Care Management Matters January 2017 by Care Choices Ltd

CARE HOME FINANCES

FEBRUARY 2017 Â£4.00 www.caremanagementmatters.co.uk

Can you stay afloat in 2017?

At breaking point Social care 2017

Sustainability and Transformation Plans Social care must be involved

Resource Finder

Software, assistive technology and nurse call systems

Improve the

QUALITY

of your

CARE

Over 10% of all care homes currently rated ‘Outstanding’ are using our evidence of care and electronic care planning product.

9,000 care staff trained

270,000 care notes per day

240 care providers

rated ‘Outstanding’

500%

increase in the quantity of care evidenced

Mobile Care Monitoring has been revolutionising social care for over three years, and is cited in numerous CQC reports because of the benefits it provides. To find out how Mobile Care Monitoring can help in your care setting, call:

01483 604108 www.personcentredsoftware.com • care@personcentredsoftware.com

Revolutionising social care

In this issue From the Editor

Is it just me…? Editor in Chief, Robert Chamberlain, considers the impact of growing numbers of delayed discharges for mental health NHS patients.

CMM News

Business Clinic Our panel looks at Brendoncare’s Shared Care model for couples where one person has dementia.

A View from the Top Tom Owen, Director of My Home Life, reflects on the initiative’s decade of promoting quality of life in care homes.

REGULARS

Event preview 48 CMM previews CMM Insight Learning Disability and Mental Health Services on 2nd March in Manchester. What’s On?

FEATURES

Straight Talk 50 Ewan King considers how to build the future social care workforce.

At breaking point – Social care 2017 What does 2017 hold for social care? What is the Government doing to address the issues? What can the sector do? Vic Rayner, Vicky McDermott and Mike Padgham share their thoughts.

Irresistible force meets immovable object: Sustainability and Transformation Plans Debbie Sorkin sets out why social care must be involved in STPs.

Care home finances – Can you stay afloat? New research has found that 28% of care home operators are at risk of insolvency. Nick Hood explores the financial health of care homes and asks, when will the Government listen?

3rd Sector Care Awards 2016 Find out who won a 3rd Sector Care Award in December.

Resource Finder CMM explores care sector software, assistive technology and nurse call systems. CMM February 2017 3

EDITORIAL editor@caremanagementmatters.co.uk Editor in Chief: Robert Chamberlain Editor: Emma Morriss News Editor: Des Kelly OBE Content Editor: Emma Cooper

CONTRIBUTORS

PRODUCTION Lead Designer: Holly Cornell Director of Creative Operations: Lisa Werthmann Studio Manager: Jamie Harvey

ADVERTISING sales@caremanagementmatters.co.uk 01223 207770 Advertising Manager: Daniel Carpenter daniel.carpenter@carechoices.co.uk Director of Sales: David Werthmann david.werthmann@carechoices.co.uk National Sales Manager: Paul Leahy paul.leahy@carechoices.co.uk

@VicRayner

@VickyMcDermott

@Mike_Padgham

@DebbieSorkin2

Vic Rayner Executive Director, National Care Forum

Vicky McDermott Chair, Care and Support Alliance

Mike Padgham Chair, Independent Care Group

Debbie Sorkin National Director of Systems Leadership, The Leadership Centre

@ARCOTweets

@360Fwd

@Worcester_Uni

@MyHomeLifeUK

Michael Voges Executive Director, Associated Retirement Community Operators (ARCO)

Rosemary Hurtley Consultant Occupational Therapist, Quality Improvement Consultant

Dr Simon Evans Principal Research Fellow, Association for Dementia Studies, University of Worcester

Tom Owen Co-Director, My Home Life

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 2017 ISBN: 978-1-911437-27-7 CCL REF NO: CMM 14.0

Are you getting the benefit of the CMM website?

CMM magazine is officially part of the membership entitlement of:

ABC certified (Jan 2016-Dec 2016) Total average net circulation per issue 16,265

4 CMM February 2017

@NickHood5

@EwanDKing

Nick Hood Business Risk Adviser, Opus Business Services Group

Ewan King Director of Business Development and Delivery, SCIE

From the Editor Editor, Emma Morriss welcomes you back to CMM after the winter break. Welcome back to CMM. The sector has not been far from the news since we last published the magazine in November. Our packed news pages will give you a round-up of what’s been happening. As we look forward, into 2017, CMM is preparing a lot to help you get through the next 12 months.

CONFERENCES Our popular CMM Insight conferences kick off with our first Dorset Care Conference. Being held in Bournemouth on 2nd February, it proposes to be an interesting day, bringing our national conference format to the Dorset, Bournemouth and Poole region. Exactly one month later, our national CMM Insight returns to Manchester on 2nd March. This year, we have expanded the scope of the day to incorporate mental

health as well as learning disability services. We hope that this will help more providers to navigate their way through what is a particularly challenging time. More information is in the event preview on page 48. Our regional conferences in Lancashire and Berkshire also return this year. They will be held on 21st September and 18th October respectively. We’ll let you know more about those in the coming months.

AWARDS We will also be back with our fantastically uplifting 3rd Sector Care Awards. The date of the ceremony has been set for 6th December and nominations will open in due course. We had such a wonderful time at the ceremony in December, the finalists and winners all undertake some fantastic work and you can read more about it on

page 38. If you operate in the third sector, please start thinking about how you may nominate yourself in one of the award categories, it’s such a wonderful way to be recognised.

CMM If that’s not enough to keep you going, we have a packed issue of CMM for you to read too. We start with a look at the financial pressures facing social care this year, and what we, as a sector, may be able to do to help the situation. Debbie Sorkin then explores Sustainability

and Transformation Plans, and why social care should be involved. The King’s Fund has heralded these plans as the ‘best hope to improve health and care services’ and social care must be a part of them. We also have a close look at the financial situation facing care homes. There’s no denying that the situation is tough; with 28% of care home operators at risk of insolvency, Nick Hood looks at the detail. These features, plus our regular articles, will hopefully help to set you up for the year ahead. Whatever 2017 brings, CMM will be alongside you.

Email: editor@caremanagementmatters.co.uk Twitter: @CMM_Magazine Web: www.caremanagementmatters.co.uk

We buy and sell care businesses and land. We provide consultancy and valuation advice. We don’t do anything else. Dedicated to the healthcare sector – dedicated to you. For more information about Carterwood or to find out how we can help you please telephone 08458 690777 info@carterwood.co.uk

www.carterwood.co.uk

CMM February 2017 5

Is it just me...?

undoubtedly have a major impact on improving people’s quality of life and provide a far more effective use of existing budgets. The current lack of social care provision is largely down to the failure of integration. I would be surprised if there was no appetite from care providers to fill this void should sustainable funding be made available. I have written a number of times about the reported slow (or lack of) progress in integration of services across the nation, yet control of these budgets remains in the same hands. What is being done to improve how the money is spent?

Editor in Chief, Robert Chamberlain, considers the impact of growing numbers of delayed discharges for mental health NHS patients.

FORWARD VIEW

The latest data from NHS England (January 2017) makes alarming reading in respect of delayed transfers of care in mental health trusts. Delayed transfers of care are rising rapidly across the NHS, however the increase is particularly rapid in mental health trusts. BBC News reported the figures (6th January 2017) and they made stark reading. From November 2015 to October 2016, there was a 56% rise of such incidents in mental health trusts and a 30% increase in numbers at acute trusts. More than 17,500 bed days were lost due to delayed discharge across the 24 specialist trusts in October 2016 alone.

THE REASONS A lack of psychiatric support in the community and other diminishing support services was said to be a contributing factor. Budget cuts and

lack of investment, especially in light of growing demand, are, of course, the root cause. A lack of social care services is also part of the problem. The irony, as always, is the cost of such delays to the NHS. Across the whole of the NHS in England, not just mental health, the National Audit Office estimates the costs of delayed transfers of care to be in excess of £800m per year. The Government has pledged £400m for crisis resolution and home treatment teams from 2017/18 to deliver 24/7 crisis response and intensive home treatment in communities and homes as a safe and effective alternative to inpatient care. But sinking another £400m into the NHS as it is currently managed makes little sense. Surely, poor financial management across the whole NHS is a priority that must be addressed. So many separate budgets with apparent protectionism of each and

a reluctance to integrate services, ie spend budget outside of the NHS system, are costing millions. The BBC News story gave an account from an individual who had experienced delays in discharge. He claimed the reason for not being discharged was arguments between different trusts over who was responsible for paying for his ongoing care. It seems that finance management trumps the needs of the people trusts are meant to care for.

RE-THINKING How could the cost of delayed discharge be reinvested in the NHS to develop much needed services to ease the problem? Here’s a radical idea. Why not embrace social care partners and create new services designed specifically to provide ongoing support post-discharge? This would

The Five Year Forward View for Mental Health is in place, but its positive impact is yet to filter through. Failing those with mental health needs due to funding or infrastructure problems is no longer acceptable. The Government has committed to funding for implementing the mental health forward view. But we really need to see better management of funding to ensure it impacts the frontline, reducing the discharge issue and improving the lives of those being affected. To quote Paul Farmer, Chief Executive of Mind, ‘The time after leaving hospital is critical as that is when people are at the greatest risk of taking their own lives. People need the right support to recover and manage their mental health properly, and trusts should be planning properly for discharge from the point at which someone goes into hospital.’ It is time to lose the rhetoric and put the available funding to its intended purpose. The current situation cannot continue if we truly are to see improvements in mental health support.

What do you think about this? Join the debate at www.caremanagementmatters.co.uk Twitter: @CMM_Magazine CMM February 2017 7

Are you ready for your next inspection? By providing the correct training, you can create an engaged productive workforce, reduce the staff turnover and increase the standard of the care you provide. All of which will help you to surpass fundamental standards of care.

Free training consultation Call us today and reference this advert and we will happily offer you a free training consultation to see if we can help you manage your requirement more efficiently and cost effectively.

01823 332200 â&#x20AC;˘ www.redcrier.com

What does the ideal Care Worker look like for your organisation? Values-based recruitment has been proven to reduce: The total cost of recruitment Sickness and absence rates Staff turnover The cost of upskilling At the same time improving staff performance Assess yourself and trial for free in your organisation

0330 363 9996

8 CMM February 2017

Profiles4Care.com

info@profiles4care.com

APPOINTMENTS HEALTHWATCH ENGLAND Jane Mordue has been appointed the permanent Chair of Healthwatch England, having held the position on an interim basis since December 2015. She has also been appointed a nonexecutive member of the Care Quality Commission’s Board.

Funding social care The sector was dismayed with November’s Autumn Statement which did not include any additional funding for social care. Despite a concerted effort by the sector to raise awareness of the pressures being faced, the vulnerable people being left without support and the fragile state of the market, social care didn’t feature in the Chancellor’s spending plans. The sector was quick to articulate its disappointment at this ‘missed opportunity’, saying social care has been ‘snubbed’. Janet Morrison, Chief Executive of Independent Age said, ‘The new Chancellor announced more money for physical infrastructure and support for business. Yet he

failed to give any relief for the “social infrastructure” that millions rely on – our health, care and support services. Nor did he help those care employers increasingly forced to desert the state-funded care sector due to lack of funding. The longer we ignore the problem, the worse it will get. No additional funding has been forthcoming and consequently hundreds of thousands of frail and elderly will continue to suffer as care services are cut back and fall into decline.’ Three weeks later in midDecember, the Government did announce some additional funding for social care. The Communities Secretary, Sajid Javid, announced that he would bring forward flexibility

Research into precept impact Following the Government’s announcement that councils can increase the social care precept, new research has found that such increases won’t benefit the areas which need it most. Also, potential funding increases are ‘nowhere near adequate’ to sustain adult social care, according to new analysis conducted by economists at the International Longevity Centre - UK (ILC-UK). ILC-UK has found that a 3% social care precept wouldn’t benefit the local authorities which needed it most. Raising the precept will be far more effective for some local authorities than others. ILC-UK

analysis shows that a rise in the precept from 2% to 3% will bring in more money per older person for those local authorities where the older population accounts for a smaller overall proportion. In other words, those local authorities that need the money most, will bring in the least. For example: a 3% precept in Tower Hamlets raises £160 for every person over the age of 65, this is despite the fact it has a very low proportion of older people (just 6% are over 65), by contrast, West Somerset only brings in £53 per older person, despite having the highest proportion of older people in the country.

over the social care precept, so councils can choose to raise it by 3%, rather than the 2% originally planned. It was announced that this is on top of a new adult social care grant, worth £240m, and an improved Better Care Fund worth up to £1.5bn so councils can work more closely with the NHS. The Government said that it brings total dedicated social care funding to £7.6bn over the settlement period, with councils receiving almost £200bn over the Parliament. Mr Javid made it clear that more money is not the only answer, and highlighted the importance of better integrating health and social care. For more information on this and what the sector can do, see page 20.

New Year Honours Care Quality Commission Chief Executive, David Behan CBE was awarded a Knighthood in the New Year Honours. Others formally recognised from the care sector include Helena Herklots, Chief Executive of Carers UK (CBE), Ranald Mair, formerly Chief Executive of Scottish Care (OBE), Deborah Sturdy, Nurse Adviser at Care England (OBE), Alex Fox, Chief Executive of Shared Lives Plus (OBE) and Professor Keri Thomas, founder of Gold Standards Framework (OBE).

Imelda Redmond, formerly Chief Executive of Carers UK, has been appointed National Director of Healthwatch England.

FREMANTLE TRUST Jo Head has been appointed Regional Director for Older People’s Services at the Fremantle Trust.

HALLMARK CARE HOMES Hallmark Care Homes has appointed Malcolm Ross as a non-executive director.

NORTHERN IRELAND EXECUTIVE Des Kelly and John Kennedy have been asked to form an Expert Advisory Panel to help Northern Ireland’s Department of Health reform adult care and support.

ORDERS OF ST JOHN CARE TRUST Orders of St John Care Trust has appointed Jo Blackburn as Care and Quality Director to join its Executive Team.

DIMENSIONS Dimensions has welcomed Bob Tindall into the post of Managing Director.

TARGET HEALTHCARE REIT Target Healthcare REIT has appointed Ian Webster as a Non-Executive Director.

