Care Management Matters November 2014

NOVEMBER 2014 £4.00

MAKING INTEGRATION A REALITY Starting at ground level

New care home research Ensuite provision across the UK

Dementia in homecare Best practice guidance

Business Clinic

Spotlight on...

Target Healthcare REIT

Care sector training

Includes 4-page Skills Academy insert: Focus on Leadership – WorldSkills 2014

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in this issue

IN THIS ISSUE regulars 05

editor’s welcome

I s it just me...?

Editor in Chief, Robert Chamberlain considers the new quality ratings and reflects on lessons of the past.

07

N ews

10

Corporate News

12

Local Authority and Planning News

14

Property News

28

Business Clinic

30

60 Seconds with...

39

Spotlight on...care sector training

22

Target Healthcare REIT’s activity in the market is considered by the panel.

Steve Hughes, Chief Executive of Lilian Faithfull Homes is the subject of our interview.

CMM looks at care sector training providers.

47

Conference reviews

49

What’s On?

50

Straight Talk

CMM reviews the Lancashire Care Conference and the ICG Conference.

16

Lucy Hurst-Brown explores how people with learning disabilities must become truly connected.

31

features 16

Ablution Revolution?

22

Integration in practice: Making it work at ground level

Ben Hartley analyses comprehensive research into wetroom provision in UK care homes.

Residential and homecare providers are embracing integration. Debbie Sorkin reports on how it’s working at ground level.

31

Better domiciliary care for people with dementia

October started with a bang, the new quality ratings began to be published and the Care Quality Commission released a number of announcements regarding its new inspection regime. As ever, the news pages starting on page 7 summarise what’s happened in the sector since our last issue.

Inside this month, we have an interesting research piece by Ben Hartley. Ben and the Carterwood team have researched the provision of ensuite bathrooms and wet rooms across the UK. It gives an interesting picture of the market and reinforces opportunities to develop provision.

You’ll find the results on page 16.

On page 22, Debbie Sorkin has drawn together real examples of how care providers are playing a crucial part in integration. Some providers, alongside their local care associations and other partners from health, housing and the community are making a real difference at ground level. The article gives us a lot to think about in making integration a reality. Social care no longer sits on the sidelines, we can be integral to the change and cement our place as an essential part of joining up services around the individual.

Finally, as this issue of CMM hits your desk, the finalists for the 3rd Sector Care Awards are meeting the judging panel to decide the winners. If you’d like to help us celebrate the work of the not-for-profit care sector, there are still tickets available to attend. The event will be held on 3rd December with Esther Rantzen as our host. Visit www.3rdsectorcareawards.co.uk to ensure you secure your spot at these worthwhile awards.

James Cross presents top tips to deliver quality homecare for people with dementia.

35 35

Right to work in the UK

Six months on from the Government’s new illegal working requirements, CMM looks at the changes and what you need to know.

Emma Morriss Editor

Follow CMM on Twitter @cmm_magazine CMM NOVEMBER 2014 | 3

contributors

CMM CAREMANAGEMENTMATTERS November 2014 EDITORIAL AND PRODUCTION editor@caremanagementmatters.co.uk Editor in Chief: Robert Chamberlain Editor: Emma Morriss News Editor: Des Kelly Editorial Assistant: Rebecca Northfield Design and Production: Holly Cornell, Lisa Werthmann, Jamie Harvey and Gemma Cook ADVERTISING sales@caremanagementmatters.co.uk 01223 207770 Advertising Manager: Daniel Carpenter daniel.carpenter@carechoices.co.uk National Sales Manager: Paul Leahy paul.leahy@carechoices.co.uk SUBSCRIPTIONS Non-care and support providers may be required to pay £50 per year. info@caremanagementmatters.co.uk 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 © Care Choices Ltd 2014 ISBN: 978-1-910362-23-5 CCL REF NO: CMM 11.8

editorial panel Des Kelly OBE, 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

CMM magazine is officially part of the membership entitlement of:

Zoe Farrell,

Managing Partner, Nexus Corporate Finance LLP

Training Development Director, Catalyst for Care

contributors Ben Hartley, Director, Carterwood Clare Connell, Managing Director, Connell Consulting Debbie Sorkin, National Director of Systems Leadership, Leadership Centre Erica Lockhart, Co-Chair, Care Association Alliance

Lucy Hurst-Brown, Chief Executive, Brandon Trust Paul Birley, Head of Public Sector and Healthcare, Barclays Sam Emery, Associate Director, Quill PR

ABC certified (Jan 2013 - Dec 2013) Total average net circulation per issue 15, 991

4 | CMM NOVEMBER 2014

Partner, Ridouts LLP

Andrew Barnsley,

James Cross, Area Manager, Skills for Care Publications

Mike Padgham,

Steve Hughes, Chief Executive, Lilian Faithfull Homes The Home Office

is it just me...?

Is it just me...?

Editor in Chief, Robert Chamberlain gives thought to the new Care Quality Commission (CQC) quality ratings and reflects on the lessons of the past.

By the time that you read this article, the CQC will have launched its new quality ratings for social care providers and the inspections to grade providers will have begun.

In an article from The Telegraph (12th October 2014) the CQC’s Chief Inspector Andrea Sutcliffe stated, ‘From October we will be starting to rate every adult social care service to be clear whether they are safe, caring, effective, responsive and well-led. We will identify the good and the outstanding, but we will also highlight where services require improvement or are inadequate. My first priority is to get services to improve. They need to do the job they are getting paid to do, and they need to show our inspectors that they are effectively tackling the problems. But if they don’t improve – I will make sure that CQC uses its powers to force change or take action that will lead to services closing and managers and directors being properly held to account.’

Personally, I believe that the ratings are to be welcomed but they must be well-executed.

There must be universal confidence in the methodology and outcomes to avoid the pitfalls of the Commission for Social Care Inspection (CSCI) star ratings. In particular, local authority commissioners must embrace the regulator’s new system to prevent history repeating itself. I’ve chosen a couple of examples from the past to demonstrate my point.

LOCAL AUTHORITY CONFIDENCE I recall conversations with numerous commissioning teams where there was a lack of confidence in the robustness of the CSCI’s ratings. This stemmed from

questioning the approach adopted by the former regulator, especially the frequency of inspection. Many felt that the (up to) three-year gap between inspections was too long and that the quality of care in an establishment could change dramatically in such a period, thus undermining the credibility of the ratings. As commissioners, they felt that they had a duty to the public to

‘Local authority commissioners must embrace the regulator’s new system to prevent history repeating itself.’ ensure that the care they purchased was of an appropriate quality and several councils set up their own inspection programmes to do so – many of which still exist.

Interestingly, it was common to see the contradictory outcomes when comparing the star ratings with a council’s own system. A provider rated three stars by the CSCI might be viewed as low quality following a council inspection and vice versa. As well as being confusing for care seekers, this disparity gave providers an unwelcome headache.

The CQC must gain local authority confidence if they are to see an end to this confusing duplication of effort. The planned annual CQC inspections for all providers have now been changed to every

two years for those ranked ‘outstanding’ and 18 months for those awarded ‘good’. I do wonder how commissioners will receive this approach and if it eases their original concerns.

AFFORDABLE QUALITY At our CMM conference in May, Malcolm Bower-Brown, the CQC’s Deputy Chief Inspector (Central Region) stated a belief that the new ratings would help commissioners to purchase better quality care. This was not the case during the CSCI’s reign and I remember writing to the contrary in my column many years ago.

After the introduction of star ratings in 2008 a pattern emerged that showed councils were purchasing from one star and even zero stars providers. Commissioners openly admitted that their reducing budgets could not afford two and three star services.

Therefore, only those individuals who ‘topped-up’ or self-funded could access the better quality care.

Moving forward to now, local authority budgets are even tighter than before and, with the impending funding reform, the State will be purchasing greater amounts of care than previously. The conclusion I came to in my previous column is that it will be the private contributions of the public that drive up the quality of care while cash-strapped councils reward those at the poorer end of the quality scale. Can we expect commissioning practices to be any different this time around?

If you would like to comment please email robert. chamberlain@caremanagementmatters.co.uk

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CMM NOVEMBER 2014 ­­­­­­­­­­| 5

NEWS

APPOINTMENTS APPOINTMENTS DR RHIDIAN HUGHES

• Planning • Local authority • Corporate News editor - Des Kelly CQC’s new inspection model The Care Quality Commission (CQC) has confirmed how it will regulate, inspect and rate care homes and community adult social care in England. Following extensive joint development, consultation and testing over the last 18 months, CQC has issued handbooks, which will help providers understand how they will be assessed and rated.

Specialist teams, including Experts by Experience, will inspect services, unannounced, against what matters most to the people who use them – are they safe, caring, effective, responsive to their needs, and well-led? CQC will then rate these services as ‘Outstanding’, ‘Good’, ‘Requires Improvement’ and ‘Inadequate’ giving the public clear information to help them make choices about their care.

CQC has issued one handbook covering its regulation of residential adult social care and another covering its regulation of community adult social care (including homecare services).

In response to people’s feedback during the consultation, CQC: • Will further develop its ‘Provider Information Returns’ with an online system so that care providers can submit information about their services to CQC continuously.

• Has strengthened and reduced the number of ‘key lines of enquiry’ that its inspection teams will use to guide them on their visits and reviewed their language so that they reflect current practice, do not use jargon and are fully-focused on people who use services.

• Has reviewed the descriptions of its ratings so that they are clearer and use plain English.

Also, CQC has strengthened its descriptions of ‘Outstanding’ care so that it sets a high but achievable bar and will recognise services that are innovative, creative, and dynamic.

• Will publish guidance on the use of surveillance for health and adult social care providers, as well as for members of the public, to help them make decisions about its potential use. CQC expects to publish this guidance at the end of the month.

Further information is available in CQC’s consultation response, which it published alongside the handbooks.

Variation in quality of dementia care A major review of dementia care by the Care Quality Commission (CQC) says the unacceptable gap in the quality of care means it is likely that someone living with dementia will experience poor care as they move between care homes and hospitals.

CQC inspected care in 129 care homes and 20 hospitals across England, looking at four areas: how people’s care needs were assessed; how care was planned and delivered; how providers worked together and how the quality of care was monitored.

In about 29% of care homes and 56% of hospitals inspected, CQC found assessments were not

comprehensive in identifying all of a person’s care needs. In about 34% of care homes and 42% of hospitals, CQC found aspects of variable or poor care regarding how the care met people’s mental health, emotional and social needs.

The report says the variation in how care is assessed, planned, delivered and monitored by hospitals and care homes puts people living with dementia at risk of experiencing poor care.

It found when people are admitted to hospital via A&E there is too much focus on a person’s physical health needs.

There is also poor sharing of information between health

professionals, people living with dementia in care homes and hospitals may not be able to tell staff about their pain and there is a lack of understanding and knowledge of dementia care by staff.

The report adds that supporting both the physical health and mental wellbeing of a person, as well as managing known risks such as falls and urinary tract infections, can help reduce avoidable admissions to hospital and unnecessary long stays in hospital.

The findings of the Cracks in the Pathway review are available at www.cqc.org.uk/ cracksinthepathway

Dr Rhidian Hughes has been appointed as the new Chief Executive of the Voluntary Organisations Disability Group.

OSJCT HR DIRECTOR The Orders of St John Care Trust (OSJCT) has appointed Sara Wright as HR Director.

NORTH HERTFORDSHIRE HOMES North Hertfordshire Homes has voted in a new Board made up of six independent members, three council nominees and three tenants. Martin Nurse takes up the position of Chair replacing Gordon Johnston.

THE ABBEYFIELD KENT SOCIETY The Abbeyfield Kent Society has appointed Paula Evans as its new Director of Care.

NEW DIRECTOR FOR SCIE Ewan King joins the Social Care Institute for Excellence (SCIE) as Director of Business Development and Delivery.

Ewan is responsible for ensuring the delivery of SCIE’s contracted work, attracting new commissions, and supporting coproduction with people who use services and carers.

NMC CHAIR Professor Dame Janet Finch will become the new Chair of the Nursing and Midwifery Council (NMC) on 1st January. Janet brings substantial experience to the role which she gained as Vice Chancellor of Keele University from 1995 to 2010 and subsequently, in a number of non-executive director roles.

EDEN FUTURES Sam Wellington has been appointed Quality Director for Eden Futures.

NCF WELCOMES NEW CHAIR David Coull, Chief Executive of Coverage Care Services is the new Chair of the National Care Forum (NCF). David took over from Gerald Lee, Chief Executive of St Monica Trust.

Also elected to the Board are three new directors: Christine Asbury, Chief Executive of WCS Care Group; Paul Newman, Chief Executive of Greensleeves Homes Trust and Douglas Webb, Chief Executive of Cornwall Care.

CMM NOVEMBER 2014 | 7

news

IN FOCUS CQC publishes the Key Lines of Enquiry WHAT’S THE STORY?

WHY ARE THEY NEEDED?

HOW WILL THEY BE USED?

