Care Management Matters February 2021 by Care Choices Ltd

FEBRUARY 2021

www.caremanagementmatters.co.uk

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Predictions for care home occupancy

Coming through COVID

What social care needs from 2021

Social care reform

What can we learn from Japan?

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In this issue 05

Inside CQC Kate Terroni thanks the sector for its extraordinary work during the pandemic and says the CQC must become more flexible to manage risk and uncertainty.

CMM News

Into Perspective This month, our experts explore how the new immigration policy will impact on social care.

Event Review We review the LESS COVID webinar, based on the report from National Care Forum, NICHE Leeds and University of Leeds.

Straight Talk Michael Voges from ARCO examines the latest evidence on the benefits of retirement communities.

REGULARS

From the Editor

FEATURES

20 20

2021: A year of reform, hope and humanity Executive Director at National Care Forum, Vic Rayner, talks of hope for 2021 and the importance of putting people at the very centre of social care.

Drawing comparisons: Learning from Japan Japan’s social care system has faced similar pressures to those experienced in England, but a new system has been put in place. Lorcán Murray from CarePlanner Home Care Software explains the solutions Japan has put in place and how they’re working.

Finding the words: Having important conversations from a distance With COVID-19 rates rising, providers are having to have more conversations about death. Claire Henry MBE, Marie Cooper and Gina King at Claire Henry Associates discuss responding to grief and loss when you can’t be face to face.

Care home occupancy: Light at the end of the tunnel? It’s a concern on every care home provider’s mind: when will occupancy levels return to normal? In this feature, Tom Hartley, Director at Carterwood, forecasts the impact of the second wave of COVID-19 and what we can expect for occupancy.

Resource Finder There’s no denying the world is going digital. Here, we list some of the technology companies with the products and know-how to help you make the transition.

CMM February 2021

EDITORIAL editor@caremanagementmatters.co.uk Editor: Angharad Burnham Content Editors: Olivia Hubbard, Henry Thornton

CONTRIBUTORS

PRODUCTION Lead Designer: Ruth Clarry 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 Assistant Advertising Manager: Aaron Barber aaron.barber@carechoices.co.uk Director of Sales: David Werthmann david.werthmann@carechoices.co.uk

@CQCprof

@vicrayner

@CarePlannerLtd

Kate Terroni Chief Inspector of Adult Social Care, Care Quality Commission

Vic Rayner Executive Director, National Care Forum

Lorcán Murray Marketing Executive, CarePlanner Home Care Software

@weareflorence

@clairehenry

@mariecooper100

Charles Armitage Co-Founder and Chief Executive, Florence

Claire Henry MBE Director, Claire Henry Associates

Marie Cooper Associate, Claire Henry Associates

Tom Woodward Specialist Employment Solicitor, Scott-Moncrieff & Associates

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 2021 CCL REF NO: CMM 18.0

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CMM February 2021

Gina King Associate, Claire Henry Associates

@CarterwoodLtd

@ARCO

Tom Hartley Director, Carterwood

Gareth Lyon Head of Policy & Communications, ARCO

From the Editor This time of year usually brings with it resolutions and intentions to do things differently, to make changes that we think could bring balance and happiness to our lives. I don’t know about you, but I’ve found this one quite different.

GROUNDHOG DAY As we rolled over into January, it felt very much like we were going to have another 2020. We were faced with a national lockdown, COVID cases were rising with a worrying new strain of the virus, and though vaccinations were on their way, it seemed like a long time before things might improve. For me, able to work in relative safety from the comfort of my sofa, the idea that there was no ‘fresh start’ with the new year seemed doable. But my thoughts were and are with those of you who are in and out of people’s homes, working in care settings and dealing with this

Editor, Angharad Burnham, looks to the year ahead and why we must focus on what could change.

terrible illness – and the fear of it – day in, day out. We’ve heard reports that this new strain of the virus is different to the first, that it feels more aggressive and more difficult to control. I hope that you are all coping, that you are supported, and that you are seeking out extra help if you need it.

GLIMMERS OF HOPE While it’s easy to dwell on how we’ve come into the year, it’s important to focus on the positive changes it might still bring. In a feature on page 20, Vic Rayner looks at what we still have to be hopeful about. She speaks about the opportunity for reform, and indeed it does feel like there has been a shift in the likelihood of progress here. Maybe the chances of full-scale reform are still questionable, but Government’s focus on the importance of the sector seems to have changed. Priority

was given to social care in the vaccination programme, and logistical staffing pressures have been recognised with investment. It seems like we are being listened to, at least to an extent.

THE YEAR AHEAD I can’t help but be a little excited about what the year has in store, as I await the imminent arrival of a new addition to my family. This will be my final column before I enter a world of nappies and midnight nursery rhymes, and I’m delighted to let you know that Simon Bottery, Senior

Fellow at The King’s Fund, will be taking over this slot in CMM each month. Expect insights into the social care world, latest news and big-impact reports. I’ll certainly be looking forward to keeping up with his thoughts each month. While I’m off, CMM will continue to bring you expert thought leadership, major social care developments and support to keep you going through the immensely difficult days. Make sure you are signed up to our website – it’s completely free for care providers – as we expand to offer you more content in even more ways.