CMM February 2017 9

NEWS

APPOINTMENTS NICE Five new non-executive directors have been appointed to the Board of the National Institute for Health and Care Excellence (NICE). They are: Professor Sheena Asthana – public health, Dr Angela Coulter – patient/lay representative, Dr Rima Makarem – Audit and Risk Chair, Tom Wright – social care, and Professor Martin Cowie – hospital medicine.

EXEMPLAR HEALTHCARE Dr Mark Jackson has been appointed Chairman of Exemplar Healthcare.

LNT CARE DEVELOPMENTS Karen Whitehead has joined LNT Care Developments as Development Director.

EASTGATE CARE Sharon Di Maio has become Eastgate Care’s Managing Director.

SCIE Lord Michael Bichard will step down as Chair of the Social Care Institute for Excellence (SCIE) in March 2017.

AUDLEY RETIREMENT VILLAGES Audley Retirement Villages has strengthened its Land and Planning Team with the appointment of Alex Hales, who joins as Planning Manager.

LOCAL GOVERNMENT OMBUDSMAN Michael King has been appointed the new Local Government Ombudsman.

NHS CONFEDERATION Niall Dickson is the NHS Confederation’s new Chief Executive.

10 CMM February 2017

3rd Sector Care Awards success STPs – The 3rd Sector Care Awards were was hosted by Dame Esther Rantzen best hope held at the London Marriott Hotel, and included 12 hotly contested Grosvenor Square on 7th December. categories. More information on the The annual award ceremony for day and details of the winners can be to improve those working in the third sector found on page 38. services and Transformation Consultation on ‘next phase’ of Sustainability Plans (STPs) offer the best hope to improve health and care services CQC regulation despite having been beset by The Care Quality Commission (CQC) is inviting people to give their views on its plans to deliver a more targeted, responsive and collaborative approach to regulation across health and adult social care in England. The consultation will run until 14th February and CQC expects to respond formally to the feedback from the consultation in spring 2017. The proposals, published in late-December, describe how CQC intends to develop its ‘next phase’ of regulation for all health and

adult social care services, with a particular focus at this stage to the way it will monitor, inspect, rate and report on NHS trusts and adapt its approach in response to emerging new care models. CQC plans to work with changing care models as they develop, and ensure close alignment with other regulators to minimise unnecessary burden for providers. A further consultation focusing on how CQC will regulate adult social care and primary medical care will also take place this year.

People with learning disabilities in England The new updated People with Learning Disabilities in England report has been published by the Learning Disabilities Observatory, part of Public Health England. The report is a compendium of statistics about the lives of people with learning disabilities. It covers a wide range of information about population numbers, education, health and social care. The Learning Disabilities

Observatory (also known as Improving Health and Lives (IHaL)) was set up in April 2010 to provide high quality data and information about the health and healthcare of people with learning disabilities. The information helps commissioners and providers of health and social care to understand the needs of people with learning disabilities, their families and carers, and, ultimately, to deliver better healthcare.

problems so far, according to a new report from The King’s Fund. STPs have been strongly criticised by politicians, local authority leaders and patient groups. The report, based on interviews with senior leaders in four STP areas, supports many of the criticisms. However, despite these problems, the report urges the Government and the NHS to continue to back STPs as the best hope for delivering long-term improvement in health and social care. At the same time as supporting the idea behind STPs, the report makes recommendations for making them work better. These include the need for: • All parts of the health and care system, as well as the public, to be involved in the plans. • Improved governance, with the role of STP leaders strengthened and clarified, and NHS regulation changed to make it easier for organisations to work collaboratively. • National bodies in the NHS to ‘stress test’ STPs to ensure the assumptions behind them are credible and the proposed changes realistic.

Adult social care market shaping The Department of Health has published guidance to help people and organisations understand adult social care market shaping and how to take action. The market shaping guidance covers the need for responsive and sustainable markets in adult social care to be developed and supported through market shaping, market oversight and contingency planning.

The new guidance is aimed at: • People who buy social care services, including local authorities, clinical commissioning groups, personal budget holders and self-funders. • Social care providers, including those regulated by the Care Quality Commission (CQC). • Wider services which support the wellbeing of local populations, including community and

voluntary services, micro and social enterprises, personal assistants, housing, leisure, transport, and information and advice services. • A range of potential investors in social care. The guidance, Adult social care market shaping is available to read on the Department of Health’s website.

The Touch Series The complete nurse call solution

Location

Data logging

Cloud based

Integration

The Intercall Team look forward to meeting with you, For any enquiries please get in touch: please get in touch - weâ&#x20AC;&#x2122;d love to hear from you. 01403 713240 or sales@intercall.co.uk +44 (0) 1403 713240 | intercall.co.uk

NEWS

WCS Care get Out & About home up to six trips a month for a flat fee of less than half the cost of running and staffing a dedicated minibus. Trips will be facilitated by a trained Oomph! conductor who will drive the bus, support staff to get participants on and off and create the trademark Oomph! party atmosphere on board. Trips are agreed with individual homes and personalised to reflect the interests and needs of residents as well as staffing ratios of homes. Destinations for the pilot include Brooklands motorsport and aviation museum, Kew Gardens, Grayshott Pottery and the Lightbox Gallery.

WCS Care is the first client for a radical new solution from Oomph! Wellness to make a regular, rich programme of outings available to any care home. Oomph! Out & About will leverage Oomph!’s relationships with care groups across the country to achieve economies of scale for cost-effective access to transportation and premium destinations. Piloting with brighterkind and St Cloud Care in Surrey and Hampshire since November, it will roll out nationally from April 2017 and operate 110 minibuses by summer 2018. The service will offer any care

Cross-party agreement on funding needed now The Prime Minister must find cross-party agreement on health and social care funding. That is according to a letter from the Chairs of three House of Commons Select Committees. This is the strongest call yet to Prime Minister, Theresa May, to address the challenges facing health and social care. The three Chairs, Sarah Wollaston MP, Chair of the Health Committee, Meg Hillier MP, Chair of the Public Accounts Committee, and Clive Betts MP, Chair of the Communities and Local

Government Committee have sent a letter to the Prime Minister. In the letter, they say that a ‘political consensus’ is needed to address the ‘pressing social care challenges facing the country’ and that it must also include the NHS. They call on the Prime Minister to invite all parties to take part in an urgent review, covering the health and social care systems. The MPs continue, ‘In short, the problem is widely recognised – we now need political agreement so that a solution for the long term can be found.’

Learning, Candour and Accountability – CQC publication The Care Quality Commission (CQC) has published review of the way NHS trusts review and investigate the deaths of patients in England. In Learning, Candour and

Accountability, CQC was unable to identify any trust that demonstrated good practice across all aspects of identifying, reviewing and investigating deaths, and ensuring

GUARD

that learning is implemented; although they observed some trusts demonstrate promising practice at individual steps. The review focused on five key

areas: involvement of families and carers, identification and reporting, decision to review or investigate, reviews and investigations, and governance and learning.

Safeguarding is your business

– and it’s our business too Review Audit Investigation Support

12 CMM February 2017

Have you got a problem with your regulator on Safeguarding? Would you benefit from independent assurance that your Safeguarding systems are fit for purpose? Do you have a particular service that is causing you concern? Is there a Safeguarding allegation that would benefit from skilled, external, investigation? Whether in response to a problem already identified, or because you or your Board want to be confident that risks are mitigated, CareGuard will deliver what is required. We have a team of experts who not only know what to look for, but will support you in just the way you need. For further information, visit our website www.careguard.uk.com or call us on 01903 791388

NEWS

Inquiry into supported housing funding reform The Work and Pensions Committee and the Communities and Local Government Committee have launched a joint inquiry into the Government's funding reform for supported housing. The inquiry will examine the planned changes for 2019-20, when core rent and service charges for supported housing will be funded through Housing Benefit

or Universal Credit up to the Local Housing Allowance (LHA) rate. For costs above this, funding will go to local authorities for disbursement locally. The Committee will consider whether the new system will ensure that the varied rate of the LHA cap will not adversely affect tenants and providers in low-value parts of the country.

It will examine how existing tenants will be protected following the switch and ask whether the changes should be piloted. The inquiry will also look at the effect that uncertainty about the new model is having on the sector and explore whether separate funding models are needed for refuges and other short-term supported housing services, or

sheltered housing services for elderly people, which would require a higher cap. How the localised funding pots would work, including how the money will be ring-fenced and which factors should be used to determine an areas allocation, are also due to be investigated. For those wanting to respond, the deadline for written submissions is 3rd February 2017.

Learning disability services in Wales Healthcare Inspectorate Wales (HIW) has published a report on the performance of NHS learning disability services in Wales, following its recent inspections. Since July 2015, HIW has been assessing how well the NHS provides specialist services for adults with learning disabilities in Wales. Overall, HIW found that people with learning disabilities were treated with dignity and respect by staff. Access to general healthcare services was

good and patients were supported to manage their own health conditions. HIW was also pleased to find that health communication passports were in place for many people. It was also positive to see specialist learning disability liaison nurses in place in some health boards. Findings were positive even though staff faced significant challenges. These challenges were mostly associated with the

Continuing Healthcare (CHC) funding process and, in some areas, access to speech and language therapy. However, NHS residential services for people with learning disabilities require significant improvement. HIW found that whilst staff generally tried their best to care for patients, this was often not underpinned by good management and staffing arrangements. HIW also found poor record-keeping

and environmental issues and that health boards did not have sufficient oversight of these services. Staff at many of the services told HIW that there was a general lack of understanding of learning disabilities by medical staff. All health boards in Wales must make sure that staff are aware of the provisions of the Mental Capacity Act 2005. HIW has made a number of recommendations for health boards and policy-makers to consider.

Your happily ever after starts hereâ&#x20AC;Ś Your focus is on delivering great care to your residents so you need flexible software that helps you be more efficient and supports your growth. Advanced donâ&#x20AC;&#x2122;t offer fairy tales, just care home management solutions that provide genuine benefits, including: > Improved CQC compliance > Access to real time information > Increased quality and quantity of care delivered > Bespoke solutions that meet your individual needs We support over 3,000 care homes improve their efficiency by delivering them the care management solution of their dreams. Get in touch to find out how we can help you! Call: 0845 160 5555 Visit: oneadvanced.com

CMM February 2017 13

14 CMM February 2017

NEWS

Re-think reductions in public health funding Planned reductions in public health grants will only deepen the social care crisis and compound pressure on the NHS, county leaders have argued. With the unanimous view across the social care sector that adult care is fast reaching a tipping point, the County Councils Network (CCN) is calling on the Department of Health to re-think its year-on-year reductions in public health funding. CCN argues that taking money away from preventative services is counterproductive in the long-term, as it could end up increasing costs for the NHS further down the line. This could seriously hinder the ability of the health service to hit the significant efficiency targets required

by the NHS Five Year Forward View. Since the responsibility for public health was given back to local government in 2013, the Government has implemented a £200m in-year cut to budgets in 2015/16, followed by a £77m reduction in the current financial year. Reversing the planned reductions for the remainder of the Parliament would give a timely boost to councils and show Government’s commitment to prevention. It would result in an extra £84m being made available for council budgets across the country in 2017/18. After that, CCN is calling for no further reductions for three years.

Mental health care improvements needed Faster improvements are needed in how people are cared for when detained under the Mental Health Act, warns the Care Quality Commission (CQC). The quality regulator has found that there is a lot of good practice in how psychiatric inpatient units are caring for people when detained under the Mental Health Act, but that there is still much to be done to improve this type of mental health care.

In its annual review of the Mental Health Act, the Care Quality Commission has outlined how several healthcare services in England are using the Act to maximise people’s recovery, wellbeing and support when they have been detained; however, it raises concerns that progress needs to happen at a faster pace for key issues, such as patient involvement and protection of rights.

£10m a year more for Welsh social care An extra £10m a year of new funding will help ensure the Welsh social care sector is strong and sustainable for the future, according to Minister for Social Services and Public Health, Rebecca Evans. The new investment will form part of a three-way agreement to be established between the Welsh Government, local government and social care employers to work together to create a more stable

social care workforce. The Welsh Government funding will help meet the extra costs associated with the introduction of the National Living Wage. It is in addition to the extra £25m for social care, which was announced in the draft 2017-18 Budget in October. Further funding to support social care in 2017-18 will be available as the maximum weekly charge for domiciliary care rises from £60 to £70.

New Apprenticeship standards Two of the new Apprenticeship standards and assessment plans are now available for adult care employers to use and learning providers to implement. The new standards are Adult Care Worker (Level 2) and Lead Adult Care Worker (Level 3). The assessment plans for two further standards, Lead Practitioner in Adult Care (Level 4) and Leader in Adult Care (Level 5), are awaiting final approval from ministers pending agreement on the funding bands. The new standards have been designed by adult care employers, acting as part of the Government’s Trailblazer initiative, to replace the current Apprenticeship frameworks. The standards are two-page documents listing the skills, knowledge and behaviours needed for apprentices to be competent

in these occupations. They have been created by the Trailblazer group to strengthen the generic competencies of care workers across all sub-sectors of adult social care. The assessment strategy includes the completion of the Care Certificate and a formal diploma at the relevant level, plus, as is the case for all new Apprenticeships, rigorous and graded tests taken at the end of the Apprenticeship to prove that the apprentice has fully absorbed all they have learnt. It is expected that from 2017 onwards, starters on the new standards will gather pace as endpoint assessment organisations emerge from the registration process and design their tests and as the old frameworks are phased out.

New funding for new care model vanguards NHS England has announced £101m of new funding to support and spread the work of the new care model vanguards. The vanguards are partnerships of NHS, local government, voluntary, community and other organisations that are implementing plans to improve the healthcare people receive, prevent ill health and save funds. Considerable progress has been reported to have been made since the vanguards were launched

in 2015 and there is emerging evidence that they are making significant improvements at a local level. This includes reducing pressure on busy GP and A&E services. In addition to the funding, the vanguards will continue to receive support from NHS England and other national bodies to implement their plans, including how they harness new technology, including apps and shared computer systems.

They are also receiving help to develop their workforce so that it is organised around patients and their local populations. New models of care, including the work of the vanguards, are key to the delivery of sustainability and transformation plans (STPs), which are being developed across the country. In order to secure their allocated funds, vanguards will need to meet a number of conditions, including spread of

their new care models within and across STPs. This includes producing guidance and materials for others to use and clear quality improvements and costs/savings. Local evaluation remains a critical part of the programme and will be funded separately, with details set out at a later date. For more information on why social care must be involved in STPs, read Debbie Sorkin’s article starting on page 25. CMM February 2017 15

NEWS

Good practice on ‘effective healthcare for older people’

2016 POLL RESULTS February

March

If given the go-ahead, will another commission on the future of health and social care bring about the solutions needed?