The Care Quality Commission’s new inspection and regulation regime went live on 1st October 2014 and will lead to the award of a quality rating. CQC has developed the Key Lines of Enquiry (KLOEs) as prompts and sources of evidence as a means of answering the five key questions of a service. Is the service: safe, effective, caring, responsive and well-led? They, therefore, underpin the inspection and assessment. The KLOEs are not intended to be an exhaustive list but are designed to cover the sorts of questions that will be covered during the inspection process.

To direct the focus of the inspection, the CQC inspection teams will use a standard set of key lines of enquiry (KLOEs) that directly relate to the five key questions.

Having a standard set of KLOEs ensures consistency of what the inspector will look at under each of the five key questions and a focus on those areas that matter most. This is vital for reaching a credible, comparable rating.

To enable inspection teams to reach a rating, they will gather and record evidence in order to answer each KLOE.

The KLOE set out clearly the definitions of the five key questions.

They illustrate the potential sources of evidence that an inspector will be interested to review including: any feedback from external sources, what people receiving services have to say, what staff working in a service say, reviews of individual records and observational study.

In addition, the KLOEs include some helpful prompt questions relating to the area being considered.

Knowing what an inspector

Councils advised about care charging The Local Government Ombudsman (LGO) is advising councils that they cannot significantly change contractual funding arrangements for current care home residents because they alter the way they commission care.

The LGO is saying councils should not reduce the amount they pay for care home placements, and leave families to find the difference, where there are funding agreements already in place for a particular level of care.

The advice follows an investigation where the LGO found fault in the way Tameside Metropolitan Borough Council had acted when it changed the way it commissioned care. A man complained to the LGO that his mother, who was 80 and had dementia, had to pay significant additional costs every week to remain in the home she had lived in for the past three years.

When the council reviewed

8 | CMM NOVEMBER 2014

the way it commissioned placements, the home in which the man’s mother lived was excluded from a new quality framework, despite meeting the set criteria. As a result, the council reduced the amount paid to ‘off framework’ homes and there was a shortfall in the amount paid to the care home, which the family had to make up.

The LGO recommended the council reimburse the woman’s estate the full amount of the third party top-up payments, apologise to her son and pay him £250 in recognition of the time and trouble he has gone to in bringing the complaint. The council has also been requested to review the individual cases of other affected residents and consider whether a similar remedy is appropriate.

This applies to all affected residents placed at the same home, and any other care homes, prior to the introduction of the quality framework.

is looking for will be equally helpful for a care provider to enable them to prepare and assemble evidence.

WHAT WILL HAPPEN NEXT? The CQC has been testing the process over the summer and from 1st October 2014 every service in England will be assessed, evaluated and rated under the new regime.

This will result in an overall rating for the service.

The inspectorate has committed to rating every registered service by the end of March 2016.

BAME Leaders Programme The National Skills Academy for Social Care has developed The Moving Up – BAME Programme for Black, Asian and Minority Ethnic leaders in recognition of the importance of having a more representative leadership profile in the sector.

It is for leaders who already have experience managing services; typically service

managers, registered managers, heads of service (or equivalent) and operational managers who have the ambition and potential to progress to the most senior positions in social care.

Further information including how to apply and details of the course visit www.nsasocialcare. co.uk/programmes/moving-upbame

Updated DBS guides Disclosure and Barring Service has published a series of updated briefings around such issues as eligibility, workforce and supervision guidance.

These are DBS check – eligible positions guidance; DBS guide to eligibility; and DBS Adult workforce guidance. They can be found at www.gov.uk

Care Act resources SCIE is developing resources that will help people understand and implement the Care Act. They complement statutory regulations and support being developed by others. They include tools and

resources on assessment and eligibility materials, new advocacy duties and an online safeguarding adults guide.

They will be available at www.scie.org.uk

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corporate news

Target Healthcare REIT’s results

Cygnet acquired by UHS Cygnet Health Care has been acquired by Universal Health Services (UHS) following an exhaustive search for a new strategic partner.

UHS is the largest and most respected healthcare provider in the USA. Established for 35 years, its Behavioural Health Division operates 195 facilities in 37 states; Washington, DC; Puerto Rico; and the US Virgin Islands.

It provides comprehensive inpatient and outpatient mental

health and substance abuse services, as well as a number of specialist programmes for eating disorders, trauma, autism spectrum disorders, and neuropsychiatry services.

It also operates an Acute Care Division, providing medical and surgical services in 25 facilities.

The acquisition of Cygnet is the first of its kind by UHS outside of the Americas, and reflects the close cultural and philosophical fit between the two companies.

Bluebird Care expands global network The US parent company of Bluebird Care, one of the UK’s fastest-growing homecare providers, is set to expand with the acquisition of an Australian-based provider.

Caring Brands International Inc. acquired Just Better Care, a Sydney-based care franchise network covering the major cities in Australia. Just Better Care joins Interim Healthcare and Bluebird Care in this global network with immediate effect.

Like Bluebird Care, Just Better Care provides customers with bespoke home care packages for customers in need of services including dementia, live-in, end-of-life, palliative and elderly care.

Commenting, Bluebird Care Chairman, Paul Tarsey said, ‘We are delighted to be a part of this ambitious red ad_60 x 187_CMM:Layout

partnership of fast-growing, high-quality homecare providers. Our shared values and the importance we place on delivering tailored care packages, means that the addition of Just Better Care to the network is an excellent fit.

‘Care delivery in Australia is going through some of the significant changes that we saw in the UK a few years ago, and this presents us with a huge opportunity in this exciting and growing market.’

Just Better Care and its newly-established partners in Bluebird Care and Interim Healthcare will continue to operate as separate entities, retaining their own branding, though there will be opportunities to interact and exchange information across partnership.12:09 Page 1 1the 6/10/14

Target Healthcare REIT, the specialist investor in UK care homes, has announced its results for the period from incorporation on 22nd January 2013 to 30th June 2014.

Highlights as at 30th June 2014 include: • The company had raised £95.7 million from a combination of institutional investors, wealth managers and private investors.

• The Net Asset Value (NAV) per share as at 30th June 2014 was 94.7 pence. Share price of 104.75 pence as at 30th June 2014 represented a 10.6% premium to the NAV. • Dividends of 8.0 pence per share declared and paid in

respect of the reporting period.

• The company had invested capital in a portfolio of 17 care homes with a market value of £83.2 million and had cash balances of £17.1 million.

• On 23 June 2014, it secured a new five year £30 million term committed loan and revolving credit facility, of which £12.3 million was drawn-down at the period end.

• Since the period end the Group acquired a further six care homes, for approximately £31.5 million (including acquisition costs).

For more information on Target Healthcare REIT and its model, see Business Clinic on page 28.

Regard acquired Montreux Capital Management, the adviser to The Montreux Healthcare Fund, and Macquarie Lending (Macquarie) has announced the purchase for £119.5 million of The Regard Partnership (Regard), a learning disability care homes business with freehold real estate backing across England and Wales. The transaction closed with Montreux Capital Management taking control of Regard.

Regard provide quality residential care and supported living services to hundreds of users across more than 120 sites. The Montreux Healthcare Fund has taken a majority equity stake in Regard, bringing their significant management experience in the

care homes sector. This includes, via The Montreux Care Home Fund, the majority ownership of the ACH care homes business.

Macquarie originated the Regard transaction and developed the capital structure of the deal. Providing a bespoke unitranche loan and minority equity financing, Macquarie introduced Montreux Capital Management to the transaction resulting in a competitive offer on an accelerated timetable. A $300 million credit fund advised by Farallon Capital Europe, which is focused on lending to European mid-market borrowers, also participated in the debt facility following an introduction by Macquarie.

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corporate news

Ansel Group sold to Cambian Group Mid-market advisory firm Clearwater International has advised Ansel Group, a specialist in personality disorder services, on its sale to London Stock Exchangelisted Cambian Group.

Established in 2008, Ansel works with people with complex mental health needs and operates 24 beds from its base in Nottingham. The business works with individuals from all ages and

backgrounds, including prisoners and ex-prisoners, in an attempt to rehabilitate and reduce the likelihood of re-offending. Ansel recently reported turnover of £3.5m in the year to March 2014.

London-headquartered Cambian Group is one of the UK’s largest providers of specialist behavioural health services to both adults and children. Established in 2004, the company has grown

New Signature community GB Building Solutions has been awarded a fourth contract by Signature Senior Lifestyle to build a £13m care home in Sunninghill, Berkshire.

Signature currently operates seven senior care communities.

This latest contract is part of Signature’s £250m plan to develop further communities in London and the Home Counties.

GB Building Solutions has worked closely with Signature on new care home developments

worth a total of £34m in Epsom, Coombe and Marlow.

Sunninghill Care Home will feature 69 private apartments that vary from studios to one bedroom suites. There will be 24 dementia suites, designed to offer support for individuals requiring specialist dementia care. The home will include a cinema room, hair salon, therapy room, and a restaurant with private dining facilities and will open its doors to residents during winter 2015.

rapidly, currently employing 6,000 staff across its 250 facilities. It works alongside 140 UK public authorities and offers services to almost 2,500 people. Cambian has performed strongly since listing on the LSE and has a market cap of more than £385m.

The acquisition of Ansel will enable Cambian to strengthen its offering in the East Midlands, while providing access to Ansel’s

cutting edge Nottingham clinic.

The deal also provides the opportunity for Ansel to get in touch with a greater number of patients and extend its knowledge and client base further.

Clearwater International’s healthcare team including partner Marcus Archer, director Ramesh Jassal and associate director Helen Lowe, advised Ansel on the transaction.

Support grows for care farm Cultivating confidence was the aim of the day when local families were invited to visit a North London care farm, to take part in a variety of guided activities. Young people and adults with a range of care and support needs attended the open day at SweetTree Fields in Mill Hill.

As a care farm, SweetTree Fields has been specially designed to create positive experiences within a safe,

nurturing and social environment. It offers activities ranging from gardening and horticulture, to woodwork and animal care, suitable for people of all ages and abilities.

The open day was hosted by the learning disabilities team from SweetTree Home Care Services, who provide tailored support at home and in the community for people with learning disabilities, autism and complex behavioural needs.

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local authority and planning news

Eleanor Care in West London Homecare provider Eleanor Care has secured a new contract to provide services to five boroughs in West London. Eleanor Care was successful in three tenders to provide homecare, reablement care and enhanced home-based care services to the elderly and disabled in Brent, Ealing, Hounslow, Harrow and Barnet.

The company which operates

throughout London and its outskirts and Poole, Dorset, has its headquarters in Lewisham and provides homecare, live-in support workers, nursing, palliative care, and respite services. Commencing from 1st October, the contract will also see the care company recruit new staff from the local communities where they will operate.

New adult care service opens in Hartlepool Danshell is investing in a new adult residential service in Hartlepool. Hope House provides six bespoke, selfcontained flats, each with ensuite facilities, kitchenette and separate lounge areas for adults with learning difficulties.

The new service was planned in close partnership with the local NHS Health Commissioner and Hartlepool Borough Council to configure the care to meet the

12 | CMM NOVEMBER 2014

needs of the area. Three service users will move into Hope House over the coming months and they, and their carers, have been involved in the layout, furnishing and design of their flats to create personal, bespoke facilities. The service will continue to work closely with Hartlepool Borough Council and existing community learning disability services, which will be providing multidisciplinary support.

Building work commences in Derby Building work has commenced on a pioneering facility dedicated to the care of young adults with acquired brain injuries or complex disabilities in Derby. Due to open early next year, the ÂŁ1.5m development named Nightingale Home is the latest facility to be launched by Progress Care Solutions.

The period Victorian property is a former private nursing and midwifery hospital and later a Macmillan unit in the city centre.

It is undergoing extensive internal renovations to create a luxury home offering residential and respite services for clients with complex needs.

Boasting eight individually designed residential suites and four respite bedrooms, the rooms will be adapted for each client to create a bespoke home-fromhome feel. Nightingale Home will also have two spacious communal areas, a state-of-the-art sensory room and hydrotherapy facilities.

Buckinghamshire home opens Up to 50 new jobs are to be created in Buckinghamshire following the opening of a new luxury care home. Buckingham House, in Gerrards Cross, provides nursing, dementia and residential care and is the latest care home launched by Maria Mallaband Care Group (MMCG).

Facilities at the home include a cafĂŠ, dining rooms and spa, as well as landscaped gardens.

A dozen residents have already signed up to live at the 53-bed home. The Group has recently opened homes in Bath and Dorset and will introduce a further three in Canterbury, Bicester and Surrey in the coming months.

local authority and planning news

City West extra care in Salford £8m care home plan for Housing Fund.

City West Housing Trust has Shrewsbury Amblecote Gardens will launched a new extra care facility that will change the way health and housing services are delivered to vulnerable people in Salford. Amblecote Gardens in Little Hulton has been designed to help to build better relationships between vulnerable residents, essential care and wellbeing services and the wider community.

The facility is the first extra care scheme to be built in Salford since 2009, and is the first in the country to be developed using the new Care and Support Specialised

provide 66 apartments and has been built using £1.45m of funding from the Department of Health and the Homes and Communities Agency.

The facility will be surrounded by a mix of more than 100 new family homes, putting it at the heart of a newly created community and giving residents easy access to key facilities such as shops, a library, GP services, and a pharmacy, while also ensuring they can draw on the support of neighbours when necessary.