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

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Unlike most new years, where we have a fresh start, this year feels very different. As COVID-19 figures rise and we begin a national lockdown, you continue to do extraordinary work. Once again, the world is closing its doors, people are shielding to keep themselves safe and you continue to drive to people’s homes and complete long shifts in care homes under challenging circumstances. I recognise how difficult it is for everyone working in social care right now and I want you to know that through our regulatory activity, we will continue to support you in the difficult weeks ahead. We've updated our website with our current approach across all sectors. Infection prevention and control (IPC) has always been important, but never more so than now. In response to the challenges of the COVID-19 pandemic we introduced IPC inspections to share good practice, uphold high-quality care and ensure services are safe. Since the beginning of the pandemic, we have completed over 2,500 risk-based inspections of adult social care locations and over 850 IPC inspections. This includes approved designated locations, measured against our 'eight ticks' of IPC assurance. As we enter the new year, we’ll continue to look at IPC on risk-based care home inspections, including where there are rising cases of COVID-19 and in response to whistle-blowing or information of concern. Feedback through Give feedback on care really does make a difference. From 1 April 2020 54.5% of our risk-based inspections were triggered by information of concern. Through our Because We All Care campaign, we’ve joined up with Healthwatch to call for feedback from unpaid carers. We’re incredibly grateful that many have already shared their experiences of what care is like in people’s own homes, care homes, hospitals and GPs – good and bad. I’d like to make a plea that carers continue to talk to us about what care is like, as they are our eyes and ears on the ground. We must all continue to be vigilant when it comes to PPE and making sure IPC policies are up to date. These areas are critical to keeping people who use services and staff safe and it’s something we should all keep talking about. This year, we’re beginning to explore developing our care home IPC methodology for community settings such as supported living and extra care.

Inside CQC K

A T

Kate Terroni, Chief Inspector of Adult Social Care at the Care Quality Commission (CQC), thanks the sector for its extraordinary work during the pandemic.

We’ll continue to look at IPC on inspections of designated settings for people leaving hospital who have tested positive for COVID-19, and have assured over 130 settings so far on the scheme. We’re now going to be helping the system to increase capacity by inspecting services where intelligence indicates a potential improvement. If the inspection is positive, this could lead to a change in rating and additional capacity locally. In December, we published the second report of Professor Glynis Murphy’s independent review of its regulation of Whorlton Hall between 2015 and 2019. Debbie Ivanova, Deputy Chief Inspector, will be leading a programme that will help us better identify unacceptable care. We’ll begin with a systematic review of all Inadequate and Requires Improvement inpatient units for people with a learning disability and/ or autism. We’ll focus more on people’s

experiences to ensure our reporting reflects how it feels to be cared for in a service. COVID-19 has accelerated change across health and social care, and in this new world we must also transform. We need to make changes to the way we regulate so that it’s more relevant and has positive outcomes for everyone. People’s expectations of care have changed. We need to be more flexible to manage risk and uncertainty. We’ve learned a lot from our response to the pandemic and we’re using this to put us in a better place for the future and to support services to keep people safe. We’ve just launched our strategy consultation and would like to hear what you think, so that we can make our strategy work for everyone. You can respond until 5pm on Thursday 4 March 2021. I’d like to end by sincerely thanking you and your teams across the country for all that you continue to do.

Kate Terroni is Chief Inspector of Adult Social Care at the Care Quality Commission. Share your thoughts and feedback on Kate’s column on the CMM website, www.caremanagementmatters.co.uk CMM February 2021

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CMM February 2021

NEWS

APPOINTMENTS DHSC

National Care Forum warns of social care staff pressures The National Care Forum (NCF) has issued a warning about how care providers across the country have been hit hard by staff absences associated with high levels of community transmission of COVID-19. NCF asked care providers, in a snapshot survey, to give details of the most challenging staffing situation that they have faced between 1st January 2021 and 8th January 2021 across their whole range of services. NCF is now calling on Government to take note of just how hard COVID-19 is hitting the frontline. According to the survey results, individual services are reporting between 11% and 40% staff absence and a few services

are reporting staffing absences of over 50%. Absences were said to be caused by a combination of COVID-19 positive cases being picked up by testing, selfisolation following contact tracing, shielding and childcare responsibilities. Survey respondents said that in the very short term, they are having to run services through a combination of offering extra overtime to other staff, bringing in staff from other services and not accepting new referrals or admissions from hospital or the community. Where absences cannot be resolved in-house, care providers were using agency staff. However, according to NCF, this is not a

sustainable position and must be addressed before the sector is overwhelmed. Vic Rayner, Executive Director of NCF, said, ‘It is essential that Government takes heed of this early warning signal that care services are under immense pressure. Staff in care services have been at the very front line of this battle against COVID-19 for over 11 months and are shattered both physically and emotionally. Individuals and teams are stepping up once again to flex and cover largescale staff absences brought about by a combination of testing, selfisolation, shielding and childcare. They are undoubtedly heroes but asking them to do this over and over again is not sustainable.’

COVID-19 Vaccines Delivery Plan Tens of millions of people will be immunised by Spring at over 2,700 vaccination sites across the UK, Government has announced. The UK COVID-19 Vaccines Delivery Plan sets out how Government will work with the NHS, devolved administrations, local councils and the Armed Forces to deliver the vaccination programme. Government said that by the end of January, everyone in England will be within ten miles of a vaccination site or, for a small number of highly rural

areas, the vaccine will be brought to them via mobile teams. The Department of Health and Social Care (DHSC) said there will also be capacity to deliver at least two million vaccinations in England per week by the end of January and all residents and staff in care homes will be offered a vaccine by the end of the month. Government said every at-risk person will have easy access to a vaccination centre, regardless of where they live. The expansion of the

programme will also mean all adults will be offered a vaccine by the Autumn. Government and the NHS have also mobilised a workforce of over 80,000 health professionals to help in the delivery of the programme across the different vaccination sites, with over 200,000 additional members of the public expressing their interest in helping with the non-clinical elements of the rollout – such as administrative support, logistics, stewards and first aiders.

The Department of Health and Social Care (DHSC) has appointed Professor Deborah Sturdy OBE as the first Chief Nurse for Adult Social Care. Deborah will work closely with the Minister for Care and the Chief Nursing Officer to ensure the provision of high-quality, personalised, joined-up care. Professor Sturdy will also help develop social care policy and how it relates to the workforce.

HFT Kirsty Matthews has been appointed as the new Chief Executive Officer of Hft. Kirsty has held a variety of senior leadership roles in both public and private organisations within the health and care sector over the last 30 years.

AMBIENT SUPPORT Lee Hodgson has joined Ambient Support as Chief Information Officer. With extensive experience in driving business and technological strategies, Lee has held a number of senior roles with Macmillan Cancer Support, Isle of Wight Citizens Advice and as a Senior Aircraft Engineer with the Royal Navy.

