Care Management Matters April by Care Choices Ltd

APRIL 2017 ÂŁ4.00

www.caremanagementmatters.co.uk

THE GIG ECONOMY

Whatâ&#x20AC;&#x2122;s its role in social care?

Values based recruitment Time to change your approach

Delivering safe care

Making sure your clients are protected

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In this issue From the Editor

Is it just me…? 07 Vic Rayner sits in for Robert Chamberlain and gives her view of the Budget and what it means for social care. CMM News

Business Clinic Our panel comments on SuperCarers, a new online platform matching care workers to people needing care.

A View from the Top Kevin Gunputh, Managing Director of Luxury Care Group is the subject of our interview.

Event review CMM reviews the CMM Insight Learning Disability and Mental Health Services Conference in Manchester.

What’s On?

Straight Talk Ollie Watson shares how data can help domiciliary care providers target areas of growth and understand their clients.

FEATURES

REGULARS

The Gig Economy and social care Sara McKee delves into the detail of the Gig Economy and the role it could play in social care.

Delivering safe care – how can it best be assured? Colin Young looks at the main considerations to ensure your service is safe and focuses on core values of staff and local management.

Values based recruitment – we need a new approach Harriet Phillips explores values based recruitment, how it starts before you even speak to a candidate and, when applied correctly, even helps you to retain staff.

Maximise your interiors to maximise your profits Roy Edwards discusses how well-devised interiors can attract private clients and help to maximise profits.

Resource Finder – specialist solicitors CMM brings you details of specialist social care solicitors and the services they offer. CMM April 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

@SaraMcKeeFRSA

Vic Rayner Executive Director, National Care Forum

Sara McKee Founder, Evermore

@DeardenPhillips

@EwanDKing

Craig DeardenPhillips Managing Director, Stepping Out

Ewan King Director of Business Development and Delivery, Social Care Institute for Excellence (SCIE)

@ACSLLP

Colin Young Managing Director, Nomad Care Management Ltd

Matthew Wort Partner, Anthony Collins Solicitors LLP

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: 978-1-911437-35-2 CCL REF NO: CMM 14.2

4 CMM April 2017

Kevin Gunputh Managing Director, Luxury Care Group

Harriet Phillips Employer Engagement Manager, Profiles4Care

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

@Profiles4Care

@NHG_UK

@CACI_LocStrat

Roy Edwards Marketing Director, NHG

Ollie Watson Director, CACI

From the Editor Inside this issue of CMM we have a number of interconnecting features. Firstly, our cover story is an exploration of the Gig Economy and its role in social care. For those of you who haven’t heard of it, a Gig Economy business is similar to that operated by Uber. It offers an online platform where people can buy products and services on-demand. There is a growing number of organisations offering services like this in social care, and Sara McKee explores the model and considerations for the social care market on page 20.

ONLINE CARE PLATFORM Following on from that, our Business Clinic looks at SuperCarers, which is an online care platform for people looking for care and care workers. It matches care workers with clients based on personality and interest, as well as

care need, location and timing. We ask our panel for their thoughts on the organisation and the model in general on page 30.

Editor, Emma Morriss explores this issue’s articles and how many of them complement each other to offer a rounded view of things happening in the sector.

SAFEGUARDING Also inside this month’s issue, we look at safeguarding and the steps organisations need to take to keep their clients safe, especially from abuse. Colin Young explores the importance of the core values of staff and local management in this, offering insight into what providers can do to minimise risks. His feature starts on page 26.

VALUES With Colin exploring the importance of staff values in keeping clients safe, there was mention of values based recruitment. This approach to recruiting staff has been growing over the last few years,

but changing the way something as huge as recruitment is carried out isn’t easy. That is why Harriet Phillips has drafted an article for us, discussing the details of values based recruitment, what it means, how it can be undertaken and the benefits of doing so. Her article starts on page 35.

USEFUL INFORMATION As well as these features, we also bring you a piece focusing on interior design and how the

interiors of a care home can help the bottom line. Plus, our Resource Finder explores care sector solicitors, A View from the Top is from Kevin Gunputh of Luxury Care Homes, and Ollie Watson of CACI explores data to help homecare providers considering where to expand. I hope you find these features of use. I will sign off with the announcement in the Budget of some funding for social care. It may not be enough, but it’s better than nothing.

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

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CMM April 2017 5

Is it just me...?

concern to the sector, with the Budget statement appearing not to recognise the much broader social care responsibilities of authorities towards people with learning disabilities, and indeed to prevention.

Vic Rayner sits in for Robert Chamberlain and gives her view of the Budget and what it means for social care.

On 8th March, the Chancellor, Philip Hammond outlined the first full Budget post-Brexit. What will it mean for social care? Of course – the devil is always in the detail – and we haven't had much of that as I write. Instead, what I will lay out now will give you a flavour of the what – without the necessary detail of the how and when.

FUNDING The Chancellor announced an additional £1bn for adult social care this coming financial year – which he wrapped up in a statement suggesting there would be an additional £2bn for the sector over the next three years. The £1bn identified for 2017 was described as a bridge to the Better Care Fund additional monies, which had been back-loaded towards the end of the Parliament.

We now know a little more about how this £2bn funding will be allocated, as on Thursday, the announcement detailing the level of financial support to individual authorities was released. In addition, reassurances were provided by key politicians that this allocation was in fact ‘new money’, rather than a diversion of existing resources. Of course, this funding comes on the back of the changes announced in the local government settlement in December, which included giving local authorities permission to increase their council tax by up to 5%; 3% of that protected for social care funding. It also included the announcement of funding to be derived from reallocation of the new homes bonus to local authorities, badged as a mechanism to balance out the geographic differences arising from raising revenue through the council tax precept.

WORKFORCE

In the Budget, the Chancellor also referred to the need to address the long-term funding of social care, suggesting that there would be a Green Paper on this issue forthcoming, but promising not to exhume the notion of a ‘death tax’. The promise of this Green Paper is critical to identifying a solution that will enable the funding to keep pace with the ever-growing need for social care. With this in mind, reform of the delivery of integrated health and social care was also given a budget boost, with the Chancellor announcing £325m of capital to be spent on ten pilot Sustainability and Transformation Plans which are likely to focus on the ongoing drive to move care closer to home. One point of note, though, is the very strong link in the Budget to increased funding to reduce delayed discharge of older people. This will be of great

Whilst many were waiting for the financial announcement, it could've been easy to gloss over the workforce developments. However, there were a number of areas of interest for social care. Once again, there was a reiteration of the increase to the National Living Wage. Alongside this, there were potentially some areas where there will be greater incentives for people to consider entering employment, including: • Extension of free childcare for three to four year olds to 30 hours per week. • New funding for ‘returnship’ schemes to bring people back into public and private sector after a career break. • Apprenticeships – including increased emphasis on parity of esteem for vocation to academic routes – potentially bringing new grants and funding for people entering into vocational routes – which provides potential for social care. In evaluating the implications of the Budget, I will be keeping a weather eye on the short-term cash injection racing towards social care, particularly working to ensure that this heads straight to the frontline. However, the main prize for the sector is keeping that long gaze towards the horizon, where the Green Paper looms, offering reform to take us from 2020 to beyond.

Vic Rayner is Executive Director of The National Care Forum. What do you think of the Budget? Join the debate at www.caremanagementmatters.co.uk CMM April 2017 7

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APPOINTMENTS SCIE

Government announces funding for social care in the Spring Budget The Government has announced funding for social care in its Spring Budget Statement. The announcements set out to ‘support the social care system with substantial additional funding, so people get the care they deserve as they grow older, and support both local NHS plans and improvements to Accident and Emergency with new capital investment.’ Building on the Local Government Finance Settlement announcement, the Government has pledged £2bn in additional funding for social care to councils in England between 2017-18

and 2019-20. £1bn will be provided in 2017-18. The Government said, ‘Building on the approach to the Better Care Fund, councils will need to work with their NHS colleagues to consider how the funding can be best spent, and to ensure that best practice is implemented more consistently across the country. ‘This funding will be supplemented with targeted measures to help ensure that those areas facing the greatest challenges make rapid improvement, particularly in reducing delayed transfers of care between NHS and

social care services.’ Other announcements include: • £100m for the NHS for capital investment in A&E departments. • £325m for Sustainability and Transformation Plans (STPs) over the next three years to support those STPs where there is the strongest case to deliver real improvements for patients and to ensure a sustainable financial position for the NHS. • A Green Paper on the future of social care later this year. Further detail is awaited.

New report reveals pressure on My Home Life partners with public services including hospitals and adult social Performance Tracker, published by King's Fund the Institute for Government and care which are both being pushed to the Chartered Institute of Public Finance and Accountancy, has found that until recently the Government managed to maintain the quality of public services while controlling spending. However, it says that the UK faces a combination of failing public services and breached spending controls unless urgent action is taken. According to the report, the Government’s own data shows its original approach had run out of steam by 2015. The report uses government data to examine five key public services,

breaking point. It says the Government now risks bouncing from spending crisis to crisis, against the backdrop of Brexit negotiations. The report makes several recommendations, including that assumptions behind spending decisions should be subject to independent scrutiny. The report suggests the Government should consider creating an ‘Office for Budget Responsibility for Public Spending’, to help embed efficiency within public sector decision-making.

The King's Fund and My Home Life have created a unique partnership to provide a learning network for care home providers, commissioners and local NHS partners. The network will support collaboration and partnershipworking within six localities and will create a critical learning and development space for anyone working at the interface with care homes. There are four modules covering changing policy, care homes and hospitals, primary and community care, and the future of care.

Alison O’Sullivan, a former President of the Association of Directors of Children’s Services and former Director of Children’s, Adults and Social Services at Kirklees and Bradford, has been appointed as the new Chair of the Social Care Institute for Excellence (SCIE). Following a competitive recruitment process, qualified social worker Mrs O’Sullivan was appointed to replace current chair, Michael Bichard, when he steps down on 31st March 2017.

OPTIONS Options, the specialist autism provider of Outcomes First Group, has teamed up with leading autism campaigner, Anna Kennedy OBE. Options has appointed Anna as the Group’s Autism Ambassador.

