently. Ireland s nursing home sector plays a vital role providing longterm residential care for over 27,000 people through care provision in public, private and voluntary beds. It is vital now the Irish Government, its Department of Health, the Health Service Executive and related agencies in Ireland engage constructively with the nursing home sector to prevent a crisis and to ensure that nursing home capacity is able to meet future demand.

CMM APRIL 2014 ¦ 27

28 ¦ CMM APRIL 2014

From long-stay to the community the deadline looms As we hurtle towards the June 2014 deadline to move people inappropriately placed in long-stay hospitals back into their communities, CMM looks at progress and innovation in the sector to help make it happen. More than two and a half years have passed since BBC One’s Panorama programme exposed the horriﬁc psychological and physical abuse of people with a learning disability at Winterbourne View assessment and treatment centre, near Bristol. After the abuses came to light, a Serious Case Review into events at Winterbourne View by South Gloucestershire’s Adult Safeguarding Board concluded that ‘hospitals for people with a learning disability should not exist. While they do exist, they should be seen as “high risk” services’. The review also recommended greater investment in community-based care in order to prevent people from ending up in Winterbourne-style services. Following on from this report, the Government published its ﬁnal Winterbourne View report and concordat, with a strong action plan for people currently in units like Winterbourne View to be moved back to their local communities by June 2014. This deadline is fast approaching.

JOINT IMPROVEMENT BOARD The Winterbourne View, Joint Improvement Board headed, from January 2014, by Bill Mumford, Chief Executive of MacIntyre was established to oversee the programme of helping local areas to transform health and care services for people with a learning disability and behaviour that challenges. However progress has been slow and, a mere six months before the deadline, a progress report revealed that little had been done. The progress report One Year On showed that of the 48 people who were in Winterbourne View, 13 people are still within in-

patient units and one of them had sadly died. What’s more, the Learning Disability Census showed that a further 3,250 people with a learning disability and behaviour that challenges are still in similar units. At a recent meeting of the Learning Disability Programme Board, chaired by Norman Lamb MP, Mencap were told that fewer than 200 of those 3,250 people whose care was commissioned by NHS England and local Clinical Commissioning Groups will have been transferred back to their local communities by the June 2014 target date.

INNOVATION IS REQUIRED Although the deadline will not be met, there is innovation happening in the sector and for enterprising providers who are looking to offer services to assist the situation. Think Local, Act Personal has a number of useful resources including Be Bold which explores developing the market for the small numbers of people who have very complex needs. Think Local, Act Personal is still working to showcase examples of good joint-working between providers, local authorities and families. Bill Mumford explained what has been happening, ‘Key organisations including Think Local, Act Personal, Voluntary Organisations Disability Group and the Housing and Support Alliance have been working on ﬁnding and supporting personalised solutions to help people leave long-stay hospitals, developing services to wrap around them to diminish the likelihood of admission or re-admission.

CMM APRIL 2014 ¦ 29

SPEAKER

Catherine Murray-Howard, Deputy Chief Executive, Community Integrated Care

Joe McGilligan, Chair of East Surrey CCG & Co Chair of Surrey’s Health and Wellbeing Board

Trevor Brocklebank, CEO and Co-Founder, Home Instead Senior Care

SPEAKER Andrew Azzopardi, Managing Director, Sunnyside House.

SPEAKER Directors of Children and Families services

Dr Toyin Ogboye, Public Health Specialist, Specialised Commissioning NHS England

Visit Health+Care, the largest national event for health and social care Health+Care provides the perfect platform for everyone from the social and health care sectors to learn, network and source innovation from the largest national sourcing ﬂoor. It will bring all the pioneers, experts and aspirants together from across the professional boundaries to showcase what is working, discuss how integration and personalisation can be improved, how patient experience and outcomes can be bettered, and how money can be saved. Through networking, inspirational plenaries and skills development sessions delegates will take away the knowledge, skills and contacts to engage with the challenge of making our care provision greater than the sum of its parts.

Your complimentary Health+Care delegate pass will allow you to: Experience 11 conference streams of CPD content | Listen to inspirational plenary sessions | Hear 350 speakers | Meet 400 providers | Join regional networking gatherings | Follow the Technology Trail | Visit interactive feature areas and much more Passes are usually £695+VAT* but senior social care and care provider professionals can get an allocation of the very limited number of FREE passes that are available. Register at www.healthpluscare.co.uk/Kaltz *Commercial companies will not qualify for complimentary passes

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PUBLIC HEALTH

from long-stay to the community - the deadline looms

‘Hospitalisation should just be about short stays for people in crisis, genuine assessment and treatment offered by local and outreach services that are re-modelled. There is a place for forensic mental health services; a certain level of secure provision will still be required. The June deadline isn’t to remove all services of this nature, but for those who shouldn’t be in them to have their needs met more appropriately elsewhere.’

MARKET INNOVATION Now we know that services are required and local offerings are important, there are opportunities for existing providers within their local communities. Eden Supported Living has developed models of support where individuals who have spent years in multi-occupancy settings can have their own front door and autonomy. Services, to meet local needs, are delivered in small clusters of single-person fully-contained apartments. Creating an alternative to multi-occupancy settings for those detained under the Mental Health Act or requiring support under Deprivation of Liberty Safeguards (DOLS). A single-person registered care home model enables individuals being supported under DOLS to have maximum quality of life, reducing the need for hospital admissions if their mental health deteriorates, providing a stable home environment. These single-person selfcontained apartments can also offer a hospital service; individualised assessment, treatment and support to people detained under the Mental Health Act. The organisational culture encourages staff to see the person not the condition, to understand their histories and experiences and encourage a can do approach. It is inevitable that the jump from secure services to community services can be too much for some people who get stuck in a ‘revolving door’ of secure environments and these services are able to bridge this gap. They provide specialist support that individuals need for assessment and treatment, using the philosophy of supported living wherever possible ensuring that individuals are prepared for the next step on their care pathway. Individuals play an active part in constructing their own day and care packages look what a person needs for daily living and use this therapeutically. Shopping, cooking, housekeeping and community access are used to engage individuals in

their own lives and encourage recovery. Purely by looking at what people can do. Care packages can be individually costed and rotas can be more creative to enable a bespoke service that is appropriate for each individual’s needs and aspirations. As support needs change, support can be adapted. Family and friends have a very important role to play and one person even has the family dog visiting. The organisation manages risk on an individual level rather than across the service, so opportunities to engage in activities are not limited by the risk level of the group as a whole. This means more unique environments can be achieved, getting the accommodation right for the individual to ensure that environments are not only safe, but can encourage skill development and are personalised to the services user’s wishes. As a result of this way of working, the organisation has seen the use of physical restraint to manage behaviour that challenges reduce dramatically. Three of the individuals they support had a history of being physically restrained numerous times every day. In the past six months there have only been ﬁve instances of physical intervention with these three people. Individuals have measurably higher self-regulation skills and are living more digniﬁed lives. The organisation brings in a breadth of expert resources, determined by the individual needs of those in their care, by working in partnership with the Intellectual and Development Disability services of Nottinghamshire Healthcare Trust to deliver its hospital service. The Trust also enables those they support to access and fully utilise community-based healthcare services to ensure each person receives the specialist support required for their recovery and development.