RANDOLPH HILL The Randolph Hill Nursing Homes Group has promoted two of its senior colleagues to director level. Katie Wood, who moves into the role of Director of Care Standards, and Clare Allen, the group’s new Director of Nursing Homes Operations, will join Managing Director, Peter McCormick, and Director of Nursing, Ingrid Neville, on the group’s board. CMM February 2021

NEWS

APPOINTMENTS LEEDS CARE ASSOCIATION Leeds Care Association has appointed Michelle Atkinson as its new General Manager, tasked with leading Leeds Care Association through its next period of development. Michelle joins Leeds Care Association from her former role as Commissioning and Programming Lead for Leeds City Council, where she was responsible for commissioning and procuring services from both the statutory and voluntary sector to meet the needs of older people in Leeds.

LEONARD CHESHIRE David Grayson CBE has been appointed a Trustee at Leonard Cheshire and will become its new Chair later this year. Current Chair of Trustees, Sally Davis, has led the Board since October 2015 and will continue to do so until her tenure ends in October 2021. The selection of a future successor to lead the Board follows the recruitment of Ruth Owen OBE as Leonard Cheshire’s new CEO.

ADVANCE HOUSING AND SUPPORT Advance Housing and Support has announced that Sinéad McHugh-Hicks has been appointed as Executive Director of Support. Sinéad will be responsible for driving forward the organisation’s ambitious plans to improve the quality, reach and impact of its support services.

NMC CHAIR TO STEP DOWN NMC Chair, Philip Graf, is stepping down from his role, due to illness following a stroke he suffered at the end of September. The Council has agreed that current acting Chair of the Council, Karen Cox, will continue until a permanent successor is appointed. 10

CMM February 2021

Urgent call for social care funding and new recruits The Association of Directors of Adults Social Services (ADASS) has warned today that the social care sector needs immediate funding and new recruits to support its exhausted workforce. ADASS said an immediate cash injection needs to happen to ensure that vital services for older people, disabled people, families and carers do not collapse as the COVID-19 pandemic hits a new peak. It has been reported by ADASS that alarming gaps are appearing in social care teams through COVID-19 infection, self-isolation and sheer fatigue as the sector, which had existing vacancies of 112,000 prior to pandemic, is being expected to ease the strain on the NHS by supporting people discharged from

hospital to free up beds. ADASS says extra funding is needed to pay for additional staff and care. ADASS is also issuing an urgent plea for anyone with experience of care work to consider returning to the job to help the care sector get through the coming weeks. The association has asked for an additional £480m in England to increase provision of care at home for older and disabled people so that they can live independently, with good support, and can be kept out of hospital for as long as possible. ADASS is also seeking extra help for family carers who are providing the most intense support for loved ones. It says an extra direct payment of £50 per week for carers is needed during the worst

of the pandemic to enable them to pay for respite breaks and keep going until the pandemic eases. ADASS is urging a major overhaul of pay and conditions for care workers. ADASS is calling for a national care wage of at least £10.90 and significant investment in training and creation of career paths to put social care work on equal level with that in the NHS. James Bullion, ADASS president, said, ‘We need funding, now, to enable care providers to recruit extra skilled pairs of hands and we are asking anyone who has done care work in the past to think very seriously about returning to help us get through this. Every single person who steps forward will be making a huge contribution.’

Landmark reform of mental health laws The Government has announced landmark reforms of mental health laws, which are said to provide more control over care and treatment for people detained under the Mental Health Act. A package of reforms has been set out in a wide-ranging new Reforming the Mental Health Act White Paper, which builds on the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018. The White Paper sets out the path towards the Government’s commitment to introduce the first new Mental Health Bill for 30 years and end the stigma of mental illness once and for all. The Government will consult on a number of proposed changes, including:

• Introducing statutory ‘Advance Choice Documents’ to enable people to express their wishes and preferences on their care when they are well, before the need arises for them to go into hospital. • Implementing the right for an individual to choose a ‘Nominated Person’ who is best placed to look after their interests under the Act if they aren’t able to do so themselves. • Expanding the role of ‘Independent Mental Health Advocates’ to offer a greater level of support and representation to every patient detained under the Act. • Piloting culturally appropriate advocates so patients from all ethnic backgrounds can be better supported to voice their individual needs.

• Ensuring mental illness is the reason for detention under the Act, and that neither autism nor a learning disability are grounds for detention for treatment of themselves. • Improving access to communitybased mental health support, including crisis care, to prevent avoidable detentions under the Act. This is already underway backed by £2.3bn a year as part of the NHS Long Term Plan. Mark Winstanley, CEO of Rethink Mental Illness said, 'The publication of the White Paper to reform the Mental Health Act is a hugely significant milestone in a long struggle for change. Many people will take for granted their right to have choice and control over the medical treatment they receive.’

Registering for free PPE The Care Quality Commission (CQC) has said PPE will continue to be provided to registered providers for free (for COVID-19 needs) via the PPE portal until the end of March 2021.

Over 20,000 adult social care providers have already registered to use the portal, which can be done using a CQC-registered email address. To help with ordering on

the PPE Portal the Department for Health and Social Care has created a step-by-step video. Providers can also monitor the GOV.UK guidance page for updates.

CMM February 2021

NEWS

CQC and Healthwatch urge unpaid carers to share feedback The Care Quality Commission (CQC) and Healthwatch England are calling for feedback from unpaid carers following a year which has seen enormous challenges for those working in the health and social care sector, those using services and their loved ones. The CQC and Healthwatch said unpaid carers have played a greater role than ever before in supporting people with their care

needs, providing an incredible contribution in the fight against COVID-19. In addition to the direct support they provide, carers play a vital role in sharing feedback about their care experiences. That is why as part of the Because We All Care campaign, the CQC and Healthwatch are asking carers to tell them about the care their loved ones receive, positive or negative, across care

homes, GP services, hospitals or in the home. People can give feedback on their experiences of care, or those of someone they care for, on the CQC website or through their local Healthwatch. Local Healthwatch organisations can also help with advice and information to access support. Sir Robert Francis, CEO of Healthwatch England, said, ‘Unpaid carers are the backbone

of our health and social care systems and their commitment and compassion have never been more vital. 'The COVID-19 pandemic has had a big impact on both them and those they care for whilst prompting a huge rise in the number of people taking on caring roles, ranging from shopping for food and collecting medicine to providing emotional support.’