Will the next 10 years bring a fair funding solution for people requiring social care?

No 44%

YES 84% NO 16%

Yes 28% Don’t know 28% 0

April

May

Are you involved in any new model development programmes?

What is your quality rating? Outstanding 8% Good 54% Requires improvement 0% Inadequate 8% Not yet rated 31%

No 91% Yes 9% 0

100

June

July

Do you feel confident about your business?

Did you participate in Care Home Open Day 2016?

Yes 70%

NO 75%

No 30% 0

YES 25%

September

October

Do you have recruitment and/or retention issues?

Are you considering exiting the market?

Yes 44%

NO 70%

No 56% 0

YES 30%

November

December

Do you have good working relationships with your local hospitals?

Do you feel that social care is in crisis?

YES 86% NO 14%

No 62% Yes 38% 0

16 CMM February 2017

Source: www.caremanagementmatters.co.uk Figures correct at time of print.

The British Geriatrics Society has published 'Principles and Standards' of good health care for older people, with a particular focus on those living with frailty. The new paper sets out, in clear and simple terms, the principles of healthcare that the Society endorses for older people in acute, community and care home settings, and the standards which are needed to underpin these principles. The principles are: effective, accessible and timely care; autonomy, choice and personcentred; and safety and dignity. Included in the 'Principles and Standards' are the Society's fundamental beliefs that: • Older people should be properly

valued, listened to and treated with compassion, and have their dignity, beliefs, needs and privacy respected at all times. • All older people should have equal access to assessment, care and treatment regardless of age, gender, racial or ethnic background, religion, sexual orientation, beliefs, disabilities, marital or civil partnership status. • Older people should be safeguarded from harm due to abuse, exploitation or neglect. • Health care professionals should involve (but only with consent from the patient or in their best interests) the families, carers and representatives of older people in decisions about their care and treatment.

OWCH – Older Women’s Co-Housing The Older Women’s Co-Housing (OWCH) is a group of women over fifty who have created their own community in a new, purposebuilt block of flats in Barnet, North London. New Ground Cohousing is now complete and OWCH members began moving into their new homes recently, with an intention that everyone will have moved in by February.

OWCH has said that it is carving out a path for others in the older age group to follow and hope the senior cohousing community could enrich the last years of many, and reduce pressures on health and care services, if local authorities, planners, policy-makers and developers helped remove the many obstacles society puts in its way.

Cambian sells adult services division Cambian Group has sold its adult mental health, learning disabilities, and acquired brain injury business to Cygnet. Candesic conducted the vendor commercial due diligence for the Cambian Group, supporting the sale of the adult services business to Cygnet Health Care for £377m. Founded in 2004, Cambian is one of the largest providers of specialist behavioural health

services for children and adults in the UK. Cambian owns a portfolio of over 300 purpose-designed facilities and nine fostering offices in the UK. Cygnet Health Care operates 21 centres with over 1,000 beds in the UK. It is a wholly owned subsidiary of UHS with a national UK footprint. UHS is one of the largest hospital management companies in the United States.

NEWS NEWS / IN FOCUS

Building the future social care workforce A report from the Social Care Institute for Excellence (SCIE) discusses how the sector could respond to economic and political change to develop the future social care workforce. It is well recognised that more care workers are needed to meet the care and support needs of the future. Care workers: building the future social care workforce looks at three hypothetical future scenarios, and how the sector might respond to the challenges and opportunities those scenarios offer in relation to recruiting, training and retaining care workers. The report was based on discussions with key stakeholders and forms part of a wider research project supported by JP Morgan Chase Foundation.

Carterwood advises LNT Carterwood has secured another turnkey completion for LNT Care Developments, with the sale of a scheme in Welwyn Garden City, Hertfordshire. The scheme has been acquired by Country Court Care and will result in the construction of a state-of-theart, investment grade 60-bedroom care home in the southern part of the town. Development is due to commence imminently and is expected to be completed in approximately 12 months.

Derbyshire care home sold DC Care completed on the sale of Littlemoor House, Newbold, Derbyshire. The care home supports five younger adults with learning disabilities. The home was purchased by Mr Shakti Patel.

In focus Competition and Markets Authority’s market study of care homes WHAT IS THE STORY?

The Competition and Markets Authority’s (CMA) has launched a market study into care homes and care homes with nursing for older people, looking into possible competition or consumer issues. The study aims to assess whether the market works well within the current funding and regulatory frameworks. The market study will evaluate the effectiveness of competition between care homes in driving quality and value for money for residents and taxpayers. It will also consider how local authorities and other public bodies purchase and assign care home places, and how they encourage and shape local supply.

WHAT IS THE STUDY SCOPE?

The CMA study will assess how people find the experience of choosing a care home, explore whether the current regulation and complaints system gives residents adequate protection, and examine how well care homes are complying with their obligations under consumer law. As part of this, the CMA will look very closely at reports of potentially unfair practices and contract terms being used by some care homes to assess how widespread these concerns are, how they are affecting residents, and whether they are likely to breach consumer law.

ANYTHING ELSE?

The CMA will be looking at a variety of issues including:

• The main pressures for care home providers that affect their long-term sustainability (for example changes in costs and regulation). • How well the way local authorities and the NHS buy services works. • How local authorities and regulators affect outcomes, including through ‘market shaping’ activities. • How regulations in each nation affect care homes and competition between them. • Any impediments to the supply of care home places, both for self-funded and local authority funded residents. • Anything that prevents the type of competition you'd expect in a healthy market, such as barriers to entry and expansion, and a lack of capacity. • Whether older people and/or their representatives are being disadvantaged through the use of unfair terms and conditions, and whether there are unfair business practices. • How older people and/or their representatives first choose a care home, and if there's appropriate information available to them.

ARE ANY ISSUES CONSIDERED OUT OF SCOPE OF THE STUDY?

Funding of the care sector and standards are considered out of scope. The focus is consumer orientated and, therefore, the CMA has stated that it is particularly interested in looking closely at

whether care home providers are incentivised to compete with each other to attract business and whether this helps improve value for money for customers. For example, do the ways self-funders choose care homes, or local authorities procure services, reward providers for trying to improve their services? How well are potential residents able to assess different care homes, given they're often making quick decisions under very difficult circumstances?

WHAT ELSE WILL CMA BE CONSIDERING?

Following concerns raised by some charities, the CMA is also asking residents and their representatives to report on their experiences of potentially unfair practices and contract terms, for example around: • Hidden unexpected charges. • Fee increases at very short notice and without clear explanation. • Large deposits or upfront payments without being clear what they cover. • Unreasonably long notice periods to leave the home. • Additional charges for residents in receipt of local authority funding where it may not always be clear what they're being charged for. • Residents and their families being deterred from complaining.

WHAT TIMESCALES ARE PROPOSED?

The deadline for submissions was 15th January 2017. An interim report will be produced in June, with a final report in November 2017. CMM February 2017 17

NEWS

Closing the disability employment gap

Inquiry about truth and lying in dementia care

The Voluntary Organisations Disability Group (VODG) is calling for more practical solutions to close the disability employment gap in a new report. Closing the disability and employment gap outlines successful employment and training schemes delivered by specialist disability organisations. It includes recommendations for government, employers and care providers to boost employment for working-age disabled people.

A report of the major Mental Health Foundation Inquiry into Truth and Lying in Dementia Care, commissioned and funded by the Joseph Rowntree Foundation, has been published. There are around 850,000 people living with dementia in the UK and the ageing population suggests this figure will rise significantly. Around half of these people may be living with different realities. People with more advanced dementia may experience challenging and

The publication is a response to the recent Green Paper on work, health and disability, which VODG hopes will spark fresh dialogue between policymakers, disabled people, businesses and charities. Despite a commitment to ‘aim to halve the disability employment gap’ in the 2015 Conservative Party manifesto, the UK’s disability employment gap is around 32%. Less than half of disabled people are in work, 48%, compared to 80% of their non-disabled peers.

distressing symptoms, such as confusion and disorientation. These experiences may appear to be or feel very meaningful to them, and responding to them purely as symptoms of an illness can be unhelpful or even harmful to the person. Carers often have challenging decisions to make when a person is living with different realities and beliefs – something that increases as the dementia accelerates. The report sets out a number of key principles that should drive good practice.

Transforming mental health support The Government has announced measures to transform mental health support in schools, workplaces and communities. The plans aim to make mental health an everyday concern for every part of the system. Some of the measures include:

a major thematic review of children and adolescent mental health services across the country, led by the Care Quality Commission; a new green paper on children and young people’s mental health to set out plans to transform services in

Start working with the latest technology to free your staffs’ time for the care that matters. Sekoia is an app-based solution for care homes that want to benefit from a digital toolbox. Your care documentation is done with the single touch of a button. All your information is at hand in the care situation, enhancing care quality and heavily reducing paperwork and unforeseen mistakes. Sekoia 2 Eastbourne Terrace London W2 6LG Office DL: +44 7854 906 571 contact@sekoia-care.co.uk www.sekoia-care.co.uk

18 CMM February 2017

schools, universities and for families; a new partnership with employers to improve support in the workplace; further alternatives to hospital to support people in the community; plans to rapidly expand treatment by investing in and expanding digital

mental health services; and new ways to right the injustices people face. The Government will also support NHS England’s commitment to eliminate inappropriate placements to inpatient beds for children and young people by 2021.

NEWS

‘Staggering’ rise in unmet needs Mental Capacity Act resources The number of older people in England living with some level of unmet social care needs has soared to 1.2 million – up by a staggering 48% since 2010. The analysis by Age UK found that since 2010, 383,900 more people aged 65 or over are now living with an unmet social care need. This means nearly 1 in 8 older people are struggling without the help they need. Among the 1.2 million, Age UK’s analysis shows that 696,500 older people do not receive any help at all, from either paid care

staff or family and friends, and that a further 487,400 receive some help but not enough, often because help is only available at certain times of day or their carers are only able to manage some tasks but not others. Furthermore, nearly a quarter (291,400) of older people with unmet social care needs has difficulty with three or more essential tasks; this is nearly half (45.5%) of all those who reported needing help at that level – 52,700 of them receive no help whatsoever.

Nursing degree apprenticeship The Government has announced a new nursing degree Apprenticeship, opening up a career in nursing to more people. Once established, up to 1,000 apprentice nurses could join the NHS each year. The new nursing associate role will work alongside healthcare support workers to deliver handson care, freeing up nurses to focus

on clinical duties and take more of a lead in decisions around patient care. Interest in the role has already seen Health Education England expand the number of training places in the pilot from 1,000 to 2,000. People who complete the nursing associate Apprenticeship will be able to count that training towards a nursing degree.

The Social Care Institute for Excellence (SCIE) has produced a new film exploring the Mental Capacity Act and how to use it. It adds to a wealth of resources that are part of its Mental Capacity Act Directory. In the new film, Baroness Finlay, Chair of the National Mental Capacity Forum, explains how the Mental Capacity Act can support care staff with difficult decisions. The information produced

by the National Mental Capacity Forum forms part of the Mental Capacity Act Directory on the SCIE website. The Directory helps to raise awareness of the Mental Capacity Act, including the Deprivation of Liberty Safeguards. There is useful information and tools to help understand or implement it. It contains material for people who may be subject to the Act’s provisions, and for professionals from a range of backgrounds.

Outstanding care staff honoured Outstanding care staff and care teams from across the county were honoured at the Surrey Care Awards. Over 400 care employers and staff celebrated this year’s Awards, which were presented by TV and film actress Jenny Seagrove. The Surrey Care Awards are the county’s ‘Oscars’ for care staff. The Awards recognise the hard work and dedication of people working in a

wide variety of jobs in adult social care. The 65 finalists were nominated by their colleagues, with glowing and often moving testimonials from the people they support and their families. The Awards are organised by Surrey Care Association, which represents the interests of over 700 independent providers of care and support services in the county.

2018

CMM February 2017 19

At breaking point Social care 2017

20 CMM February 2017

What does 2017 hold for social care? What is the Government doing to address the issues? Will it make a difference? What can the sector do?

Vic Rayner, Executive Director, National Care Forum Vicky McDermott, Chair, Care and Support Alliance Mike Padgham, Chair, Independent Care Group

WELCOME, BUT IN NO WAY ADEQUATE, FUNDING ANNOUNCEMENTS Vic Rayner, Executive Director, National Care Forum The prevailing comment within social care about November’s Autumn Statement was – what comment? The silence from the Chancellor on the issue of the paucity of funding to care for the most vulnerable members of society was deafening. This was all the more disappointing when married with the almost unprecedented uniting of opinions across the sector – including commissioners, the regulator, providers, people using services and their carers – about the exceptionally fragile state of adult social care in the UK. Amongst much of the anger expressed across the piste, I found

the commentary on the decision take a worrying turn. The narrative began to focus on the unwillingness of the Government to fund the most ‘basic’ of care needs for individuals, and lots of headlines and political commentary centring on the ‘kind of nation’ that we wished to be, that didn't even meet these basic needs. Whilst I understand that this approach had the potential to apply leverage to the Government over its inaction, there is a huge risk that it reinforced in the general public’s mind the notion of a set of social care services far removed from the complex and compassionate care that is being delivered 24/7, 365 days a year. Having seemingly ignored the needs of social care in the Autumn Statement, in contrast, the Secretary of State for the Department of Communities and Local Government put it centre stage in his statement about the Local Government Settlement in mid-December.

In perhaps direct response to the criticism levelled at the Chancellor, Sajid Javid delivered two explicit funding initiatives aimed at addressing short-term pressures within the system. The first of these, to increase the flexibility of the social care council tax precept, falls foul of all of the challenges to the existing precept. It is seen to benefit wealthier parts of the country, which will gain substantially more revenue from the increase, and in contrast places a significant burden on deprived areas of the country where the tax will have a disproportionate impact on low income households. The second rabbit out of the Secretary of State’s hat was the announcement of a new, centralised social care fund developed through re-profiling some existing local authority income. This fund will be used to target areas of highest need. Whilst both of these are welcome, they are in no way adequate to address the current and future

funding gap for social care. Neither did they begin to shift the balance of the debate into recognising that the cost of care is rightly high, and likely to grow, as there is nothing basic about either the needs of the people receiving care, or the skills of those delivering it.