MOVING FORWARD What Eden Supported Living is doing can be replicated elsewhere and there are many other examples of good, innovative services developing locally where they are needed. But it needs more than that; it needs conversations to be had at local level, in every locality. Bill Mumford concluded, ‘Discussion has moved locally and focuses on how local areas manage the challenge of closures in a person-centred and personalised way. We need in addition to system change to systemic problems, behaviour change; good local decision-

making can overcome most issues with joint working between families, individuals, local leadership and progressive providers.’ Providers can do this by speaking to their commissioners and if that’s not easy to achieve Bill recommends providers ‘persist’. The Joint Improvement Board is working with the Association of Directors of Adult Social Services and the Care Providers Alliance to help providers and local authorities to work together. The Finding Common Purpose report published by ADASS in conjunction with CPA explores how this type of joint working can be achieved. Progressive providers need to create and sustain dialogue with commissioners, look at current innovation and the needs of their local areas to help achieve suitable, local services for those needing to be moved back into the community from inappropriate placements so individuals are no longer out of sight. CMM

FURTHER INFORMATION THINK LOCAL, ACT PERSONAL A national, cross sector leadership partnership focused on driving forward work with personalisation, communitybased social care. www.thinklocalactpersonal.org.uk. VOLUNTARY ORGANISATIONS DISABILITY GROUP A grouping of over 70 leading voluntary sector and not-for-profit disability organisations that works on behalf of its members to influence and develop social care policy, build relationships with government and other key agencies, promotes best practice and keep members up-to-date on matters that have an effect on service delivery. www.vodg.org.uk THE HOUSING AND SUPPORT ALLIANCE A national charity and membership organisation working with people with learning disabilities, families, advocacy organisations, housing and support providers and commissioners. It wants to create more choice and control for people with learning disabilities over where they live and how they are supported. www.housingandsupport.org.uk

With thanks to Beverley Dawkins OBE, Special Adviser at Mencap, Bill Mumford, Director, Winterbourne View Joint Improvement Programme and Chair of Think Local Act Personal’s National Market Development Forum and Jackie Astill, Head of Quality and Specialist Services, Eden Supported Living.

CMM APRIL 2014 ¦ 31

THE CARE BILL

why leadership will be essential in making it work DEBBIE SORKIN REPORTS ON SOME OF THE KEY PROVISIONS OF THE FORTHCOMING CARE BILL AND WHY IT WILL BE CRUCIAL TO STRENGTHEN LEADERSHIP CAPACITY IN SOCIAL CARE STAFF TO WORK WITH ITS IMPLICATIONS The Care Bill is now reaching the ﬁnal stages of its journey through Parliament, and is expected to receive Royal Assent in April. The Care Bill aims to bring care and support legislation into a single statute and is designed to create a new principle whereby the overall well-being of a person is central to the care and support they receive. The emphasis is on prevention, so that people receive support before they need expensive hospital care,

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and re-ablement. As a corollary, the Care Bill will require the promotion of the integration of care and support with health, housing and other services to ensure the best outcomes for people. To support this, a £3.8 billion Better Care Fund will become available in 2015/16 to promote joint-working and early interventions between health and social care services. Local authorities are already looking at this fund and how best to use it in their areas. The Care Bill facilitates many of the key elements of the Government’s response to the Francis Report on the failings of Mid-Staffordshire NHS Trust. For example, there will be a duty of candour for social care organisations as well as for hospitals, most likely to be implemented through standard safeguarding procedures. The Care Bill also gives greater operational independence to the Care Quality Commission, setting out its duties overseeing the ﬁnances of larger care providers with third party or private equity backers, and introducing the new system of Ofsted-style care provider ratings (‘Outstanding’, ‘Good’,

‘Requires Improvement’ and ‘Inadequate’) that will be put in place from October 2014.

FUNDING REFORMS - THE REALITY On top of these changes, which will affect the sector in many ways, the Care Bill’s provisions represent the most significant reforms to social care funding in decades. It is these reforms that could have momentous implications for care providers. The Bill seeks to put into place, at least to some degree, the key recommendations of Andrew Dilnot’s 2012 Review. In theory, the Bill seeks to provide people with financial protection, with everyone being in a position to know what they will have to pay towards the costs of meeting their care and support needs. So, for example, in April 2016, a cap of £72,000 will be introduced on the amount that any individual will have to spend on care in their lifetime. People who face the risk of having to sell their home in their lifetime to pay for care home fees will also have (from April 2015) the option of a deferred payment, as long as they meet newly created, standardised eligibility criteria. This is irrespective of whether or not the local authority pays for their care. The figure of £72,000 sets the bar at a considerably higher level than Andrew Dilnot originally proposed – he suggested £35,000 – but it is at least an acceptance of the principle. However, not only is it a large amount of money for most people – when the median annual salary in this country is around £26,000 – but it may also turn out to be chimerical in practice. For residential care, this is for two reasons. Firstly, the £72,000

limit only applies to the standard rate that local authorities pay for a bed in a care home, so if the actual rate is higher, it won’t cover the difference. Secondly, it doesn’t include ‘hotel’ costs – the room itself, the bed, the food, the heating and so on. Some estimates suggest that people will actually face paying £150,000 for their residential care before the Government steps in. And the insurers do not appear to be in a hurry to come up with new products to help ﬁll the gap, which was the basic fall-back idea in the original Dilnot Review. The picture is similar for domiciliary care; if typical care at home costs in the region of £15 per hour (source: Money Advice Service and United Kingdom Home Care Association), for those requiring 40 hours of care a week it will take 2.3 years to reach the cap, but for those requiring 10 hours of care a week it will take nine years. So it is possible that only a minority of people living in their own homes will ever reach the cap.