A new care home with nursing facilities is being planned for Shrewsbury by Coverage Care.

The company has applied for full planning permission for the 90-bed home on land occupied by a former Territorial Army centre.

The proposed £8m project is the latest in a series of new build care home developments by the company in Shropshire over the last four years.

If granted planning permission, Coverage Care’s Shrewsbury home is destined

for a 2016 opening and is expected to employ more than 120 staff.

The proposed new home will have 90 large en-suite bedrooms over two floors, with a third storey frontage as part of the overall design, and two wings on each floor, each with its own lounge and dining area, sharing communal rooms and a private garden area to the rear of the building.

It will be Coverage Care’s third collaboration with Castlemead Group.

Richmond Villages in Derbyshire Richmond Villages has released details of its seventh village, to be built at Aston-on-Trent, Derbyshire. Once complete it will provide 125 homes for those over 55, and an additional 60 care home beds.

The development follows

ICH0002-0814-UK-AD-HALFPG-V4.indd 1

the company’s acquisition by Bupa last year, and the success of its other new villages, Letcombe Regis in Oxfordshire, Painswick in Gloucestershire and Northampton. The new retirement village will occupy the site of the former hospital.

The new £30 million Richmond Aston-on-Trent will be within easy reach of the M1 and some seven miles south east of Derby.

It will initially comprise 47 Village apartments offering an independent lifestyle - one and two bedroom apartments (with

the average size of a two bed being 1,100 sq.ft), 30 Village suites (one and two bedroom) which come with a ‘hotel style’ package to help with all daily chores, and a care home providing nursing and dementia care.

10/08/14 11:48 AM

CMM NOVEMBER 2014 | 13

property news

CMG acquires Starr Care Carterwood has successfully acquired Starr Care, a domiciliary care provider based in Surrey, on behalf of Care Management Group (CMG).

Starr Care, has provided homecare and support services since 2000. It was owned and founded by Nigel Sibley and has a team of 35 care and support

Woodstock nursing home sold

workers.

Garry Fitton, Financial Director at CMG commented on the acquisition, ‘As part of our expansion and acquisition strategy Starr Care fits very well with our future growth plans. We were delighted with the approach Carterwood took to fulfil our brief and the short timescales involved.’

GVA’s sales with nursing was registered for 66. The new owner is Clactonbased Elder Homes Group. It has 13 homes plus a day care centre and independent living facilities.

GVA, acting for Joint Administrators David Riley of Grant Thornton, has sold Harmony Care Limited and Brooklands Nursing Homes.

The purpose-built care home

Belong Warrington opens Belong Warrington, a new £9.5m care village, is now open on Loushers Lane, Warrington.

Facilities include a bistro, hair salon, exercise studio, function rooms and therapy rooms, all of which are open to members of the wider community as well as people living within the village.

Care services, including homecare, Experience Days (day care centred in the village amenities) and an Admiral Nurse service, are all operated from Belong Warrington.

Designed by Manchester and London based architects,

Pozzoni, a specialist in ‘personal architecture’ and designing for the needs of older people, the new care village was built by the Warrington-based Cruden Construction. Belong Warrington is the fifth community care village to open in the North West, following in the footsteps of successful sites in Macclesfield, Crewe, Wigan and Atherton.

The village households are specialist care settings, providing 24-hour care, including nursing and dementia care. The village also has 18 apartments where people can live independently.

The Bristol office of Christie + Co has sold Woodstock Nursing Home in Gloucester to Coate Water Care. Acting on behalf of Millie and John Barnes, who had operated the business for over 28 years, Christie + Co received a strong level of interest in the 28 bedroom nursing home. The care home, renowned locally for its excellent level of care and

dedicated staff team, caters for older people with a dementia diagnosis who need nursing care.

Woodstock also specialises in end of life care.

The acquisition of Woodstock brings the number of care homes owned by Coate Water to seven, and complements the recently opened Chapel House Care Centre in Gloucester.

Lloyds funds Devon purchase A couple from Devon have invested in a care home, securing the jobs of its 21 members of staff and continuing care for the elderly, with the support of Lloyds Bank Commercial Banking.

Court House Residential Home in Cullompton can accommodate 23 residents and was bought by Lorna Turner and Marcus Lyward with the support of a £598,000 loan after the previous owner decided to focus on business interests elsewhere.

As the care home is near full-capacity, the purchase has enabled the residents to keep their home, and the couple are now planning to hire additional staff over the coming months.

Lorna will be looking after the finances of Court House while Marcus, who has more than 25 years’ experience in the care sector and previously owned a residential home for the elderly specialising in dementia care in Cornwall, will oversee the care of its residents.

Although Court House is registered to provide accommodation and care for the elderly, Lorna and Marcus are looking to explore care for those with dementia.

The home features an extension that meets the needs of its residents and encourages those staying to take part in a wide range of social activities and engage with the local community.

Springfield Healthcare to open supported living Springfield Healthcare is set to open a new £800,000 supported living development in Hartlepool. The ‘Pathways to Independence, Independent Supported Living Scheme’ facility comprises five, twobedroom apartments and a further single bedroom

apartment, along with a ground floor drop-in centre with a TV area and kitchen facilities, and staff available 24-hours a day. Located close to shops and amenities, it provides a halfway step for young people, preparing them for living independently in the

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two businesses within the Springfield Healthcare Group in 2012: Springfield Homecare and Seacroft Care Village.

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CMM NOVEMBER 2014 | 15

Ablution Revolution?

A Comprehensive Research Study into Wetroom Provision in UK Care Homes Ben Hartley analyses the provision of ensuites and wetrooms in UK care homes and draws some interesting conclusions.

16 | CMM NOVEMBER 2014

It is said that, apart from death and taxes, the only certainty in life is change - a truism, for sure, but one that warrants some reflection when we consider how society thinks about the way we care for our older people, and particularly in relation to residential settings.

Before launching into the research I’d like to draw comparisons with the hotel and guesthouse sector. It’s not that long ago that ensuite bathrooms in hotels and guesthouses were a dream for the future. Today, they’re as standard as the beds in the room.

Residential care for older people though might not be keeping up with the ablution revolution, which was our starting point in deciding that there needed to be some in-depth work to establish the current position.

We embarked upon a thorough and extensive research project, carrying out a comprehensive survey over six months involving more than 6,000 telephone interviews. It reveals a very interesting picture. The research includes data from the whole of the UK and

comprises information from private, not-for-profit, local authority and some NHS care homes.

Where we were unable to contact a care home directly, we made a number of assumptions based on data from other sources including the A-Z Care Homes Guide and the Care Quality Commission. The principles of what we did and why are relatively easy to convey. The detail, however, is trickier and, unless you are a stats lover, a little less inspiring.

DEFINITIONS For the purpose of this research, we describe an ensuite bedroom as one where there is at least a WC and wash hand basin. Such a room may also provide, though this is not a requirement for the purposes of our definition, a shower cubicle, bath or wetroom.

By contrast, our definition of a bedroom with an ensuite

wetroom is one where there is a full wetroom, i.e. a walk-in shower complete with level access as well as the WC and wash hand basin.

In effect, this is a subset of the ensuite bedroom provision – simply characterised by a higher level of facility.

HEADLINE RESULTS We know that care homes aren’t keeping pace with the rate of change witnessed in hotel stock, however, although we knew that provision was more limited, the findings have shown an even bigger gap in provision than anticipated.

Very few groups operate 100 per cent wetroom provision – Porthaven, St Monica’s Trust and Belong are examples. Of those operating over 2,000 bedspaces, Ideal Care Homes and Sunrise Senior Living performed best with 95 per cent, highlighting the direction of travel here.

g

CMM NOVEMBER 2014 | 17

ablution revolution?

g

Our hypothesis was never going to be one-sided. We knew that there was still a large segment of the sector where wetrooms are not provided, but it is the full extent of this quality gap – if I can call it that – that wasn’t apparent before we undertook the research.

Another factor we did not see was the extent to which the national average masks some considerable variation amongst the regions. I hope this research might provide operators with some useful guidance as to where opportunities for improvement exist.

DRILLING DOWN The first interesting result shows that in the UK, the overall provision of wetrooms in our care homes is approximately 14 per cent of total registered capacity, although, as alluded to above, this varies enormously from county to county, town to town and country to country when analysed in detail.

As can be seen in Figure 1, Scotland has the highest provision of wetrooms overall with 19 per cent. This is compared with Wales, which has the lowest provision at 5 per cent, England with 14 per cent and Northern Ireland with 10 per cent.

The number of ensuite bedrooms also varies from country to country, with Scotland again delivering the highest proportion of 75 per cent, considerably higher than the national average of 62 per cent. Northern Ireland has the lowest ensuite provision at 34 per cent, Wales has 44 per cent and England delivers a 63 per cent provision.

are highest. This is reflective of strong competition for land for alternative forms of development, which has restricted new build care developments over the past few decades.

• Both the North East and North West have low provisions of 8 per cent and 7 per cent respectively. Regional average house prices of £138,582 and £156,362 respectively have meant that in recent years, other parts of the country, which can attract private fee paying clients, have been more appealing for development.

Even if homes in these areas that achieve acceptable occupancy levels were re-configured to offer ensuite wetrooms, they would only gain modest fee increases of £10 to £20, which would not warrant the additional investment. There was a spate of new development in the North East in the 1980s and 1990s, accounting for the large proportion of ensuites, but it seems that providing wetrooms was not necessarily a requirement at that time; and that basic ensuites were only just coming to the fore of client requirements.

Figure 2 – Government Office Regions in England – Wetroom Provision

Figure 1 – Percentage of Ensuite Bedrooms and Wetroom Bedrooms by Country

Figure 3 – Government Office Regions in England – Ensuite Provision

When this is broken down further by Government Office Regions (GOR), (Figures 2 and 3) there is a wide differential from region to region. The disparities are due to issues such as wealth, population density, the number of new build developments and regional planning policies.

Some key points to note include: • The largest wetroom provision in England is in the South East at 19 per cent. This is driven by a number of factors, the average house price exceeding £285,000 and high population density being the main determinants. There is a high correlation between house prices and the fee levels achieved within care homes at a regional level, so those homes built in highly affluent areas can justify higher specification care homes. London has a 14 per cent provision, which is significantly lower than the surrounding area, even though average London house prices 18 | CMM NOVEMBER 2014

When reviewing the overall UK data, the maps (Figures 4 and 5 overleaf) demonstrate clearly that Scotland has the highest percentage of both ensuite and wetroom provision.

Scotland also has the highest percentage of local authority homes with ensuite wetrooms. In addition, the standardised baseline fee rates across the whole of Scotland have made it attractive to developers and operators in comparison with other parts of the country, which have seen reductions or a freeze in baseline fee rates.

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ablution revolution?

Figure 4 – % Ensuite provision by GOR

We do not see provision of ensuite wetrooms increasing significantly in areas such as the North East and North West of England, unless there is an increase in baseline fee rates, which given the current local authority constraints is unlikely.

There is also an increase in the number of operators looking to reconfigure existing accommodation to incorporate wetrooms. Much of this comes from operators with fewer than five homes, offering a very high standard of personalised care, who consider that providing an ensuite wetroom will ensure their services are fit for purpose.

Figure 6 – % of new beds built with wetroom facilities by year, 1993-2013

Figure 5 – % Wetroom provision by GOR

Analysing this further, we looked at historic building data over the last 20 years. The results in Figure 6 show a large increase in wetroom provision from 2002 (with a slight dip in 2004 and 2009) until 2013. From 10 per cent in 2002, this has increased significantly to 70 per cent of all new builds in 2013; a 60 per cent increase in 11 years. We anticipate the proportion of wetroom beds to increase further over the coming years to fulfil market and consumer expectations.

POST TOWNS Our research enables us to drill down to the individual settlement, and the local disparities are particularly noticeable at this level. Only 13 post towns in the UK have a 100 per cent wetroom provision, with some 612 postal towns having no wetroom provision whatsoever.

CONCLUSION

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FUTURE TRENDS

According to the research, it appears that new builds increasingly contain, or are set to contain, wetroom facilities. In the last three years, over 95 per cent of proposed elderly care homes for which we undertook feasibility studies have incorporated wetrooms in their design. We anticipate that this trend will continue. We are also seeing the size of wetrooms increase. Five years ago wetrooms were in the order of 2.5 sq. m, but this has now increased to 3.5 to 4+ sq. m.

20 | CMM NOVEMBER 2014

The levels of wetroom provision are probably lower than most of us expected, but they conclusively reinforce the opportunity for developers and operators to develop this important feature in future care homes. This will improve the living standards of all those who occupy them.

As for those providers that operate facilities without ensuite wetrooms consider this: every March and September many are struck by the number of newly-registered cars on the road.

However, there are a larger number of older vehicles that continue to transport their owners successfully from A to B. Whilst most of us would like the newest cars with the flashiest gadgets, what ultimately matters is the roadworthiness of the vehicle we are driving.

Physical facilities matter in care homes, but it is the quality of care on offer that will always be the most important factor.

CMM Ben Hartley is Director at Carterwood. Ben.hartley@carterwood.co.uk

CMM NOVEMBER 2014 | 21

Integration

in practice

Making it work at ground level

Debbie Sorkin reports on how residential and homecare providers are engaging with the integration agenda and developing their own services as a result.