New projects to support people with complex needs In 2021, the Queen’s Nursing Institute (QNI) will be able to support ten nurse-led innovation projects that aim to improve care for people with complex needs. The projects have been made possible thanks to funding from The Burdett Trust for Nursing. The ten chosen projects focus on improving health for people with complex needs in primary care/

community settings. According to the QNI, applicants were asked to demonstrate that their project could lead to reduced hospital admissions for people living with complex needs, where those needs could instead be successfully managed in the community. Each project leader will benefit from a bespoke yearlong programme of professional

support and funding from the QNI. Due to limitations imposed by the pandemic, the programme workshops will be held online. The first workshops took place in the second week of January 2021. Sue Boran, the QNI’s Director of Nursing Programmes, said, ‘I am delighted that we will be able to work with ten nursing teams in such diverse community specialisms

across England and Wales this year. These nurses are facing growing challenges in the delivery of care for people with ever-more complex needs in community and primary care settings, and through shared learning and encouraging innovative approaches we will be able to achieve significant outcomes for healthcare in the future.’

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CMM February 2021

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New grant to support care home testing In a bid to increase care home testing, £149m has been made available in a new Government grant. The money will be distributed via local authorities and will cover the infrastructure costs of the expanded testing programme, including setting up safe testing areas, and resource costs

including gaining consent for tests, supervising the use of PPE and swab tests, and then processing and logging the results. Funds can also be used for staff training and for staff time. The Government has made the following changes to testing: • Two lateral flow device (LFD) tests to be added to weekly

staff testing in care homes. This means that staff will do a polymerase chain reaction (PCR) and an LFD test on day one and an additional LFD test mid-week. • LFD test to be taken before shifts for any staff who need to work in more than one location to deliver safe staffing levels.

• LFD test to be taken before shifts for staff who have been away from work and missed their weekly test. • When any resident or staff member has a positive PCR or LFD test, each member of staff should do a daily LFD test for seven days and preferably at the start of shifts.

Care home visiting is stalling, warns charity Age UK has warned that progress in resuming care home visiting is stalling and has called on everyone to pull together to make it happen. The charity issued this warning in December 2020, as it published a new report, Behind the headlines: why in-person care home visiting must get going again, which lays bare the intense suffering experienced by many older people and their families and friends because of their

enforced separation throughout much of the pandemic. To inform the report, Age UK carried out a snapshot survey of 2,732 people. The survey was open from 23rd October 2020 until 19th November 2020. The key findings from the survey include: • 70% said that they had not been able to visit or see their loved one since the start of the pandemic. • 34%, or one in three, said

that they had been offered no alternative to in-person visiting, such as a video call. • Nearly 70% of those who said they had been unable to visit their loved one since the start of the pandemic also added that digital and phone communication was not a good alternative to in-person visits in their case. • 45% of family, friends and residents who had been able to visit each other during the pandemic said that seeing their

loved ones in person was vital because their loved ones couldn’t use digital options. A key theme that came through in the findings was how terrible many families felt because they knew that their loved one would not understand why they weren’t visiting them and would feel abandoned and unloved. This was a particular fear when the older person in question was living with dementia.

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NEWS / IN FOCUS

Report reviews Housing with Care programme A report commissioned by the Department of Health and Social Care (DHSC) has evaluated the Care and Support Specialised Housing (CASSH) programme. The programme provides capital funding to build new specialised housing in England for older people and disabled adults with care and support needs. It is implemented by the Greater London Authority and Homes England (referred to in the report as 'implementation bodies’) on behalf of DHSC. The report suggests that housing with care is another viable and valuable option for older people, along with other care services such as care homes and homecare.

The research was conducted by The King’s Fund and the University of York at the request of DHSC. The research included an extensive review of available evidence and research on the health and social care value of the new generation of retirement housing, alongside a study of the Government’s capital funding system for housing association and local authority provision. Michael Voges, Executive Director of ARCO, explores this more in this month’s Straight Talk on page 50. The full report outlining the benefits of the CASSH programme can be accessed on the University of York website. Visit www.york. ac.uk

NCF launches Caring in COVID ebook The National Care Forum (NCF) has launched Caring in COVID – a collection of stories about care, communities and leadership during the COVID-19 pandemic. The book records and highlights responses from NCF members, brought together as a collection of real-life stories in an ebook. The NCF hopes that the ebook will become part of the British Library collection for future generations,

acknowledging the legacy of 2020 and the role care providers have played in the fight against COVID-19. Vic Rayner, Executive Director of NCF, said, ‘This book is more than just a nod to social history; it demonstrates how people’s lives are enriched by the role of those working in the care sector through their creativity, dedication and passion, and through their many skills and talents.’

Memorable music could reduce anxiety Research by Birmingham City University academic, Mark Brill with Pendine Park Care Homes in Wales found that using music at the point of care can reduce stress, particularly for those living with dementia. The researcher also said that music could reduce anxiety among older people during COVID-19 vaccinations.

Mark worked alongside Manchester Metropolitan University’s Dr Stuart Cunningham and Dr Harry Whalley from the University for the Creative Arts in the wellbeing study. Visit the Journal of Healthcare Engineering to read the full study: https://www.hindawi.com/ journals/jhe/2019/8924273/

IN FOCUS NHS Digital publishes new reports WHAT’S THE STORY?

The latest statistics on adult social care which cover the outcomes, activity, finance, and the opinions of those receiving care have been published by NHS Digital. The survey, which is in its tenth year, seeks the opinions of service users aged 18 and over, who are in receipt of long-term support services, which are funded or managed by social services. The annual survey conducted by councils with adult social services responsibilities (CASSRs) provides estimates for all people using services based on a survey sample. In 2019/20, responses from a sample of 62,520 people were used to provide estimates for an overall population of 608,145 people using services.