IMPLICATIONS FOR CARE PROVIDERS All of this has implications for independent sector providers. Firstly, staff in residential care and home care services could find themselves being the first port of call for service users and their families when the latter are seeking information on what the changes mean for them. They could also be the focus for complaints when people realise that the cap may not be as advertised. Secondly, there could be a significant financial effect, as any service user looking to see when they might qualify for funding will go to their local authority in the first instance. And the

CMM APRIL 2014 ¦ 33

local authority, under the Care Bill, will have a new duty to arrange care for self-funders if they are asked to do so. If selffunders are paying more than the local authority is paying for an equivalent level of care, this may lead to requests by self-funders to the local authority to purchase care for them at the lower price. If local authorities are able to charge fees for arranging care on request, and have every incentive to obtain extra funding where they can, this could mean a reduction in overall funding going to care providers, and less choice in the market in the longer term if some providers withdraw.

BE PREPARED So how can providers prepare for what’s coming? The key thing is to start preparing now, and not to wait until the changes take full effect. Although there is no ‘magic bullet’ that will pre-empt or remove the risks, it seems to me that a fundamental thing to do, whether you’re an employer in the private or in the not-for-profit sector, is to strengthen your staff team as much as possible. You will need staff who have knowledge and understanding about the changes and their implications; who know that the picture will be complex and have the patience to work with that; who have the confidence to use and impart their knowledge; and who are prepared, in every sense, to work in an integrated system. In other words, the changes will require leadership behaviours: the willingness to manage people and performance; the ability to communicate complex or difficult messages in a clear, accurate and straightforward way, alongside the ability to use listening and feedback skills to promote the needs of people who use services and to ensure that they, and their families, understand what is happening. It means having people who can build networks and partnerships across sectors, for example, through working with Clinical Commissioning Groups. At operational leader (ie Registered Manager) level, this includes being able to understand the changes coming into place through the Bill and to translate them into understandable information for service users, relatives and other carers. At strategic leader level, it means being able to develop and convey a vision for service provision in the new social care landscape, and framing a strategy to deliver it. And it means having people who can assess and manage the risks associated with service developments, balancing economic considerations with the need for service user safety. And there are practical steps you can take. The Department of Health has produced a number of Fact Sheets on different aspects of the Bill, which you can download - see box for details. You can use the Leadership Qualities Framework for Adult Social Care - see box for details, and the tools that go with it, to start preparing and strengthening leadership capacity in your staff team. There are peer networks and local events for Registered Managers - see box for details that can provide a place where the changes coming in the Care Bill, and the implications, can be discussed. Also Skills for Care will be working with the National Skills Academy for Social Care and The College of Social Work to put in place a national learning and development programme for the whole care and support workforce. All employers should be looking at this as part of their future planning. Because if there was ever a time to make an investment in developing the leadership your staff can offer, it’s now. CMM Further resources www.gov.uk/government/publications/the-care-bill-factsheets www.nsasocialcare.co.uk/about-us/leadership-qualities-framework www.nsasocialcare.co.uk/registered-managers Debbie Sorkin is Chief Executive of the National Skills Academy for Social Care Debbie.sorkin@nsasocialcare.co.uk.

34 ¦ CMM APRIL 2014

Care Conference

Supported and organised by Care Management Matters

FOR YOUR 2014 MARKETING SCHEDULE! Focusing on the future of care and commissioning

Save the dates!

2014 JUNE

2014 SEPTEMBER

2014 OCTOBER

North West

Care Conference

4 June 2014

THE FUTURE OF CARE & COMMISSIONING 18 September 2014

16 October 2014

In association with the Lancashire Care Association

What to expect from these events

Delegate proямБle

s 4HE DAY WILL INCLUDE PRESENTATIONS FROM HIGH LEVEL SECTOR REPRESENTATIVES

ALONG WITH AN EXHIBITION AND A CHOICE OF WORKSHOPS

WNERS $IRECTORS 3ENIOR -ANAGEMENT / from the Independent Care Sector WITHIN 2ESIDENTIAL AND $OMICILIARY #ARE AND OTHER SECTOR PROFESSIONALS

s !N AGENDA THAT HAS BEEN PUT TOGETHER IN PARTNERSHIP WITH THE RELEVANT LOCAL CARE ASSOCIATIONS PROVIDERS AND OPINION LEADERS IN THE REGION MEANING THAT IT TOTALLY REmECTS THEIR NEEDS s .ETWORKING OPPORTUNITIES WITH HIGH LEVEL DECISION MAKERS AND LIKE MINDED COLLEAGUES FROM WITHIN THE INDEPENDENT SECTOR

s OF DELEGATES SAID THE EVENT HAD FULlLLED THEIR NEEDS AND EXPECTATIONS s OF DELEGATES SAID THEY WOULD BE RETURNING TO NEXT YEAR S EVENT s OF DELEGATES SCORED THE SPEAKER PRESENTATIONS AS @GOOD OR EXCELLENT

For exhibitor enquiries please call Paul or Tracey on 01223 206965 For delegate enquiries please call Denise Woodhatch on 01293 854401

SPOTLIGHT ON… assistive technology The choice of assistive technology is vast and, as well as helping to relieve the pressure for care home staff, it can help people to remain more independent. From helping to monitor medical situations, to ensuring staff can get to a resident more quickly; many of the nurse call systems are designed specifically with care homes in mind. They can help manage staff and resources more efficiently, let everyone know which member of staff is taking care

36 ¦ CMM APRIL 2014

of which resident and when a resident needs assistance, as well as deal with more specific medical situations. For example, a wrist worn device can alert to a potential epileptic seizure; while sensors can detect potential areas that might form into pressure ulcers. There’s a wealth of ways that technology is helping those working in care services. CMM has rounded-up some of the best assistive technology alternatives on the market.

AIDCALL - WWW.AIDCALL.CO.UK

Stress less with a nurse call system from Aid Call. An Aid Call wireless nurse call system will make life easier and more efficient for your staff and is simple for residents to use too. The Touchsafe® Nurse Call System is attractive, functional and reliable but robust enough to withstand the demands of the care or nursing home environment. Aid Call has been leading the way in wireless nurse call technology for over 30 years and offer a wide range of products and bespoke solutions designed specifically to meet the needs of care homes. Our first class knowledge, innovative approach and reputation for delivering safe and efficient solutions, positions us as the leading supplier of wireless nurse call solutions. The Aid Call Nurse Call system brings flexible and powerful features that allow you to focus on the most effective care delivery, rather than being constrained by the limitations of technology. Our nurse call systems include many features designed to help care homes manage staff and resources more efficiently. The ‘Accept’ feature allows staff to see that a colleague has already accepted a call, to

avoid staff doubling up and attending the same resident call, and ‘next call waiting’ helps staff to use their time more efficiently. Aid Call’s Nurse Call system also features a call logging facility which records the staff member in attendance. This facility allows you to track and monitor individual staff activity and helps to provide greater clarity and accountability in a care management environment. The system also incorporates the most advanced two-way radio technologies featuring automatic acceptance, ‘listen before talk’ anti-collision, and it meets the highest Class 1 European safety critical accreditation. When combined with Aid Call’s call logging system, management are able to analyse response and attendance times at client and nurse level. These features are useful to maximise efficiency and improve the overall quality of care offered to clients. With financial challenges facing the care home industry, there has never been a greater need to offer more cost effective solutions. Aid Call nurse call solutions offer stress free functionality and safety coupled with the reliability and heritage you would expect.