22 | CMM NOVEMBER 2014

Integration is at the heart of the Care Act and local authorities are in the midst of preparing for the changes that will start to take effect in April 2015, when their duty to provide advice and information on a broad range of social care issues will formally come into force. Integration has also been at the core of the recent revised bids to the Better Care Fund, the results of which have now been announced by the Department of Health.

At the same time as this activity has been taking place, there has been a quiet revolution – not widely reported – happening on the ground. Many care providers around the country have taken a leading role in engaging with the integration agenda. It has been heartening to see social care not only at the table but reaping real rewards as a result. In part, this has been through social care making its case and getting the message across that the interrelationship between health and social care is so strong that a) if it’s a social care issue, it’s also a health issue – if not immediately, then in the future; and b) social care can be part of the solution to healthcare issues, whether these are to do with discharge from hospital or with ways to prevent people ending up at the door of A&E in the first place.

INTEGRATION IN PRACTICE These are just some of the examples that I’ve come across in recent months – and I’m sure there are many more.

In Wiltshire, the Systems Resilience Group, which meets monthly, comprises representatives from organisations involved in health and care services across the county.

Alongside people from the clinical commissioning groups (CCGs), NHS trusts, emergency services and the local authority, there are representatives from residential care – through Care UK – and homecare, through a consortium of providers including Mears, Somerset Care, MiHomecare and Leonard Cheshire.

Through support from the local authority and others involved in the Group, some homecare providers are starting to offer their staff guaranteed salaries, contracts of employment and pensions, deliberately moving away from zero-hours contracts and minimum levels of pay. They can do this because the system as a whole has recognised the value of what homecare providers can do, and has been prepared to back this with funding. The issue facing homecare providers in the area is now how to recruit and retain people with the right values, to meet additional demand – they are currently looking at around 30 new customers every week.

Related issues around the social care workforce are at the heart of integration projects in other parts of the country. In Waverley, Surrey, there is a new project supported through the national Systems Leadership – Local Vision initiative that I wrote about in CMM September. Waverley Health and Wellbeing Partnership is undertaking pioneering work to increase the supply of high quality care workers in the local area, with the requisite skills to work in the new integrated health and care economy, and to keep the supply at a sustainable level.

These challenges are particularly acute in Waverley, due not only to its demographic profile, but also to local issues including relatively high costs of housing, relatively high average local wages, high employment rates (and hence competition for good people), and the rural nature of

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CMM NOVEMBER 2014 | 23

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integration in practice making it work at ground level

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the borough. The project looks to tackle multiple issues through a wide-ranging collaboration. Crucially, its partners include care providers, via Surrey Care Association, and a well-known local residential care provider, Birtley House.

The local Health and Wellbeing Board is also supporting the project, alongside the local authority, local CCGs, hospital trusts and housing associations. Again, social care providers will be at the heart of the work and will reap the benefits from having high-quality care professionals who will stay to create careers in the sector.

If you are a care provider – whether in the private or the not-for-profit sectors, whatever your client group; and whether you support self-funders or obtain funding from local authorities – you should start thinking about making links with your local CCGs and other system-wide bodies, if you haven’t already done so.

WORKING WITH HEALTH You can also go directly to healthcare. In Shropshire, a group of care providers under Shropshire Partners in Care, including Marches Care and Coverage Care, came together with local NHS foundation trusts in a series of development days to look at how they could work together in a more integrated way.

The first day alone saw practical examples of jointworking identified and acted upon. One individual was transferred the same day from a hospital to a care home.

Funding was identified to enable GPs to go into care homes – without charging fees – with a view to preventing residents, on a systematic basis, from having to be admitted to hospital. For the first time, local care providers have been invited to take part in planning for winter pressures.

These examples are currently being written up as a case study, and the lessons – as with the work in Waverley – should be transferable to other parts of the country.

Care providers involved with older people have been particularly involved in working with healthcare and other partners to create better services for people with dementia.

In Hertfordshire, a new Systems Leadership – Local Vision project is underway. The lead bidder for the project was Hertfordshire Care Providers Association (HCPA), working in conjunction with Hertfordshire County Council, local CCGs and the Health and Wellbeing Board, alongside Crossroads Care. The aim is to provide a holistic approach for individuals living with dementia in their own homes. HCPA’s homecare providers will be central to the work, which will include improved access to, and contribution to the design of local services, better support for carers and the strengthening of relationships between volunteers and the local community.

Similarly, in Brent, care providers in the Brent Dementia Action Alliance are involved in a wide-ranging Systems Leadership – Local Vision programme to ensure not only that families and care providers are better able to support people with dementia, but also that universal services, such as public transport, respond better to people’s needs and that private sector companies know how to respond. For example, local supermarkets will be encouraged to think about how they can make shopping easier for people with dementia. In Birmingham, residential

and homecare providers are part of the ‘ring of confidence’ being built around people with dementia and their families, as part of their ‘Healthy Villages’ initiative.

WELLBEING INITIATIVES Social care providers are part of broader wellbeing initiatives, drawing on their role as community hubs. In Kent, providers such as Greensleeves took part in open space events and were included as part of the County’s Better Care Fund bid. In Nottingham, residential and homecare providers have been part of a new Multi-Agency Safeguarding Hub established to produce a better, faster and more integrated safeguarding service for adults and children. In Coventry, care provider membership organisations including Care England, the National Care Forum and the UK Homecare Association have promoted a Local Vision initiative to increase levels of physical activity in the city, rolling it out to care homes so they can involve their own residents. Finally, in Cornwall, local care providers have been involved in a countywide programme to reduce food poverty and ensure that no-one in Cornwall goes hungry.

KEY MESSAGES There are numerous opportunities for care homes and homecare providers to get involved and a number of key messages keep coming across: 1. Engage with your local CCG(s) and other system-wide groups.

2. Work with your local care association if they are involved in discussions around integrated services.

3. Social care has long been a source of innovation and community links – don’t be nervous about bringing your ideas to the table.

4. Think about developing your staff teams to work across systems and sectors. Collaborative skills are becoming more and more essential.

5. Make connections with local partners and build relationships. Getting things done depends more on relationships, trust and commitment, and less on formal structures.

6. See yourselves as part of the collective leadership of the system, as well as leaders in your own services and organisations.

Over the coming months, there will be more funded Systems Leadership – Local Vision projects around the country, as the Leadership Centre works with NHS Leadership Academy Local Development Partners and others to support the spread of systems-wide working.

Again, we’d welcome applications with social care providers at the helm.

CMM Further information www.localleadership.gov.uk/place/lvinvitation/ Debbie Sorkin is National Director of Systems Leadership at the Leadership Centre. Debbie.sorkin@localleadership.gov.uk

CMM NOVEMBER 2014 | 25

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CMM NOVEMBER 2014 | 27

business clinic

TARGET HEALTHCARE REIT’S IMPACT

In just 18 months, Target Healthcare REIT has made a real impact on the sector, reigniting the sale and leaseback model, investing all its initial funds and now raising more.

Target Healthcare REIT Ltd (Target) was launched in March 2013 with the remit to invest in UK care homes and other healthcare assets. The London Stock Exchange defines a Real Estate Investment Trust (REIT) as a single company REIT or a group REIT that owns and manages property on behalf of shareholders. The company’s concept is, ‘to bring much needed investment into the elderly care sector to improve the quality of the lives of the growing numbers of vulnerable elderly members of society, because life is precious.

‘We know from our personal experiences that care is a 24/7 vocation and that, done properly, can significantly enhance the quality of lives of those whose acuity of needs require residential care. We invest significant time in understanding the culture of healthcare providers and choose to invest in only those whose values are consistent with our own.

‘There is a sound underlying commercial benefit from this approach. Care homes with excellent care standards tend to perform much more profitably than those that don’t.

Investment in maintaining the quality of the

facilities and training of staff is reflected in the bottom line.

‘We are focused on behaving ethically; we always act with integrity; we place diligence at the heart of our business; we perform detailed analysis; we are genuinely passionate about what we do.’

WHO IS BEHIND TARGET? The team is very experienced in the sector.

The board comprises six non-executive directors and an independent investment manager, Target Advisers. Chairman Malcolm Naish has over 40 years’ experience in the real estate industry. He is a chartered surveyor and has been involved in investment management for many years. One of the Non-Executive Directors is Professor June Andrews, Director of the Dementia Services Development Centre at the University of Stirling. The Centre is a world-leader for dementia care home design and Professor Andrews is a world-renowned dementia specialist.

The company’s investment manager, Target Advisers was established in 2010 by

its Managing Partner, Kenneth MacKenzie.

Mr MacKenzie is an experienced care sector professional who built up and developed Scotland’s largest home care company, Independent Living Services.

INVESTMENT STRATEGY When it was launched, Target set out its targeted investment strategy focusing on building a portfolio of predominantly residential and nursing care home properties in the UK. The investment manager is responsible for sourcing suitable acquisition opportunities. Properties are high quality, modern purpose-built buildings, located in well-researched areas that have sufficient, sustainable demand for places and an ability to maximise private pay clients.

These high quality properties must also have equally high quality care and support too. Businesses must be run by experienced operators, offering high standards of care that meets Care Quality Commission outcomes and are, therefore, sustainable businesses over the longer term.

A good time for the REITs to be investing

The model will have a short life

Paul Birley Head of Public Sector and Healthcare Barclays

Erica Lockhart Co-Chair Care Association Alliance

Sale and leaseback is a tried and tested method of funding care homes. It provides an alternative to traditional bank debt for operators who wish to expand, who perhaps don’t have the necessary capital stake that is required for securing bank finance. The obvious downside is that the operator won’t benefit from any increase in capital value of the home, however they will get additional operating profits which in turn could help them provide their stake for further expansion.

The sector has also seen a number of overseas REITs (particularly from the USA) entering the market. This will make the market more competitive which should be good for operators, although it may drive the returns down a little for Target and the other REITs. The model is relatively simple in that they attract funds and then invest in care homes to get a higher return.

The issue that could arise is operator failure and with Target

28 | CMM NOVEMBER 2014

only investing in homes that are well located with sustainable demand for places, even in this scenario it should be possible to find another operator who could run the home with little disruption to the rental payments. The issue with some recent operator failures was that some of the homes were over-rented and this meant that in their demise, landlords had to take rent cuts. The key will be what happens if market rentals start to fall and Target suffer an operator failure – will they be able to replace with someone that can pay the same rental? Target will also need to ensure the homes remain fit for the future and, therefore, require a minimum level of capital expenditure to ensure the homes remain in demand.

Target, therefore, offer a good alternative to bank financing.

Healthcare is, and has always been, a cyclical market and now appears to be a good time for the REITs to be investing.

Investment in the sector is welcomed, as is the choice of investment routes for providers.

This route of financing is potentially a high-risk strategy, but could be the right option for some providers who would benefit from the opportunity to release money from their business but still want to continue with the operating side. It would mean the operator would be more highly-leveraged than through normal bank debt, but sometimes ‘needs must’ and in those circumstances it could, therefore, be a positive choice.

The approach described does nothing to imbue confidence in the model since it depends heavily on the self-funder market but does not address the impact on the model of the interference caused by Dilnot and the Care Act 2014. In view of this, it is not possible to draw any confident conclusions as to the sustainability of the model

going forward and particularly once Dilnot begins to bite, which could take two or three years.

The model depends heavily on property values. These are beginning to rise now that confidence is building in the economy and it is inevitable that rents will increase with the strength of the economy. This is essential for the model to work.

The model concentrates on high-value youthful stock. Again, to maintain the credibility of the model, the stock will need to be turned over as it ages and could, out of necessity, be sold on at below cost prices.

Our overall view is that the model will have a short life.

Timing is of the essence, get the timing right and operators could do well with this model, get it wrong and an operator by losing their freehold could risk any long-term security and future business.

business clinic

THE PORTFOLIO The company currently owns properties which are leased back to operators, typically over a term of 35 years. Current operators are Balhousie Care, Ideal Carehomes, Orchard Care Homes, Care Concern Group, Bondcare and Priory Group. The company has also recently exchanged contracts on an additional 80 bed, modern purpose-built care home in Hastings, Kent.

The majority of the properties in the portfolio were built between 2010 and 2014, with some dating back to 2006. According to the company’s results released on 8th October, the portfolio, at 30th June had a market value of £83.2 million with an annual running yield of 7.58 per cent. Since that date the company has added six further purpose-built facilities to the portfolio for a total consideration of approximately £31.5 million plus a new property in Hastings for approximately £8 million.

SALE AND LEASEBACK The model is not new, it is reigniting sale and leaseback. Selling off the property assets to release equity, then leasing it back over the long-term whilst operating the business has been very common in the sector and seen as an alternative to bank financing. Care home

providers have great assets in their buildings and selling the property to lease it back over the long-term is a way to release equity to grow or develop.

However, it’s not without its controversy.

Most recently it was the model which saw Southern Cross struggle to meet its rent obligations in light of reduced fees from local authorities who purchased the majority of its beds, eventually leading to its demise. The model received a lot of bad press at the time.