CAMBIAN GROUP Cambian, a leading provider of specialist education and behavioural health services for children, has announced that Anoop Kang will be joining the Board as Chief Financial Officer (CFO) in July 2017. Martin Hopcroft will continue as CFO in the meantime.

AUDLEY Audley Retirement has announced the appointment of two of its senior management team to the Group Board. Kevin Shaw, formerly Development Director, becomes Managing Director – Development and Paul Morgan, formerly Operations Director, becomes Managing Director – Operations. Katherine Rose, formerly Marketing and Communications Director, has been appointed Group Marketing Director. CMM April 2017 9

NEWS

Social care 'on borrowed time' A new report from Age UK concludes that, ‘We are living on borrowed time in saving social care for older people from complete collapse’. The report, The Health and Care of Older People in England 2017 uses official statistics and new analysis. It examines the Government’s strategy for keeping the social care system from total collapse, but concludes it is failing and that the situation is getting worse. Key findings in the report include: • There are now nearly 1.2 million people aged 65+ who don’t receive the care support they need with essential daily living activities. This represents a 17.9% increase on last year and a 48% increase since 2010. • The percentage of the older population receiving social care

support fell from 15.3% in 2005/06 to 9.2% in 2013/14. • There has now been a £160m cut in total public spending in real terms on older people’s social care in the five years to 2015/16, during a period of rapidly rising demand because of a growing ageing population. • The Government hoped the precept would raise £1.8bn a year by 2019/20 but actual amounts are falling slightly short and the impact varies a great deal by area. • Since 2010 there has been a steady decline in the number of residential home beds but huge variation across the country, with the reduction ranging from 18% in London to 2% in the East of England.

Sicker patients main reason for winter pressures Sicker patients with more complex conditions are the main reason for worsening performance in A&E departments, according to The King’s Fund’s latest quarterly monitoring report. 80% of NHS finance directors who responded to a King’s Fund survey identified higher numbers of patients with severe illnesses and complex health needs as a key reason for the pressures on A&E units, while 70% of respondents cited delays in discharging patients from hospital. This contrasts with 27% who pointed to poor access to GPs and 20% who identified shortages of clinical staff as key factors.

The survey also highlights the huge effort made by the NHS to prepare for increased pressure on services during the winter. More than 70% of the trusts surveyed increased their staff, while 80% of clinical commissioning groups paid for extra resources in primary care. The quarterly monitoring report from The King’s Fund follows news from NHS Improvement of a £886m deficit among NHS providers at the end of the third quarter 2016/17. Increased spending on agency staff and outsourcing to the private sector may make it difficult to reduce this deficit before the end the year.

45 clients over the age of 65. The home has a 'Good' Care Quality Commission rating and was part of

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Leicester care home sold DC Care has completed the sale of Clarendon Mews Care Limited, which includes Clarendon Mews care

home, in the centre of Leicester for an undisclosed sum. The purposebuilt care home is registered for

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NEWS

Prevalence and dynamics of social care The Institute for Fiscal Studies has published a report on the prevalence and dynamics of social care receipt. Produced with funding from the Health Foundation, as part of a broader programme on the allocative efficiency of health and social care spending, The Prevalence and Dynamics of Social Care Receipt examines the

prevalence of social care and the changes to the needs and care receipt of individuals across time and between different birth cohorts. Using data from the English Longitudinal Study of Ageing, the Institute for Fiscal Studies (IFS) has updated existing evidence on the prevalence of receiving help with certain activities among older people. Specifically, describing who

receives help, what type of help is received, how many hours of help are received from different sources, and the role of local authorities and private finance. The IFS also pulls together the first evidence on the dynamics of care receipt in England. This includes how the proportion of individuals receiving domestic care changes when

Target acquires homes in Dorset Target Healthcare REIT has completed the acquisition of two purpose-built care homes in the village of Three Legged Cross near Wimborne, Dorset for an undisclosed price. The two homes are adjacent to each other and comprise a total of 70 bedrooms. Acorn Lodge was built in 2012 and has a total of 26 bedrooms with full en-suite bathrooms. Oakdene was built in the 1990s

and was subsequently extended over a number of years to a total of 44 bedrooms. On acquisition, the combined homes were let to Dorset Healthcare Limited, which is part of the Care Concern Group. Care Concern operates 37 homes across the UK, with an emphasis on quality of care and a high service offering. The lease is for 35 years. Following acquisition, Target

Healthcare and Care Concern intend to undertake renovation works to Oakdene, with a view to enlarging some bedrooms, providing additional lounge space and generally bringing the home in line with the other assets in Target Healthcare's portfolio. These renovation works at Oakdene will be carried out over a period of time to minimise disruption to the residents of the home.

considering a period of time rather than a snapshot, and what characteristics and factors are associated with starting and ending care receipt. Finally, the report considers how the receipt of care differs across different date-of-birth cohorts, the possible drivers of this variation and its potential implications for an ageing population.

LNT sells home to Oakdale Care Group LNT Care Developments has sold Timken Grange in Duston to Oakdale Care Group. Once complete, Timken Grange will provide a state-of-the-art 66-bed care home. The construction of Timken Grange in Duston is due to complete in December 2017.

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NEWS

CQC fee changes confirmed Following a public consultation last year, the Care Quality Commission (CQC) has outlined the fees that providers of health and adult social care in England will be charged from April 2017 to recover the costs of their regulation. CQC’s regulatory functions are funded both by fees paid by providers and by grant-in-aid from the Department of Health. Government policy requires CQC to move towards full chargeable cost recovery (FCCR)

for all health and adult social care providers in England that it regulates. Over the last few years, CQC’s fees have been increasing and grant-inaid reducing to achieve FCCR for all sectors. CQC is making savings over the period to 2019/20. In 2015/16, their budget was £249m. The budget for 2019/20 will be £217m, a reduction of £32m. During 2016/17, CQC has made over £10m in efficiency savings. The amounts that providers will

pay for their regulation will depend on the type of health or social care they offer, as well as how close their sector is already to meeting the chargeable cost of their regulation in full. Examples of the changes providers can expect to fees in 2017/18 include: • £163 increase for a care home with 26 to 30 residents to £4,375 a year. • £823 increase for a single-location community social care provider (such as a homecare agency) to

Top tips when choosing a support provider The Voluntary Organisations Disability Group (VODG) has launched a practical guide to help people choose the right social care support. Top ten tips when choosing a support provider is designed to be used by those looking to secure high-quality social care for themselves or for a relative or friend. It helps people consider

the differences between receiving support from a care provider organisation or directly employing a personal assistant (PA). It also describes other methods of support, including assistive technology, or combining a range of different support options. The guidance suggests that if individuals assessed as requiring support under the Care Act are to

make an informed choice about their care, they should ask providers some essential questions. As well as demystifying issues, such as the Care Act, personal budgets and employing PAs, the resource sets out the pros and cons of different types of care. The publication also includes a jargon buster that puts social care terminology into plain English.

Delivering Sustainability and Transformation Plans The Government must be prepared to back radical changes to health services to secure the future of the NHS, according to a new analysis on delivering Sustainability and Transformation Plans published by The King’s Fund. The report argues that Sustainability and Transformation Plans offer the best hope of delivering essential reforms to NHS services. The proposals that have been put forward need to be developed into credible plans focused on the most important priorities in each area. Much more effort must be put into engaging NHS

staff, patients and the public, local authorities and others in developing these plans. The King’s Fund calls on the Government to support reforms to services where the case for change has been made. This includes changes to the role of acute hospitals to concentrate specialist services where the evidence shows this will deliver better outcomes for patients. The report also argues that additional investment in social care and the NHS will be needed to deliver the proposals set out in Sustainability and Transformation Plans. The report argues that

Sustainability and Transformation Plans present an opportunity to move care closer to home and moderate demand for hospital services. However, it says that proposals to reduce the number of hospital beds are not credible unless investment is first made in services in the community. This includes making better use of existing community services through greater integration of the full range of out-of-hospital care. It warns that cuts in social care and public health budgets will make it difficult to strengthen services in the community and give greater priority to prevention.

Villa Care opens ward at Wharfedale Hospital Villa Care Group, a Leeds based healthcare company, and Leeds Teaching Hospitals NHS Trust have signed an agreement to open the Bilberry Unit at Wharfedale Hospital in Otley, a facility providing nursing beds. 12 CMM April 2017

The beds will be for existing older patients who have finished their acute episode of care at St James’s University Hospital or Leeds General Infirmary and are medically-fit for discharge from the Trust, but are waiting whilst

assessment or packages of care are put in place. Nursing and care in the Bilberry Unit will be provided by Villa Care Group, while Leeds Teaching Hospitals will provide physio and occupational therapy staff.

£2,192 a year. • £65,375 increase to £202,239 a year for a NHS trust with an income of £125m to £225m. • £1,952 increase for a single-location GP practice with 5,001 to 10,000 patients to £4,526 a year. • £113 decrease for a single-location dental practice with four chairs to £837 a year. The fees represent 0.16% of overall indicative turnover of the market.

Impact of the social care crisis on GPs and A&Es New research on the impact of the social care crisis on GPs shows that a lack of social care is piling pressure on surgeries and A&Es. The poll of over 1,000 GPs, undertaken by Medeconnect on behalf of the Care and Support Alliance, reveals: • An overwhelming 92% of GPs think social care services are failing to give patients sufficient care. • 89% think reductions in social care have contributed to pressures in their surgeries. • 93% think this has led to increased pressures in A&E and contributed to an increase in delayed discharges from hospital. • GPs also think that things are going to get worse, with 8 out of 10 GPs (81%) thinking care services would worsen over the next two to three years. • Almost 9 out of 10 GPs (88%) think that due to cuts to social care there is less care than there was just two years ago. • Nearly 1 in 3 (31%) GPs thought that 1%-5% of appointments could have been avoided if better social care was in place another 30% thought 5%-10%, and more than 1 in 10 (12%) thought as many as 21-30%.