Telephone: 0800 052 3616 • Email: sales@aidcall.co.uk • www.aidcall.co.uk

COURTNEY-THORNE - WWW.COURTNEY-THORNE.CO.UK

Courtney-Thorne announces a new product launch - the unique CT-CLOUD nurse call data storage and reporting service. Aimed at both small and large care home groups, the new CT-CLOUD nurse call storage and reporting system allows anytime and anywhere access to all ’08 Nurse Call System’ information. Data is provided for single or multiple care homes at any given time. CT-Cloud gives care managers 24 hour access to key response and performance information. Whether that access is made on a desktop or laptop computer, tablet or smartphone, all data is securely loaded to ‘the cloud’ with reports delivered by email whenever required. Designed to link seamlessly with Courtney-Thorne’s ground-breaking CT-TOUCH Nurse Call system, CT-CLOUD is so straightforward to use, it requires no training to operate. A simple, clean and responsive user interface ensures all data is easy to access by as many users as has access to password and login details. The wireless 08 Nurse Call System is highly flexible, and when configured with dedicated assistive technology accessories, it becomes a customised nurse call system to meet individual resident/patient needs. Assistive technology accessories include bed exit or floor pressure mats, fall saver sensors, chair or bed watch sensors and enuresis detection. Alternative triggers such as air pressure switches, head operated switches, breathing monitors and a range of

neck or wrist worn pendants all contribute to the design of a system that meets the needs of residents. It really is the carer’s decision on what sort of nurse call system they want to implement as they need to get the balance right between monitoring a resident to deliver an appropriate level of care and being intrusive/contravening personal and human rights. A tough call for them and a rewarding challenge for specialist design consultants to meet. Cost is individually tailored depending on system and features specified by the customer to meet the need of the resident/patient. Courtney-Thorne offers 24/7 support which is provided to all customers and offered to mainland England, Scotland & Wales. Courtney-Thorne’s expanding number of customers include Barchester, Gracewell Healthcare, Care UK, Colten Care, Orders of St John Care Trust, Leonard Cheshire Disability, Reading Council, Cumbria Care, Medway NHS Foundation Trust, North Devon Primary Care Trust and many more. Ensuring a safe environment for patients and care staff is uppermost in the minds of Courtney-Thorne. They continue to develop their ethos of providing innovative nurse call systems to the UK care industry. A vastly experienced and knowledgeable team in sales, engineering, customer service and product development ensures CourtneyThorne remain at the cutting edge of nurse call technology.

Telephone: 01202 573300 • Email: sales@courtney-thorne.co.uk • www.courtney-thorne.co.uk / www.nursecallsystems.co.uk

CM2000

CallConfirmLive! Monitoring is a fully hosted, Web enabled electronic monitoring solution providing accurate, real-time care visit data via the internet, 24 hours a day, 365 days a year. CallConfirmLive! does away with paper time sheets and allows customers to electronically log, analyse and report on home care delivery, ensuring a cost effective and quality assured home care service. Using the CallConfirmLive! Visits screen, it is possible to see at-a-glance how a home care service is performing and to become immediately

aware of any potential failings. Office staff know the real-time whereabouts of their Care Workers and can take proactive action should visits start to be delivered late, or should a visit be missed. The system provides instant alerts for missed or late calls together with a comprehensive range of performance related reports.

Telephone: 0121 308 3010 • Email: Sales@cm2000.co.uk • www.cm2000.co.uk

CMM APRIL 2014 ¦ 37

spotlight on... assistive technology C-TEC

C-TEC’s revolutionary and highly cost-effective range of dementia care products have been specifically designed to meet growing demand from the care industry for innovations to aid people suffering from dementia, Alzheimer’s and other degenerative illnesses. The range includes enuresis (bed wet) sensors, bed/chair exit sensors, PIR power interfaces, floor pressure mats and LED lights, all of which can

be easily interfaced to existing Quantec systems and therefore represent excellent value for money. The new range is very flexible. Systems can be created for specialist dementia sites using individual QT630 controllers to operate an extensive range of dementia care devices in every bedroom. Alternatively, QT637 Enuresis/General Purpose Interface Sockets and QT638 PIR power interfaces can be used to connect devices such as enuresis (bed wet) sensors, passive infrared sensors and floor pressure mats to Quantec addressable systems already in operation.

Telephone: 01942 322744 • Email: sales@c-tec.co.uk • www.c-tec.co.uk

GHM

Improve staff mobility, with award winning ghm’s integrated WIFI, nurse call and telephone systems. Remote handsets allow staff to be contacted anywhere in the care home, making it possible for staff to receive emergency calls without returning to a fixed line. Existing nurse call systems can also be integrated to deliver alerts direct to the integrated WIFI mobile handsets.

Carers can also access patient records and information on a wireless tablet at the point of care and nurse call alerts can be sent to the tablet with the relevant patient information such as medication, history and relatives’ contact details. The result: Reduce the number of devices that your carers need to carry and greatly increase the information available to them, wherever they are in the home. Winners of the Comms National Awards Enterprise Vertical Solutions 2013.