However, Southern Cross was a different company to those Target invests in. Target focuses on high-quality, new stock and seeks to maintain an appropriate proportion of private fee paying residents to local authority funded residents via its investment strategy. Southern Cross had a large supply of older stock, many homes competed with others locally and were heavily reliant on local authority placements. Target, via its investment manager Target Advisers, also focuses heavily during the investment period in ensuring the rents are set at sustainable levels over the long-term.

INVESTING FURTHER In the 18 months since its launch, Target has invested all of its initial funds. In early September it announced it would issue up to 100 million New Shares, including up

A positive development Clare Connell Managing Director Connell Consulting The entrance of the REITs to the care home market has been a positive development which could improve quality in the sector, particularly for private pay elderly care. However, there is currently a shortage of elderly care homes suitable for the private pay market and in the right catchment areas to interest the REITs. Currently there are care homes for the elderly being sold for 10 times EBITDA (excluding head office costs). Valuations like these do suggest a return to the heady days of 2007 when they were commonplace.

It is difficult to see how such valuations can work long-term for investors and operators. High rents for operators are a particular burden for care homes that cater for older people who are local authority funded. The rates paid by local authorities are low, margins are tight and cost control is difficult when the Care Quality

to 50 million New Shares under an Initial Placing and Offer. It intends invest these net proceeds within five to eight months.

According to Chairman Malcolm Naish’s introduction to the company’s results, ‘In September, the company raised gross proceeds of £17.4 million following the issue of 17.2 million further shares.’ Under the 12 month placing programme, the company expects to issue further shares to fund acquisitions as opportunities arise.

In the announcement relating to the Hastings acquisition, Investment Manager Kenneth MacKenzie said, ‘We have a number of other deals with both regional and national operators in advanced non-binding legal negotiations, and we expect to make further announcements soon.’

CMM

Over to the experts...

There is clearly a market for Target Healthcare REIT to invest in and an appetite for the model it backs. The market is seeing property prices and demographics rise whilst private pay clients are demanding excellent care in high quality surroundings. Is this the return to the boom?

Is the sale and leaseback model sustainable?

Is it a real alternative to bank financing? Will it drive up quality or increase the divide between private-pay and local authority funded placements? What do our experts think?

ELECTRICITY OR GAS TOO DEAR?

Commission has increasingly high expectations to be met, including the home environment and regular refurbishments.

Whilst private pay rates for elderly care are more generous, it is a competitive market and the opening of new homes in the local area can increase pressure on care home occupancy and increase costs as customer expectations for what a private pay care home looks like and services it offers increases.

When I have visited some high-end private pay homes recently, it is clear the standard of décor and restaurant service in the dining rooms is much more sophisticated than it was 10 years ago, which does increase costs.

A difficult scenario for a care home provider is when they experience a drop in private pay admissions and have to start accepting local authority funded clients to fill beds and their margins are really hit.

As energy brokers, we deal with a wide range of suppliers and can usually tell you in just a few minutes where the best deal is for you.

There’s no obligation and no charge. We can remind you when it’s time to give notice and help with recouping levies that, as a Care Home, you may have been charged in error.

Call us on 01606 334949 and when it’s time to renew your gas or electricity contract, we will search the market for you.

ces

Cisco Energy Services Energy Brokerage and Consultancy Francis and Karalee Charnock T: 01606 334949 E: francis.charnock@ciscoenergyservices.com

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CMM NOVEMBER 2014 | 29

60 seconds with...

PHSC

Health & safety consultancy and training specialists

60

SECONDS WITH...

STEVE HUGHES Steve Hughes is Chief Executive of Lilian Faithfull Homes which operates four care homes in the centre of Cheltenham with 210 residents and 260 staff.

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WHAT IS YOUR BACKGROUND? I’ve been in post for six years, before that I was Business Services Director for Pegasus Retirement Homes. My background is business, IT, HR and marketing. I’ve been a non-executive director of the Institute of Directors (IoD) and I’m a Chartered Marketer. When I left Pegasus I wanted to make a difference, do something for social good and move into the charity sector. I saw this role advertised and applied. It’s quite a small team here at Lilian Faithfull so I’m involved in lots of things from relatives’ enquires to overseeing building projects, CQC paperwork, staffing issues and marketing.

WHAT ARE YOUR THOUGHTS ON THE CARE ACT? I wish for some stability in the sector but that is never going to happen. The Care Act is well intentioned and some aspects of it are very positive, including the work around wellbeing and prevention. I think the new care ratings are vital and the change of inspection emphasis is welcomed.

We were part of the pilot for this.

The increased transparency and openness are great for the sector too.

I am, however, concerned about implementation of the funding reforms. Lots of work is needed on how they will be implemented. The financing of the Care Act is also a real concern. As a charity we work hard to ensure people are able to remain in our care homes if their funding runs out. Our fees are slightly lower

than market rate and this means that self-funding residents aren’t subsidising local authority rates.

It important to clearly explore the way that care costs versus hotel costs will work as there is no doubt that people will query things, for example the food bill if their loved one doesn’t eat much.

WHAT ARE THE BIGGEST CHALLENGES? There are four main challenges.

Firstly, a shortage of staffing. There is plenty of demand for services but a shortage of qualified and capable staff, especially nurses.

Secondly, funding is a challenge. We have a dialogue with the local authority who want to reduce fees when costs are increasing. They are not realistic in what they expect to pay.

Thirdly, accessible, high quality care for all. We are able to do this as a not-for-profit organisation but there are new entrants to the market who won’t be willing to accept people who can’t pay for their fees in the long-term.

Fourthly, social isolation resulting from people being cared for at home is a challenge to the sector as a whole.

WHAT’S THE BEST ADVICE YOU WERE EVER GIVEN? When I branched out on my own I was advised to join a professional institution and continue with lifelong learning. I’m a member of the IoD and the Chartered Institute of Marketing plus I’m a member of the National Care Forum, who do a lot of great work for the not-forprofit care sector. It was the best advice I was ever given.

CMM

BETTER DOMICILIARY CARE FOR PEOPLE WITH DEMENTIA

With two-thirds of people living with dementia remaining in their homes, properly trained homecare staff are the key to enhancing the quality of life of these people and ensuring your business meets the rising demands of your client-base. James Cross explores top tips to help providers deliver better quality homecare for people with dementia.

According to Department of Health research two thirds of all people with dementia live in their own home. Therefore it is critical that domiciliary care providers ensure their employees can access quality learning and development opportunities to offer the best possible care and support for people with dementia.

To help providers, Skills for Care has compiled Better domiciliary care for people with

dementia, a good practice guide that includes best practice top tips and practical examples from social care employers and key partners across England. The guide sets out 11 areas which help contribute to providing better domiciliary care for people with dementia. Whilst all 11 areas are key to providing better domiciliary care for people with dementia, in this feature we will focus on a selection of those areas.

SUPPORTING NEW STAFF Unless a new worker has encountered dementia through a family member or in a previous field of care, then their experience can be limited. They may also have some common misconceptions. These can include: • Only older people get dementia.

• People living with dementia are all aggressive and/or violent.

• Nothing can be done for people living with dementia.

• People living with dementia are a danger to themselves and possibly to those looking after them.

• People living with dementia cannot advocate for themselves.

To support new staff into the homecare sector, it is essential to address any misconceptions.

These five top tips can help.

1. Make dementia awareness training part of every new employee’s induction process.

2. Do not overwhelm new workers with huge amounts of statistics – provide information in digestible sections.

3. When training more than one new worker, understand that they will have different learning needs.

4. Provide continuity of care for the person with dementia, this will enable new workers to build a solid foundation with them.

5. Incorporate different training techniques, ranging from group training sessions to on the job training.

ENHANCING QUALITY OF LIFE THROUGH ACTIVITIES Activity-based support can help alleviate the symptoms and enhance quality of

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CMM NOVEMBER 2014 | 31

better domiciliary care for people with dementia

g

life and independence for someone with dementia.

Activities don’t need to be excursions, or take a long time.

They can be adapted to suit the length and type of visit someone receives. For example, a short visit can be enhanced by a chat about something in a person’s home, sharing a news story, or a walk around the garden.

Potting a plant, playing a game, or companionably watching television all provide an activitybased focus. For longer visits, baking a cake, visiting a coffee shop or going to a community event can give stimulation and enjoyment. It could be anything that meets the person’s interests.

Equally important is to be reactive to circumstances. This means workers should try to provide spontaneity and avoid activities being too rigid and prescribed. Considering a person’s own skills can be the key to successful activities – a person can pass on their skills to workers, whether that’s teaching them crochet or explaining the offside rule.

To enhance the quality of life of people living with dementia through activity-based support, try these five top tips.

1. Always have a dementia link worker at meetings, to ensure due consideration is given to this important area of care.

2. Ask a support worker to find out something new each week about the person with dementia and report back to the team. This encourages more varied conversations and activities with individuals.

3. Know what is going on in your area and who are the key people to contact, for example, who are the dementia advisers? Who is the village agent? These people will help keep you up-to-date with activities and events which might be beneficial to individuals with dementia.

4. Empower your dementia link workers to liaise with social workers and families; families in particular will have a wealth

32 | CMM NOVEMBER 2014

of knowledge about their loved ones which can be the basis of activities, conversation and meaningful moments.

5. Use the Kitwood equation to problem solve: life history is very important but this needs to be combined with knowledge about an individual’s health conditions, their social psychology and personality. Together this will give a true understanding of the person’s needs and help with a person-centred approach.

Retention in the homecare sector remains a challenge for employers, with average turnover rates of 32.6%

MOTIVATING STAFF Motivation refers to the energy and commitment with which an individual or group performs a task or role. Motivated workers deliver higher quality care because they care about what they are doing. They often learn faster and have more ideas and are less likely to make mistakes.

Motivated homecare workers are enthusiastic, patient and encouraging to others. This impacts on the care they deliver to individuals and families (Benson and Dundis 2003).

Retention in the homecare sector remains a challenge for employers, with average turnover rates of 32.6 per cent (Unison 2012). Undoubtedly, staff motivation plays a critical role in maintaining workforce stability. Motivation remains such a challenge in homecare workers supporting people with dementia for a number of reasons, these include lone homecare workers, varied hours, complex work, poor integration across health and social care services, funding and poor levels of pay.

Care work is one of the most rewarding and self-fulfilling career choices. Homecare workers spend time giving to the most vulnerable people in our communities; they support families to stay together, give older people the choice to remain in their homes and people with disabilities the chance to lead

an independent life. Homecare workers go home at the end of the day knowing that they have made a real difference to somebody’s life and how they choose to live it. These factors mean that intrinsic motivation is the key to a homecare worker’s performance and fulfilment.

Therefore it is important that employers should strive to create an environment where intrinsic motivation can flourish. These five top tips can help: 1. Base recruitment on values and competences to ensure you’re employing the right people with the right values for the role.

2. Ensure employees have the expertise, support and tools they need.

3. Understand situations from the worker’s perspective.

4. Treat homecare workers as professional experts and support their career development.

5. Have clear and achievable goals so that success can be verified and celebrated.

WHEN BEHAVIOURS CHANGE OR CHALLENGE When supporting people with dementia there may be times when their behaviour changes and this could be regarded by some as challenging. In this instance, the person may be trying to communicate or share their emotions. Life histories and knowing personal life

details about the person can help to understand what may be triggering any behaviour changes. Consider the following top tips when supporting staff whose clients’ behaviour may have changed.

1. Leadership: be clear on your leadership influences and translate these into your business plan. Have a clear vision of what services you want to provide, and include workers, customers and carers in shaping your services.

2. Developing and supporting workers is a sharing process; assist workers to be accountable for communicating difficulties and changing needs.

3. Dig deeper when faced with

labels such as ‘challenging behaviour’; often the person who needs support is trying to communicate.

4. Person-centred care is challenging to get into everyday care; attention to detail on support plans and their formulation process is key to working this way.

5. Communication: what do we do with it? Look at the lines of communication open to workers, customers and carers and let them witness the effectiveness of communicating. Highlight changes that have taken place due to their input.

These are only a few areas that Skills for Care has explored

to help providers and support staff caring for people with dementia in their own homes.

There is further information plus lots of useful examples of how organisations put this into practice in Skills for Care’s guide Better domiciliary care for people with dementia.

The best practice case studies are from domiciliary care employers developing their workforces to support people with dementia. They include useful, practical solutions to implementing some of the key aspects of delivering great domiciliary care for people with dementia living in their own homes. The best practice examples are given by organisations including Home

Instead, Cardinal Healthcare, Meritum Independent Living, Cherish Care, Care Direct Salford, HomeCareDirect, Quality Care Home Services Limited, The Good Care Group, Ann Tuplin Care Services and DoCare.

CMM

FURTHER READING www.skillsforcare.org.uk/ dementia www.skillsforcare.org.uk/ Document-library/Skills/ Dementia/Better-domicilarycare-for-people-withdementia.pdf James Cross is an area manager at Skills for Care. Email: james.cross@skillsforcare.org.uk

CMM NOVEMBER 2014 | 33

34 | CMM NOVEMBER 2014

SIX MONTHS ON FROM NEW MEASURES BROUGHT IN TO MAKE IT SIMPLER TO CHECK THE IMMIGRATION STATUS OF POTENTIAL EMPLOYEES, CMM LOOKS AT THE CHANGES AND WHY PROVIDERS NEED TO ENSURE THEY GET IT RIGHT.