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NEWS

NAPA reports on Comic Relief choir project The National Activity Providers Association (NAPA) has reported on the findings of a choir project funded by Comic Relief. Choirs, comprising staff, residents and relatives, were set up in six care homes owned by Fremantle Trust and Greensleeves Care. These homes were chosen for the project by NAPA, due to the fact that they all have ‘Good’ Care Quality Commission ratings and are owned by charities

who place a great deal of importance on the provision of activities. Six professional singing facilitators were recruited and attended a training workshop at the beginning of the project. They delivered a total of 72 choir sessions in the six homes, coming in on a fortnightly basis for six months. The choir groups sang familiar songs, learned some new ones and, in one home, wrote their own song. They

Handovers in care settings The ways that care home staff change shifts and how they exchange information when coming on and off duty are widely thought to be crucial for ensuring safe, highquality and dignified care for older people, according to new research by the Social Care Workforce Research Unit, part of the Policy Institute at King’s College London. Based on interviews and observations with staff in five care

14 CMM April 2017

homes in England, the research sheds light on what seem to be the most important things to take into account when organising shift changeovers, including clear communication; transparent and readily available written records; attention to confidentiality and respect for residents’ dignity; punctuality of staff; and making sure that staff value this part of their daily routine and are paid for it.

also learned about singing and performing techniques. Staff buddies in each home were encouraged to attend sessions with residents and to talk about the project between sessions and provide encouragement, sharing the experience with the residents. Staff helped evaluate the project by filling in wellbeing assessment forms with the residents and writing in their own reflective diaries.

Links with local community groups, including a local young people’s theatre, college and local choir groups were made for three of the six homes and people from these groups joined with the care home choirs and took part in the celebration events. Each home held a celebration event, where the choir performed the songs they had been singing to an audience of other residents, staff, family and friends.

Dementia-friendly faith communities Faith Action has created a collection of inspiring examples of how faith communities from different traditions are tackling issues to become dementia-friendly. It has also developed a collection of resources. Discussions with faith groups have highlighted what faith has to offer to people living with dementia

and their carers. Findings on what faith communities have to offer, include connecting people with their faith and with each other; the power of prayer to uplift; ways of connecting people with others so they are not isolated and can continue to function as part of the community; being part of a community of people who share values of care; and compassion.

NEWS

New home for Bromsgrove

Age no barrier to living well

Nottingham based Clegg has been awarded a £4.6m contract with Cinnamon Care Capital to build a new care home in Bromsgrove, Worcestershire. The Bromsgrove care home, called Burcot Grange, will provide 56 en-suite bedrooms along with a hairdressing salon,

Age UK’s Wellbeing Index finds that age is not a barrier to living well. The Wellbeing in Later Life Index, developed by Age UK and the University of Southampton, analysed data from 15,000 people aged 60 and over to measure the wellbeing of the UK’s older population. It looked at how people were doing in different aspects of their lives under five key areas – social, personal, health, financial and environmental. The findings overall showed that there is no ‘magic bullet’ for positive wellbeing in later life and that a range of factors play a part in contributing

coffee shop, reception area and landscaped gardens. Primarily for residents with dementia, the building will be adjacent to the existing Burcot Grange care home, operated by the Cinnamon Care Collection, and is set to be completed in autumn 2017.

Transformation of care and support The Social Care Institute for Excellence has updated its total transformation of care and support research to highlight the savings that scaling up promising models can make. Scaling up promising models of care, support and community health services could increase costeffectiveness for the NHS and local authorities – and improve outcomes for local people, according to Total Transformation of Care and Support: Second Edition. It indicates that if six

promising, but under-used, models of care were scaled up within a large city, such as Birmingham, it could result in over £9m of savings each year across the local authority and the NHS – as well as improved outcomes for local people. The paper uses existing data on the current use of care services in Birmingham, plus data on the effectiveness of six models of care from across the country, and projects the potential impact of using those models to their full extent.

to a person’s overall sense of wellbeing. The Index found that taking part in ‘creative activities’, such as the arts, had the most direct influence in improving a person’s wellbeing in later life. This included dancing, playing a musical instrument, visiting museums, photography, singing, painting and writing. The Index provides a unique snapshot on how older people are doing now and shines a light on some of the changes that are needed to improve the quality of life for the ageing population in future.

Carterwood’s first agency sale for Hamberley Hamberley has completed a deal to sell a proposed 64-bed luxury care home site to Barchester. The sale was conducted by Carterwood and is the first agency deal the firm has executed for the award-winning

developer. The site occupies a prominent position on Glastonbury Road in the affluent city of Wells and is surrounded by a new residential development.

Qualifications in Activity Provision From care staff to managers, activity organisers to day-centre staff, domiciliary workers to owners and volunteers, these courses are suitable for all. They will support learners to contribute to the planning, delivery and evaluation of individual and group activities and to meet a range of individuals’ different needs. It will further learners’ understanding of the part activity has to play in providing person-centred care. It is increasingly recognised that Activity Provision can make a significant contribution to well-being and quality of life, and the Care Sector reports a need for specialist training for their staff in this area. NAPA is delighted to offer two courses that meet the needs of the specialist activity workforce. NAPA offers: Level 2 Award in Supporting Activity Provision in Social Care (QCF) accredited by OCN London This knowledge only course is provided through distance learning with telephone tutor support. Level 3 Certificate in Activity Provision in Social Care (QCF) accredited by OCN London This higher level course is knowledge and competence based. The student will be supported throughout this distance learning course to research the assignments, write narrative comparisons and evaluate their day to day work.

For further information please visit our website www.napa-activities.co.uk NAPA 1-2.indd 1

I have grown in confidence through the NAPA course. The course has certainly made a difference to the provision in our home.

31/01/2017 16:43

CMM April 2017 15

NEWS

Social media toolkit for healthcare

Nationwide roll-out of minibuses

Skills for Health has launched a social media toolkit with advice and best practice on how to use social media effectively. Whether new to social media or making sure existing social presence is fit-for-purpose and operates at its full potential, the new toolkit is designed to instruct

Budgetary constraints on the care sector are said to have put outings under threat. However, Oomph! has come up with a solution and is investing £4m into a new excursions service for people in care. A nationwide roll-out will start in five regions following a successful pilot. The new Out and About service

and educate organisations and their employees on how to use these platforms effectively and efficiently. The free social media toolkit has been specifically created for the healthcare sector, with support from Public Health Wales, key industry experts and employers.

starts in April when minibuses will hit the roads in the South East, South Wales, Liverpool and North West, East Yorkshire and East Midlands. Day trippers will take in premium locations such as museums, music and sport events, botanic gardens and art galleries as well as outings to markets, pubs and farms.

CQC prosecutes Liverpool care home

BBC report highlights abuse in homecare

The Care Quality Commission (CQC) has prosecuted a Liverpool care home for failing in its duty to provide safe care and treatment. The provider has been ordered to pay £82,429.72 in fines and costs by Liverpool Magistrates’ Court. The CQC brought the prosecution against the owners of Mossley Manor Care Home following 14 offences, including

More than 23,000 allegations of abuse have been made against care workers operating in people's homes across the UK, according to data obtained by the BBC. The BBC Radio 4 programme, File on 4 requested the data under the Freedom of Information Act. The request asked for the numbers of allegations of abuse and neglect made against homecare workers contracted by local authorities. The BBC found that between

failing to provide safe care and treatment, resulting in residents being exposed to significant risk of avoidable harm; failure to notify the CQC of the deaths of ten residents, and failure to notify CQC of three serious incidents. The registered providers, brothers Mr Amjad Latif and Mr Amer Latif, of Liverpool, pleaded guilty to all offences.

Carer Friendly Communities Eight major charities have combined forces to get communities across the UK involved in the run-up to Carers Week 2017 (12th to 18th June). Carers Week 2017 will focus on building Carer Friendly Communities – places that understand a carer’s daily reality and do what they can to make life a little bit easier for them. David Mowat MP, Minister for Community Health and Care, joined senior representatives from the Carers Week charities, NHS, local government and business to launch community engagement for Carers Week, encouraging local

organisations, the public and carers to get involved in the week and pledge their support to build Carer Friendly Communities. Carers Week helps the public to understand more about caring, highlights the challenges carers face and celebrates the contribution carers make to their families and communities. The campaign galvanises support from all corners of society, including individuals, local organisations, businesses, politicians and the media. It will also be a time of intensive local activity with thousands of events taking place across the UK.

Mitie sells homecare business Mitie has disposed of its social care division comprising Enara and Complete Care to Apposite Capital LLP for £2. Mitie will contribute £9.45m to the funding of trading losses and the cost of turnaround. 16 CMM April 2017

Enara, trading as MiHomecare, provides care at home for people who require help and support due to illness, infirmity or disability. Complete Care provides nurse-led, complex care solutions in the home.

2013-14 and 2015-16, there had been at least 23,428 safeguarding alerts across the UK, with most of the alerts related to care provided in England. The research also discovered that prosecutions were rare, with just 700 of the 23,428 alerts resulting in police involvement and only 15 prosecutions. More than 9,700 alerts involved people aged over 80, and 164 were about people who were aged over 100.

Sheffcare's dementia contracts Sheffcare has been awarded a major new Sheffield City Council contract to provide respite and day support for people living with dementia. Sheffcare’s new Dementia Day Support Services will help people with dementia to remain independent, supporting them as they regain and maintain the skills they may have lost

as a result of their dementia. The new service will also provide an opportunity for carers to take a break, helping them to sustain their caring role. The respite service will provide ten planned beds at Sheffcare’s homes across the city and a further four unplanned/emergency beds.

Integration toolkit for nursing leaders The RCN has reaffirmed its commitment to supporting the broad aim of providing quality health and social care that is fully integrated from the point of view of people using services, by developing a UK-wide toolkit for members working in strategic decision-making roles or involved

in forums around integrated care. The toolkit has a series of themed prompt questions for reflection and action. It is intended to support nurses to provide confident leadership to shape, deliver and monitor safe, quality and local integrated services.