Telephone: 01865 367111 • Email: info@ghmcommunications.com • www.ghmcommunications.com

INTERCALL NURSECALL SYSTEMS - WWW.INTERCALL.CO.UK

For over 25 years Intercall has been providing professional solutions to help nursing homes and hospitals manage patient care on a 24 hour, dayto-day basis. Intercall is one of the most advanced ranges of nursecall system available today and our systems couple functionality with the most up to date reliable electronic technology available. Our philosophy is simple, provide feature packed systems that are simple to operate, outperform our competitors and are competitively priced. Intercall’s latest IP based technology provides significant features and benefits over older style systems by providing a simple web based user interface. From this interface a whole range of data can be programmed, viewed, shared, integrated, recorded or stored on a single system. Installing Intercall’s IP based system is the best way to ensure you are doing all you can to futureproof your call system. It also enables a common platform for seamless integration with other Building Management Systems and third party communication devices such as CCTV, DECT, Fire alarm etc. Intercall systems can be speech or non-speech and provide a wide range of features such

as handsfree two-way speech facilities between all audio units. All room call points have built in infra-red receivers, which enables call to be sent remotely from the call point without the need for trailing wires. Using the infra-red triggers it is also possible to identify the call to a specific calling resident. The Intercall 700 system is fully addressable and system configuration including resident and room descriptions – are software controlled and can be altered at any time. Another specialised product in the Intercall range is the Intercall Dementia Care Unit that has specifically been developed to provide non-intrusive help for residents who may need assistance when they are confused. Although primarily used during the night, the Dementia Care Unit can provide 24-hour monitoring of patients without the need for constant intervention from your staff. Intercall takes pride in providing a friendly, reliable service. It has a technical helpline and a network of highly trained distributors and installers are available nationwide to assist you with any enquiries or technical issues. Intercall is recommended by the NCA and is specified by a large number of the main nursing home groups in the UK.

Telephone: 0500 212123 • Email: sales@intercall.co.uk • www.intercall.co.uk

MEDICARE SYSTEMS LTD – WWW.MEDICARESYSTEMS.CO.UK

Medicare, are experts in the field of wireless radio nurse call systems with resident and staff friendly features.

can be extended as your business grows. The Medicare wireless radio nurse call system can be expanded easily and quickly. Being wireless, installation normally takes just a day or two and there is little or no disruption to the residents and staff.

The call systems, are used in nursing and residential homes, sheltered housing complexes, NHS and private hospitals as well as clinics throughout the UK and Europe. They are both easy for staff and residents to use, and reliable and tough to withstand the demands of the care environment.

The Medicare Wireless Nurse Call Systems has a wide range of add on products including, dementia care alarms, call facilities for disabled users, epilepsy and enuresis detection, fall risk alarms, pressure mats, call system audit trail, room visit logging with staff member identification.

Wireless Radio Nurse Call benefits: • Design, manufacture and installation, • Professional service, • Manufactured in the UK, • Nationwide coverage, Email: Info@medvivo.com • www.medvivo.com • After-sales support, • 24hr Technical helpline, • Low cost leasing available.

The latest innovation from Medicare Systems is real-time e-logging which allows access to all the information on the nurse call system from any PC or android device anywhere in the world. E-logging has proved to be a massive success and leads the way in the reporting of call information.

The HTM6000, Medicare Systems’ latest range of radio nurse call products, is a highly durable and reliable wireless nurse call system specifically designed for the care industry and can be found in nursing homes, residential homes, hospices and hospitals throughout the world.

Medicare Systems offers a professional service from initial consultation right through to installation and after-sales support, with a nationwide service support run from its bases in Dorset, Oxfordshire, Lancashire and Scotland. Further service support is also provided by an approved distributor network throughout the UK and Eire.

With the facility to cater for between one and one thousand call points, the HTM6000 system incorporates the best in radio technology and remains the easiest of all radio nurse call systems to use and maintain. Medicare Systems are cost effective both in initial purchase and future maintenance and

Whatever your requirements, Medicare Systems are able to tailor the system to suit your individual needs and after installation, you will have the reassurance of the Medicare service support team, available to you 24 hours a day.

Telephone: 0800 849 5123 • Email: info@medicaresystems.co.uk • www.medicaresystems.co.uk

38 ¦ CMM APRIL 2014

Prove your water systems are free from LEGIONELLA BACTERIA from just

£44.50 +VAT

JUST 3 EASY STEPS to peace of mind... 1

We send you a sterile bottle, you ﬁll it from your hot taps and showers

You let us know the sample is ready, and place it in the supplied bag

We collect, perform the laboratory analysis and send you your certiﬁcate

We also carry out LEGIONELLA RISK ASSESSMENTS, in accordance with the HSE’s L8 Code of Practice.

To enquire call FREEPHONE on:

0800 048 1737

or visit our website at www.AquaCert.co.uk

AquaCert is part of the EMS group, which also carries out Air & Water Hygiene Surveys and Tank Repairs and Replacements

CMM APRIL 2014 ¦ 39

spotlight on... assistive technology

MEDVIVO

By bringing together the wide range of expertise required, the Medvivo service provides integrated solutions to the full spectrum of health and social care problems threatening the ability of the vulnerable and those with long term conditions to live at home. The Medvivo service combines technological innovation with clinical excellence to offer imaginative, pragmatic, clinically focused solutions, with proven real world benefits for service users and commissioners.

Resilience, service continuity, sustainability and value for money are key features of the Medvivo ethos, delivering a service that understands and responds to the needs of its users, working collaboratively across health and social care boundaries in a truly integrated model of care, closer to home, regardless of time of day. Our Telecare service has received the TSA’s Platinum accreditation and we are the first organisation to receive the TSA’s Integrated Code of Practice for our telehealth and telecare services.

Telephone: 0800 8600 768 • Email: info@medvivo.com • www.medvivo.com

MYAMEGO®

MyAmego® is a monitoring, risk management and assessment system which supports the implementation of person-centred care delivery in assisted living, residential and nursing settings. It enhances quality care delivery to people with dementia and other high needs providing messages to staff pagers for users who may be at risk or require assistance. It also prompts staff to take pro-active care intervention when required, supporting consistent and appropriate care delivery, for example for bed turning, hydration reminders or time

sensitive medication requirements. Reports from MyAmego aid on-going assessment of conditions, rehabilitation and re-enablement of residents and the planning of appropriate on-going care provision on a personal basis. Increasingly the detailed monitoring and reporting capability is being used to evidence care delivery and staff activity, proving a valuable tool in the safeguarding of both residents/patients and staff. MyAmego has nurse-call capabilities and can work with other nurse call systems.