In May 2014, the Home Office brought in new measures to make it simpler to check the immigration status of potential employees and that they have the right to work in the UK. At the same time it doubled the maximum penalty for employers who break the law. The changes were designed to get tougher on those who break the rules, while supporting employers by ensuring they undertake the correct checks on their employees.

HOW DID THE LAW CHANGE? The new illegal working requirements which came into force on 16th May 2014 made a number of changes to the previous illegal working scheme.

One of the largest was that the maximum civil penalty for employing an illegal worker in the UK increased from £10,000 per illegal worker to £20,000 per illegal worker. The Government also reduced the list of acceptable documents for right to work checks, to make it easier for employers to comply.

There is no longer a requirement in all cases for annual follow-up checks for people with timelimited right to stay in the UK. The frequency of checks will depend upon the employee’s immigration leave, which should save costs to most employers. The document list for those with time-limited stay has also been separated into two subgroups to clearly distinguish when the follow-up check is required when permission to work as shown on the document expires, and when it takes place after 6 months.

Where the employer is

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RIGHT TO WORK IN THE UK

CMM NOVEMBER 2014 | 35

right to work in the UK

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reasonably satisfied that an existing employee has submitted an in-time application to the Home Office or has an appeal pending against a Home Office decision, their statutory excuse is extended for a maximum of 28 days beyond the expiry date of immigration leave in order for the employer to make the correct right to work check with the Home Office’s Employer Checking Service. There is also an extension of the grace period for conducting right to work checks on employees affected by the Transfer of Undertakings (Protection of Employment) Regulations.

Employers now have up to 60 days available for these checks and must also keep a record of the date on which a check was made.

If employing international students who have limited immigration leave and permission to work, students are required to provide the employer with evidence of their term and vacation times for the duration of their studies in the UK. This should help employers to understand when they may employ a student part time and full time and is necessary to establish and retain a statutory excuse. Finally, the partial checks process that some employers found unhelpful and confusing are no longer used.

WHAT WILL HAPPEN IF EMPLOYERS ARE FOUND TO BE EMPLOYING AN ILLEGAL WORKER? If found to be employing an illegal worker, employers will receive a ‘referral notice’ to inform them that: • the case is being considered; • they may be liable to a civil penalty of up to £20,000 for each illegal worker.

Employers will not face a penalty if they can prove they conducted the required checks, unless it is found that they employed someone who they knew did not have the right to work. If found liable for a penalty, employers will be sent a ‘civil penalty notice’ and have 28 days to respond. The notice will include payment options and information 36 | CMM NOVEMBER 2014

on what to do next, as well as how to object and appeal against the penalty.

If convicted of ‘knowingly employing’ an illegal worker, this carries a sentence of up to two years’ imprisonment and/or an unlimited fine.

Businesses which employ illegal workers may also have their details published by the Home Office.

WHAT IF A JOB APPLICANT CAN’T SHOW THEIR DOCUMENTS?

THREE STEP GUIDE FOR CHECKING AN APPLICANT’S RIGHT TO WORK 1. OBTAIN THE RIGHT DOCUMENTS The types of documents that can be used as proof depend on whether the person has restrictions on their right to live and work in the UK. If an employee has a limited right to work in the UK, employers are required to check their documents again. The Government has produced guidance on preventing illegal working in the UK which contains lists of acceptable documents and when to check these, as well as tools to assist in conducting the right to work check.

The Home Office’s Employer Checking Service will inform an employer see if an applicant has the right to work if: • they can’t show their documents and employers are reasonably satisfied that they have an outstanding appeal or application with the Home Office; and • they have one of the following documents: an Application Registration Card or a Certificate of Application.

www.gov.uk/government/collections/employersillegal-working-penalties

To request a check, you can download and complete the employer checking service enquiry form available via www. gov.uk/check-job-applicantright-to-work and email it to employercheckingservice@ homeoffice.gsi.gov.uk.

• the person has permission to do the type of work you’re offering (including any limit on the number of hours they can work);

WHAT HELP IS AVAILABLE? The Government’s online interactive checking tool www.gov. uk/legal-right-work-uk provides quick and easy help for employers to check right to work documents.

For employers who need more help they can contact the Home Office helpline on 0300 123 4699 or email businesshelpdesk@homeoffice.gsi. gov.uk.

The care sector attracts a lot of overseas workers, it is an employer’s responsibility to ensure all staff have a legal right to work in the country and with increased fines for employing illegal workers, it’s important to make sure your processes are up to date.

CMM With thanks to the Home Office.

2. CHECK THE DOCUMENTS ARE VALID You need to check that: • the documents are original, genuine and refer to the applicant; • the dates for the worker’s right to work in the UK have not expired; • photos are the same across all documents and look like the applicant; • dates of birth are the same across all documents;

• all documents are current (other than those issued to UK, EEA and Swiss nationals and Permanent Residence Cards issued to family members of EEA nationals); and • if two documents give different names, supporting documents show why this is, for example, marriage or divorce.

3. COPY AND KEEP THE COPIED DOCUMENTS FOR YOUR RECORDS When you copy the documents: • make a copy that can’t be changed, such as a photocopy; • for passports, copy any page with the expiry date; the applicant’s personal details including nationality, date of birth, name, photograph and signature together with the current immigration endorsement (eg a work visa) copied on both sides; • for all other documents, make a complete copy; • keep copies during the worker’s employment and for two years after the person stops working for you; • ensure you record the date you made the check; and • for migrant students, keep a record of their term and vacation times.

An outdoor covered area is a great selling tool to prospective residents and their families... ... Thats why care homes around the country are choosing Canopies UK. With the Care Quality Commission inspecting care homes throughout the country its no wonder they are looking to improve their facilities and make a good impression.

A canopy can help protect against the worst of the weather, helping to provide a safe and dry area underfoot, free from frost and slippery surfaces, eliminating potential hazards.

They are great in the summer months too, helping to extend your living space and allow your residents outside to enjoy the fresh air.

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karen@canopiesuk.co.uk

To arrange a free survey call Karen:

01254 777002 Ext: 221

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CMM NOVEMBER 2014 | 37

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01/10/2014 09:57

R O T C E CAR E S

N I I N A G R T

Spotlight on...

The care sector has a duty to ensure that all staff are properly trained. Whether that training is Common Induction Standards, Manager Induction Standards, dementiaspecific training, health and safety or anything else, it’s important you and your staff receive the right training from quality providers. Training can be delivered in so many different ways from face-to-face, on or off-site, DVD, e-learning and more. This issue CMM has turned its spotlight onto care sector training providers and hopes they will help you keep on top of your organisation’s training needs.

AGE UK TRAINING – WWW.AGEUK.ORG.UK

As the UK’s leading charity for older people, Age UK believes everyone should be able to enjoy later life. That’s why the training arm, Age UK Training, has extended its range of exclusive courses to help meet workforce development needs on topics linked with ageing, with a ground-breaking new dementiarelated training programme called Remember Me. Specialising in programmes relating to the care sector, Age UK Training understands that compassionate, competent care is crucial, not only for those who require support, but also for those working within the industry.

With over 800,000 people aged over 65 living with dementia in the UK, Remember Me has been designed to encourage better support and understanding amongst social and health care practitioners who support older people with dementia. Using real case studies and practical learning, this essential new course places participants in the shoes of the person living with dementia, providing valuable insight into the challenges they faced and first-hand experience of what it may feel like.

Delivered by Age UK’s expert trainers, who draw upon years of frontline experience, the programme places individuals at the heart of the training. Reflecting this person-

centred approach, participants are taught via five Foundation modules, which highlight how professionals can best support older people in their care.

Training can also be tailored to include Age UK’s powerful Sense of Ageing programme, a unique module designed to help care workers understand the way physical ageing impacts on everyday life. Developed with gerontologists, the course uses an interactive workshop that provides participants with the chance to experience the physical effects of ageing and sensory impairment. Stimulated through use of special equipment, users get a first-hand experience of what it’s like when vision, hearing, touch, dexterity and communication skills decline.

As a national training provider, Age UK Training has offered training and consultancy across the UK for over 60 years. Including in-house, apprenticeships and e-learning approaches, it reaches over 10,000 people each year, with a range of training topics that reflect Age UK’s expertise, innovation, creativity and vision for those in later life.

Delivered by Age UK’s expert trainers, all courses have been designed to shape best practice, enhance staff performance, increase career development opportunities, and attract and retain valuable staff. Age UK Training customises its courses in line with business needs, ensuring that they are treated to suit the needs of organisations where individuals or a few staff are looking for specialist development in a subject area.

Telephone: 0808 168 1225 • Email: trainingteam@ageuk.org.uk • www.ageuk.org.uk

CMM NOVEMBER 2014 | 39

who’s who…

The RCN: working with you to support your business.

“The involvement of the RCN reassured staff that matters are being dealt with properly.”

Nuffield Hospitals

The RCN is not just for nurses.

Every day we’re helping managers and care homes to: • improve their organisation’s learning and development programme • enhance quality and standards of care • boost staff morale.

First Steps (for HCAs) is just one of the many resources we offer to help you. Mapped to national occupational standards and covering many aspects of the Care Certificate*, First Steps is an online programme that can aid you as a manager with your workplace inductions.

To find out how else we can work together visit www.rcn.org.uk/independentsector or call us on 0345 772 6100 to speak to one of our advisers quoting CARE SHOW B’HAM. 40 | CMM OCTOBER 2014

*From March 2015

spotlight on…care sector training

ALZHEIMER’S SOCIETY – WWW.ALZHEIMERS.ORG.UK/TRAINING

Leading the way in dementia training, Alzheimer’s Society Training and Consultancy is committed to improving life for people living with dementia, through workforce development and best practice in dementia care. As the leading dementia organisation, naturally, the experience of people living with dementia is at the centre of all training and consultancy programmes.

In response to research, developments in adult learning, and economic pressures on the care sector, Alzheimer’s Society Training and Consultancy has developed a new, innovative training portfolio which includes shorter, more accessible and flexible training across all learning levels and skill areas. The course portfolio is under constant development, utilising the expert knowledge of the Society to ensure it remains evidencebased and cutting-edge. Courses that are launched now include: • Step Inside – An interactive skills-based course designed to equip anyone working alongside people living with dementia with the knowledge, confidence and desire to understand and walk with people on their journey.

• Responsive Behaviours – Arms care workers with strategies and techniques to help them to embrace new approaches when supporting a person living with dementia.

• Meaningful Occupation – This course enables participants to understand the importance of providing opportunities for people living with dementia to be involved, included and fulfilled.

Please contact us to find out about other courses, including our leadership programme.

Consultancy and bespoke training solutions - Our consultants will work with you to assess your organisational dementia skill base and develop a specific training package tailored to meet identified needs. This can include bespoke training and specialist input on a variety of topics including nutrition, pain assessment, communication skills and our coaching support.

For small organisations, open courses are available to individuals; you may prefer us to train groups within your workplace. We can also provide Cascade programmes where key members of internal training teams are enabled to flow training across the entire workforce, so whole teams are equipped with common skills and knowledge in dementia.

Taking a person-centred approach, Alzheimer’s Society Training and Consultancy provides outcome-based solutions, increasing staff confidence and potential to enable compassionate and high quality support to people affected by dementia.

Alzheimer’s Society Training and Consultancy also offers a DVD and CD-ROM: Tomorrow is Another Day, which is designed to be delivered to staff working in residential care.

It covers the experience of dementia, supporting people, providing occupation and communication.

Alzheimer’s Society offers the Foundation Certificate in Dementia Awareness for staff undertaking our courses, and look out for the joint award with the Royal Society for Public Health – Understanding Dementia (Level 2), which is set to be the benchmark for health and social care staff.

Telephone: 01904 567909 • Email: dementiatraining@alzheimers.org.uk • www.alzheimers.org.uk/training

NATIONAL SKILLS ACADEMY FOR SOCIAL CARE – WWW.NSASOCIALCARE.CO.UK

Skills for Care and the National Skills Academy for Social Care is the employer-led workforce development body for adult social care in England.

It offers workforce learning and development support and practical resources from day one of entry level, right through to those in senior leadership and management roles. It is dedicated to supporting and promoting excellent training provision, and recognises high quality in social care training through its unique Endorsement Framework.

The Endorsement Framework identifies and badges training providers who can show that they explain and encourage leadership behaviours, and can demonstrate the impact these behaviours have on how people care. The recommendations of the Cavendish Review, Care Quality Commission Essential Standards and the Care Act mean that excellence in training is more important than ever.

Its Endorsement is the quality mark for learning and development providers in the adult social care sector. The application process acts as a tool for self-evaluation, professional development and quality improvement and can be used as a mechanism for organisational and staff development that makes a difference. It is specifically designed for the needs of social care employers and learners and has a positive impact on the lives of the people that they support.

There are three types of Award available within the Endorsement Framework.

• Recognition Award: Recognised providers demonstrate that they take a professional

approach to learning and development in adult social care.

• Excellence Award (for existing Recognised providers): Providers who are ‘Centres of Excellence’ demonstrate exemplary commitment to meeting the needs of learners in adult social care, understanding and measuring the impact of their provision on the lives of the people who use services, all in compliance with the social model of care.