WHAT ARE THE FINDINGS?

Findings from the Personal Social Services Adult Social Care Survey England 2019-20 found that 64.2% of people using services were very or extremely satisfied with the care and support they received. This is a very similar proportion to last year. Slightly more people required practical help on a regular basis compared to last year and 6.3% of people said they felt socially isolated. There was an increase in delayed transfers of care from hospital, from 10.3 per 100,000 population in 2018/19 to 10.8 per 100,000 population in 2019/20. Local authority spending was £19.7bn in 2019/20. This represents an increase of £918m from the previous year. The area of care which saw the largest increase in expenditure was longterm support, which increased by £748m to £15.4bn in 2019/20. The average cost of residential care for

a person aged 65 and over rose from £636 per week in 2018/19 to £662 per week in 2019/20, while the average cost of nursing care for the same age band increased from £678 per week in 2018/19 to £715 per week in 2019/20. The total number of services provided for people aged 65 years and over was 495,575 in England, between April and September 2020. The statistics revealed that 113,775 services were not provided at all.

WHAT DO EXPERTS SAY?

Deborah Alsina MBE, Chief Executive of Independent Age, said, ‘These damning latest figures underline the urgent need for reform of our broken social care system. The statistics from NHS Digital, taken between April and September of this year, reveal that almost a quarter of older people who were seeking social care help were denied it. The equivalent of more than 600 older people a day were denied vital support for basic tasks such as help washing, preparing meals and going into town. The Government cannot allow this to continue. ‘The Government must bring forward a funding plan that ends the cycle of crisis in social care, and it must be distributed fairly based on need. Care should be free at the point of use, paid for through general taxation, to ensure everybody can receive the help they’re entitled to. ‘We’ve been waiting over a year for the Prime Minister to f ulfil the promise he made to reform social care. Politicians must seize the opportunity to create a care system that allows people in later life to live with dignity, choice and purpose.’ CMM February 2021

NEWS

Urgent call to review carers’ breaks

Campaign celebrates homecare support

Carers UK has called on the Government to urgently review carers’ breaks and invest in them to ensure that carers can take a significant break over the winter months. Carers have reported being worn out and physically and mentally exhausted after months of caring without respite. Carers UK carried out an online survey between 7th and 10th December 2020. A total of 2,284 people responded to the survey. Some of the findings included: • Over half of carers (59%) were too worried about COVID-19 to risk seeing their family and friends this year. • Two thirds (68%) said they had already gone without lots of support this year. • 81% of carers said they wanted to go into the New Year with a clear sense that the Government

A survey has revealed that nearly 90% of people think Government should widen housing options for older people. The survey, conducted by Later Life Ambitions (LLA) and Associated Retirement Community Operators (ARCO), explains the mismatch between the needs and wants of older people and the options available to them. The survey included 301 older people and 12 operators. 62% of the individuals surveyed were aged 65 or over, and this group of people overwhelmingly supported Government action to increase the provision of housing for older people. The survey also found that: • 56% of people are interested in moving, rising to 70% if to somewhere with care and support as an alternative to a care home. • 53% say their local area does not

values carers and will provide more support and recognition. • 59% said being able to see family or close friends and get a break from their caring role would help. • A third (36%) said help from a supportive community would make a difference, such as an offer to cook a hot meal. Helen Walker, Chief Executive of Carers UK, said, ‘Carers say they feel invisible and that the Government doesn’t value them. Carers UK is calling on the Government to increase the income of carers entitled to Carer’s Allowance, just £67.25 a week, by £20 a week, to match the increase made months ago to Universal Credit, helping carers manage the higher costs of caring in the winter and the lack of services available to help them stay in work.’

have enough downsizing options, including those with care. • 14% said they would like to move specifically to a retirement community. • Despite the demand to move to a retirement community, just 0.6% of over-65s currently can live in a retirement community in the UK, compared to at least 5-6% in New Zealand, Australia and the US. When asked to rank top priorities for Government change, the creation of alternatives to care homes came first, followed by developing a clear national strategy to encourage growth. Also rated as important was the need to provide more information to older people about their choices, making improvements to the planning system, and strengthening consumer protection and clarity.

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CMM February 2021

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NEWS

NCF releases Pulse Survey results The National Care Forum (NCF) has shared the results of its second Pulse Survey of the adult social care sector, to provide in-depth analysis of how providers are operating during the second wave of COVID-19. Working together with Information by Design, the survey was completed by NCF members operating 1,456 care and support services throughout England. Participants employed over 47,000 staff and supported almost 51,000 people across a wide range of care services including care homes, community-based services, supported living and extra care housing. The data provides a snapshot of some of the key issues over the period of 1st to 30th November 2020. Notably, care providers reported the significant cost of administering lateral flow tests,

with many stating the need for a dedicated staff member to take on this role. When asked if they felt the increase of testing to twice weekly for staff and weekly for residents was achievable, many expressed concerns due to the ongoing pressures on care providers. There is an indication that there has been an improvement in the speed of COVID-19 test results, with almost 57% of tests returned in 48 hours compared to 24% in the last survey looking at the period of 1st to 31st October 2020. Some of the other key findings from the survey include: • 99% of those responding reported compliance with whole home testing of staff weekly and residents monthly (98%). • 73% of services reported that the allocation of PPE was not

sufficient to meet their COVID-19 responsibilities. • Fewer than 1% of services were able to source PPE from the Local Resilience Forum or local authority. • 75% said their revenue was down, and 83% said their costs were up, creating greater fragility to an already stretched and underfunded sector. • Only 38% of community services were able to run as normal, with 62% either unable to operate or operating a much smaller proportion of their usual services. • 82% of services were supporting fewer people face to face and 91% were supporting fewer people overall. • Local authority funding was down for 48% of services and income from people who pay for their own community services was down by 48%.