Telephone: 01353 741 545 • Email: info@myamego.com • www.myamego.com

NIGHT OWL CARE MONITORING – WWW.NIGHTOWLCAREMONITORING.COM

Night Owl Care Monitoring is the simple way to efficiently and safely check on residents living within a care environment and digitally store a record of the care given. With frequent stories of neglect and bad care reported by the press, the Night Owl Care Monitoring system has revolutionised the way that hourly, daily and routine checks are recorded by carers. Many of these complaints about the care system have been based on families feeling their parents are not being attended regularly enough by carers. The Night Owl Care Monitoring system can allay their fears with detail recorded of every check, observation or treatment given. As it is impossible to record the detail without being in the resident’s room, it makes for extremely reliable evidence, giving families peace of mind to the amount of care. Here’s how it works: • When the resident is visited, the caregiver clicks the client’s data disk that is mounted inside their bedroom. • The caregiver then selects the appropriate disk from the ten on the wireless electronic notepad once the client’s needs have been met. The options can be tailored to meet

the needs of an individual home but commonly range from ‘client asleep’, ‘client awake’, ‘liquid given’, ‘very disturbed’ to ‘incontinent pad change’ and ‘room secured’. • In the morning, the Senior Carer or Manager attaches the reader and selects the Night Owl programme on the computer and downloads information. This is automatically stored along with the date on its own database. All this documented and saved information gives solid assurances for staff and the care home and protection against any claims of neglect. Copies of the checks made on individuals can also be sent to the families if desired and care managers can analyse the data to see if there is any change in the resident during the night and adjust care plans accordingly. Night Owl is used as a monitoring system in care homes, nursing homes, domiciliary environments receiving care and hospitals. The cost of the Night Owl Monitoring System is £390.00 for a 10 bedded home and additional buttons for extra rooms is £3.90. This amount is made in one payment and there are no service fees. With the Night Owl system in place, managers and care home owners can more effectively ensure that families’ instructions are being adhered to and exactly what care and attention the resident is receiving.

Telephone: 01843 844634 • Email: nightowlcaremonitoring@aol.co.uk • www.nightowlcaremonitoring.com

40 ¦ CMM APRIL 2014

spotlight on... assistive technology

PERSON CENTRED SOFTWARE – WWW.PERSONCENTREDSOFTWARE.COM

Launched towards the end of last year, Mobile Care Monitoring by Person Centred Software provides an innovative solution for evidencing care that is focused on improving the quality of life for service users and carers.

to carer with care plans, planned care routines and shift handover notes; and carer to carer workflow with service user preferences, flags for overdue care, and happiness indicators. All this added together makes a unique solution to a very simple objective: to improve the life of everyone involved in social care.

In social care, the primary objective has to be to improve the quality of life. Carers do their job because they love caring for people, so we start by helping to remove their routine tasks of writing daily records and making record keeping fit in around their care duties. We also want service users to feel comfortable, safe and, above all, happy so we’ve made this objective the core of our product by measuring their happiness during each care interaction.

The benefits of Mobile Care Monitoring include: • Carers get more time for care because they spend less time on administration and are better informed. • Service users have less stressed care staff caring for them, and the system audits how happy service users are. • Care managers get an holistic overview of care, presented in ways that helps them quickly identify potential problems, and know that all service users are being well cared for. • A service user’s family and friends can know instantly that their loved one is receiving the care they need and is happy.

Mobile Care Monitoring incorporates hand-held devices to collect evidence of care at the point of delivery, with processes built-in to provide protection to service users and staff. Through efficiency, accuracy, transparency and team working, the system provides time savings for everyone involved in care, allowing more one to one time with service users, and also provides increased profitability through reduced staff induction costs and increased income. The system is easy to use, fast, and icon driven with limited need for typing. Visibility and transparency ensures that information is managed across the organisation. Carer to nurse workflow is through automated escalation of certain care interventions; nurse

Mobile Care Monitoring is in use by customers providing the following care services; frail elderly nursing and residential care; supported living; learning disability; and domiciliary care. The system is available for £15 per FTE user per month, based on one device per 2 FTE users. All prices are fully inclusive, covering software, devices, support and taxes.

Telephone: 01483 604108 • Email: care@personcentredsoftware.com • www.personcentredsoftware.com

POSSUM

Founded in Buckinghamshire in 1961, Possum are today market leaders in the provision, installation and support of electronic assistive technology solutions, including Telecare and Environmental Control Systems. The company’s mission is to harness modern technology to empower disabled and elderly people and increase their independence.

market brought in partnership with Danish Care. The first of its kind, the technologically advanced ‘plug and play’ Epi-Care free wrist worn device, is a night and day solution and uses a 3-dimensional accelerometer and Bluetooth technology to detect tonic-clonic seizures sending a signal to a receiving device. With an accuracy of over 87%, the mobile device is a flexible option compared with existing bed based solutions. The device is worn on the person enabling constant monitoring and the advanced technology can distinguish between seizures and every day activities. For further product information and clinical trials details contact Possum office.

In 2012, Possum introduced the next generation of epilepsy detection into the UK Telephone: 01296 461000 • Email: Telecare@possum.co.uk • www.carehometelecoms.co.uk

SAFETY SYSTEMS

The Emfit Tonic-Clonic Seizure Monitor This Equipment has been clinically tested to detect 100% of nocturnal tonic-clonic seizures that continue over 10 seconds. The equipment consists of: • Control Unit with 2 AA batteries • Wall mounting kit • Bed side clip • Under mattress bed sensor • Optional power supply is also available.

• No Delay, 3, 6, 10, 15 or 30 minute options. This can also be disabled and used just for the seizures. • Volume options: very loud, loud,quiet and mute. • Bed exit function. • A numerical rotary switch indicates a suggested sensitivity setting based on the user’s bodyweight in killograms. We have a range of additional equipment for carers and parents including a Care Alert Kit, pagers and dispersed alarms

• The tonic-clonic seizure notifications are 10,13,16 or 20 seconds. Telephone: 07885 999483 • Email: ashleyburton@safetysystemsdistribution.co.uk • www.safetysystemsdistribution.co.uk

Next edition: Who’s who... Property Professionals If you would like to feature in the next Who’s who please email editor@caremanagementmatters.co.uk or tweet us @CMM_Magazine

www.caremanagementmatters.co.uk CMM APRIL 2014 ¦ 43

" # " # Ƥ ! " !

spotlight on... assistive technology

PERSON CENTRED SOFTWARE – WWW.PERSONCENTREDSOFTWARE.COM

Mobile Care Monitoring incorporates hand held devices to collect evidence of care at the point of delivery, with processes built-in to provide protection to service users and staff. Through efficiency, accuracy, transparency and team working, the system provides time savings for everyone involved in care, allowing more one to one time with service users, and also provides increased profitability through reduced staff induction costs and increased income. The system is easy to use, fast, and icon driven with limited need for typing. Visibility and transparency ensures that information is managed across the organisation. Carer to nurse workflow is through automated escalation of certain care interventions; nurse

Telephone: 01483 604108 • Email: care@personcentredsoftware.com • www.personcentredsoftware.com

POSSUM

In 2012, Possum introduced the next generation of epilepsy detection into the UK Telephone: 01296 461000 • Email: Telecare@possum.co.uk • www.carehometelecoms.co.uk

SAFETY SYSTEMS

The Emfit Tonic-Clonic Seizure Monitor This Equipment has been Clinically tested to detect 100% of nocturnal tonic-clonic seizures that continue over 10 seconds. The equipment consists of: • Control Unit with 2 AA batteries • Wall mounting kit • Bed side clip • Under mattress bed sensor • Optional power supply is also available.