Employers - if you’ve got staff on different contracts, automatic enrolment doesn’t need to be complicated. It takes just five minutes to find out if you need to offer your staff a workplace pension. Find help and get to know your responsibilities by using our Duties Checker at www.tpr.gov.uk/care Don’t ignore the Workplace Pension. It’s the law.

18 CMM April 2017

NEWS / IN FOCUS

Lloyds Bank funds supported living site A specialist healthcare provider has opened a supported living site in Merthyr Tydfil with the help of a sixfigure funding package from Lloyds Bank Commercial Banking. Castle Care Specialist Services has transformed a previous Lloyds Bank site on Market Street into eight, one-bedroomed supported living flats suitable for those with specialist needs. The first residents have moved into the apartments.

Housing for older people inquiry The Communities and Local Government (CLG) Committee has launched an inquiry into whether the housing on offer in England for older people is sufficiently available and suitable for their needs. The inquiry follows research which indicates pensioners are stuck in oversized properties worth £820bn in market value. The inquiry is launched at a time of significant housing shortages, rising numbers of older people, pressures on social care and with just 2% of the country’s housing stock designed with older people in mind. Government efforts to boost home building and home ownership focus on first-time buyers and younger generations. However, some argue that boosting the delivery of specialist retirement housing would free-up homes currently underoccupied by older people. Official data show that 8.1m properties, or 35% of all homes in the country, are ‘under-occupied’, which is defined as having at least two spare bedrooms. The inquiry will consider whether a national strategy for the support of housing provision specifically for older people is needed.

In focus Changes to Apprenticeship Funding – understanding the new rules WHAT’S THE STORY ABOUT?

Skills for Care has published details of the new apprenticeship funding and how it is changing from May 2017 with the introduction of an Apprenticeship Levy. UK employers who pay over £3m in payroll per year will become a ‘Levy paying employer’ and will pay 0.5% of payroll over £3m on a monthly basis. Other employers (ie those with payroll costs below £3m) will fall into two categories: Non-Levy paying employer with more than 50 employees; and Non-Levy paying employer with fewer than 50 employees.

WHAT DOES THIS NEW POLICY MEAN?

This new Government policy on apprenticeship funding includes how much employers will be able to spend on each apprenticeship and the rules that employers will need to follow. The levy is for employers to use to fund apprenticeship training in their organisation.

WHERE DO LEVY PAYING EMPLOYERS START? There is a dedicated website on funding apprenticeship learning where employers can work out how much they need to pay. Levy payments will be paid into a digital account which employers will need to set up before May 2017. The Manage Apprenticeships Service and HMRC both have information on this.

WHAT ELSE SHOULD I KNOW?

In its practical guidance, Skills for Care says that the Government is proposing 15 funding bands for apprenticeship learning which will set an upper limit on the amount of funding the Government will provide. The cost of learning will have to be negotiated by employers with learning providers. Anything above the upper limit will have to be funded by the employer. The funding bands will be used for both the new standards and the old framework apprenticeships until they are withdrawn. However, the funding will not be the same for both systems. The current proposal for adult social care is: for new standards published for Adult Care Workers and Lead Adult Care Workers, the upper limit is set at £3,000 per apprentice. For framework apprenticeships, the proposal is that Level 2 Health and Social Care will have an upper limit of £1,500, Level 3 Health and Social Care will be limited to £2,000 (adult social care pathway only) and Level 5 Care Leadership and Management an upper limit of £2,000. Employers who do not pay the levy will fund apprenticeships through a co-investment model. The Government is proposing that this will be a 1:9 ratio with the employer contributing 10% of the total negotiated cost of learning and the Government co-investing the other 90%.

For employers who have fewer than 50 employees and take a 16-18 year old apprentice or a 19-24 year old who is leaving care or who has a local authority Education, Health and Care Plan, they will have 100% of the training costs paid by the Government. Employers with more than 50 employees who take on a 16-18 year old or a 19-24 year old who is leaving care or who has a local authority Education, Health and Care Plan will receive an additional £1,000 toward to cost of training support and their learning provider will receive an additional £1,000. Support for English and maths will be paid by Government at a flat rate of £471 per qualification to the learning provider and will not be taken out of the employer’s digital account. Extra support is also available to the learning provider for support for apprentices with additional learning support needs.

WHERE CAN I GET HELP TO FIND OUT MORE ABOUT THESE APPRENTICESHIP CHANGES?

Skills for Care has produced specific practical guidance and has a wealth of information that employers in the care sector might need. It includes a specially created Preparing for the levy checklist which takes you through what you need to know, and do, until May 2017. CMM April 2017 19

G I G E TH Y M O EC ON L CARE A I C O S D N A Q

I’ve heard a lot about the Gig Economy and whether there’s a place for it in social care. What is it and could it help to create a sustainable social care market?

Sara McKee, Founder, Evermore.

I recently gave evidence to a Work and Pensions Select Committee on the Gig Economy, examining whether the UK welfare system adequately supports the growing numbers of self-employed and Gig Economy workers. They were interested in my opinion about the flexibility of the Gig Economy and my personal experiences of what works and doesn’t work as a selfemployed person. They were clearly looking at the Gig Economy from the perspective of upping employee protection and Frank Field, the Committee’s Chair, is calling for equal rights of ‘giggers’, including a guaranteed minimum wage. I can understand why. No-one wants to see workers exploited and certainty of employment is important to many people. However, as we’ve seen with zero hours’ contracts, there are pros and cons. Flexibility to fit other passions, like acting, writing and music, around other 20 CMM April 2017

mainstream work is often more appealing than a guaranteed level of income each month. However, I wonder whether the prism the Gig Economy is currently being viewed through is actually limiting our thinking. We are well-versed in the challenges of this industry. Our population is ageing (that’s a market opportunity to me, but that’s another story), public sector budgets are shrinking, workforce attraction and retention is, and always has been, tricky. These are big issues and we won’t make any headway by tinkering around the edges. We need to be more creative about how we think about the workforce in general and we need to be open to new ideas. Can the Gig Economy be part of the solution?

WHAT IS THE GIG ECONOMY? We should start with the question, ‘What is the Gig Economy and what does it actually mean?’ The phrase was coined in around 2009, according to the Financial Times, when unemployment was at a high and people were working several part-time jobs. In reality, it’s been around for decades and its origins trace back to gigging musicians. The companies most famous for taking advantage of, and shaping the modernday Gig Economy, include the ride-share app Uber, home-stay network AirBnB, food delivery company Deliveroo and chore outsourcer TaskRabbit. These companies operate in different markets, but what they have in common is that they provide an online platform where people can buy products and services on-demand. The suppliers of the goods or services are treated as self-employed by the platform owners, so there’s no sick or holiday pay and no certainty of work or income. Advocates for this style of working claim it offers greater flexibility and freedom, and means people can work in a way that meets the needs of their lifestyle. Its popularity in the UK is booming. According to the Office for National Statistics, around 5 million people are self-employed currently and part-time self-employment, which is more reflective of the Gig Economy, has increased by 88% between 2001 and 2015.

CMM April 2017 21

THE GIG ECONOMY AND SOCIAL CARE

THE GIG ECONOMY AND THE CARE SECTOR There are some key reasons why the Gig Economy ‘unicorn’ companies (those startups with a market value of over $1bn), like Uber, have been successful. They’ve understood their target audience, created a way that is easy and convenient for a consumer to buy a product or service, and made it affordable. That’s what Uber’s Co-Founder, Travis Kalanick said in an interview with American organisation AARP. He said the future of the shared economy is, ‘all about convenience, quality and affordability for the consumer’. This is exactly where care needs to be heading. It’s easy to be swept away with emotion in the care sector. We are dealing with people’s lives and often the end of those lives. We are involved 22 CMM April 2017

in hugely intimate tasks, looking after people’s emotional wellbeing as well as their physical needs. However, at the end of the day, we’re providing a service and someone – whether it’s the Government or the private funder – is paying for it. It’s a marketplace. This is the mindset that we need to embrace if we’re going to have a sustainable care sector in the future. This is not radical thinking. There are already companies that have applied more of a commercial marketing approach to product development in this sector, and are using the Gig Economy to deliver care and support to people in their own homes. In the US, there are companies like CareLinx, which has more than 150,000 caregivers available to hire, KindlyCare and Care.com. Closer to home, there’s been the recent launch of online homecare agencies Cera, HomeTouch and Vida. All of these companies provide an

online portal, where customers can find and book qualified care workers ondemand. They attract and vet the staff, but the relationship is held by the customer, and managed via either the portal or a smartphone app. At the other end of the care spectrum, Envoy positions itself as a family concierge service. It matches the likes of stay-athome mums, who are looking for flexible work, with older people who might need help with ‘light tasks’ rather than personal care. These tasks include grocery shopping, walking the dog, transport, errands and basic housekeeping. These companies service the privatepaying market and earn their money by charging a service or membership fee to the customer. In Envoy’s case, it’s also offering its services to corporates who are looking to support the care workers in their workforce. The services they’re offering aren’t new. They’ve

THE GIG ECONOMY AND SOCIAL CARE

Economy approach, this is a matter of watch this space. Legal experts are warning organisations that individuals who spend all their time working for one business will probably be treated as an employee by the courts, regardless of whether they are labelled as self-employed. Plus, the Government is expected to publish policy recommendations in the summer on the rights of Gig Economy workers. Further afield, there are moves to ensure workers are protected. If we look to the US again, the National Domestic Workers Alliance has partnered with Care.com to promote good work and fair standards in care work. Plus, the Good Work Code has been created to provide a framework for supporting workers in the online economy. The framework has eight values that define good work and they are: • Safety. • Stability and flexibility. • Transparency. • Shared prosperity. • A liveable wage. • Inclusion and input. • Support and connection. • Growth and development.

just harnessed technology to make it convenient, accessible and affordable for the consumer. As you can see, the Gig Economy is already in the care sector and disruption is happening.