MORE PUBLIC UNDERSTANDING OF THE REALITY OF THE CARE CRISIS IS NEEDED Vicky McDermott, Chair, Care and Support Alliance While it is encouraging that the Government is finally starting to acknowledge the crisis in social care, its pre-Christmas announcement of the Local Government Settlement failed to deliver the money needed to address the immediate crisis in social care. Let alone tackle any of the longterm problems. According the Institute of Fiscal Studies (IFS), the funding was

CMM February 2017 21

AT BREAKING POINT – SOCIAL CARE 2017

worth £700m over two years, not the £900m the Government claimed. Local governments are also still having to make cuts so, as the IFS highlights, funding cuts could still fall on social care services, as long as councils prove the cuts are less than they would have been before the promised precept rise. While there is confusion over figures, currently more than one million older and disabled people have unmet needs for care and support in England. These people are missing out on essential support for help with everyday tasks like washing, dressing or eating. There are also record levels of delayed transfers of care as hospitals struggle to cope. The tightening of the eligibility criteria has seen at least half a million fewer people receive care since 2005/6 – a reduction of 30% – while increasing demographic pressures mean more of us need care. Funding pressures mean that in some areas councils are not able to pay for the full price of care, and care homes are closing as a result. Government figures show that 380 care homes have closed since 2010. When care homes close, people have to go further away from family to find a place, which makes it harder on families to visit. Or, increasingly, there may not be anywhere for them to go at all. Despite these warning signs, the Government still fails to give social care anywhere near the funding it needs. A fundamental problem with campaigning on social care is that it is little understood and, therefore, not protected by public outrage like health or education. Can you imagine the understandable outcry there would be if a third of hospitals had closed? Or, if over five years, a third of students were turned

away from our schools? That is the equivalent to what has happened in social care. People often don’t even know what the term social care means. It isn’t part of the health service, like many expect it to be. It isn’t a benefit, even though you’re tested to receive it. It is hard to see. It isn’t summed up in three instantly recognisable letters such as NHS. It isn’t associated with hospitals or GP surgeries or ambulances or waiting rooms. It’s hidden from view, in the homes of older and disabled people. As many families know, not getting support is heart-breaking and potentially dangerous. Because of this lack of public understanding, politicians keep failing to address the issue. Since 1997, and Labour’s Royal Commission, up until the last Conservative manifesto, which promised to introduce the cap on what individuals had to pay towards the costs of their own care (which was subsequently postponed to 2020), Governments of all colours have talked about changing the funding model for care, but have not implemented much-needed reforms. And the reform they have implemented, namely the Care Act, is being totally undermined. Money is tight and political energy is being consumed with Brexit, on top of the normal business of Government. It is, therefore, clear that as we fight to ensure we have a care system that works, we need to reach more members of the public and highlight, in an understandable way, what the care crisis means for them, their family and their community, and demonstrate just how invaluable the service is. MPs need to start feeling the pressure to ensure there is proper action to tackle this crisis. And they need to feel that now before the crisis deepens.

WE NEED FRESH THINKING AND A ROOT AND BRANCH OVERHAUL Mike Padgham, Chair, Independent Care Group The Government’s decision to allow local authorities to increase their council tax to help pay for social care is a welcome move – but really not one that will solve the crisis that is affecting the care of our oldest and most vulnerable citizens for the long-term. It is, at best, a sticking plaster on a gaping wound. The extra money councils will raise over the next couple of years won’t even begin to address the predicted £2.8bn shortfall and won’t scratch the surface of the problems facing social care. We are seeing care homes closing or taking fewer people. Domiciliary care providers are also closing or handing back unsustainable contracts. In short, we see people going without care. It feels very much like we have tried everything to get social care’s case heard – to no avail. What do we need to do? Is it time for supporters to stand as MPs or as local councillors to see if we can change social care from within? What solutions would we propose once there? Allowing local authorities to increase council tax places the entire burden on council tax-payers and is only a short-term measure. We need fresh thinking and a root and branch overhaul. In short, if the country wants to end this crisis and give vulnerable people the care they have a right to, it is going to have to pay for it and more funding needs to go into social care. To begin with, diverting funds into social care will save money for the NHS. It is obvious that looking

after people, where they want to be cared for – in their own home or in care homes – is wholly better and less expensive than having them in hospital beds. Merging the NHS and social care into a single department – the Department for Social Care and Health, for example – is long overdue. It has never made sense to have the two separate. We should have this single department to provide services, properly funded through national, rather than local taxation. Would people say ‘yes’ if there were a referendum on aiding social care? Using the independent sector more is another obvious solution. It has been proven time and again that independent providers can deliver services more efficiently and cost-effectively than in-house teams. The independent sector also has the flexibility and flair to come up with new solutions as care needs and economic climates change. There is a case for having the independent sector better represented at the heart of the decision-making process, to harness the entrepreneurial flair that the independent sector brings to the table. Why not second them into Government or the Civil Service to help? We also need incentives to keep providers in the market and encourage new ones to join and invest, as we look forward to meeting the ever-increasing demand for care. We are making progress, but it is one step forward, two steps back. Like the England football team ahead of a major tournament, we get our hopes up only to have them cruelly dashed. We need to take decisive action to find a proper solution now. No more reports, no more talking and no more short-term, sticking plaster solutions. Otherwise, history is set to repeat itself in 2017 and beyond when more and more people will go without the care they deserve. CMM

Vic Rayner, Executive Director, National Care Forum. Email: vic.rayner@nationalcareforum.org.uk Twitter: @VicRayner Vicky McDermott, Chair, Care and Support Alliance. Email: vicky.mcdermott@papworthtrust.org.uk Twitter: @VickyMcDermott Mike Padgham, Chair, Independent Care Group. Email: m.padgham@stcecilias.co.uk Twitter: @Mike_Padgham What do you think 2017 holds for social care? How would you address the challenges? Share your thoughts on the CMM website www.caremanagementmatters.co.uk Subscription required. 22 CMM February 2017

New learning activities to help you

Develop the English, number and digital skills of social care workers Every worker in adult social care needs English, number, digital and employability skills, including team work, and problem solving skills. These are collectively known as core skills. Having the right core skills will ensure social care workers provide high quality care and support can complete adult social care qualifications and training, including the Care Certificate meet sector standards, including CQC requirements and the Social Care Commitment.

Download free learning activities to help www.skillsforcare.org.uk/ coreskills Weâ&#x20AC;&#x2122;ve launched new learning activities to help care workers develop their core skills. There is also guidance for managers to help them address core skills in the workplace and develop the core skills of their staff. Request a free managers guide by emailing marketing@skillsforcare.org.uk

2017

AL CE ON EN TI ER NA NF CO

CONFERENCES • EXHIBITIONS www.caremanagementmatters.co.uk

@CMM_Magazine #CMMInsight

Learning Disability & Mental Health Services 2ND MARCH 2017

THE RENAISSANCE HOTEL, MANCHESTER NEW VENUE AGENDA INCLUDES: • • • • • • • •

Navigating the changing policy environment Regulation and driving up quality Best practice support for safe and quality care Delivering supported accommodation Tackling recruitment and retention Employment Law Delivering prevention in mental health services Managing the challenges of medication management

SPEAKERS FROM:

AGENDA DEVELOPED WITH

• Mental Health Foundation • Care Quality Commission • Social Care Institute for Excellence • Public Health England • Mental Health Providers Forum

Tickets £195 +VAT • CMM website subscribers receive 10% discount for booking online.

SPONSORSHIP AND EXHIBITING OPPORTUNITIES AVAILABLE Tel 01223 206965 24 CMM February 2017 Web www.caremanagementmatters.co.uk

Sponsor

Organised by

Debbie Sorkin sets out why social care must be involved in STPs. Often, when I’m speaking at social care events, I ask people in the audience – commonly owners, managers and staff of residential care and homecare providers – if they’ve come across Sustainability and Transformation Plans (STPs). More often than not, I get blank looks; or, if people have had bruising experiences in trying to get involved with them, outright hostility. Many social care providers have found it difficult, if not impossible, to obtain any meaningful

IRRESISTIBLE FORCE MEETS IMMOVABLE OBJECT

S u s t a i n a b i l i t y a n d Tr a n s f o r m a t i o n P l a n s CMM February 2017 25

IRRESISTIBLE FORCE MEETS IMMOVABLE OBJECT: SUSTAINABILITY AND TRANSFORMATION PLANS

involvement at the planning stage. The same goes double for voluntary and community groups. So I appreciate that some readers of CMM may be wanting to hurl the magazine at the wall by this point. But please stay, because STPs are here; are happening; and will start being implemented this year. They are likely to have a significant impact on the way that healthcare, in the broadest sense, is organised and delivered in your area. For that reason alone, they will have an impact on social care. My argument is that now, when things start to move from plan to implementation and reality intrudes, is the time for social care to show just what it can do and can offer. If ‘no plan survives first contact with the enemy’, then this is when social care can come to the table, put unworkable plans – where it’s not been included – to one side and get everyone to get real.

STPS: THE THEORY To start with, for anyone who’s not aware of them, this is what STPs are and where they come from. The term was first coined in NHS England’s Delivering the Forward View: planning guidance 2016/17-2020/21. Essentially, this set out a blueprint for how the NHS in England was going to deliver the key aims of its five-year plan, the Forward View, which had been published in 2014. The plan was based on taking a much wider view of health and wellbeing, with an emphasis on a more joined-up, placebased approach. Crucially, these joinups expressly included collaboration between mental and physical health, and between health and social care, with a view to keeping people healthier for longer; in their homes; and not having to go into hospital unless they absolutely needed to. The planning guidance, published in December 2015, divided England into 44 large areas, called ‘STP footprints’. In each area, the NHS was charged with coming up with an STP, to reorganise healthcare provision and delivery. The aim was for more healthcare to be delivered in the community via primary care and NHS community trusts, with less of the focus on large, central 26 CMM February 2017

hospitals. There was also explicit recognition that those involved with putting the plans together needed to include everybody. 'System leadership is needed…it involves…developing a shared vision…learning and adapting… and having an open and iterative process that harnesses the energies of clinicians, patients, carers, citizens… and local community partners including the independent and voluntary sectors, and local government. The STP must also cover better integration with local authority services, including, but not limited to, prevention and social care.'

THE PRACTICE: 'NOT OUR FINEST HOUR' In practice, links with social care have been very patchy, to the point of nonexistence in many cases. My sense is that there are a number of reasons for this. Firstly, the NHS imposed highly unrealistic timescales to produce highly complex plans – they were originally meant to be completed in a three-month timescale and submitted to NHS England in June. Although the deadlines were subsequently extended until late-October, there was no time

how to go about getting them. In 40 out of the 44 STP footprints, the process was led by a hospital trust chief executive, or their counterpart in a clinical commissioning group. In addition, there were, and are, very different cultures – an NHS whose natural bent is towards working with what it sees as equivalent large-scale organisations, rather than at the scale social care operates – and enormous financial pressures bearing down on all health and care services. As such, it was never entirely clear to many people whether the aim of STPs was to develop a truly integrated health and care system, or whether it was to fix the NHS’ financial black hole (hospital trust deficits reached almost £2.5bn last year). If that wasn’t enough, NHS England imposed secrecy (or at least gave contradictory advice) about the plans, not allowing any degree of proper public engagement and involvement. This meant that even when social care

“STPs are here; are happening; and will start being implemented this year. They are likely to have a significant impact on the way that healthcare, in the broadest sense, is organised and delivered in your area.” or opportunity to go back and revisit things from the start. It also meant that those involved came from a narrow band. It wasn’t just social care that felt excluded: surveys showed most GPs felt uninvolved and not consulted. This was compounded when the individuals charged with leading the process came from the NHS, didn’t have relationships with social care providers or local government and didn’t know

PROTECTING YOUR CARE BUSINESS BETTER THAN EVER BEFORE CHIS (care home insurance) and PrimeCare Insurance (domiciliary care insurance), two specialist services under one roof. It is this recognised market expertise that sets us apart from others, enabling care providers to benefit from the very best value for money insurance and advice on risk-related matters. Call us now on 01273 645 928 or email simon@chis.net for your free no obligation quotation for your insurance needs.

Divisions of Howden PrimeCare Insurance Services Limited and Care Home Insurance Services are trading names of Howden UK Group Limited, part of the Hyperion Insurance Group. Howden UK Group Limited is authorised and regulated by the Financial Conduct Authority in respect of general insurance business. Registered in England and Wales under company registration number 725875. Registered Office: 16 Eastcheap, London EC3M 1BD. Calls may be monitored and recorded for quality assurance purposes. Ref:3431. 11/15

Calvert Trust Exmoor enables people of any age and any disability to experience exciting, challenging, and enjoyable accessible activity holidays with family and friends.

At our five star, fully accessible residential centre on the edge of Exmoor National Park all activities and facilities are specifically designed and equipped to cater for everyone.

Stay with us for a few days, a week, or just for the day; however long youâ&#x20AC;&#x2122;re here youâ&#x20AC;&#x2122;ll discover it's what you CAN do that Counts! www.calvert-trust.org.uk/exmoor

01598 763221

exmoor@calvert-trust.org.uk

Maintain high occupancy in the safest environment Datix incident and risk management system analyses safety information, fosters a culture of learning and delivers a higher quality of care to your residents

Datix, Melbury House, 51 Wimbledon Hill Road, London, SW19 7QW T 020 8971 1971 E info@datix.co.uk

28 CMM February 2017

www.datix.co.uk

IRRESISTIBLE FORCE MEETS IMMOVABLE OBJECT: SUSTAINABILITY AND TRANSFORMATION PLANS

providers asked to be involved, they often got knocked back. The secrecy also put local councillors at risk of being accused of conniving in plans to cut services. The outcomes have been predictable. Firstly, some STP places broke ranks with NHS England, and published their plans before they’d been centrally approved. In Birmingham, the council Chief Executive, Mark Rogers, who had led the STP process, accused the NHS of using STPs mainly to try to sort out its debt crisis. Trust has been thin on the ground. Secondly, the secrecy behind the process has given others free rein to define STPs as being purely about cuts. There have been headlines in the national press, such as that in The Guardian in November 2016, 'Thousands of beds to go in NHS shake-up', and the British Medical Association has weighed in with a view that STPs risk being used as a cover for cuts and 'starving the NHS of resources'. Thirdly, there is a widespread view that the plans themselves are not financially credible. A survey of clinical commissioning group leaders carried out by the Health Services Journal showed two-thirds had low or very low confidence that the sums worked. So when Matthew Swindells, NHS England Operations Director, called the handling of the process 'not our finest hour', this was what he meant.