• No Delay,3,6,10,15 or 30 minute options. This can also be disabled and used just for the seizures. • Volume options: very loud, loud,quiet and mute. • Bed exit function • A numerical rotary switch indicates a suggested sensitivity setting based on the users body weight in killograms. We have a range of additional equipment for carers and parents including a Care Alert Kit, pagers and dispersed alarms

• The tonic-clonic seizure notifications are 10,13,16 or 20 seconds Telephone: 07885 999483 • Email: ashleyburton@safetysystemsdistribution.co.uk • www.safetysystemsdistribution.co.uk

Next edition: Who’s who... Property Professionals If you would like to feature in the next Who’s who please email editor@caremanagementmatters.co.uk or tweet us @CMM_Magazine

www.caremanagementmatters.co.uk CMM APRIL 2014 ¦ 43

conference review

CMM INSIGHT - THE FUTURE OF LEARNING DISABILITY CARE

25th February, Manchester

The 6th CMM Insight conference was held at the Renaissance Hotel in Manchester on 25th February. The packed conference programme and accompanying workshops gave the delegates much to discuss throughout the day. Alan Rosenbach, Special Policy Lead at the Care Quality Commission (CQC) presented delegates with an overview of developments at the regulator with regard to learning disability services. He also gave an update on the CQC’s progress towards implementing its commitments to transform care for people with learning disabilities as a signatory of the Winterbourne View concordat. The CQC is using experts by experience as part of its inspection process and Alan explained that inspection was becoming a team pursuit including experts by experiences and best evidence to make independent judgements reflecting the reality of what they see. He also mentioned that CQC staff were being given the opportunity to move around to work where their skills are the best fit. Margaret Flynn, Independent Adult Safeguarding Expert and author of the Winterbourne View Serious Case Review gave a powerful and honest presentation of the abuse at Winterbourne View. She explained there were many warning signs to the low standards of care at Winterbourne View including the fact that it had no registered manager for at least two years. Margaret stated that, ‘It is unlikely that the Serious Case Review identified all the crimes and abusive acts to which patients were subject.’ She also raised that progress in moving individuals back into the community had been disappointingly slow. The room was left empowered by her presentation to ensure that nothing like this ever happens again. The Association of Directors of Adult Social Services’ Joint Leads for the Learning Disability Policy Network, Andrea Pope-Smith and Rosy Pope followed Margaret with discussion of how providers and local authorities can work together to support people with learning disabilities. The Finding Common Purpose report they explored should give providers and commissioners a way to work together to help people with learning disabilities move back in their local areas. Workshops These three presentations created a buzz amongst delegates during the break and into the workshops. Steven Rose and Sarah Maguire of Choice Support’s workshop explored the Driving up Quality Code to improve quality in

services. Steve Strong from the National Development Team for Inclusion and Juli Carson of Choice Support delved into the Feeling Settled Toolkit which offered best practice and resources to help develop person-centred individual pathways. Sarah Beattie of Biodose shared examples of how to minimise risks of medication mistakes. Afternoon session Lisa Hopkins, Executive Director of Practice Development at Dimensions began the afternoon session with an explanation of the Dimensions model of Positive Behaviour Support and Capable Environments. It gave best practice examples of how to reduce challenging behaviours, increase the quality of life of people being supported whilst making cost savings. Lisa was followed by Duncan Astill, Partner at Mills & Reeve who explored the Mental Capacity Act and Deprivation of Liberty safeguards. This important area can be complicated so Duncan set out what providers should know to operate in their clients’ best interests. The market overview was delivered by Cirion Plant, Director at GVA who explained there is continued transfer of resources from residential care to supported living although there has been some protection for the learning disability in local authority adult social care budgets. He summarised that it was a very challenging financial climate overall especially with downward pressure on fees. Fee cuts and quality The day concluded with a panel discussion of the impact of fee cuts on quality care. Anna Galliford, Chief Executive of FitzRoy began the session with a brief explanation of her organisation’s report into short-term planning in learning disability services which wastes money. The panel then took questions from the floor. Panellists included Anna Galliford, Rosy Pope and Andrea Pope-Smith, Stewart Wallace, Strategic Director at CareTech Community Services, Steven Rose, Chief Executive of Choice Support and was chaired by Nick Johnson, Development Director at Exalon Autonomy Group. Conference Chair, Robert Chamberlain, Editor in Chief of Care Management Matters then brought the event to a close summarising that another eventful day had given all delegates much to consider and left everyone motivated to improve the lives of those they support. Special thanks to the event sponsors CareTech Community Services, GVA and Mills & Reeve for their support, plus the exhibitors who made the event possible.

44 ¦ CMM APRIL 2014

what’s on?

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WHAT S ON? Event: Date/Location: Contact:

Event: Date/Location: Contact:

March 12th and April 3rd

The Cholmondeley Room, House of Lords, Westminster, overlooking the Thames. The events are kindly hosted by Lord Clement-Jones, CBE and Lord Ribeiro Kt CBE Organised by LCS International in partnership with the Adam Smith Institute, the events bring together senior people in the private and public sectors and facilitate discussion between the NHS, Social :LY]PJLZ HUK [OL PUKLWLUKLU[ HUK ]VS\U[HY` ZLJ[VYZ VU [OL ZPNUPÄJHU[ challenges and opportunities in health and social care. These events are held against the background of important changes in health and care delivery as part of the Coalition Government’s initiatives on Integrated Care, the forthcoming change in leadership of NHS England and the recent Institute of Fiscal Studies’ joint report with the 5\ɉLSK -V\UKH[PVU VU 5/: HUK :VJPHS *HYL -\UKPUN [V Our Speakers are Baroness Brinton, Liberal and Social Democrat spokesperson on Health, Sir Richard Thompson, President of the Royal College of Physicians, Sandie Keane, President of ADASS and Ian Smith, Executive Chairman of Four Seasons Health Care. The event takes place on Thursday April 3rd between 3.30pm and 5.00pm and is kindly hosted by Lord Ribeiro Kt CBE. Full afternoon tea will be served. Delegate Price per event: £69 + VAT. To book call LCS on: 01483 773214 or email: info@lcsic.com or book via our website: www.lcsic.com