IS IT A SOLUTION? There are pitfalls in the Gig Economy approach and one of the biggest is the possible exploitation of workers. The recent Pimlico Plumbers court case, as reported by the BBC, highlights the fine line between being classed as an employee versus being a self-employed contractor. In this case, the court ruled that a contractor was actually a fulltime employee as he had worked solely for Pimlico Plumbers for six years, and consequently, he was entitled to the same protections as a full-time member of staff. For organisations considering the Gig

There are challenges with everything, but I think there are real positives from the Gig Economy and lessons that can be applied to the UK care sector. One of the best aspects is that the workforce has the freedom to make its own decisions. This autonomy is something we’ve embraced at Evermore by creating self-managed teams of Mulinellos. They have been empowered to make the decisions that impact our customers on a daily basis, and they also have the freedom to manage their own schedule. Admittedly, our Mulinellos are employees rather than contractors, but it is something I’d consider. A workforce of contractors certainly makes a company more agile and responsive to customer demand, plus there are protections that can be put in place for the workers as I’ve discussed.

Another lesson we can learn from the Gig Economy is the power of transparency. In the case of AirBnB and Uber, they have user ratings to build trust between the customer and the service provider. HomeTouch has followed this approach and uses TrustPilot, where customers can provide feedback and a rating too. It is also putting the customer at the heart of the service by offering convenience, quality and affordability.

WHAT’S THE FUTURE? We’re seeing the breakdown of the care sector. The behemoths are selling off care homes at a rate of knots. Traditional domiciliary care providers are at breaking point. Local authorities and the NHS are looking for new solutions. From the customers’ viewpoint, recent Ipsos MORI research has found that just 1% of the population want to spend their later years in residential care. This isn’t surprising, yet there hasn’t been the same level of innovation within residential care as there has been in homecare.

THINGS HAVE TO CHANGE People of all ages and stages in life want to live in a multitude of different ways. Plus, people want to work in different ways too – they want a whole life rather than a work/ life balance. The nine to five job and career for life will be rare in the future. The Gig Economy holds some answers for the care sector and we shouldn’t be frightened of the changes it’s bringing. However, there’s more than that, we should also look to the wider Sharing Economy for inspiration, where consumers essentially rent out what they’re not using. It is small, collaborative and local approaches that will meet people’s needs in the future, rather than large corporates. Within the Sharing Economy, the emphasis has shifted to providing personalised and local products, services and experiences. That’s what people want when it comes to their later years too. CMM

Sara McKee is Founder of Evermore and Director of Market Innovation. Email: sara@evermorewellbeing.com Twitter: @SaraMcKeeFRSA Do you think there’s a role for the Gig Economy in social care? Share your thoughts and access the article’s references at www.caremanagementmatters.co.uk Subscription required. CMM April 2017 23

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Delivering safe care

How can it best be assured?

Colin Young looks at the main considerations to ensure your service is safe.

26 CMM April 2017

One of the five key questions addressed and reported on by Care Quality Commission (CQC) in its inspections of health and social care services is, ‘Is the service safe?’. The safety of people in care is affected by a whole range of things, but the first thing in most people’s minds, when thinking about safety, is whether the person receiving support is being abused – physically or verbally. Of course, everyone wants to know that the right medicines are given at the right time, that a doctor will be called if needed, that the staff are able to transfer people safely, that they won’t be scalded in the bath etc. However, the thing that keeps families, and often clients themselves, awake at night is concern about the attitude and behaviour of staff.

SEVEN ORGANISATIONAL ELEMENTS What can and should providers do about this very real concern? There are seven main organisational elements which contribute towards a provider’s ability to deliver safe care. Of these, the first two listed below are absolutely core and essential priorities. The other elements can all play a part, but these two are pre-requisites, without which there can be no assurance that safe care is being

delivered. The seven elements are: 1. Staff core values. 2. Local management. 3. Organisational culture. 4. Training, supervision and communication. 5. Incident reporting and review. 6. Audit. 7. Policies and procedures. Some points relating to the other five elements are included in the panel. However, in this article I want to reinforce what I believe are the two main issues.

STAFF CORE VALUES Any organisation is only as good as the staff it employs. This is a truism. The people who directly deliver care and support are generally: • The largest single group of staff within an organisation. • The least well-paid. • The least well-educated. • The least experienced. None of these factors is the fault of the staff themselves, rather the system in which they work

and the values of our wider society, which don’t recognise the importance of their role in terms of pay and status. Addressing these broader issues is not within our gift, although we should all do what we can to pressurise leaders and policymakers to act. However, given these realities, what can we do to minimise the risk that we will end up with people in caring roles who really don’t care?

MINIMISING RISKS There are many things that contribute towards an organisation’s ability to recruit and retain staff with the values required. However, I suggest there are four important practical steps that managers, and particularly those making recruitment decisions, should take: 1. Use values based recruitment. All the effort in the recruitment process should be towards establishing whether the applicant has the right values. This is much more important than their education or experience. Of course, it’s also more difficult to assess in an interview process, but there are ways in which, through questioning and observation, people’s acceptance of the value of all human beings, irrespective of their age, abilities etc. can be tested. Their reaction to stressful situations

CMM April 2017 27

DELIVERING SAFE CARE – HOW CAN IT BEST BE ASSURED?

can also be explored in a variety of ways. 2. Training and supervision. In the early stages of a new employee’s work, it is critical, not only that adequate training is given, but that there is close and regular supervision by someone whose own values are not open to question. Supervisors need to observe directly the work of the new employee, and also get feedback from others with whom the person has worked – including, where possible, clients and their families. Some people have an ability to ‘put on a show’, but not many people can keep this up at all times and an inkling of concern, expressed by colleagues or others, should raise alarm bells and ensure close monitoring is maintained. 3. Whistleblowing. This is really part of the wider culture of the organisation, but whatever the overall policy and practice, it is critical that, at a local level, there is a clear understanding about the values expected and the obligation on all staff to uphold this and report even the slightest issue of concern. What is perhaps even more important, is that when issues are raised, however trivial they may appear and whoever they are raised by, they are followed up actively and immediately. 4. Discipline/dismissal. Staff are quite rightly protected from unfair dismissal through employment law, but this can sometimes lead to managers being overly cautious in taking formal action when areas of concern are identified. However, it is critical – and particularly where issues occur early in someone’s employment – that robust action is taken where there is evidence that someone has displayed attitudes or behaviours that are inappropriate. A clear message needs to be given to the individual concerned and the wider workforce. Act early, nip issues in the bud and take no unnecessary risks. Knowing how hard it is to recruit and retain good staff, it is tempting to compromise both in the recruitment process and in supervision and/or discipline. Managers will be under pressure to maintain staffing levels and avoid use of agency staff. This can drive compromise against an individual’s better judgement, and could lead to them thinking, ‘will I end up with anyone better if I don’t take them’, ‘I’ve got more confidence in someone I can monitor directly than with agency staff’, ‘I’ve advertised three times for this job and there are no better candidates’, for example.

Yes, this will mean some risks have to be taken on occasion – isn’t all recruitment a risk anyway? However, take risks around ability and experience, rather than around values. Where the risk is taken on appointment, ensure that supervision and monitoring is even tighter than it would otherwise be.

LOCAL MANAGEMENT Whether or not a provider has the right culture, provides good training, policies, reporting systems, and the myriad things that make an organisation ‘Good’, it is the quality, approach and values of the local manager that really makes the difference. It has been said by many, including by me on numerous occasions, ‘Show me a good manager and I’ll show you a good service’. There is lots of evidence to support this assertion. Nowhere has this been better demonstrated to me than during my time with Castlebeck, where I was Operations Director after the Winterbourne View abuse scandal. The CQC’s review of the abuse concluded, ‘There was a systemic failure to protect people or to investigate allegations of abuse,’ and this reflected on the overall organisation as well as the individual service. However, the organisation still had some excellent services. Those services were managed by competent and committed managers, who often had to battle hard to support their service users and their staff in difficult circumstances. Where there were problems – and this was not just at Winterbourne View – it was evident that whilst there were organisational failings, some of the responsibility lay with weak local management. Again, the CQC’s review stated, ‘There was a lack of leadership and management and ineffective operation of systems for the purposes of monitoring of the quality of service that people receive.’

PRIORITIES Whilst many factors can contribute to the delivery of safe and, particularly, non-abusive care, staff core values and local management issues are paramount. For organisations looking to ensure safe care for their residents, my strong advice would be to prioritise values-based recruitment, effective supervision, and invest in and support the best management at service level. CMM

OTHER IMPORTANT FACTORS CONTRIBUTING TO THE DELIVERY OF SAFE AND NONABUSIVE CARE AND SUPPORT • Organisational culture. An organisation should put people before profit, take a long-term view, and value and support the frontline workforce. Owners, directors and managers need to share and live the core values that underpin safe care. • Training, Supervision and Communication. Structured and effective training is important, although it will minimally impact on people who don’t start with the right values and beliefs. Equally important is regular and structured supervision, including observation and feedback from others. Perhaps the most neglected is effective communication on a regular basis between the Board, local managers and all staff. • Incident reporting and review. It is essential that there is an open and honest culture where all incidents are reported, recorded and reviewed. Lessons need to be learned both from individual incidents and, at a service and organisational level, from the close monitoring of trends to identify things such as individuals who feature regularly in incidents, and patterns in particular locations, at certain times of day or with specific managers or shift leaders etc. • Audit. At both a service and organisational level, safeguarding and similar issues need to be subject to structured audit, just like the finances are. The safety of care is just as important as health and safety. • Policies and procedures. Organisations need comprehensive policies to evidence externally that they have the right approach and systems in place. However, their impact on local, frontline staff should not be overestimated. Policies and procedures need to be available for reference, but requiring people to read policies has minimal impact when compared with training and supervision.