NEVER LET A CRISIS GO TO WASTE Now, where are we and what can you do as a social care provider to influence what happens and get your voice heard? Well, all of the draft STPs have now been published. If you’re not sure of your STP footprint, go to the NHS England website and search ‘STP Footprints’. You can commonly find the plan on your main hospital trust or clinical commissioning group website too. Most base their plans on overhauling community-based care; on reconfiguring secondary care in acute hospital trusts;

and on reducing NHS costs by having providers come together to share and cut back-office costs. An in-depth analysis by the King’s Fund in November 2016, showed that progress had mainly been determined by local context and history of collaborative working, and confirmed that tight deadlines had often made meaningful involvement, from social care or the public, difficult. Difficult, but not impossible, though. In Lincolnshire, a strong local care association has been centrally involved at the planning stage, and this is reflected in the quality of the plan. For example, there is a commitment to working across a shared care plan with information shared across sectors, and with care delivered by a health and care workforce that is equally valued. The summary states, 'We will bring together doctors, nurses, mental health practitioners, social care professionals, therapists and other community based professionals to work as one team in a neighbourhood, linking in with wider services and support…Staff in nursing and residential care homes will be treated as vital members of the wider integrated team, having immediate access to shared care plans. They will have a more proactive role in the care of their residents.' The plans are now being assessed by NHS England and NHS Improvement. The likeliest outcome is that in some shape or form, a number will get the green light to proceed to implementation this year, even if much more detailed work needs to be done. However, my hunch is that there will not be the revenue or capital funding on offer for the plans to be implemented on the scale originally envisaged. There will also be a recognition at local level that much more meaningful involvement will be needed for implementation to have any chance of success. If you’re a provider, I think that now might be the right time to get together with others – either through a care association if you have one that works well, or as a more informal grouping

“My hunch is that there will not be the revenue or capital funding on offer for the plans to be implemented on the scale originally envisaged.” – and start conversations with people involved in the STP process. Initially, I’d suggest using them as a way to explore options of what social care might both give to and get from involvement, and to show people just what social care can do. Don’t assume that people already know; find allies – such as from primary care or allied health professions – who can influence and make the case for you and with you; and keep persevering if you get a rebuff. Be prepared for this process to take time, and to feel messy and frustrating. But don’t stand apart, or assume that things can’t change. The experiences of care providers in Lincolnshire, or of providers involved in the Enhanced Care in Care Homes new models of care, have shown that they can. The stakes are high: this could be an opportunity for social care to show health what truly collaborative systems leadership looks like: and how social care can transform the lives of people who use services. Who wouldn’t want that? CMM

Debbie Sorkin is National Director of Systems Leadership at The Leadership Centre. Email: debbie.sorkin@leadershipcentre.org.uk Twitter: @DebbieSorkin2 Are you involved in STPs? Will you make your voice heard now? Share your thoughts on the CMM website www.caremanagementmatters.co.uk Subscription required. CMM February 2017 29

SHARED DEMENTIA CARE – SUPPORTING COUPLES TOGETHER Brendoncare is launching a new dementia extra care model called Shared Care. It intends to offer all the care people with dementia and their partners need to help support them together and prevent unnecessary hospital admissions, whilst offering assistance to people living with dementia in the local community too. Brendoncare is a Winchesterbased charity. It runs 10 care homes and four housing with care developments. It also operates more than 85 friendship and wellbeing clubs across Dorset and Hampshire for older people who may otherwise be lonely. Added to this, it provides a hardship fund for people who cannot afford to get to its clubs, meaning nobody is excluded, whatever their financial situation. It also offers a ‘Care for Life’ promise, which means that a resident will not have to leave if their financial situation changes.

NOBODY IS EXCLUDED It is with this sentiment, that nobody is excluded, that Brendoncare has developed its new model, Shared Care, for couples where one person is living with dementia. Supporting couples where one person has care needs can be difficult. With a significant reduction in shared rooms, commonly, when one member of the couple enters care the other remains at home. This can be particularly distressing and difficult for people to come to terms with.

OTTERBOURNE HILL Brendoncare’s Shared Care model is committed to addressing this ‘terrible pain of separation’ that so many couples experience as the needs of those with dementia necessitates more specialist care. It also aims to address other difficulties being faced by people living with dementia such as social isolation, scarcity of respite and a reliance on hospital care. The Shared Care model will be based at a new housing with care 30 CMM February 2017

development, Otterbourne Hill in Hampshire. Construction started in October 2016, with residents aiming to move in around summer 2018. Otterbourne Hill will be built to provide a range of services with the right level of support for each person. The 64-bed care home, built to the Stirling Gold Standard for care home design, will offer nursing and dementia care in small, family-feel households. There will also be 20 one- and two-bedroom dementia-friendly apartments specifically for couples living with dementia, allowing partners to continue to care for one another with full access to care, support and respite services when needed. Brendoncare hopes to offer all apartments for rent. Beyond the care home and independent living apartments will be the community hub. The hub will house the usual services and amenities, which are a familiar part of extra care schemes, such as a restaurant, library and hairdresser. However, it will also host specialist dementia support including dementia-friendly clubs. These activities, information and resources will be open to residents and the wider community. There will be an indoor winter garden and sensory gardens in the landscaped grounds and a bowling green for gentle exercise and enjoyment.

OFFERING SOLUTIONS There are a number of solutions offered by Brendoncare’s Shared Care at Otterbourne. Keeping couples together. The apartments will enable couples to

live independently with the care they both need. If a person’s dementia symptoms progress to the point that they require a move to the care home, the partner can continue to live within the scheme and play an active role in the care of their loved one. The couple will both be familiar with the site and staff and, with the partner still living on site, it will make it easier to visit and be together. A sense of community. People living with dementia at Otterbourne Hill or in the surrounding areas will have access to a wide variety of activities, social groups, support and advice within the dementia-friendly community hub. It is hoped that this will reduce isolation and loneliness and provide the opportunity to develop new friendships. This will open the setting to the wider community, and specifically those local people living with dementia and their partners. It will encourage community engagement and participation, offering local people dedicated dementia support regardless of where they reside. Specialist nursing care. The nursing staff will be trained in specialist dementia nursing care. Couples living in the apartments will also benefit from the expert nursing skills of the staff. It is hoped that this high level of specialist training will minimise the need for emergency hospital admissions and, by association, ease the pressure on the NHS. With the NHS increasingly struggling due to cuts in social care, a specific focus on reducing unnecessary admissions should be of benefit to the individual and the NHS. Giving carers a break. Good quality respite care is difficult to find.

Brendoncare is looking to address this with the availability of planned and emergency respite care for those living at Otterbourne Hill as well as those living with dementia in the local community. It will provide relief for carers from the demands of caring for a loved one who is living with dementia, and enabling them to pursue their own interests. Brendoncare says that residents in the apartments whose partner may become regularly distressed or agitated at night will also benefit from this service.

LEADING THE WAY The charity says that the model will ‘lead the way in dementia care by providing a life-changing alternative for couples facing dementia, enabling them to stay together with the benefit of care when needed.’ CMM

OVER TO THE EXPERTS... Extra care or independent living is not a new model, however, Brendoncare is confident that its Shared Care dementia model is the answer to the needs of couples where one person has dementia. Is this the solution to end couples being separated at such a delicate time? Is the model unique in offering the three services on the one site? Does it offer something different for families and the wider community? Are there other innovative solutions to supporting couples where one person is living with dementia? What does the panel think?

CLARITY AND EXPECTATION MANAGEMENT NEEDED In my view, Otterbourne Hill has the potential to be a pioneering scheme. Most existing dementia schemes (in both care homes and extra care) have tended to focus more on the support for individuals with dementia, and not their loved ones caring for them. I think clarity and expectation management will be very important for the scheme to succeed. Should the care-giving partner outlive their spouse/partner, a slightly delicate issue may arise concerning their right to remain as a tenant at the scheme. Brendoncare may need to include a provision in the tenancy agreement that means that the surviving partner may need to move on in order to prevent the apartments being occupied by older people who do not require specialist dementia services. Clearly, a sensible balance needs to be struck to give residents time to look for alternatives in a

HUMANE AND COMPASSIONATE PHILOSOPHY

time of grief. To avoid conflict and false expectations, it will be important to be very clear that the tenancy might need to be tied to a specific set of circumstances (ie couples where at least one partner has dementia). Older people typically seek assured tenancies if renting, so the benefits of the dementia offer would need to be emphasised to compensate for the fact that for the surviving partner, moving to Otterbourne Hill may only be an interim solution when it comes to making a new home in old age. These are not insurmountable problems. With the right approach to clarity and expectation management, Otterbourne Hill may well lead the way in establishing a new and innovative form of living for couples with dementia. I wish them all the best.

Michael Voges Executive Director, Associated Retirement Community Operators (ARCO)

Having worked with Brendoncare for many years, it was clear that the vision of partners staying together was part of a humane and compassionate philosophy for its housing. Investment in ongoing quality, practice and work-based learning and development was affirmed by its drive towards adopting the Resident-Centred Care Home Standard (360 Standard Framework). With the development of clubs and its community focus, the natural progression is towards providing dementia-friendly communities, where connectivity and life balance is restored. Giving relief happens where quality of relationships is at the heart of a service, and the wellbeing of the person living with dementia and their loved one is recognised. Actively addressing loneliness, striving for positive engagement and a proactive approach to person-centred carer support, within a listening leadership,

is fundamental. It is also about prioritising improvement, driven from listening to the needs of the resident and understanding the complex role of the ‘primary carer’, and addressing and enabling what staff need to deliver this. Quality of life for the carer prevents their decline and restores their ‘relationship’. Supporting the progression of dementia for their loved one gives hope and energises everyone. Strong intergenerational connections with the community, using the power of music and new innovations, such as Magic Tables and failure free activities, can further bring young and old together. Culture is king; caring environments, on a journey of continuous improvement, with relationships at the heart, top down, bottom up is the best way to futureproof sustainable quality.

Rosemary Hurtley MSc, Dip COT, FRSA Occupational Therapist, Quality Improvement Consultant. Co-developer of the 360 Standard Framework

SHOULD BE EVALUATED TO BUILD A SOLID EVIDENCE BASE How best to support people living with dementia is a key question for housing with care, and one for which there is little research evidence. Recently, there has been a move away from ‘specialist’ schemes or units for three main reasons. Firstly, they do little to address the stigma that is still widely-associated with dementia and to support the integration of people living with the condition with wider communities. Secondly, there is growing awareness of the benefits of the community hub model of extra care housing, particularly in terms of increasing opportunities for social interaction. Thirdly, the specialist model poses challenges in terms of how best to support a partner of the person with dementia, who can feel sociallyisolated within a dementia-specific scheme and can face a disruptive change in accommodation when their loved one moves to a different setting or passes away.

The inclusive model proposed by Brendoncare is to be welcomed. Crucially, it will enable couples to continue living together when one partner has dementia. At the same time, it can provide the specialist care and support that the person with dementia is likely to require. In addition, the operation of a community hub should provide access to activities, services and social opportunities for both partners. The success of this approach will depend to a large extent on the scheme being designed, managed and operated in a way that maximises these opportunities. There may be learning that can be incorporated from similar approaches, such as Stanton Lodge in Swindon. I do hope this initiative will be fully evaluated so that we can start building a solid evidence base.

Dr Simon Evans Principal Research Fellow, Association for Dementia Studies, University of Worcester

Tax advice - why us? Our... Knowledge

VAT

EXPERIENCED TAX-QUALIFIED ADVISERS.

BUSINESS STRUCTURING

Sector know how

ANDY BROOKES Partner

25 YEARS’ OF UNRIVALLED EXPERIENCE.

CAPITAL GAINS TAX

Approach

TRANSACTIONS, PLANNING AND EASY TO UNDERSTAND AND SUPPORT

JOHN LUCAS Partner

CLEAR COMMUNICATION.

CORPORATION TAX

Reputation

PROUD WINNERS OF THE BRITISH ACCOUNTANCY AWARDS 2015 TOP 50 TAX TEAM OF THE YEAR.

RACHAEL ANSTEE

Partner

EMPLOYEE SHARE SCHEMES

Hazlewoods Health and Care Team – you should get to know us! 01242 237661 www.hazlewoods.co.uk / @HazlewoodsCare

HealthCare Tax Oct16 91x110 AW.indd 1

CMM February 2017 31

02/12/2016 14:07

IO N

F U N DIN

Where innovation meets inspiration

R AT

RE A EC

T www.healthpluscare.co.uk

THE NATIONAL EVENT DEDICATED TO SECURING THE FUTURE OF CARE TAKE A DAY OR TWO TO INVEST IN THE FUTURE OF YOUR CARE BUSINESS AND COME AWAY WITH A WORLD OF INSPIRATION:

28â&#x20AC;&#x201C;29 June 2017 | ExCeL London

Discover new telecare innovations and technologies to enhance the services you provide. Make savings and access new pots of funding - hear from ministerial speakers about developments in the regulation of adult social care that directly affect your business. Find out how to build, retain and develop a quality workforce. Find out how to implement the National Living Wage with minimal damage to profits. Find out how to encourage choice of care. Start networking with Trusts to promote community-based services. Network with CCGs, Local Authority Directors, Trusts and GPs who could uncap new pots of funding and help improve your business.

CMM ARE DELIGHTED TO BE ABLE TO SUBSIDISE CONFERENCE PASSES FOR MEMBERS TO ATTEND HEALTH+CARE FOR FREE. SECURE YOUR FREE PASS AT WWW.HEALTHPLUSCARE.CO.UK/CMM SUBSIDISED PASSES ARE ONLY AVAILABLE UNTIL 31ST MARCH. 32 CMM February 2017

Supported by:

Organised by:

A VIEW FROM THE TOP

T O M

O W E N

Tom Owen is Co-Director of My Home Life.