RCN Older People s Nursing conference and exhibition 2014 25th March 2014, Birmingham Royal College of Nursing, Tel: 020 7647 3580

Event: Date/Location: Contact:

Care Show Bournemouth 26/27 March 2014, Bournemouth The Care Show www.careshow.co.uk/bournemouth

Event: Date/Location: Contact:

Reforming Social Care Conference 2014 27th March 2014, Central London GovKnow, Tel: 0845 647 7000

Event: Date/Location: Contact:

Skills for Care Annual Conference 2014 27th March 2014, Birmingham Skills for Care, Tel: 0113 241 1295

Event:

Next steps for mental health policy: integration, access and public mental health 29th April 2014, Central London Westminster Health Forum, Tel: 01344 864796

Date/Location: Contact:

Event:

2014 Adam Smith Institute and LCS Health and Social Care Spring Events

ACEVO Health and Social Care Conference 2014 25th March 2014, House, London Association of Chief Executives of Voluntary Organisations, Tel: 020 7014 4615

Date/Location: Contact:

Event:

LCS and the Adam Smith Institute Health and Social Care Conference 3rd April 2014, London LCS International Consulting, Tel: 01483 773 214

Date/Location: Contact:

Improving elderly care services: funding, integration and personalisation 8th May 2014, Central London Westminster Health Forum, Tel: 01344 864796

Event: Date/Location: Contact:

The Alzheimer s Show 16-17 May 2014, London Draw Events Limited, Tel: 01892 723 195

Event: Date/Location: Contact:

Health+Care 2014 25th/26th June 2014, London Closer Still Media, www.healthpluscare.co.uk

Event: Date/Location: Contact:

The Autism Show 27th/28th June 2014, Manchester Tel: 01538 755623

CMM EVENTS Event: Date/Location: Contact:

The Transition Event 22 May 2014, Birmingham Care Choices, Tel: 01223 207770

Event:

Derbyshire and Nottinghamshire Care Conference 2014 4th June, East Midlands Care Choices, Tel: 01223 207770

Date/Location: Contact:

Please mention CMM when booking your place. CMM APRIL 2014 ¦ 45

straight talk

straight talk Stewart Wallace explores how the sector can ensure Winterbourne View never happens again. STEWART WALLACE

STRATEGIC DIRECTOR

CARETECH COMMUNITY SERVICES

The appalling events at Winterbourne View showed us just how cruel people can be while maintaining the pretence of care. Everyone in the social care world has been touched by this and I believe that we have all taken the lessons to heart.

and common accusation whenever scandals occur in privately run services. These scandals, and indeed the one at Winterbourne View may have been inﬂuenced by business considerations but we all know that at heart this is not what is wrong.

What changes do we make to ensure that this never happens again? Is it simply a matter of auditing more often, creating a quality check environment and developing a more safety conscious management regime; or do we approach this at a more fundamental level?

We need to understand much better why abuse occurs and what we as a sector can do about it. A lazy solution is to increase scrutiny. Well, ok, we certainly need to do that. Is training the answer? Maybe, but no amount of training would have prevented the cruelty we witnessed. What it may have done though is to help managers identify potentially cruel people. Managers must be brave enough to separate out those who care and those who do not.

The fact is that if managers and staﬀ cared enough about the people they support then Winterbourne would not have occurred. Care ‒ it underpins and is fundamental to what we do but it s not a term that you hear very often and those who do use the term often attract severe tutting noises from those who feel that it represents an old fashioned and uncomfortable approach. Should we apologise for caring? Well of course not, that would be just plain silly. After all, we are the caring profession and the clue is in the name. Why then has the word care become such an uncomfortable term, shunned and criticised by care professionals across the UK? We all feel warmly approving of the term support because it implies self-determination and a direct user lead. We support people because caring for them suggests paternalism overlaid by a rather patronising attitude.

Ultimately, we need to ensure that all our staff are thoroughly decent people who care about what they are doing and care about the people they are supporting. This means offering our support workers a decent living wage and that must be funded from the public purse. We need to find better ways to attract people who really understand what care means and who are enthusiastic about delivering support. Can we become more sophisticated about selection? Or as providers are we so desperate that we will take just about anyone and simply hope that they will make the grade.

So, perhaps, we should use the word care more frequently and just make sure that we are using it in the right way.

If we can find ways to attract and select the right people, our logical next step is to ensure that we tell them what their job really entails. In my travels across the provider world and in all sorts of organisations I consistently find staff who have never been guided on how to do their jobs. Yes, of course, they know the practical stuff and most have an induction. But what do they learn about active support? How much do they know about engagement and empowerment? Do they know how to have a respectful and lively discussion with someone whose powers of verbal communication are weak? Are they encouraged to use the skills, enthusiasm and experience from their private lives in the workplace? Do we show our frontline colleagues how to advocate in a way that empowers their service user or do we settle for speaking on their behalf in a way that damages self-esteem. Do we invest in shared values?

But care alone has never been enough. Some of us are old enough to recall the dreadful scandals and widespread abuse that was common in the old long-stay hospitals and in many of the long-established services run by respectable charities. No one has suggested that the problem there was about proﬁt. An hysterical

In summary then, let s recognise and celebrate the excellent work done by providers and support staﬀ while committing ourselves to universally higher standards. We should achieve this by improving the pool of support staﬀ and recruiting managers who care about more than their pay cheque.

It doesn t have to be like that. The best carers support people to achieve their aspirations and enable them to live how they choose for themselves. Many of us care deeply about this and we care about the people we support. We care about doing a good job and feel rather proud that we do. We do not care for the people we support but we do care about them and perhaps a bit more caring by the managers and staﬀ at Winterbourne View would have prevented the cruelty that we saw so graphically on our televisions.

DO YOU AGREE WITH STEWART? PLEASE EMAIL YOUR THOUGHTS TO EDITOR@CAREMANAGEMENTMATTERS.CO.UK 46 ¦ CMM APRIL 2014

Following the success of 2013 ’s event, where over 600 people attended and benefited from the conference, we’re once again bringing you…

In association with

Becoming an adult

- building the best future for young people with additional needs

Thursday 22nd May 2014 at the National Motorcycle Museum in Birmingham. (Coventry Road, Bickenhill, Solihull B92 0EJ)

To register your interest in attending, book your place or sponsor this event please contact us on 01223 207 770 or email info@progressmagazine.co.uk. The Transition Event is the one-day forum for young people with additional needs, their parents and professionals to explore the move to adulthood. Incorporating a series of main presentations, workshops, interactive sessions and an exhibition of service providers.

www.progressmagazine.co.uk/events.html

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