Colin Young is Managing Director of Nomad Care Management Ltd, developers of CareGuard. He was previously Chief Operating Officer with Leonard Cheshire Disability and Operations Director at Castlebeck Care. Email: colin.young@careguard.uk.com What measures do you take to deliver safe care? Share your thoughts on the CMM website www.caremanagementmatters.co.uk Subscription required. 28 CMM April 2017

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SUPERCARERS – CHANGING THE FACE OF CARE? SuperCarers is a new, online care platform that is changing the way people access care staff and services. Is it the type of innovation the sector needs? SuperCarers is a new care company inspired by the personal experiences of founders, Adam and Daniel Pike. The idea came to them after watching their mother caring for their grandmother. They found the care that their grandmother was receiving was expensive, inconsistent and poor quality, putting pressure on their mother to support her with informal care. Seeing the strain this put on their mother, they set up SuperCarers. Adam explained, ‘We give families the choice and control over who cares for their loved one, allowing vulnerable people to stay in their own homes for longer, whilst rewarding hard-working and compassionate carers. We know the difference superior care can make to the whole family.’

INVESTMENT The company is currently backed by the founders of Innocent Smoothie via their JamJar Investment Fund (investors in Deliveroo and Babylon Health) and Sir Tom Hughes-Hallett, the former Chief Executive of Marie Curie, now the Chairman of Chelsea and Westminster Hospital. SuperCarers also received backing through equity crowdfunding platform, Seedrs. Adam explained, ‘Seedrs gave the families and communities an opportunity to invest in us, a business they use, they are fundamentally part of and they believe in. We are a people business and we believed this would help to support our goals of creating a movement to transform care. ‘We have the support of some eminent business angels who have 30 CMM April 2017

real expertise in the sector, such as Sir Tom Hughes-Hallett, and the early stage venture capital fund of the founders of Innocent Smoothie, who have also invested in other consumer-focused businesses. The background and track record of these individuals help build the momentum and act as proof to other investors of the strength of SuperCarers.’

HOW DOES IT WORK? The company offers a personal matchmaking service where people can find care workers for themselves or their families. It matches care workers with clients based on personality and interest, as well as care need, location and timing. Heading onto the website, it breaks down the process into four steps. Firstly, you describe what you’re looking for from a care worker. That could be specific care or support needs, care worker skills and the preferred care schedule. The SuperCarers team then matches these to the most suited care worker on its database. Families can then view the care worker’s profile and arrange to meet them before deciding to book their services. Adam explained the process in more detail, ‘When a client makes an initial enquiry, we are able to identify their care needs, from their physical needs, for example needing a carer with experience of a particular condition, to other requirements like their social, intellectual, cultural and emotional preferences. ‘When carers join our community, their skills, interests and passions are captured and this data is used to match them to families, who then

have a choice of carers. Families can choose who to have a phone conversation with and then an initial meeting to determine which carer is the best fit. After this, they are able to choose who they want to invite over the threshold to care for their loved one – it’s truly person-centred care.’

CARE WORKERS All care workers are vetted with background checks, including enhanced DBS, identity, right to work and document checks. They are also interviewed face-to-face by SuperCarers to assess their values, character and care qualifications. Adam continued, ‘SuperCarers focuses on the livelihoods of carers. Carers are attracted because they can work flexibly: many carers will have their own existing private clients, work for care agencies and homes and then use the SuperCarers platform to build their own private client base. In addition, as a result of working directly with families without agency middlemen, they earn transformative rates. SuperCarers takes a booking fee of 25% on transactions. This rate is consistent across homecare and night-time care, however it is lower for live-in care.’ ‘Great care starts by paying carers fairly and so all SuperCarers earn more than the living wage (£9.75 in London). This ensures that we are able to attract and retain the best carers, who in turn attract their friends and colleagues.

PRICING The care packages have a minimum price and duration. Care during the

day starts at £14 per hour and is a minimum of 3 hours long. Care at night starts from £110 a night for sleep-ins and £145 per night if on-call. Live-in care starts at £750 per week. Care workers can be flexible to the individual’s needs and will be matched with the relevant specialist skills as required. As with traditional care at home, care workers can assist with everything from companionship and activities to personal care and medication reminders.

REGULATION SuperCarers defines itself as an ‘introductory and brokerage service’ and, as Adam explained, is not within the scope of CQC regulation. ‘SuperCarers does not direct or manage care and instead empowers families and carers to manage the care directly, using simple and easy-to-use digital tools. We have a Care Advisory Board which suggests how we can continue to improve the quality of our service. The Board is chaired by Alan Rosenbach, former Head of Strategy at the CQC.’ CMM

OVER TO THE EXPERTS... SuperCarers is representative of some new models of care which are entering the market. Is there a place for introductory and brokerage sites like this? Does the market need such innovation? Will there be public interest, and, given it is so new, and not regulated by the CQC, are there likely to be safeguarding, regulation or employment law considerations?

BEST TO ENSURE WORKERS’ RIGHTS FROM THE OUTSET It’s great to see new models of care developing. This model appears to rely on the care staff being genuinely self-employed, but it is good to see the commitment to pay more than the living wage. Recent employment cases have found people such as a plumber, a mini cab driver and a bike courier to be workers who are entitled to the National Minimum Wage and the protections of and rights under the Working Time Regulations, such as paid holiday and daily and weekly rest periods. What about a SuperCarer? My view is that they will meet a number of the key worker tests. They will work under a contract to personally perform work and they won’t typically be carrying out the work as part of a wider business offer. It would need careful contract drafting and consistent practice on the ground if the desire is to avoid worker status. It is also likely SuperCarers are acting as an Employment Business, a regulated

function under Employment Business Regulations. The Budget suggests the Government will crack down on the tax advantages perceived to be enjoyed by the genuinely self-employed, which may hamper the attractiveness of the selfemployment model. The Taylor Review, looking at new models of working, is due in July and given the way recent cases have developed, we would expect recommendations to ensure worker rights for as many as possible, given the rapid growth in people who are self-employed. For organisations like SuperCarers, it may be best to structure their businesses to ensure workers’ rights are in place from the outset, so they can build and sustain an attractive proposition in a market struggling to find good care staff.

Matthew Wort Partner, Anthony Collins Solicitors LLP

THE MODEL OF WORKING IS SHOWING EARLY PROMISE We have looked at this model as part of a project we’re conducting looking at the future of the social care workforce. We’ve looked at issues of workforce readiness, recruitment and progression in the social care sector. We’ll be launching our report on 30th March, which includes SuperCarers and other potentially innovative examples that are encouraging recruitment and retention of adult social care workers. Our research has found that the SuperCarers model can provide a personal service. The people who receive the care and support are matched with the care staff who have the skills and availability to support them. Plus, clients can view staff profiles. About 70% of clients are self-funders. Care staff spend time finding out about the person they’re supporting, so we hope it provides a personalised service. The SuperCarers model of

working is showing early promise and we hope that it encourages people to come to the sector because there are distinct benefits. Those benefits have the potential to make a positive impact on the recruitment and retention of skilled workers through greater flexibility, increased pay – staff get a living wage, which isn’t always available – along with improved job satisfaction, morale and confidence. Care staff report feeling appreciated for their skills while having the opportunity to develop their learning via the increased responsibility they take on. They are also likely to have more autonomy; and all of this is a potentially attractive proposition for those thinking of joining or staying in the care and support sector.

Ewan King Director of Business Development and Delivery, Social Care Institute for Excellence (SCIE)

I AM DELIGHTED THAT SUPERCARERS IS HERE Supercarers and similar sites aspire to become the Uber of care. The model connects freelance care workers in their area to people who need care. The attraction of these sites is that they enable care workers to earn a proper wage, drawing a higher calibre of care worker into the market. So, what's not to like? Well, a bit like an Uber taxi driver, the care worker is unregulated. They come with no guarantees that they have the right skills, training or temperament. Should this put us off? Or trigger an avalanche of regulation? Despite the risks, I would say 'no', at least until the model has got a foothold. CQC regulation or forcing care workers to become employees would very quickly recreate the lowwage, high-cost industry that has generated all sorts of different risks. Before regulation is even considered, it should be clear that the benefits of a better-paid independent workforce are not a

sufficient counterweight to the risks of paying the minimum wage. Will these models be for everyone? Probably not. Many people need teams of care workers who work together as a unit, easily recruited and managed by an agency. Many people want someone else to deal with no-shows and the supervision. SuperCarer models, for many, will be too much risk and hassle. Personally, I am delighted that SuperCarers and their ilk are here. It will challenge the industry. Yes, there are things to sort out. The next step is to use the technical innovation of these platform models to ensure that people can easily check the skills and backgrounds of care workers. Some sites use TripAdvisor type ratings. But overall, a big welcome to SuperCarers and all the ‘Ubercare’ style sites.

Craig Dearden-Phillips Managing Director, Stepping Out

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LNT’S INSTITUTIONAL INVESTOR THE FUTURE OF FINANCE?

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

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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.’

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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.

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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.

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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.

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.

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Definitions

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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.

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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.

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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.

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A VIEW FROM THE TOP

K E V I N GUNPUTH Kevin Gunputh is Managing Director of Luxury Care Group.

REFLECTIONS ON THE LAST DECADE Social care has become far more difficult to operate in. The regulatory burden has increased whilst the funding has decreased. This has its advantages as it has reduced the number of poorer operators but it has left the stronger ones struggling too. Regulation has led to more training requirements which smaller operators can struggle to afford. Regarding funding, I’ve had recent conversations with banks who are no longer funding homes with fewer than 25 beds. Lending criteria has tightened and it means that, from a commercial point of view, it’s hard to move a portfolio forward. Providers have had to tighten up their costs, culture and mindset. We deliver ‘Outstanding’ care with the tools at our disposal. We’ve become more efficient, effective and transparent. We work with Nourish Care so have embraced technology which allows us to spend more time caring and less time on paperwork. We’re a people business, we need to be looking after people. We’ve worked hard to become an ‘Outstanding’ provider with a strong reputation. We had a very open culture and a strong duty of candour mindset long before it became a statutory requirement. We look at what works and replicate it, but we also look at what doesn’t work and how to improve it. We take ownership of any issues that may arise and learn from them.