REFLECTIONS ON THE LAST DECADE When Julienne Meyer and I first began the work of My Home Life ten years ago, we didn't think that a small project, founded by National Care Forum and Help the Aged, would develop into a programme working nationally and internationally to promote quality of life in care homes. A core value for me has always been the need for My Home Life to immerse itself in the sector, helping to understand the experience of those living in, dying in, working in and visiting care homes from a range of lenses and perspectives. Most of the contact with the sector has been via the 1,000 care home managers that we have worked with as part of our Leadership Support programme. These managers are the My Home Life ‘movement’. They have helped us to remain grounded in the real day-to-day experience of care homes, and convey the good practice and the challenges they face to the wider world. Over the decade, I have had the privilege of hearing stories of care home practice that are so touching they give me goose-bumps. Often, the stories convey a beautiful sense of love and kindness between staff and residents which, in this harsh world, feels rare and wonderful. Almost in the same breath, we hear stories that are deeply upsetting. The perceived threats posed by the wider world of commissioning, safeguarding, regulation; the ever-mounting paperwork or new

initiatives that take managers away from their role of promoting quality. It is deeply disturbing how many of the managers we have worked with have left social care on health grounds. How much of this is due to ever-increasing stress, the complexity of the work, the constant requirement to do more for less and the fear-based culture that keeps managers awake at night and puts a stranglehold on innovation? Sometimes, it feels that all we can do is offer a space for these managers to breathe, reflect, find some surplus energy, and ‘go again’, with brave hearts and renewed fight to make a difference. Indeed, it is the extraordinary commitment and strength of character of managers that is, perhaps, the biggest revelation for me. It has been an honour to see managers growing together into a force to be reckoned with, challenging one another, acting as colleagues rather than competitors. Some of the innovation that we have seen shows how, despite it all, there remains a hunger within care homes to continue the journey of improvement. PROJECTIONS FOR THE NEXT DECADE As 2017 arrives, I feel older but not necessarily wiser about the future. Right now, it feels difficult to predict how things will pan out domestically and across the globe for any of us. Whatever happens, it’s not going to be pretty. Care homes will close; budgets

will keep tightening; and the doctrine of ‘care homes as last resort’ will become even more embedded in commissioners' practices. None of this bodes well for future, positive partnership or investment. The key message is the importance of taking active steps to weather this storm. We are cogs in a broken system, it feels as if we are on a hamster-wheel. Looking after ourselves and taking our own resilience seriously is crucial. The world is changing and we need to be emotionally strong enough to take tough decisions to guide ourselves to safety. A workforce that feels worn out is a workforce that will not find it easy to set a new direction of travel. With resilience comes increased confidence, which will help us turn the tide. We can work better together, to communicate to the world the difference we make every day. We can take steps to demonstrate that we are a professional sector, constantly reflecting on practice and taking ownership of the agenda for change and improvement. We can reach out to commissioners and communities and offer ourselves as a solution to the increasingly diverse needs and aspirations of our communities and the challenges facing health and social care. However 2017 pans out, My Home Life will carry on offering encouragement and professional support to practitioners to help them promote quality of life in their care homes. CMM

Read other A View from the Top interviews on the CMM website www.caremanagementmatters.co.uk Subscription required. CMM February 2017 33

Care home finances

CAN YOU STAY AFLOAT?

New research has found that 28% of care home operators are at risk of insolvency. Nick Hood explores the financial health of care homes and asks, when will the Government listen?

34 CMM February 2017

When the Chancellor closed his Autumn Statement on 23rd November without making any mention of financial help for the embattled social care system, care professionals across the UK were aghast. They deal day-to-day and moment-to-moment with the realities of the financial crisis engulfing the most vulnerable in our society. They know that every part of the system is at risk of collapse. Increasing numbers of private sector operators are withdrawing from domiciliary care services. The NHS is facing an unprecedented issue with delayed transfers of care, because there is insufficient domiciliary and residential care capacity to deal with patients ready to be discharged from hospital. Care home operators are refusing to accept local authority funded residents because the fees they will pay are well below the cost of providing care. The larger operators are closing homes on an increasing scale: Four Seasons has closed or sold 51 homes in 2016 and plans to exit a similar number next year. HC-One has disposed of 25 homes this year. The total number of homes in England has fallen from 18,000 in 2010 to 16,600 in July 2016, according to the Care Quality Commission, which is monitoring the situation with understandable concern. The words of the Four Seasons finance director in their latest quarterly results announcement says it all: they are aiming to have 'a smaller portfolio of higher performing homes'.

sector’s financial health, such workouts may not be possible in future. In fact, not only is the overall number of homes falling, but operators’ investment in the sector is declining. This is despite much talk of consolidation into larger operating units as smaller businesses close and the major operators’ talk of committing to bigger and more cost-efficient home profiles. The average gross assets per operator is now £2.47m, compared to £2.62m in March 2014, a drop of almost 6%.

FINANCIAL HEALTH OF CARE HOMES

ZOMBIE OPERATORS

The latest research carried out by Opus Business Services, using the database and analytics of the financial health monitoring specialists Company Watch, reveals precisely why homes are closing. The headline statistic says, 'Over a quarter of all UK care home operators are so vulnerable that they are at risk of failing or needing a financial rescue.' This means that some 6,600 care homes could close over the next three years. Our analysis showed that 1,718 care home operators out of the total of 6,178, whose financial health we analysed, were in the Company Watch warning area, with a financial health rating (H-Score®) of 25 or less out of a maximum of 100. Being in this warning area means that a company is at significant risk of failing. Chart 1 shows the spectrum of the residential care sector’s finances.

The next concern is ‘zombie’ operators, whose companies have higher liabilities than the value of their assets – the commercial equivalent of negative equity in your house. There are 751 (12%) operators in this category and between them their net deficits total £671m, a figure which has risen by 53% since March 2014. Chart 2 shows the escalating problem with zombie operators.

EA AR 28%

34%

The underlying causes of the sector’s financial malaise are focused in three key areas, the first of which is high gearing. It was a surprise to find that 83% of operators did not borrow at all, while another 2% have borrowings of under £10,000. This may be because the property in which the home is located, and its related debt, is held outside the operating company, or else it may be rented. But those 15% of operators who do carry debt are borrowing far too much – a staggering 121% of their net worth. Overall, the sector has gearing of 80%, a level well outside financial norms. Total debt is £4.5bn, an enormous burden and one which would be well over £5bn if comprehensive financial data for three of the major operators (Four Seasons, HC-One and Barchester) was available.

Chart 2 Total Negative Net Worth of ‘Zombie’ Care Home Operators

671 534 437

£m

0 -10 76

WARN ING

Chart 1 Financial Health Rating – October 2016

EXCESSIVE DEBT

October 2016

18% 26

5 1-7

March 2014

PROFITS

20%

January 2016

Traditionally, struggling care homes have not ended up in administration or liquidation in significant numbers, because commercial sensitivity to their plight means that there is usually a way to find a consensual solution. Major creditors, such as lenders, have been willing to write-off debt and new operators have been found to take over running the homes, without disturbing the residents. But with the rapidly deteriorating state of the

Last, but by no means least, running residential care homes is, at best, a marginally profitable business, and since the introduction of the National Living Wage (NLW) last April, it is now unprofitable for many operators. Our research covers financial data for accounting periods prior to April, when the average annual pre-tax profit per operator was only £34,000 (compared to £40,000 in 2014), equivalent to roughly £10,000 per care home based on an average across the sector of some 3.3 homes per operator. The total profits earned by the sector were only £209m, compared to an estimated increase in annual labour costs from the effect of the NLW of over £400m.

CMM February 2017 35

CARE HOME FINANCES – CAN YOU STAY AFLOAT?

Operators are caught in a pernicious profit pincer movement. Where reliant on local authority contracts, their revenue is inadequate because of downward pressure, over a number of years, on the fees local authorities pay out of ever more restricted care budgets. Their largest cost, labour, has been rising due to the Government’s minimum wage policy. Finally, they face constant pressure from the Care Quality Commission to increase standards. Unfortunately, this analysis ignores a very large elephant lurking in care home finance departments. Business models are becoming skewed by local authority fee reductions, so that many can only survive by raising the fees of privately-funded residents. Those homes whose catchment areas have insufficient potential private residents may end up going to the wall – indeed anecdotal evidence suggests that some operators have already started negotiating with local authorities to find new operators for some of their unprofitable homes as an alternative to just closing them. These are also the types of homes being closed by the larger operators. Other operators have simply started refusing to accept any more local authority funded residents on the basis that they lose less money that way. This is serious enough, but what will happen when privately-funded residents and their relatives finally rebel at having to pay much more for the same service and facilities than the publicly-funded resident sitting next to them? Then the Government will face a systemic threat, which will make the collapse of Southern Cross look like a tea party.

Chart 4 Average Financial Health Score Per Region 56

East Anglia 51

East Midlands

London

North REGION

North West

N Ireland

Scotland 53

South East

South West

Wales 51

West Midlands

East Anglia

London

63000

REGION

19000 63000

N Ireland

74000

Scotland

93000

South East 50000 39000 27000 10000

20000

30000

40000

REGION

45% 59%

South East

61% 52%

South West

180%

Wales 94% 20%

40%

60%

80%

100%

120%

140%

160%

180%

PROSPECTS

41000

66%

PERCENTAGE OF DEBT TO NET WORTH

North

Wales

54%

West Midlands

72000

West Midlands

33%

Scotland

45000

East Midlands

South West

45%

N Ireland

North West

7200089%

East Midlands

North West

Chart 3 Average Annual Pre-Tax Profit Per Region

Chart 5 Average Gearing Per Region

North

Within our overall analysis of the residential care sector’s finances, there are wide regional variations. Unsurprisingly, average annual profitability is far higher at £93,000 in the South East with its abundance of wealthier private residents than the figure of £19,000 in the North West, as chart 3 shows.

London

COMPANY WATCH H-SCORE

REGIONAL DIFFERENCES

East Anglia

50000

60000

70000

80000

90000

100000

£ PER ANNUM

Regional financial health also varies. Scotland has the highest average Company Watch health rating of 62 out of a maximum of 100, while the West and East Midlands have the lowest at 51 each. The full analysis is in Chart 4. Debt levels are very different around the country. London has the lowest, with an average gearing of only 33%, while Wales has far and away the most extreme gearing at 180%, although this is affected to some extent by the debt at one local operator.

Ultimately, the residential care sector’s problems and its prospects are a function of government policy and its general underfunding of social care. Its policies depress profitability and put severe stresses on operators’ balance sheets, whilst reducing incentives for existing operators to expand or indeed stay in the market at all, and for new players to enter it. This is at a time when demographic realities mean that the UK needs more care home beds, not fewer. The pressure on the Government to act is intensifying by the day. Is it listening? Judging by the latest announcement of its sticking plaster proposals to allow local authorities to raise council tax to create extra funding for care, it has heard the pleas, but it clearly does not understand the problem. A one-off boost to funding, which will then be clawed back in succeeding years is better than nothing, but it simply kicks the care crisis can a little further down the road when the financial potholes will be even deeper. In any case, it will be woefully inadequate to bridge the huge gap between weekly costs and the fees that are currently being offered for publicly-funded residents. CMM

Nick Hood is the Business Risk Adviser for the Opus Business Services Group. Email: nick.hood@opusllp.com Twitter: @NickHood5 Is this analysis of the financial health of care homes familiar to you? Share your thoughts and read the full text of the report into care home finances on the CMM website www.caremanagementmatters.co.uk Subscription required. 36 CMM February 2017

New Innovation Wireless Nurse Call Technology, that’s reliable, affordable and...

Nurse Call Systems for your Hospital & Care Home environment NEW Touchsafe® Pro Always at your call

Call: 0800 052 3616 Web: www.aidcall.co.uk

Social Care Showcase 2017 ‘Developing Resilience in Health & Social Care’ Wednesday 8th March 2017, 9:00am – 3:30pm Brighton Racecourse, Freshfield Road, Brighton East Sussex BN2 9XZ In it’s eleventh year, the region’s top business advice and training event for adult social care providers, The Surrey and Sussex Social Care Showcase, takes place at Brighton Racecourse on Wednesday 8 March 2017. Free*conference and exhibition for adult social care owners, chief executives, managers, senior staff and professionals across Sussex, Surrey, Brighton and Hove. * Free Event to those providing care services in East Sussex, West Sussex, Brighton & Hove and Surrey. Others are welcome to attend however will incur a £45 delegate charge.

Exhibitors include:  Training Providers  Care Associations  National Organisations supporting Health & Social Care  Professional Services  Workforce Development Specialists  Lawyers  Business Focus Services  Suppliers to Care Industry. Over 25 Seminars available:  Andrea Sutcliffe, CQC  Prof Graham Stokes, BUPA  Keith Hinkley, ADASS  Vic Rayner, National Care Forum  Mei-Ling Huang, QualitySolicitors Burroughs Day  Debbie Sorkin, The Leadership Centre, plus Legislation Updates, Business Advice Seminars, plus many more !

For full details visit www.careshowcase.org.uk For details on exhibiting please email showcase@surreycare.org.uk Thanks to the support of our partners:

Media Support:

CMM February 2017 37

HEADER

3RD SECTOR CARE AWARDS 2016 The ceremony is over, the winners have been announced and everyone has been recognised for their hard work and commitment to supporting society’s most vulnerable. The 3rd Sector Care Awards, once again, made its mark on the sector.

The day was an incredible success. Not only did attendees get to hear about the amazing best practice being carried out by third sector providers, they were also entertained by fantastic performances from Dance Unity and Halas Homes. The moving dance routines brought many audience members to tears. Dame Esther Rantzen once again kept the day running smoothly. Putting her interviewing techniques to good use, drawing out why the winners were truly deserving and making the day very special for everyone in attendance. The Awards were so well-received, #3rdSectorCareAwards trended on Twitter for the second year running. Sitting at number 2 – just below Prime Minister’s Questions, the exposure helped to raise the profile of the winners and finalists. The event was made possible thanks to the supporters and sponsors, whose generosity helped the Awards recognise the innovation and excellence of the finalists.