Bringing the Inside Out Chapel House Care, which runs two care homes in Puddington, Cheshire, has been included in a book about life in care homes during the COVID-19 lockdown. The book, Bringing the Inside Out, has been published by the arts and literature charity, Living Words. The charity spoke to more than 60 care home residents with dementia, their carers and relatives as part of a pioneering UK-wide project. They ran weekly sessions with carers from 15 British care homes – including The Chapel House and Plessington Court – to enable the words of people with dementia to be part of the book. Each person’s sounds and words were captured using their ‘Listen Out Loud Methodology’, allowing people’s words to be captured as they spoke them – making for an unconventional use of grammar and arrangement on the page.

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NEWS

Northumbria University launches major new project New Year's Honours List Awards A research team at Northumbria University has launched a project exploring how carers and care workers recognise and manage deterioration in the health of people with learning disabilities and autism. According to Public Health England, people with learning disabilities and autism are more prone to chronic health conditions than the rest of the population and are often more susceptible to acute conditions, including sepsis. While several tools to help recognise early deterioration do exist, Northumbria University says there is a lack of evidence around their effectiveness as well as no consistent, national approach to using them. To address these gaps in research, experts from Northumbria University will be working with regional NHS Trusts

and other partners, including The UK Sepsis Trust, to explore how carers and care workers use a range of assessment tools, including Early Warning Systems, to ensure timely provision of healthcare for people with learning disabilities and autism. The project has been funded by NHS England and NHS Improvement and Health Education England. This study will investigate how families and non-clinical care home staff use these tools to recognise the signs of deterioration that might indicate sepsis or other serious problems. This will help identify what works best for carers and care workers and assist in making decisions about how to equip them with the resources they need. Additionally, the project will evaluate the effectiveness of the various Early Warning Systems

(EWS) used in community and primary care settings. These EWS are based on infrequent but regular measurements of vital signs to provide a baseline, and aid the interpretation of complexity in vital signs and deterioration in adults with a learning disability or autism. Dr Jane Greaves, Senior Lecturer in Northumbria’s Department of Nursing Midwifery and Health and Project Lead, said, ‘Currently, there is no consistent, national approach to using EWS in primary care settings. By focusing on the role of carers, this project will provide crucial evidence for future decision-making by policy makers and practitioners, in seeking to improve the early identification and management of ill health in individuals with learning disabilities and autism.'

The Queen’s New Year’s Honours list has been released. Those acknowledged from health and social care include: • Charles Pearson CBE. • Malini Nebhrajani. • Professor Graeme Betts. • William Ian David Plaistowe. • Claudia Claire Sykes. • David Edward Ballard. • Charles David McQuistan Flear. • John Godden. • Dr Richard Harling. • Stephen Holmes. • Catherine Paterson. • Judith Stella Rhys. • Myrtle Joan Clements. • Laura Jane Gaudion. • Lisa Jane Randell. • Charito Romano. • Andrew Lennox Rowe.

Housing for older people must improve, says survey A survey has revealed that nearly 90% of people think Government should widen housing options for older people. The survey, conducted by Later Life Ambitions (LLA) and Associated Retirement Community Operators (ARCO), explains the mismatch between the needs and wants of older people and the options available to them. The survey included 301 older people and 12

operators. 62% of the individuals surveyed were aged 65 or over, and this group of people overwhelmingly supported Government action to increase the provision of housing for older people. The survey also found that: • 56% of people are interested in moving, rising to 70% if to somewhere with care and support as an alternative to a care home. • 53% say their local area does not

have enough downsizing options, including those with care. • 14% said they would like to move specifically to a retirement community. Despite the demand to move to a retirement community, just 0.6% of over-65s currently can live in a retirement community in the UK, compared to at least 5-6% in New Zealand, Australia and the US.

When asked to rank top priorities for Government change, the creation of alternatives to care homes came first, followed by developing a clear national strategy to encourage growth. Also rated as important was the need to provide more information to older people about their choices, making improvements to the planning system, and strengthening consumer protection and clarity.

COVID-19 impact on people with learning disabilities Research has been published by Dimensions, revealing the extent of isolation experienced by people with learning disabilities and autism due to the coronavirus pandemic. The research was launched on 3rd December, which marked The International Day of People with Disabilities. Between September and November 2020, Dimensions conducted an online survey including 125 responses from people with learning disabilities and autism. Some of the key findings were: • 93% of people with learning 18

CMM February 2021

disabilities or autism feel more isolated from society due to the pandemic. • 76% have been made to feel like they do not matter compared to other people. • 75% worry that after the pandemic, they won’t get the same opportunities they had before. • 97% feel Government should do more to address their s pecific needs. • 97% say it’s important that more people understand how

coronavirus has affected people who have learning disabilities and autism. Seeing this year as a catalyst for change, 67% are hopeful that more reasonable adjustments for people who have learning disabilities and autism will be considered in the future, and 57% have been inspired to get more involved in politics and decision making. Sarah Walters, Campaigns Manager at Dimensions, said, ‘Our research highlights just how

isolating the pandemic has been for people with learning disabilities and autism, with many worried that in the future, they won’t have the same opportunities they had before. Yet, many remain hopeful our society will evolve to be more inclusive. We cannot let them down.’ The research has been published alongside the Dimensions Coronavirus Learning Disability and Autism Leaders’ List, in association with Learning Disability England and The Voluntary Organisations Disability Group (VODG).