PROJECTIONS FOR THE NEXT DECADE Consolidation is likely to lead to limited choice. Venture capitalist and outside investment will consolidate the market and could lead to standards dropping. Looking at CQC data, many ‘Outstanding’ services are single, double or small operators, they have the personal touch and emotional investment in the business from the top down, or bottom up, depending on how you look at it. In a small business, you can feel the culture, you can check on all aspects and be both proactive and reactive, making changes as soon as they’re needed. You don’t have layers of management to go through. I think the regulatory burden will remain, there are changes happening, but I think it’ll be more of the same. The financial strain is massive and will increase. Brexit will increase costs; social services budgets are continuing to decline. This will lead to smaller providers, those with 25 to 30 beds, struggling. The impact of homecare will be lessened as it’s becoming more expensive to deliver, especially with the National Living Wage increasing. If the Government doesn’t put money in, the sector will explode and only the strong will remain. Those with leasehold models will continue to see costs increase and will need to make further efficiencies, such as stripping out middle management. Over the longer term, there’s the question of robotics and AI, will that start to grow?

INSIGHT I’m hands-on, I help with all aspects of the business if I need to, from maintenance up to board level. I’m forward thinking, try to be innovative and, of course, caring. I have a diverse role, I get on and lead by example. INFLUENCES I have three. My dad, Mahen came to the UK in 1966 with nothing but a briefcase. He gave me a stepping stone, his business was built on the same saying that we follow today, ‘I’d never run a home that I wouldn’t put my parents in.’ My Uncle Raj in London runs care homes and is an accountant. He’s taught me how to make a business work and to budget. Finally, Mandy Kittlety my Director of Operations is the person I can speak to and bounce ideas off. As Managing Director, you need someone to lean on, so she is my sounding board. LESSONS Don’t to be afraid to learn. Also, it’s important that you manage the emotional side of your personality: your fears and anxiety. We all have it, but it’s how we manage it that matters, we can’t let it affect our lives as we can't give up when people need us most. ADVICE Build the right team. You can’t do it on your own. Bring in people who have different strengths to you, if you want to grow. CMM

Read about Kevin's typical day on the CMM website www.caremanagementmatters.co.uk Subscription required. CMM April 2017 33

Values Based Recruitment WE NEED A NEW APPROACH

Harriet Phillips explores values based recruitment and why the sector needs it. It has been over three years since the Cavendish Review was published, following the Francis Inquiry into Mid-Staffordshire NHS Foundation Trust. Included in its ‘Recruitment, Training and Education’ recommendations for the NHS and social care, the Review stated that, ‘Employers should be supported to test values, attitudes and aptitude for caring at the recruitment stage.’ Values based recruitment immediately became an industry buzzword with substantial resources thrown behind it. Campaigns and pilot projects to develop best practice were instigated across 34 CMM April 2017

the country. Having been at the vanguard of the Department of Health and Skills for Care’s work on this since 2013, we have witnessed some remarkable successes, but also how the sector can get it wrong.

WHAT IS VALUES BASED RECRUITMENT? Values based recruitment looks at all aspects of the recruitment process. To start with, you look at your own organisation to understand how your applicant pool sees you. Consider: • What image are you presenting to the community? • Are you offering open days? • How is social media and local media used for recruitment? • Do you take part in local events? • How familiar is your brand? Then consider how, where and when you advertise roles: • How are you describing social care as a career? • How much are you sharing about the culture of your organisation? • What mediums are you using to advertise care roles? • If you are continually advertising for staff, what signal is this giving out? These two stages take place before you even have a direct interaction with your candidates and there is no way of measuring who is ‘lost’ here or who could be self-selected out of the process but isn’t. One of the key issues in the sector and reasons for high turnover is panic recruitment to fill a vacancy. Nothing is gained from recruiting someone who (a) does not understand the role or (b) does not share the values of the organisation. A lot is actually lost, including time and money. Moving onto the application stage, consider how user-friendly the process is: • Do candidates get to meet current post holders/ tour the home? • What process do applicants follow, i.e. online/ paper based testing? • What language is being used through the process? • How is contact maintained with applicants? These considerations will help you to understand how your organisation is viewed by candidates that want to work for a quality, caring provider.

WHAT DO VALUES LOOK LIKE? Now it is time to move onto assessment,

CMM April 2017 35

VALUES BASED RECRUITMENT – WE NEED A NEW APPROACH

which is where values come to the fore. Values based recruitment may appear startlingly obvious and even straightforward to achieve, but the most common error is choosing the wrong values to assess for. What does an ideal care worker look like? Who should you recruit to your senior roles? There is no blanket answer when it comes to values profiles. It needs to be set at an organisational and a local level. Ask three different managers to provide a list of desired traits and you’ll end up with a very long list describing someone that doesn’t exist. We call it the tall-short person job specification. Many employers pad out the specification to find, not just a new member of staff, but a superhuman placement who can be all things, to all people, all of the time. This issue grows exponentially when it’s a committee decision. For most organisations, the answer is right under their noses. Benchmarking against the people who are already doing the job well is simple, fast and effective. It’s important to note that values should be set specifically to the role. Those that are a ‘must have’ are the priority, such as being naturally empathetic, thoughtful and supportive. For those, you may have to forego the ‘nice to haves’ like dynamic or innovative. Values required for care workers are not applicable across the entire workforce. It seems obvious, but when setting the benchmark for values, the accountant should not share the same values as frontline care staff. These are completely different roles requiring, not simply a different skillset and aptitude, but attitude too. A corporatewide approach to setting values (like most mission statements) makes them more akin to a marketing slogan than an actual reflection of how the company would work, especially when under pressure. Also, consider that individual care roles in different environments often require different values, so copying from the internet probably won’t work.

ASSESSING VALUES Values based recruitment needs to run through the organisation, picking certain elements but not fully committing to it rarely works. The Cavendish Review did not clearly state when in the recruitment process candidates should be assessed for values, so many employers slot it in at the end, usually at the interview stage. It is a truism that people are generally hired on aptitude and fired on attitude. Yet most of

the focus on recruitment remains on aptitude and qualifications. As these are the easiest to check and tick off against requirement lists, it is understandable that they are the first port of call. Plus, once having invested the time and effort into getting them to the interview stage, there’s a common mistake that if their values aren’t up to scratch, maybe that can be fixed on the job. Social care is populated with many people who have the necessary skills and aptitude, but an individual’s core values and attitude must come first, they are the only things that can’t be taught or upskilled. Assessing values should include values based interviewing, probing questions designed to draw out evidence around the candidates’ natural responses, learning and reflection. All of these give you a manual on how that person operates, what their priorities are, how they are likely to react under pressure and what motivates and demotivates them.

THE VALUES OF A SUCCESSFUL CARE WORKER From an insider’s perspective, having assessed tens of thousands of care workers in the last four years we identify the typical person who is successful as a frontline care worker as having the following traits: • They take pride in being seen as reliable, consistent, loyal and knowledgeable.

happening and when they feel valued and safe. They are likely to become anxious and stressed if the organisation is chaotic, if they feel they are prevented from doing a good-quality job, or if the threat of redundancy or substantial changes arise. These staff want job security and are not likely to change jobs unless they are really uncomfortable and are sure it's for the best. Money does not primarily motivate them in their work. They are motivated by doing the best job they can and if they are prevented from doing this they will walk. The main driver for them to consider leaving a job is likely to be if they feel their employer is out of tune with their own values of reliable, consistent delivery of good quality services. For example, if they are not given the opportunity to improve and develop their skills on an ongoing basis.

IT DOESN’T STOP WITH RECRUITMENT It’s important to realise that recruiting for values is a cycle and doesn’t stop once you’ve recruited. To keep valuable staff, you must treat them in a way that they will respond to positively. For people who prefer to work in a stable, organised fashion, endless interruptions and frequent uncertainty will do little other than drive them out of the door. This may require changes to work practices,

“Benchmarking against the people who are already doing the job well is simple, fast and effective.” • They will strive for competence and then perfection in everything they do. • They prefer stability, predictability and regularity, they will likely not respond well to last minute decisions or work being allocated to them unexpectedly. • They will not react well to feedback or criticism that is knee-jerk or emotionally charged, and this type of feedback will likely cause damage to their confidence and to the relationship. • They are happiest when they know what's

rotas, responsibilities, but unless employers understand and meet the work-related needs of their team, all the effort, investment and training will simply walk away, values in hand. This puts employers back in the situation they were trying to value engineer themselves out of in the first place. The values based recruitment cycle is simply best practice but with a solid foundation to operate in the same way as you wish your employees to; intelligently, considerately and with empathy. CMM

Harriet Phillips is Employer Engagement Manager at Profiles4Care. Email: Harriet@profiles4care.com Twitter: @Profiles4Care Have you used values based recruitment? Share your experiences on the CMM website at www.caremanagementmatters.co.uk Subscription required. 36 CMM April 2017

ACCOUNTS AND AUDIT

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VALUATIONS AND DISPUTES

Service led

TAX ADVISORY SERVICES

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CMM April 2017 37

Maximise your interiors

s t fi o r p r u o y to maximise

Roy Edwards discusses how welldevised interior design can attract private clients and, after investment, can help to maximise profits. However, it’s not just interior design, ongoing care of interiors is important too.

38 CMM April 2017

Well thought-out interior design is the first thing that ‘sells’ a care home, and it’s crucial to create the right first impression. After all, the success of a care home business rests on showing potential clients that your home is the place where they or their loved ones will be able to live a full and independent life. As a care home owner or manager, it’s your goal to

demonstrate that you take pride in providing a welcoming environment, where residents, their families and your staff are valued and respected. How do you go about creating and maintaining a care home environment that can attract new residents and enhance existing residents’ wellbeing, whilst maximising your profitability for the benefit of your business?

confusion, reduces tension and helps to improve their health. To create a dementia-friendly environment, take the following into consideration: • Ensure residents know what to expect from each room. From our experience, successful dementia settings are homely, appropriate for function and easy for residents to recognise. • Create a focal point for each room, and use a bright colour scheme to create a feeling of warmth and happiness for residents. • Windows should not be covered to allow the maximum amount of natural light to enter rooms. • Use furniture to create a friendly environment. For example, ensure doors are made from solid dull materials, not reflective materials, as these can confuse and scare residents, as they may think someone else is behind the door. • Include retro furniture which would be familiar to residents, such as old TV units and dining furniture. • Take age-related impairments into account, such as sight, hearing and memory loss. • Use accessories to trigger memories, such as photographs and classic art. These accessories can also be used to create talking points for residents and their visitors.