For those who were not able to attend, or didn’t get a chance to nominate, the 3rd Sector Care Awards will return in 2017. The ceremony will be held on 6th December 2017. Details of when nominations open will be available at www.3rdSectorCareAwards.co.uk

Appreciate. Celebrate. Network. 38 CMM February 2017

WINNERS Compassion Award – Alfred Court Team, The Somerset Care Group Innovative Quality Outcomes Award – Community Integrated Care and Widnes Vikings Creative Arts Award – Community Development Team, Certitude Community Engagement Award – Port Sunlight River Park Team and Autism Together Citizenship Award – Community Integrated Care and Widnes Vikings Leadership Award – Castle Supported Living End of Life Care Award – EachStep Blackley, Community Integrated Care Collaboration (Integration) Award – Lambeth Integrated Personalised Support Alliance

@3rdsectorcare #3rdsectorcareawards

Making a Difference Award – Christine Asbury, WCS Care Beyond Governance Award – Michael Atkins, Vibrance

Contribution to Sector Development Award – ROC, Robert Owen Communities

@3rdsectorcare #3rdsectorcareawards

Creative & innovative ways to achieve excellence Creative & innovative ways

@3rdsectorcare #3rdsectorca

Technology Award – SMaRT Messenger, Nottingham Community Housing Association

@3rdsectorcare @3rdsectorcare #3rdsectorcareawards #3rdsectorcareawards

Creative & innovative to achieve excellence to achieve excellence Creative Creative&&innovative innovativeways ways to toachieve achieveexcellence excellence Organised by

Organised by:

Headline sponsor

Headline sponsor:

Sponsors

Headline sponsor:

@3rdsectorcare @3rdsectorcare #3rdsectorcare #3rdsectorcar Headline Headline sponsor: sponsor:

Creative Creative & & innovative innovative w w to to achieve achieve excellence excellence

Organised Organisedby: by:

Supporters

CMM February 2017 39

Resource Finder Software, Assistive Technology and Nurse Call Systems

In a digital age, providers are increasingly looking to technology to aid their business and free up time for the core role of caring. Whether itâ&#x20AC;&#x2122;s nurse call systems, HR and rotas, administration, compliance, care planning, or something else, there are a number

40 CMM February 2017

of different products on the market to assist you. Whatever your business need, the following software, assistive technology or nurse call systems may be able to help you streamline your business and improve efficiencies.

Ablyss Tel: 01625 535685 Email: sales@ablyss.co.uk Website: www.ablyss.co.uk

SECTORS • Residential care homes. • Nursing homes. • Supported living. • Learning disability homes. • Mental health. • Rehabilitation.

PRODUCTS • Full care recording and evidencing. • Mobile app for recording at point of care. • Accident and incident monitoring. • Deprivation of Liberty Safeguarding. • Employee absences and training. • Assessment tools and body maps.

COMPANY PROFILE With the current media spotlight on care homes and the changes to legislation that will evolve, the care sector is facing a period of unprecedented change. You need to rest assured in the knowledge that your chosen care management software can cope with these changes, as well as being easy enough to use for your daily support team. The Ablyss Care Management System (CMS) offers you one of the most intuitive and adaptable systems in the marketplace. It was developed in 2003 and offers a range of cost effective products that can be used in a large range of care home environments. The software is fully supported and continually updated to comply with industry regulations and our support team is at hand to help with any queries

Advanced you may have. At Ablyss, we have looked to embrace the technology that surrounds us, whilst providing solutions that are workable, efficient and reliable. By providing you with the right tools, you can quickly record data and then ultimately assess how your residents’ needs have changed over time. This way you can easily evidence your care and adapt it to your residents’ changing needs. Ablyss CMS is fast becoming a favourite amongst a range of care providers, from nursing and residential homes to rehabilitation facilities. Users have experienced massive time saving benefits with reviews being completed in 10 minutes, rather than in two hours, and compliance checks being completed over 60% faster. Essentially, CMS will streamline the way you manage your information, leaving you free to do what you do best – care. To see what Ablyss CMS could mean to you, visit our website or call us on 01625 535685 for your free 30-day trial or to book a demonstration.

Tel: 01233 722670 Email: ahcmarketing@oneadvanced.com Website: www.oneadvanced.com

SECTORS • Care management. • Care administration. • Care homes. • Home care. • Reablement. • Mental health. • Supported living. • Local authority. • Community care. • Healthcare providers.

PRODUCTS • Mobile care monitoring. • Mobile care evidencing. • Integrated care planning. • Care management. • Workforce rostering. • Staff records. • Finance and payroll. • CRM.

demands of the health and care sectors. The versatility of our care solutions enables the management of care and operational requirements, right from the assessments stage, through person-centred care planning, care scheduling, staff HR management, time and attendance to income and billing, in order to create a total business solution. The modules within our care solution complement one another to make it a care software system that gives owners and managers the tools to deal effortlessly with all the complex demands and processes involved in running a busy care organisation.

COMPANY PROFILE Over the last 20 years, Advanced has established itself as the leading health and care IT software provider. Our teams know and understand the health and care sectors and can confidently offer a high quality service that delivers specialist IT solutions across an extensive range of clinical and non-clinical disciplines. We have over 1,300 customers, who we continually work with to refine and extend our offerings in order to meet the constantly changing CMM February 2017 41

RESOURCE FINDER

Aid Call

CareDocs

Tel: 0800 052 3616 Email: sales@aidcall.co.uk Website: www.aidcall.co.uk

Tel: 0333 500 5115 Email: info@caredocs.co.uk Website: www.caredocs.co.uk

SECTORS • Care home. • Nursing home. • Sheltered housing. • Hospices. • NHS.

PRODUCTS • Nurse call. • Staff attack. • Paging. • Assistive technology. • Telecare. • Performance monitoring.

COMPANY PROFILE For 35 years, Aid Call has been leading the way in the design and manufacture of wireless nurse call technology. It offers a wide range of products and bespoke solutions that meet the specific demands and requirements of the care home environment. Through facilitating better communication and the co-ordination of staff time, they are able to enhance levels of care and encourage a more person-centred approach. The newest system, the Touchsafe Pro, is the product of a wealth of industry experience, with a focus on development and innovation and a reputation for delivering safe and powerful solutions. With new user-friendly touchscreens to

42 CMM February 2017

further improve usability, increased flexibility to accommodate changing resident requirements and innovative features to increase functionality, the Touchsafe Pro is the most advanced system on the market. Its wireless configuration allows for complete flexibility and mobility. Without having to rely on cables and stationary wiring points, installation is quick, undisruptive and is specific to each site. The system can facilitate individual resident requirements, can adapt to change and can be added to over time. Innovative features and powerful software achieve unrivalled functionality. Improving the speed of call responses and increasing the depth of information available to both staff and management will heighten team performance and support staff in providing the most effective care. Aid Call systems are programmed to track and record all call information. Details of outgoing calls are stored, including call location and response time, to provide a comprehensive insight into staff activity and performance. This protects you and your staff and is an invaluable audit tool. In addition, Aid Call manufactures an extensive range of assistive devices. These allow you to adapt your new system to support residents with varying needs. Consequently, you can build a truly unique centre for care.

SECTORS • Care homes. • Nursing homes. • Home care.

PRODUCTS • Complete care recording solution (hardware + software).

COMPANY PROFILE Do you spend far too much of your time checking that your care records are up-to-date? Wouldn’t it be wonderful if you had a system that showed, at a glance, if any details were missing or records needed updating? If that sounds too good to be true then you need to know about CareDocs. All the necessary information – including daily notes and care plans – is constantly monitored to check that it’s being updated and nothing has been missed. If a resident’s records are not updated within 24-hours of the last note then it automatically alerts you. The system will also ensure that essential details, such as the doctor’s contact details, are recorded and that updates to journals and short-term care plans are constantly monitored.

care docs time to care

Care planning with CareDocs is a simple, 3-step process. The system creates a draft care plan from an assessment; you can edit this draft document as much as you wish so that you can have a fully personalised document which not only reflects all the resident’s needs but also includes all the important personal information that you want to record. You can update the care plans with any changes in circumstances as often as you wish and then evidence regular reviews quickly and easily. All CareDocs systems include the facility to add ‘point of care’ notes. Any internet-enabled device can be used to add details of care events to a resident’s records as they occur. This helps to ensure that your care records are personalised, up-to-date and fully detailed. As well as residents’ records, CareDocs can monitor daily checks such as fridge and freezer temperatures and equipment servicing schedules. If you would like a free demonstration in your home without any obligation then please go to our website, www.caredocs. co.uk or call us on 0333 500 5115. Start saving time and money today.

Providers activate your FREE subscription today

CMM November 2016

Book your tickets now! www.3rdsectorcareawards.co.uk

BESPOKE EDITORIAL, NEWS, OPINION AND BEST PRACTICE INFORMATION

Wednesday 9th December 2015 11.30 - 16.30

Congratulations @DesKellyOBE @NCFCareForum for your continued support of @skillsforcare as a valuable Board member! Oct 17

HOME

NEWS

FEATURES

EVENTS

ABOUT US

CONTACT

NOVEMBER 2016 £4.00 www.caremanagementmatters.co.uk

STEP UP YOUR CQC RATING

iPad

Book your tickets now! www.3rdsectorcareawards.co.uk

BESPOKE EDITORIAL, NEWS, OPINION AND BEST PRACTICE INFORMATION

Wednesday 9th December 2015 11.30 - 16.30

Congratulations @DesKellyOBE @NCFCareForum for your continued support of @skillsforcare as a valuable Board member! Oct 17

HOME

Moving from Good to Outstanding

NEWS

FEATURES FEATURES

EVENTS

ABOUT US

CONTACT

Features

F i n d i n g yo u t h e s o l u t i o n s s i n c e 2 0 0 3 .

Breaking down barriers

Healthcare for people with learning disabilities

Book your tickets now! 4:08 PM www.3rdsectorcareawards.co.uk

Wednesday 9th December 2015 11.30 - 16.30

Ablution Revolution? BESPOKE EDITORIAL, NEWS, OPINION AND BEST PRACTICE INFORMATION

LNT’S INSTITUTIONAL INVESTOR THE FUTURE OF FINANCE? The LNT Group’s Founding Chairman, the Group is LNT Software, an integral Lawrence Tomlinson, has been a vocal care sector software package. advocate for the need for sensible REFINANCING financing in business since the credit In April 2013, the Group finalised a crunch. As one of two Entrepreneurs £100 million refinancing, though the in Residence at the Department for process was not straight forward. At Business, Innovation and Skills, he the time, Lawrence Tomlinson was published an independent report in quoted as saying the deal had taken November 2013 which looked into two to three years to come together, bank lending practices and how involved four different banks and had certain banks deal with businesses in ‘issues’. He named Santander and distress. In April 2013, the Group had negotiated a £100 million refinancing Yorkshire and Clydesdale Banks in the of the business with a collective of process, plus it’s reported that RBS banks. With that up for renewal in and Bank Leumi were also involved. September 2014, the Group has Mr Tomlinson went on to say that the announced a £51 million debt facility amount of paperwork involved was with L&G Capital. As the insurer looks ‘phenomenal’ and that the whole to increase its involvement in the care process was ‘complicated’. sector, is this the future of financing? He has, however, given very positive feedback about several of the banking partners involved in LNT GROUP the 2013 refinance. He told CMM, The LNT Group, chaired by British ‘Whilst there were complexities in entrepreneur Lawrence Tomlinson, the 2013 refinance which were costly, includes a number of different, and far-reaching companies including the and at times challenging, it met care sector focused Ideal Carehomes, our finance needs for 2013 to 14. I found Santander and Yorkshire Bank LNT Construction and LNT Software, particularly helpful throughout the plus LNT Solutions and Ginetta Cars. past year, and Leumi continue to be a Ideal Carehomes is a care home operator, offering high quality services key partner in enabling our care home developments.’ After all this, the deal for older people without any third would have needed to have been party top ups. Its homes are mainly renegotiated in September 2014. across the UK and are designed and With renegotiation on the horizon, developed to be future-proof. LNT Group has just announced a LNT Construction designs and £51 million debt refinancing with builds care homes, not only for Ideal L&G Capital. L&G Capital is a new Carehomes but for third parties too business line created by Legal and including Anchor, Avery, Sanctuary and Nugent Care. Having built 52 care General to provide five key functions: direct investments; implementing homes since 2009, with 36 being run by Ideal Carehomes, it offers providers the investment strategy across the balance sheet; managing the Group’s turnkey solutions and is currently Shareholder Funds investments working on developments in the and managing the Group’s debt and south and Home Counties. The third care-focused company in liquidity. One of the drivers behind

Business Clinic

A different approach to attracting staff

Resource Finder

Congratulations @DesKellyOBE @NCFCareForum for your continued support of @skillsforcare as a valuable Board member! Oct 17

HOME

Does a new 10-year deal between L&G Capital and LNT Group, owner of Ideal Carehomes, signal a change in care sector financing?

Marketing and recruitment

It’s not L&G’s first investment in the care home sector. It acquired 13 care homes from MHA for just over £70 million in December 2013 and it forward funded and purchased five care homes in Suffolk with Care UK for £31 million. These were funded on behalf of Legal and General Property’s Managed Property Fund. L&G DEAL The deal between LNT Group and L&G Capital, which was announced in mid- TARGET HEALTHCARE REIT May, is a £51 million debt facility, over On the same day as the L&G ten years, to LNT Group incorporating Capital announcement, Target all its subsidiaries. It is secured Healthcare REIT Ltd announced that against the Group’s portfolio of care it had acquired a portfolio of three homes and will give the company homes from Ideal Carehomes for the ability to move forward with approximately £13.9 million. These building a sustainable and growing have been leased back to the operator build pipeline of new care homes. for 35 years. The announcement Mr Tomlinson explained the drivers comes just a month after Target behind the deal with L&G Capital, ‘Our Healthcare REIT acquired two decision to take a debt facility from other Ideal Carehomes, the first for Legal and General was largely driven £3.8 million and another, due for by the offer of long-term finance and completion in summer 2014, for £5.1 their understanding of our business million. In 2013, Target Healthcare model which we believe paves the REIT also acquired homes from Ideal way for a fruitful partnership for the Carehomes in September for £4 future.’ million and £18 million for four homes Alex Gipson, Lending Manager at in March. CMM Legal and General, said, ‘Organisations OVER TO THE EXPERTS... that hold enduring business models and that, therefore, operate and Given the tough nature of the bank plan over medium- to long-term finance market, highlighted by the horizons are clearly better matched ‘issues’ faced by LNT in 2013, do to external capital that operates over these new financing options mark similar long-term durations. For this the future for care sector financing? reason, the financing needs of LNT’s Are more providers going to have to Ideal Carehome business provides a look farther afield than the traditional very natural fit with Legal & General’s banks to access finance? Will we long-dated pension and annuity see more organisations such as liabilities and we expect increasing L&G begin to meet the needs of the opportunities in sectors such as market, not necessarily being met the care home market, supporting by the traditional banks? Is this the organisations committed to delivery changing face of care sector finance? of long term solutions to meet What does our panel think? increasing demand.’