+44 (0) 117 214 0125 www.care-planner.co.uk CMM February 2021 19

2021:

A YEAR OF REFORM, HOPE AND HUMANITY

CMM February 2021

Early indications suggest that January will feel very much like early 2020, with high levels of outbreaks, staff shortages, pressure and, very sadly, infections and deaths. Not quite the New Year everyone had hoped for, but quite possibly the beginning many would have predicted. So, what about hope? Are we at the moment that hope is allowed? Clearly, vaccination brings promise and there is a sense that we might just begin to start counting the days towards a more positive future rather than marking up the days since the pandemic began. The impact of this shift in focus on those receiving care and support, the workforce and those operating care services will be vital. But the road to that hopeful land looks harsh and inhospitable from the cold coalface of January. The things that need to feel very different are manifold. Let’s start with the Government definition of care. It has, of course, been very important that the Government has focused much of its attention on what is happening in care homes. However, the flipside of that is that other parts of the sector have vacillated between a position of playing heavily delayed catch up or being completely ignored. Government guidance has come late and, in many cases, has borne little resemblance to how services are run and what can be achieved within existing capacity. The lack of knowledge about what happens within care homes pales into insignificance compared to the lack of knowledge of what supported living is, how day services operate or what the role of a personal assistant is. However, the statements made by Government talk about care, the care workforce and those receiving care as an homogenous group. This is a grave concern for the reform agenda. Worryingly, the small amounts of attention that seem to have been focused on the longer term still cling to the notion that the big issues are linked only to older people and the costs of residential care on an individual’s wealth.

PEOPLE AT THE HEART OF CARE

It’s safe to say that 2020 was not the year that anyone predicted. Ways of working had to be adapted overnight and pressures mounted, while any notion of planned change was pushed aside. With a vaccination programme underway, Vic Rayner of the National Care Forum takes a look at what we might expect from 2021.

We need the year ahead to be about people. Ironically, in a pandemic that has absolutely been about people, and the impact of COVID-19 on people, the directions for social care have been firmly footed in a narrative dominated by process. The voices of people – those who receive care and support and those on the frontline – have been hard to hear above the grinding gears of guidance development. What feels almost like an industry in its own right runs the risk of dominating the very essence of care – the fact that people sit at the heart of it. CMM February 2021

> 21

2021: A YEAR OF REFORM, HOPE AND HUMANITY

We need 2021 to bring those people right back to the forefront of everything that we do, and for there to be a rebalancing in favour of independence, rights and connections. One clear sign that we are moving in the right direction will be when we have families and loved ones back in the heart of all care settings. I know many have said it, but some of the most heart-breaking images of 2020 have been of people split asunder by screens, windows, drive-bys or some other mechanism. Of course, these approaches have been an important part of bringing people together as much as possible, within the rules and regulations, but they have sat painfully, and it has sometimes felt as if the anger and despair around the lack of visiting could rip the heart and humanity out of care. Hope for the year ahead does correlate strongly for me with the reintroduction of meaningful visits and the sound of visitors’ voices once again ringing strong within care homes. Shifting the care home anthem from Dame Vera Lynn’s We’ll meet again – to Eurythmics’ Right by your side.

REFORM AND THE WORKFORCE Of course, hope for social care has often been connected to the much vaunted notion of reform. Once more, we enter a new year with the promise of transformation hot on the lips of politicians across the political landscape. We know that this discussion is progressing at pace in Scotland. But in England, we are faltering at the starting blocks (again!). We now have 18 months of promises with this Prime Minister and over 12 months of commitment within this parliament. Whilst the pandemic continues, it seems unlikely that we will see anything substantive. However, what is clear is that when the ‘bandwidth’ opens for this debate, the inequities that have been writ large during the pandemic must be addressed. A deal for the workforce will be key. The incredible commitment of staff across the country has been acknowledged, but little has been done by Government to change how it feels on the front line. As we finally exit the pandemic, we need to ensure that there is not a mass exodus from a mentally and physically exhausted workforce. Anyone who has been part of managers’ and workforce calls over the last 10 months will know just what a toll this has placed on everyone on the front line. And when the pandemic lifts, the care must carry on.

“Digital transformation has brought together hope and humanity in a way that can only expect to continue long into 2021 and beyond.”

The best reward for all will be a properly resourced and supported workforce plan. A plan that gives long-awaited parity with NHS staff, that provides a clear progression pathway, and that recognises social care as a valued and important career. Whilst I wonder whether we will see the full funding reform agenda that everyone hopes for, I anticipate that the extreme pressure on sustaining and recruiting a care workforce will mean that this is one key priority the long grass cannot hide for yet another year. My hope radar runs out of steam a little when it comes to the longer-term reform of the funding of social care. One of the things that will dominate the year ahead will be the notion of economic challenge. In the midst of that, even if social care funding reform does manage to cut through, it will need to carve out a system fit for a 21st century future – in an economy with unemployment and recession vibes that bear more resemblance to the early 1980s. That is going to be tough. The plan we land on is intended to give us a sustainable future for generations to come and the options to fund that will undoubtedly have been impacted by the massive shift in our economic projections. The downgraded Spending Review of 2020 may find itself repeated if the hoped-for ‘V-shaped’ recovery falls short of expectations. This will not be a positive backdrop against which to outline an ambitious plan for the care we all want and need to be delivered in the years ahead. It is also extremely possible that as we exit this pandemic, there is a collective gasp from the politicians who have held the ring on social care for the last 12 months and that we find ourselves arguing the case for what the future should look like with a new group of politicians who know little about the current

situation, never mind an understanding of what came before. This is all notwithstanding the gradually emerging picture of what a fully implemented Brexit Britain will look and feel like.

FINDING A WAY FORWARD Finally, one of the unassailable elements of progress that has been achieved in the last year has been that of digital transformation. In many ways, for me this has brought together hope and humanity in a way that I can only expect to continue long into 2021 and beyond. When rules and regulations would not allow people through doors, technology enabled close connection to continue. When healthcare professionals were told to stay away, technology ensured that they could stay in touch and continue to offer help and support to those most in need. When it looked as though the needs of those receiving care were to be ridden roughshod over in the drive to protect the NHS, technology enabled us to gather and share the data that showed just what a devastating effect COVID- 19 was having on those receiving care and support. I suspect it would not garner everyone’s vote as an emblem of hope and humanity. However, in an extraordinary year, the world of digital has truly opened up to social care and has been instrumental in ensuring that never more can the needs of those receiving care be ignored. COVID-19 has given us the opportunity to stand up and be counted, and for those who lead the country to be held to account for each and every way in which their decisions affect not just those who receive care, but the incredible people who work in it too. CMM

Vic Rayner is Executive Director at National Care Forum. Email: vic.rayner@nationalcareforum.org.uk Twitter: @vicrayner What are your expectations for the year ahead? How do you think the sector will fare? Share your thoughts and feedback on this article on the CMM website, www.caremanagementmatters.co.uk 22

CMM February 2021

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: S N O IS R A P M O C G IN W A DR

AN P A J M O R F G N I N R LEA As the population in the UK ages, our social care system continues to be put under more pressure. This is an issue Japan has already faced – so what can we learn from them? Here, Lorcán Murray from CarePlanner Home Care Software explains the solutions they’ve put in place and how they’re working.