• Associate Award: This is the minimum requirement for any training provider wishing to work with the body. It is an internal quality check for associates wishing to deliver the programmes and will not be endorsed by the body externally.

Endorsement gives training providers the chance to help transform the culture of social care, and shows their commitment and contribution to improving the quality of adult social care. This should ultimately result in improved quality of life outcomes for people who use services. Endorsed Providers also have preferential access to new business opportunities through employer members and by delivering Skills Academy programmes.

And the more popular their own development courses become, the greater the revenue they’ll generate.

Endorsed Training Providers are promoted by Skills for Care and the Skills Academy to 1,500 employers across social care, and have their details published on an online database, providing a unique route to market.

To find out more about the Endorsement Framework, visit: www.nsasocialcare.co.uk/ training-providers A list of current Endorsed training providers can be found here: www.nsasocialcare. co.uk/providers

Telephone: 0203 011 5280 • Email: endorsement@nsasocialcare.co.uk • www.nsasocialcare.co.uk

REDCRIER TRAINING SOLUTIONS

Redcrier has been established since 1998 as an independent training provider. In those 14 years it has evolved with the care industry to become one of the most established well-regarded specialists for staff training, offering compliance, improvements in staff performance and cost reductions.

Redcrier creates training packages around you, your staff and your training matrix. The

team offers a blended approach to staff training for over 1500 care organisations.

Redcrier supplies over 30 different health and social care courses through three unique delivery styles: The Silver Box Distance Learning System, Face to Face Courses and e-learning.

Its training can be built around your specific needs, taking into account budget, staff numbers, location and knowledge base. From large groups to small independent care providers, Redcrier can tailor a training package around your bespoke needs.

Telephone: 01823 332200 • Email: info@redcrier.com • www.redcrier.com

CMM NOVEMBER 2014 | 41

spotlight on…care sector training

will be mapped across this and, of course, the Qualifications and Credit Framework (QCF).

REGIS

regis launched its new website in October, with lots of exciting news, information and offers.

regis has delivered hundreds of ‘NVQ’ awards – now QCF – and continue to do so for some of the largest employers in the country. Face-to-face training in the workplace is still on offer, together with e-learning. Please contact Pauline Misselbrook, Managing Director for more information.

The team are currently developing resources for the new Care Certificate for next year and this product will replace its very successful Skills for Care Common Induction standards pack. All DVDs Telephone: 0800 0680 978 • Email: pmisselbrook@regis.co.uk • www.regis.co.uk

SKILLS FOR CARE – WWW.SKILLSFORCARE.ORG.UK

Skills for Care ensures that England’s adult social care workforce has the skills and qualifications to deliver high quality social care. To achieve this, we focus on the attitudes, values, skills and qualifications people need to undertake their roles.

We do not directly deliver training; instead we work with social care employers, people who need care and support, carers and other key stakeholders to develop effective tools and resources that meet the needs of the sector in terms of workforce development.

Supporting your dignity training One of the most important resources that we have developed is the Common Core Principles for Dignity Training Pack. Based on the dignity common core principles, the pack supports those involved with learning and development to continue to deliver the message of the importance of dignity in adult social care using tried and tested resources.

The resource was developed following the success of the dignity workshops delivered by Skills from Care throughout 2013 and has been tested by pilot site organisations which provide a range of different care settings across the country.

Prama Care, based in Poole, were one of the pilot sites who worked with Skills for Care on the development and testing of the training pack. They noted that their staff were ‘much more aware, considerate and respectful of people’s preferences and choices’ following the use of the common core principles.

The training pack also focuses on safeguarding and Compass Disability Services, who were also a pilot site. They noted that the safeguarded elements had increased the confidence their staff had in ‘challenging practices that do not support dignity’.

As providers can use the resource to deliver training in-house, it will allow employers to ensure that their whole workforce has an understanding of the importance of upholding people’s dignity.

Included in the training pack: • A copy of the Common Core Principles for Dignity Toolkit. Usually priced at £15, the toolkit includes good practice guidance and real life scenarios to help you embed the common core principles for dignity in the workplace.

• Stop! Think Dignity animation. The animation challenges assumptions around dignity in the workplace and helps workers and employers think of their day-to-day practice.

• Workshop presentation: the presentation guides the format of the training and is tried and tested within adult social care.

• Support for facilitators: the pack includes notes and tips for facilitators to help them in the delivery of the training.

The toolkit is available for £50. You can purchase your copy by visiting www.skillsforcare. org.uk/dignitytrainingpack.

Telephone: 0113 241 1275 • Email: info@skillsforcare.org.uk • www.skillsforcare.org.uk

SKILLSOFT – WWW.SKILLSOFT.COM/EMEA

Skillsoft is a pioneer in the field of learning with a long history of innovation, providing cloud-based learning solutions for customers worldwide, including global enterprises, Government, education and small to midsized businesses. Skillsoft provides off-the-shelf and custom content to over 6,000 customers and more than 19,000,000 learners around the world.

Skillsoft offers high-impact compliance training solutions in: • Care; • Legal; • Hospitality; • Health, Safety and Environmental.

Care organisations face an increasingly large set of legal requirements to provide training solutions in compliance job skills. Skillsoft offers care staff and managers engaging and interactive online learning experiences that helps care organisations meet their compliance training requirements.

Skillsoft is a global e-learning company, creating innovative and effective teaching solutions since 1998. It has developed into a number of different business units that cover topics, from compliance training to leadership and development. Skillsoft’s proven adult learning method has the lowest levels of scrap learning in the industry, with an 86 per cent application rate compared to the typical 20 to 50 per cent.

Its compliance courseware comes in a variety of languages, is deployable in multiple countries and includes localised content options. It’s developed for learners of all styles and the cloud-based learning solution provides a rich experience for auditory, visual and kinesthetic learners.

Your employees can enjoy interactive learning exercises, audio narration, job and visual

aids. The instructional design is effective and adapted to help employees understand how laws and regulations impact their responsibilities.

Skillsoft now offers a self-service e-commerce solution for small businesses, equipping them with tools necessary to deliver compliance training through a newly-developed interface. The compliance-based training site addresses business owners’ needs by providing single-learner, or multi-learner employee training options. Course titles include Common Induction Standards, Dementia, Mental Capacity Act and Infection Prevention and Control.

Smaller businesses can now use the UK e-commerce store to purchase licences and give employees access to the courses they need. This new store can be found at http:// store.skillsoftcompliance.co.uk.

For more information and an introductory 10 per cent discount, visit http://store. skillsoftcompliance.co.uk today and enter the code CMMOCT14 at the checkout.

Voucher code valid from 1st October 2014 to 24th December 2014.

Partnering with organisations across the health and social care sector, Skillsoft has continued to win awards and recognition as a top platform in the e-learning space by leading analysts, industry organisations and publications including Brandon Hall Group, Chief Learning Officer, Elearning! Magazine, TrainingIndustry.com and Workforce Magazine.

Skillsoft is currently meeting with select care sector clients to share and discuss the design of an e-learning solution to enable organisations to meet the demands of the new Care Certificate .

Organisations that wish to take part in this process are encouraged to contact Skillsoft directly.

Telephone: 01276 401994 • Email: emea@skillsoft.com • www.skillsoft.com/emea

42 | CMM NOVEMBER 2014

Creative & innovative ways to achieve excellence For more information on sponsoring or attending our event please contact: David Werthmann T: 01223 207770 E: david.werthmann@carechoices.co.uk

London Marriott Hotel Grosvenor Square, Grosvenor Square, London W1K 6JP Wednesday 3rd December 2014 • 11.30 - 16.30

www.3rdsectorcareawards.co.uk Organised by:

Supported by:

Kindly sponsored by:

CMM NOVEMBER 2014 | 43

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THE GREY MATTER GROUP

The Grey Matter Group provides an awardwinning online assessment system that enables people to measure and evidence knowledge and competence, mapped to national standards and Qualifications and Credit Framework units.

In 2015, it will be providing free Care Certificate e-learning courses via LogonToCare. org.uk. Resources are funded by local authorities and care associations. To find out more, you can book onto one of the free workshops for managers or get in touch via CIS-Assessment.co.uk.

The Grey Matter Group provides workforce development consultancy and undertake

various projects for example, the team have created e-learning for Skills for Care and a training booking management system in partnership with a local authority.

The Grey Matter Group’s focus and passion is about enabling organisations to improve training and make efficiencies by using technology solutions.

There are 28 case studies from customers evidencing how they have used the resources to save time, money and improve the quality of care services. These can be found at CIS-Assessment.co.uk under resources.

Telephone: 0345 873 0373 • Email: info@TGMGroup.net • www.CIS-Assessment.co.uk

THE SKILLS NETWORK – WWW.THESKILLSNETWORK.COM

The Skills Network is one of the UK’s most successful providers of training and skills solutions. It supports employers, educators and learners, both across the UK and internationally, by developing and delivering effective and innovative skills, training and educational content.

The team take pride in being the chosen training provider for an ever-growing number of businesses and organisations throughout the UK and internationally. Most of its courses are funded, so there is no cost to your employees, business or organisation.

As a training provider, The Skills Network has established strong relationships with a large number of care providers throughout the UK. It provides a range of funded and bespoke training solutions designed to upskill staff, ensuring progress both in their personal and professional development. Each year the team engage with and enrol over 25,000 learners onto a large range of courses, largely within the care sector.

The key areas of training offered within the health and care sectors are dignity and safeguarding, mental health, safe handling of medicines, diabetes, dementia and end of life care, and The Skills Network will be introducing qualifications in working with those with learning disabilities in the coming months. These are nationally-recognised qualifications which are accredited by the awarding body NCFE. All courses are available to learners either

paper-based or online through the company’s innovative online learning platform, EQUAL. The fully-funded courses are ideal for home or work-based learning, which means no classroom sessions and no exams. Learners can complete their assessments in their own time and at their own pace, preventing study from affecting busy work schedules.

Enrolling onto a funded course with The Skills Network could not be easier. With its own induction team, The Skills Network are able to come directly to your organisation to answer any queries your employees might have. The team will always arrange inductions at your convenience and at a time and date to suit you.

Throughout students’ learning experience, The Skills Network provides them with high quality customer service via an individually-assigned Learner Support Adviser. Extensive feedback and specialist support is also provided by experienced tutors.

The Skills Network has a number of partners with whom it shares unique relationships. The team understand that every organisation’s needs are different, and so tailor its services to ensure it is working towards specific training goals. It is able to provide training to work alongside your organisation’s benefit scheme, or to merge with existing staff training opportunities.

If you are interested or would like more information contact The Skills Network.

Telephone: 01757 210022 • Email: sales@theskillsnetwork.com • www.theskillsnetwork.com

W & P TRAINING – WWW.WANDPTRAINING.CO.UK

W & P is a small, family-owned training company who, through feedback from workshops have developed a suite of Business Support products, aimed at small to medium-sized businesses in the health and social care sector. Products and services include Policies and Procedures for Domiciliary or Residential Settings, Nursing/Clinical Procedures, Medication Management Forms, Staff Personnel Forms, Generic Adult Social Care Forms, Care Quality Commission (CQC) Registration Guidance for New Businesses, One to One Business Support and Advice, Bespoke Policy Writing Service, Staff Training Packs, Training Workshops, Employee Handbooks and Pre-CQC Mock Inspection Audits.

All of the above enhance and assist provider services registered with the Care Quality Commission to meet their regulatory compliance requirements under the Health and

Social Care Act 2008 (Regulated Activities) Regulations 2010. Changes to the current Regulations will be introduced in April 2015, with the New Fundamental Standards contained in the Health and Social Care Act 2008 (Regulated Activities) 2014.

These Fundamental Standards, Regulations 9 to 20 are made up of the current standards and new requirements including Regulation 17 Good Governance, Regulation 20 Duty of Candour. In addition, the Criminal Justice and Courts Bill 2014, currently being progressed through Parliament will introduce two new offences of ill-treatment or wilful neglect which are care worker offences. The definition of care worker includes those who provide the health or social care and those who supervise, manage and Directors of the organisation which provides the care. The new Inspection and Enforcement regime from the Care Quality Commission will also be implemented in April 2015. W & P Training’s newsletter will keep you up to date with all the changes.

Telephone: 01305 767104 • Email: info@wandptraining.co.uk • www.wandptraining.co.uk

CMM NOVEMBER 2014 | 45

Alzheimer’s Society launches new training course portfolio and consultancy service Alzheimer’s Society training combines a person centred approach with up-to date research and evidence-led design, to provide high quality and innovative training.

We put people with dementia at the heart of everything we do. So our outcome based solutions enable compassionate and high quality support to people affected by dementia, which increases staff confidence and realises their potential.

Courses can be delivered within the workplace or as part of our country wide open course schedule.

For more details about the courses and how to book, please contact us on: T: 01904 567 909 E: dementiatraining@alzheimers.org.uk Or visit our website www.alzheimers.org.uk/training

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conference review

LANCASHIRE CARE CONFERENCE

18th September 2014, Lancashire

The 2014 Lancashire Care Conference was organised in partnership with McCullough Moore and CMM and held in association with the Lancashire Care Association. The focus of this year’s conference was Independence, Integration and Excellence: The Challenges for Providers and Commissioners.