FEATURES FEATURES

NEWS

Camera

the business is the slowdown of bank lending which is leading to a shortage of investment capital. This has led the organisation to focus on replacing bank and Government capital with long-term institutional debt or equity funding, as it has done with LNT.

EVENTS

ABOUT US

CONTACT

Settings

Calculator

Chat

Skype

Youtube

Gmail

iCal

Ablution Revolution?

Ablution Revolution? A Comprehensive Research Study into Wetroom Provision in UK Care Homes

Integration in practice

Ben Hartley analyses the provision of ensuites and wetrooms in UK care homes and draws some interesting conclusions.

Notes

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.

Maps

iTunes

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, it’s 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.

30 CMM February 2015

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.

Financial services and consultancy

Right to work

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.

A view from the top

Definitions

Safari

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.

Mail

Weather

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.

Facebook

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.

98 SHARES

Print this article

Add your comment

Submit JAMES SMITH OCTOBER 20TH 2014 4:55PM Lorem ipsum dolor sit amet, consectetur adipiscing elit. Maecenas enim tellus, dignissim sed ullamcorper vel, pretium quis nisi. Quisque dolor elit, rutrum eget maximus nec, placerat cursus libero. Phasellus sit amet dui in metus pellentesque mattis. Integer vestibulum urna consequat nulla scelerisque, et porttitor urna suscipit. <2

HELEN MCKENNA OCTOBER 17TH 2014 2:47PM

Better domiciliary care

Who’s who... recruitment

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Maecenas enim tellus, dignissim sed ullamcorper vel, pretium quis nisi. Quisque dolor elit, rutrum eget maximus nec, placerat cursus libero. Phasellus sit amet dui in metus pellentesque mattis. Integer vestibulum urna consequat nulla scelerisque, et porttitor urna suscipit. <0

November 2014

October 2014

September 2014

July 2014

June 2014

May 2014

PROVIDERS SUBSCRIBE FOR FREE TO RECEIVE News

CQC’s new inspection model Read more

Care Homes Trading Performance Read more

Expertise secures SureCare rolls first franchise out first micro franchise Read more

End-of-life care delivery could be improved Read more

Craegmoor’s new autism service Read more

Councils advised about care charging Read more

Support grows for care farm Read more

Continued rise DOL applications Read more

Fourth Signature contract for GB Building Solutions Read more

 Access to extended features and additional content  News and email alerts  Weekly news round-up  Ability to comment on features and create a debate around important subjects  Discounts to CMM Insight events and online booking*  Access to all archived editorial  Option of a hard copy of CMM (published monthly, 10 times per year)

Non-care providers – Subscription is free for three months, £50 per year thereafter.

Subscribe at www.caremanagementmatters.co.uk @CMM_Magazine

*Cannot be used in conjunction with any other offer.

Deputy Managers West Sussex We are looking for skilled and enthusiastic Deputy Managers, to join our wonderfully talented team. Providing specialist care for people with learning difficulties, physical disabilities, neurological conditions and care for older people, Sussex Health Care has almost 20 homes, providing almost 550 beds.

What’s in it for me? Every role at Sussex Health Care is different and we offer a varied range of benefits to reflect this. Some of these include: • Staff Accommodation • Training Facilities and Support • Uniforms

As we say ‘Great care starts with great people’. Are you one of those people?

• Subsidised Meals

The successful applicant must be an RGN and will support the Registered Manager in their contact with Head Office staff, Statutory Authorities, community services, GP’s and general suppliers to the home.

Our staff members are offered excellent career prospects and we actively encourage progression within the business. Education and training are a key part of our quality strategy.

• Staff Bus Service

How do I become a part of Sussex Healthcare? To apply, please send your CV and/or covering letter to recruit@sussexhealthcare.co.uk Alternatively, please phone 01403 217338 to enquire more about our exciting opportunities

www.sussexhealthcare.co.uk 44 CMM February 2017

RESOURCE FINDER

Person Centred Software

CoolCare Tel: 0113 385 3853 Email: info@coolcare4.com Website: www.lntsoftware.com

SECTORS • Care homes. • Secure units. • Mental health. • Supported living. • Hospitals. • Administration.

PRODUCTS • Client administration. • Staff and HR. • Timesheets and rotas. • Dynamic attendance management. • CRM. • Workforce and recruitment. management. • Training management.

COMPANY PROFILE Easier care home management at your fingertips. CoolCare has been designed with users in mind, making it an all-inclusive programme covering every aspect of care home management. It includes individual dashboards which are tailored to the needs of each user, whether a marketing manager, payroll clerk or chief executive. Care home management software has never been so user-friendly and comprehensive. Our software is compatible with multiple platforms, such as iPhones, iPads, and Android devices – you can even access the

software remotely, enabling you to use the software on the move, wherever you are. CoolCare is a completely integrated product suite that covers every administrative and recording task in a care home. These include client records, billing information, staff records from an HR perspective, including training and time and attendance functionality. In addition, various financial tasks such as client billing, private monies and petty cash records are all included, along with a host of other useful features. Part of the implementation of each CoolCare installation is its tailoring and configuration for each customer, so that it fits in with existing systems and content naturally. This flexibility sets CoolCare apart from other similar systems and enables users to create a solution that suits their needs. With over 1,000 sites using CoolCare today, we have the experience to help and support each user appropriately. It is a completely cloud-based solution with a simple pricing structure that includes training, support, data migration and configuration and is guaranteed to realise ROI in a very short space of time indeed. There has never been such an easy-touse, comprehensive care home management platform, and we think you’re going to love it.

Tel: 01483 604108 Email: care@personcentredsoftware.com Website: www.personcentredsoftware.com

SECTORS • Care homes.

PRODUCTS • Software.

COMPANY PROFILE Person Centred Software provides an innovative mobile solution for evidencing care interactions and care planning, called Mobile Care Monitoring. Mobile Care Monitoring is already in use by more than 10% of all care homes rated ‘Outstanding’ by the Care Quality Commission, and has been evidenced to improve the quality of care, reduce administration and gives care staff more time to care. Mobile Care Monitoring includes apps for tablets and phones, that are optimised for ease-of-use for type of role the person normally performs, which makes the app very easy-to-use and quick to learn. The main part of the system manages the care that is provided, and allows comprehensive care planning, reporting and auditing.

Reporting extends across the organisation with Group Reporting, which highlights the performance of different communities. Care planning includes integration to call bell systems and activity planning, to provide a complete view of care each individual receives, which can also be shared with families and friends via the Relatives Gateway.

CMM February 2017 45

RESOURCE FINDER

Sekoia

Quality Compliance Systems

Tel: 07859 906571 Email: contact@sekoia-care.co.uk Website: www.sekoia-care.co.uk

SECTORS

Tel: 0333 405 3333 Email: info@qcs.co.uk Website: www.qcs.co.uk

SECTORS • Care homes. • Domiciliary care. • Supported living. • Learning disabilities. • Mental health.

PRODUCTS • Compliance management system.

COMPANY PROFILE With care inspections becoming more frequent and ever more stringent, health and social care services are under maximum pressure to manage their policy compliance accurately and effectively. Quality Compliance Systems (QCS) provides the UK’s leading quality assurance and compliance management system for the adult social care sector. Our powerful yet userfriendly system keeps all the policies, procedures and working documents that you need for compliance – including mock inspection toolkits – in one place. All documents are fullycustomisable and accessible from any web-enabled device in Word and PDF format, and are also provided in hard copies in high quality manuals. Simply enter your

46 CMM February 2017

organisation’s details once and the system populates all the relevant parts of the policies and procedures, so everything is customised to you. You can edit, view and download policies and procedures, and even upload your own documents to make the system even more comprehensive and personalised – enabling you to more easily achieve, maintain and exceed Care Quality Commission, Scottish Care Inspectorate and Care and Social Services Inspectorate Wales standards. We’ll send you a weekly email to let you know whether your system is up-to-date, and the number of updated and unread documents you have. We’ll also tell you when a policy is changed and send you updated printed versions for your hard copy manuals. The powerful QCS compliance management software is backedup by superb customer service. You can experience the system for yourself in a 24-hour no obligation free trial and if you purchase the system, our friendly customer service team will talk you through everything so you know exactly what the system can do for you. The same team is on hand at any time during office hours if you need any support.

• Care homes. • Nursing homes. • Residential homes. • Learning disability homes. • Administration and care delivery. • Care management.

PRODUCTS • Digital care planning and care delivery. • Cloud based tablet and apps solution.

COMPANY PROFILE Sekoia is a digital care planning system for care homes which frees up time to be spent where it matters the most – providing care. The solution consists of touch screens with customised apps that support the care managers, staff and residents. The screens give you access to all the information

you need, right where you need it. The result is enhanced care, fewer mistakes and greater job satisfaction. Sekoia provides you with an overview of your daily tasks and lets you manage your day, record health data, share information and report incidents, all with lightning speed at the touch of a button. We have more than 30 different apps that we put together according to your requirements, to ease your workflow and ensure care that is based on the individual needs of each resident. Using Sekoia, care homes experience a vast reduction of critical incidents and staff time used on administrative tasks, such as care notes and paperwork. We see ourselves like Q to 007. All heroes need a bulletproof toolkit. Especially those working in care.

Empower your team to make a difference Clinical, mandatory & accredited training Inhouse and open courses available

What Care Home Managers are saying about our training ... Essential Training have shown themselves to be a reliable, responsive, ﬂexible and competitive in their supply of good quality training with the experience and skills required to support our staﬀ. Barry Swinbourne Assistant Manager, Malvern Nursing Home

Book with us today: telephone 0845 344 1912 Email enquiries@essentialtraininguk.com www.essentialtraininguk.com

training group

Together we will make a diﬀerence CMM February 2017 47

EVENT PREVIEW

CMM INSIGHT – LEARNING DISABILITY AND MENTAL HEALTH SERVICES 2nd March, Manchester

MAIN STAGE PRESENTATIONS The agenda includes a wide range of experts in social care, learning disability and mental health services. Dr Iris Elliott, Head of Policy and Research at the Mental Health Foundation will deliver the keynote speech offering providers guidance on how to navigate the changing policy environment. Safe and quality care must be at the heart of all services and Ewan King, Director of Business Development and Delivery at the Social Care Institute for Excellence will explore best practice guidelines for providers to consider for their services. Offering the regulator’s viewpoint will be Debbie Westhead, Deputy Chief Inspector of the Care Quality Commission. Amongst other topics, Debbie will consider how learning disability and mental health providers are performing against CQC’s inspection regime. Adapt or Die? With incredible pressure on the sector and on individual businesses, Craig Dearden-Philips, Managing Director of Stepping Out will ask delegates whether it’s time to 48 CMM February 2017

adapt their business for the future, or take the tough decision to exit. 2017

CMM Insight returns to the North West and will be held at The Renaissance Hotel, Manchester on 2nd March. The successful, annual conference on learning disability services has also extended its agenda this year to incorporate mental health services. With both types of specialist support facing similar pressures, the agenda has been sympathetically extended to encompass them both. Delegates will have the opportunity to explore the main issues facing the sector, developments and opportunities. Kathy Roberts, Chief Executive of the Mental Health Providers Forum will chair what looks to be an informative and detailed event.

AFTERNOON SESSION The afternoon session will give delegates the opportunity to attend a choice of workshops which include the challenges of medication management, and delivering prevention in mental health services. These will be followed by Angie Boyle, Policy Adviser at the Mental Health Providers Forum, who will consider the challenges of delivering supported accommodation. Stephenie Malone, Specialist Health and Social Care Employment Solicitor at Harrison Clark Rickerbys will then take the stage to explore employment law relevant to the sector and uncover what delegates really need to know. The final presentation of the day is Marc Jones, Director of Profiles4Care who will give attendees practical guidance on how to tackle recruitment and retention. CMM Insight Learning Disability and Mental Health Services proposes to be a fantastic day, and with the addition of mental health to the already successful learning disability conference, it should be of real interest to anyone operating in either field. The event is CPD Certified and delegates will have plenty of opportunities to network and meet carefully selected exhibitors throughout the day. Tickets are available via the CMM website www.caremanagementmatters. co.uk/events. CMM subscribers receive a 10% discount on their ticket.

Sponsor

Organised by

CONFERENCES • EXHIBITIONS

Agenda developed with

WHAT’S ON? Event: Governance and Accountability in New Care Models Date/Location: 8th February, London Contact: The King’s Fund, Tel: 0207 307 2409 Event:

Building an Environment to Support Best Practice in Dementia Care – Brendoncare Annual Lecture Date/Location: 20th February, London Contact: Brendoncare, Tel: 01962 852133 Event: Better Transfers of Care for Older People Date/Location: 21st February, London Contact: The King’s Fund, Tel: 0207 307 2409 Event:

Showcase 2017 Developing Resilience in Health and Social Care Media Partner Date/Location: 8th March, East Sussex Contact: Surrey Care Association, East Sussex County Council, West Sussex County Council and Brighton and Hove City Council www.careshowcase.org.uk Event: Health + Care 2017 Date/Location: 28th-29th June, London Contact: Health + Care, Tel: 0207 348 5777

Media Partner

Event:

HCD-save money ad 91x110mm_oct:HCD

18/12/15

15:40

Want to Save Money?... You could save up to 20% on your spend by switching to HealthCare Direct

Send us your current invoices and we’ll send you back a price comparison against your current supplier.

Call us now: 020 8236 0060 www.care-house.co.uk

Digital Health and Care Congress 2017 – Embedding Technology in Health and Social Care 11th-12th July, London PageDate/Location: 1 Contact: The King’s Fund, Tel: 0207 307 2409

CMM EVENTS Event: Date/Location: Contact:

CMM Insight – Dorset Care Conference 2nd February, Bournemouth Care Choices, Tel: 01223 207770