INTERIOR DESIGN IN PRACTICE

UNDERSTAND THE NEEDS OF YOUR AUDIENCE Before you can start devising a care home design plan and considering what your return on investment might look like, you need to identify who you’re trying to appeal to and attract. You need to understand: • The marketplace you operate in and your key competitors.

• The demographics of your current and future residents. • The current and future developments within care to futureproof your investment. When you’ve decided on your key competitors, conduct an audit of their care environment offering. Focus on the design features they use, what works well and what doesn’t and use this information

to collate a list of positive and negatives. You’ll then be able to use this as a benchmark for your environment design. For the demographics of your residents, consider what design aspects appeal to them and how you can use this to enhance their wellbeing. For example, if your residents are living with dementia, you’ll need to ensure you create an environment that prevents

A great example of a residential care centre that put its residents at the heart of its design is Cedar View, run by St Cloud Care. Based on the outskirts of Croydon, South London, the home cares for up to 65 older people living with a range of conditions from chronic illnesses and advanced dementia to those requiring palliative care. What makes the environment different to many care homes is its use of memory-triggering design. The Centre includes a fully-

CMM April 2017 39

Specialist finance for care homes

Expanding services to meet growing need? Whether you plan to build new facilities, refurbish or purchase your existing premises, we could provide the finance you need to be agile enough to meet growing demand. To learn more visit

triodos.co.uk/healthcare

‘‘

We are delighted to be working with Triodos Bank. The bank shares similar core values in wanting to invest to protect and care for some of the most vulnerable in society.

‘‘

Triodos Bank currently finances 341 elderly care homes, caring for 25,000 individuals, across Europe.

Triodos offer a great service and we recommend them to associates who put people before profits. Robert Black, Chief Executive of Cornwall Care

Triodos Bank NV (incorporated under the laws of the Netherlands with limited liability, registered in England and Wales BR3012). Authorised by the Dutch Central Bank and subject to limited regulation by the Financial Conduct Authority and Prudential Regulation Authority. Details about the extent of our regulation by the Financial Conduct Authority and Prudential Regulation Authority are available from us on request. Firm reference number 183366. Registered office: Triodos Bank, Deanery Road, Bristol BS1 5AS. VAT reg no 793493383.

MAXIMISE YOUR INTERIORS TO MAXIMISE YOUR PROFITS

functional ‘curiosity-themed’ sweet shop that has nostalgic interchangeable shop fronts, creating a ‘memory lane’ street scene. The memory lane includes cobble-effect carpeted edging. Features such as this, which relate to residents’ memories, are a proven way to help them feel more at ease and can help residents familiarise themselves with their environment. It also has a library, bar, bistro and hair and beauty salon. Cedar View was designed in line with the University of Stirling’s principles on designing for dementia. The principles use science, not just style, to create the right environment, by balancing aesthetics with ease of use and accessibility. For example, it includes flexible room dividers in between dining and living spaces to help residents get away from noise and stress if they want to, and consistent colour, seating and signage to help residents navigate their way around the home with ease. The use of signage is especially important, as it was designed and positioned to help residents identify each room’s purpose.

PUT SAFETY AND HYGIENE FIRST In addition to considered aesthetics, you have to prioritise your residents’ safety. To do this, pay high levels of attention to your equipment, such as your hoists, baths and beds. Are they regularly maintained and upto-date or do they need replacing with more modern models? Good quality equipment can help you to fully meet residents’ needs. Committing to, and demonstrating that commitment to, residents’ safety can provide the final link in the chain and show that that your home is the best place for people to be.

Added to this, cleaning and hygiene and infection control are essential. When it comes to infection control, every aspect of a care environment can help prevent the development and spread of germs – and the interior design is no exception. While furnishings and fittings may be perceived as being somewhat secondary to items such as healthcare equipment, they play a pivotal role in combating infections. Plus, it’s possible for your interiors to look appealing and provide effective infection control.

FIVE WAYS TO LOOK APPEALING AND CONTROL INFECTION Here are five ways you can go about striking the right balance between design and infection control: 1. Always choose vinyl or duo split fabrics on contact areas on chairs. Not only will your chairs have a longer lifespan, they’ll be much easier to keep clean and less likely to retain fluid and stains. 2. Make sure that your freestanding bedroom furniture is fitted with castors; that way, they’ll be really easy to move around so that you can clean right underneath them, rather than around them. 3. When selecting any item of furniture, make sure that it has a smooth finish. This will make it much easier and quicker to keep clean, and less likely for any bacteria to gather in nooks or crannies. 4. Always remember to opt for a cap and coved floor vinyl for wet areas, where possible, and a good quality wood plank vinyl or impervious carpet. Both options provide more of a seamless finish and form an effective barrier against any leaks or spillages.

5. Once you’ve chosen your vinyl floor or impervious carpet, make sure that it’s fitted with as few seams as possible. The fewer seams there are, the fewer places there are for germs to congregate. While it might initially seem difficult to create a care environment that ticks both the design and infection control boxes, it is possible with the right outlook and insight.

• Remember to descale your appliances, taps and showerheads on a regular basis, as poor maintenance can lead to costly replacements. • Mattresses are another perfect breeding ground for bacteria, so make a point to check them every month. Examine the cover for staining and wear, and clean and disinfect every mattress with a multi-surface wipe suitable for use

“While it might initially seem difficult to create a care environment that ticks both the design and infection control boxes, it is possible with the right outlook and insight.” Whilst furniture can play a huge part in infection control, cleaning regimes play an even bigger part. There’s no doubt you’ll be an expert at keeping your care environment immaculately clean, but it’s important to ensure the rest of your team are clued up on hygiene hotspots and how to minimise the spread of bacteria and germs.

TOP CLEANING TIPS Here are a few of our top cleaning tips: • Door handles, light switches and places that people frequently touch are bacteria breeding grounds, so give them special attention. • Care home equipment, such as hoists and wheelchairs are often neglected and not given the love and attention they deserve. You can tackle equipment effectively and quickly with a disinfectant cleaning multi-surface wipe.

on textiles. • Don’t forget places that aren’t directly seen, like tops of wardrobes, high ledges, chair arms and over-bed tables. • Give your floors attention too. Not only do dirty floors look unattractive, they can cause accidents for residents and staff if they’re slippery. • And last, but not least, ensure your care environment is well-ventilated and smells good.

ATTENTION TO DETAIL Investing in good interior design whilst giving attention to the smaller details, and having the right products, can make a real difference. The appearance of your home sells and people want to live in a pleasant environment that not only looks good, but is safe and clean too. When all these come together, it should help you to maximise profits for your care business. CMM

Roy Edwards is Marketing Director at NHG. Email: roy.edwards@nh-group.co.uk Twitter: @NHG_UK Is interior design something you intend to invest in this year? Share your thoughts on the CMM website at www.caremanagementmatters.co.uk Subscription required. CMM April 2017 41

Anthony Collins Solicitors Tel: 0121 200 3242 Email: info@anthonycollins.com Website: www.anthonycollins.com

SECTORS

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• Adult health and social care. • Care homes. • Domiciliary care. • Mental health. • Community health. • Learning disability services.

SERVICES • Commercial contracts advice. • Data protection, freedom of information and intellectual property. • Funding and finance, grants and social investment. • Governance. • Procurement, IT and technology contracts. • Crisis management and dispute resolution. • Employment advice, pensions. • Property and construction. • Buying and selling care homes. • Mergers. • Development projects. • Regulation, inquests, judicial review. • Safeguarding children and adults.

LEAD INDIVIDUALS Matt Wort is Partner and Head of Health and Social Care. Matt’s, and the wider Employment and Pensions Team’s, focus is on working with clients to unblock difficult employment and pension issues and his experience in TUPE and National Minimum Wage is nationally

You should never underestimate the support offered by a specialist solicitor. They have years of experience supporting all kinds of care sector organisations. There is a wide range of care-focused solicitors and they offer a wealth of services. Whether you need advice on an acquisition or sale, HR or employment law, financing, regulation, governance, inquests, mental capacity, property, safeguarding or something else, the specialist care sector solicitors here should be able to help. 42 CMM April 2017

recognised. Matt also works closely with the Regulatory Team who can both reactively help with management of regulatory issues and proactively help you to get the governance right initially, to ensure you are well-led. John Wearing, Partner, leads the firm’s corporate and commercial work. John’s, and the team’s, expertise in mergers, finance, governance, collaboration, procurement, and commercial contracts means that we cover the wide range of potential corporate and commercial questions you might encounter. We draw on our experience of contracting arrangements with local authorities and the NHS, whether it is a search for funding or potential development projects – we have a team who are passionate about making a difference and delivering specialist solutions.

COMPANY INFORMATION What makes us distinctive beyond simply being a sector-specialist law firm is our people and the values we share – our passion and belief are aligned with our purpose of improving lives, communities and societies and working in partnership with our clients to achieve this. That is why we act for many leading providers, delivering commercial solutions to all aspects of their work and supporting representative bodies to help their members deliver sustainable high quality care across the sector.

Matt Wort Partner and Head of Health and Social Care Tel: 0121 214 3501 Email: matthew.wort@anthonycollins.com

John Wearing Partner Tel: 0121 212 7450 Email: John.wearing@anthonycollins.com

bevan brittan

Druces LLP

Tel: 0370 194 1000 Email: stuart.marchant@bevanbrittan.com Website: www.bevanbrittan.com

Tel: 0207 216 5557 Email: c.axford@druces.com Website: www.druces.com/care

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work hard to develop an in-depth understanding of our clients and the challenges they face both on a daily basis, and strategically. We believe this is vital to providing the best support, whether on operational matters, disputes and challenges from regulators, commissioners, or suppliers, or on strategic issues, such as governance arrangements, partnering, and optimising delivery and use of resources.’

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