The event was aimed at all North West providers including those in Blackpool and Blackburn with Darwen.

A packed conference programme had representatives from the Care Quality Commission (CQC) sharing the stage with the Association of Directors of Adult Social Services (ADASS), Community Integrated Care, Shakespeares Legal LLP, The Royal Bank of Scotland and the Lancashire Care Association.

Workshops were delivered by the National Skills Academy and Freeths LLP. Chaired by Robert Chamberlain, Editor in Chief of CMM with a welcome from Paul Simic, Chief Executive of Lancashire Care Association, the day covered all the important topics that delegates from the North West region needed to help run their businesses in challenging times.

The keynote presentation was delivered by Tracey Devine, Inspection Manager at the CQC. Tracey focused on the future of regulation and informed delegates of the current and future CQC changes including the new quality ratings system.

Roger Harcourt, Partner at Shakespeares Legal LLP followed with an in-depth look at the Lancashire market. Roger explored the areas of growth within the region, where opportunities may exist and where providers should position themselves in the market.

Safeguarding is always an important topic and Mike Briggs, Joint Chair Adult Safeguarding Network at ADASS explored the roles and responsibilities of everyone in health and care services when it comes to safeguarding vulnerable people. He also explored how providers should work with other agencies to prevent abuse and neglect.

Anne-Marie Jones, Corporate Banking Director of Northwest Healthcare at The Royal Bank of Scotland delved into the realities of the current financial and banking climate, looking at key drivers in the market, explaining what banks look for when considering financing providers and summarising what the future looks like for the sector.

Delegates had the opportunity to attend workshops before and after the break. These were Better Leadership, Better Care: Strengthening leadership and driving up quality in organisations delivered by Maureen Hinds, Head of Programmes at the National Skills Academy for Social Care and The Deprivation of Liberty Safeguards delivered by Liz Mulvaney, Head of Healthcare at Freeths LLP. The afternoon main stage presentation was delivered by Martin McGuigan, Director of Innovation at Community Integrated Care. He discussed the Care Act, including what the main points of the Act mean for providers, key issues around implementation, how it will shape the market and commissioning practices.

A panel discussion, aptly named The Changing Landscape followed Martin’s presentation. The panel contributors included speakers Paul Simic, Mike Briggs, Roger Harcourt and Martin McGuigan plus Ken Nolan, Chair of the Lancashire Care Association. They took questions from delegates and opened the floor to a debate around the Care Act, regulation and market pressures. The day then finished with a summary of the key themes by Paul Simic.

Running throughout the event was an exhibition of 37 services and brands advising, guiding and supporting delegates to help improve their businesses.

The Lancashire Care Conference was sponsored by Hazlewoods and supported by the Royal Bank of Scotland and Freeths LLP.

CMM CAREMANAGEMENTMATTERS

CMM NOVEMBER 2014 | 47

conference review

INDEPENDENT CARE GROUP 2014 CONFERENCE AND EXHIBITION

7th October 2014, York

An Inspector Calls - coming ready or not! The challenges of delivering social care in the new world.

In celebration of its 10th anniversary, the Independent Care Group Conference and Exhibition offered everyone a chance to pause and reflect on the past decade. Looking at how the association had grown but also how the issues that faced the sector in 2004 are still prominent in 2014.

Mike Padgham, Chair of the Independent Care Group, welcomed delegates to the day before handing over to The Archbishop of York, Dr John Sentamu who gave the opening address on The Living Wage.

Given changes to the inspection regime being introduced by the Care Quality Commission (CQC), the keynote speaker was Andrea Sutcliffe, CQC Chief Inspector of Adult Social Care. Her presentation The new world of regulation – October 2014 and beyond explored the forthcoming changes and what providers needed to know. Kersten England, Chief Executive, City of York Council, followed with York – a city for everyone – delivering the ambition.

Richard Webb, Director of Health and Adult Services, North Yorkshire County Council presented an overview of key issues facing the sector in Yorkshire. Penny Garner of the Contented Dementia Trust then discussed Dementia – The SPECAL Method and its guiding principles.

An exhibition showcasing more than 50 sector-specific providers ran alongside the conference with stands from law firms, insurers, software companies, banks and a selection of other products and services.

Three workshops were also on offer for delegates. Sonya Ashworth, NHS Community Infection Prevention and Control (IPC) Nurse Specialist looked at the Infection Prevention and Control CQC Inspection Preparation Pack. The Pack enables services to be prepared for CQC inspections, drawing together evidence needed to demonstrate compliance with CQC requirements and the Health and Social Care Act 2008.

Homecare – Commissioning and the National Minimum Wage (NMW) compliance identifying issues around compliance with NMW in the homecare sector and offering practical advice to providers.

The afternoon session returned to the main conference hall with John Kennedy, Director of Joseph Rowntree Foundation discussing The burden of paperwork in care homes. Ian Donaghy of Training Matters then followed with Customer service – getting it right!

Delegates had an opportunity to discuss the issues affecting them most with the panel debate. Chaired by Harry Gration the stage included Guy Van Dichele, Interim Assistant Director Directorate of Health and Wellbeing at City of York Council; Mike Padgham, Chair of the Independent Care Group; Janice Barber, Partner at Hempsons; Richard Webb, Director of Health and Adult Services at North Yorkshire County Council; John Kennedy; and Jo Bell, Inspection Manager at the CQC.

Penny Garner, who spoke on the main stage followed up her presentation with a workshop on The SPECAL method promoting lifelong well-being for the person with dementia. By using the analogy of a photograph to represent the memory system, Penny presented in simple terms how memory works, what happens to us as we age and the single dramatic change that occurs at the onset of dementia. Penny then discussed counter-intuitive communication skills and techniques that can be used when caring for people with dementia.

David Pearson, President of the Association of Directors of Adult Social Care delivered the final main stage presentation of the day summarising the state of social care and the future for providers and commissioners in Social Care – National position. Mike Padgham then closed the day.

Colin Angel, Policy and Campaigns Director at the United Kingdom Homecare Association focused his workshop on

Organised by McCullough Moore, the conference was sponsored by McClarron Insurance.

48 | CMM NOVEMBER 2014

CMM CAREMANAGEMENTMATTERS

layout on? one what’s

WHAT’S ON? Implementing the Mental Capacity Act and the Deprivation of Liberty Safeguards Date/Location: 24th October, London Community Care Conferences, Tel: 0208 652 2181 Contact: Event:

Safeguarding Adults Event: Date/Location: 24th October, London Capita Conferences, Tel: 0207 202 0593 Contact: Tackling Long-Term Conditions Event: Date/Location: 29th October, London Open Forum Events, Tel: 0161 376 9007 Contact: 2014 LCS and Adam Smith Institute Health and Social Care Winter Event Date/Location: 4th November, London LCS, Tel: 0207 108 6323 Contact: Event:

Care Show Birmingham Event: Date/Location: 4th – 5th November, Birmingham Care Show, www.careshow.co.uk/birmingham Contact: Care England Conference: The Road to Integration Event: Date/Location: 13th November, London Care England, Tel: 0207 492 4846 Contact: Improving outcomes in dementia care: integration, personalisation and the Dementia Challenge Date/Location: 25th November, Central London Westminster Health Forum, Tel: 01344 864796 Contact: Event:

Next steps for palliative and end of life care: funding, resources and One Chance to Get it Right Date/Location: 13th January, Central London Westminster Health Forum, Tel: 01344 864796 Contact: Event:

Innovative Carpet Solutions Designed for the demands of the healthcare sector, ECONOMIX offers outstanding performance, the latest trend colours and excellent environmental credentials.

Visit us at the Care Show on stand H42.

www.danfloor-economix.co.uk

2014 LCS and Adam Smith Institute Health and Social Care Winter Event Date/Location: 20th January, London LCS, Tel: 0207 108 6323 Contact: Event:

The future for social care in England - funding, integration and next steps for policy Date/Location: 22nd January, Central London Westminster Social Policy Forum, Tel: 01344 864796 Contact Event:

NICE Annual Conference Event: Date/Location: 12th-13th May, Birmingham NICE, Tel: 0845 056 8339 Contact: Health+Care 2015 Event: Date/Location: 24th-25th June, London CloserStill Media, Tel: 0207 348 5261 Contact:

CMM EVENTS CMM Insight: Learning Disability Services: Current Developments and Future Opportunities Date/Location: 26th February 2015, Manchester Care Choices, Tel: 01223 207770 Contact: Event:

0844 915 1000 info@danfloor.co.uk

Please mention CMM when booking your place.

CMM NOVEMBER NOVEMBER2014 2014 || 49 CMM 49

straight talk

straight talk Lucy Hurst-Brown explores how people with learning disabilities must become truly connected in the community.

LUCY HURST-BROWN CHIEF EXECUTIVE BRANDON TRUST The ultimate aim for any organisation working with people with learning disabilities and autism must be to actively reduce the time they spend with each person they support because they have been effectively connected in the community.

Brandon Trust was established 20 years ago with a clear remit to seize the opportunity offered by Care in the Community by supporting people with learning disabilities, many of whom were recently ‘freed’ from institutions, to live in the community.

The extent of the public outcry that followed revelations of widespread and ‘insidious’ abuse at Winterbourne View private hospital rightly focused minds on the continuing plight of people with learning disabilities and shared discussions have sadly clarified that this broader societal shift from institution to integration is far from complete.

With this in mind, the social care system needs to be turned on its head to provide better support and value for money. The current system of allocating support according to need, known as the ‘deficiency’ model, is counterproductive and not cost-effective.

Instead, an ‘asset-based approach’ must be adopted, directing resources towards building on what people can do and what is already available to them.

This is built on the premise that every single person has capacities, abilities and gifts. It considers successful intervention to be that which enables people to use these assets in a way that contributes to wider society – to become part of the action.

Rather than an exclusive focus on what is absent, asset-based approaches look to what already exists in a community and attempts to build from within it. This does not ignore the fact that some people in society may require more support – and therefore more resources – than others. The success of this approach can be measured by the extent to which allocated resources reduce people’s dependence on future resources.

The less support required from organisations like ourselves, means the more the people we work with have forged connections in their local communities. The more links the people we work with have in the community, the more they will be able to challenge society’s views about them. From the perspective of people with learning disabilities, contributing to society undoubtedly increases dignity and self-worth. It is the antithesis of the institutional approach in that it is all about creating connections that free individuals from the world and language of social care.

These connections equip people with new skills and, therefore, increase their value to society. The simple truth is that by failing to enable people to do what they want and establish meaningful nonpaid social connections, the social care system risks denying them access to new skills, opportunities, society itself and, of course, the experience of true citizenship.

In the UK today, there are 1.2 million people with learning disabilities. The vast majority of these do not live in institutions, such as Winterbourne View. They live in a range of different homes, ranging from family homes to privately rented accommodation, from social housing to small, purpose-built supported housing.

But does this signal a triumph for public policy? We know that people with learning disabilities are rarely seen. They simply do not feature in the everyday lives of most people unless they are a family member or paid employee. It is uncommon to share a bus, a workplace, a classroom, a hobby, a sport, a dance floor or a queue at the Post Office with someone who has a learning disability.

We are determined to promote the role of staff as ‘community connectors’ and tackle the idea that paid staff are the main solution in people’s lives. It is vital for anyone working in our field to actively measure how many regular and meaningful personal contacts there are between those supported and family, friends, neighbours and other people in their community. There must be an emphasis for all staff to get out of their way. This should be the measure of success reflected in public policy, organisational strategies and any employee’s sense of what it means to do a good job.

From a fiscal point of view an asset-based approach is far more costeffective than an approach centred on what a person needs i.e. that measures their problems and funds them accordingly.

At Brandon Trust we have long worked to involve people in community activities. Experience tells us that those we support have much to give, can be real assets to their communities and are frequently their own best ambassadors. The community in turn has a great deal to gain from their involvement. Just like any ‘real’ relationship, these new, deeper connections can and should involve a degree of reciprocity. Getting this right will mean improved physical and mental wellbeing, safer and more enriched life experiences, and a more robust, effective and efficient care sector.

This article is based on extracts from Lucy’s essay ‘From patients to invisible citizens’, part of ‘The Future of Disability’ published in partnership with VODG. www.demos.co.uk/publications/disability CMM

DO YOU AGREE WITH LUCY? PLEASE EMAIL YOUR THOUGHTS TO EDITOR@CAREMANAGEMENTMATTERS.CO.UK 50 | CMM NOVEMBER 2014

www.theskillsnetwork.com/cmm

FULLY FUNDED

TRAINING FOR THE

CARE SECTOR COURSES INCLUDE: Care and Management of Diabetes

Mental Health Awareness

Safe Handling of Medication

Working in Mental Health

Control of Infection in Health Care Settings

Dementia Care

End of Life Care

Dignity and Safeguarding in Adult Health and Social Care

For more information on our funded qualifications you can find us at stand A36 at the Birmingham Care Show. You can also call us on 01757 210 022, or email sales@theskillsnetwork.com

HELPING YOU MEET CQC REGULATION CHANGES FOR 2015