The consensus on social care is that it is in need of reform. While there are differing opinions on the specifics, the majority of people agree the solution must have a long-term view. In a report published on 22nd October, the Commons Health and Social Care Select Committee called on ministers to put forward a long-term reform package before the end of this financial year and to publish a 10-year plan for

CMM February 2021

DRAWING COMPARISONS: LEARNING FROM JAPAN

social care, to match the one for the NHS. The wisdom being, of course, that the difficulties involved are too complicated to be resolved by shortterm actions. One of the biggest issues facing social care is a relatively new one; an issue that several developed countries around the world are also trying to understand and counteract: we’re getting old. As the age of the nation rises, so does the cost of social care. Given that this issue is a relatively new one, there aren’t a lot of examples on which to base our response. But they do exist. Notably in the form of the Japanese care insurance system, ‘Kaigo Hoken’. In the early 1990s, Japan was in a very similar situation to the one facing England today. The number of people aged over 65 kept rising, while the number of people aged under 16 fell. A victory for family planning and healthcare, but a dangerous concoction when preparing to fund elderly care. Japan was one of the first countries to recognise this growing issue in its society and, in response, it started to ‘aggressively attack’ the problem. This dedicated approach led them to produce their current long-term care insurance (LTCI) model. The basis for this model is that the responsibility for funding elderly care is borne by society as a whole, rather than by the individuals or families receiving it. However, it is designed to allow for a competitive private market to exist within this payment structure.

THE MODEL IN SHORT In a nutshell, everyone aged 40 and over is insured under LTCI and pays insurance premiums. Premiums cover 45% of LTCI’s bill. Taxes cover another 45% and the remaining 10% is funded by co-payments from clients (although co-payments may be removed for poorer applicants). People aged 65 and over are eligible for care services whatever the cause of their disability or needs, regardless of income or whether family help is available. Your budget for services is determined by your assessment, which allows for seven ‘levels of need’. Admission to the programme and classification into levels of need in the programme are completed by computer analysis of a standard 28

CMM February 2021

questionnaire filled out by the applicant, which is then reviewed by an independent expert committee. Similar to the Scandanavian model, only formal services are provided. This means there is no option to reward informal carers with cash, or purchase non-professional care with your allowance, as people can in Germany. However, there is still a focus on driving consumer choice and market competition amongst care providers. By promoting national uniformity in the types of eligible service while allowing providers to compete for the opportunity to provide said service, the model preserves one of the most sacred aspects of British social care: freedom of choice. However, the freedom to choose your own care and the ability to choose the right care are two separate things. You need experience, knowledge and empathy to do the latter. You need a care manager.

THE ROLE OF THE CARE MANAGER The Japanese system is designed to allow clients to choose which provider they go to and what services they want to receive from them. In practice, the care manager plays a key role in determining what services a client receives. They write a weekly ‘care plan’, which is a schedule of service provision for the client. To become a care manager within the Japanese system, you must pass an exam and attend a brief training programme. Typically, care managers have experience in the field and, in many cases, they are employees of the provider who supplies most, if not all, of the care services to the client. To safeguard this system from abuse, final confirmation on a care plan always resides with the client and/ or their family. They have to approve the care plan before it is actioned, and they can change their care manager at any time. Moving the care manager into a more central role in the care process allows for a more direct application of knowledge to needs. Few would doubt the insight or empathy possessed by senior carers and co-ordinators here in the UK. Giving them more ‘official’ influence on the care their clients receive helps maximise the return on the expertise we, as a community,

DRAWING COMPARISONS: LEARNING FROM JAPAN

“Japan faced a national demographic crisis and, through focused response and ongoing review, has been able to build something that provides care to vulnerable members of society.”

receive from them. A care manager is effectively a regulatory body in the Japanese system. By making both the care manager qualification and service availability universal, the Japanese system creates a common denominator for care providers across the country. On the other side of the service, it makes the potentially daunting task of choosing care for yourself or a loved one a more straightforward process.

KEEPING IT FLUID There is no simple solution to the issues faced by social care. The Japanese have been amongst the most proactive Governments in the world to try and address their ageing population and they still face issues routinely. Recruitment remains one of the major concerns for LTCI in Japan. Major reasons for this are noted as: the wages are not very high, working conditions are tough, and there is little chance for promotion. These will sound distressingly familiar for many who currently work in the British social care system. The rising cost of the system is also a concern. Premiums have risen since its implementation. The Government underestimated the amount of

applications they would receive and, as the years went by, the cost of care continued to rise. This brings us to our final point of comparison: the LTCI review process. The law establishing Japan’s LTCI specifies a fiscal review every three years. This review has become an opportunity to review the effectiveness of the system and implement changes as necessary. One example is the introduction of ‘care prevention’ for people in the lower needs groups. Efforts to reduce cost have involved developing community involvement in long-term care and focusing on ways to help people stay independent. This review process was also used in 2010 to increase pay for care workers to help improve recruitment and retention in the sector. It would be naive to think these reviews solved every issue the LTCI faced. However, as a practical approach, establishing a routine for review helps establish a framework for improvement. In the UK, we have had The Care Act 2014 – which was the first major overhaul of social care legislation in 60 years – as well as official reports such as the Dilnott Commission in 2011, a report whose suggestions went largely unimplemented, something that Sir Andrew Dilnott admitted was due to

cost and, ‘A lack of strong support from the Treasury and strong support from the Prime Minister.’ Here, too, the UK can take a leaf out of Japan’s book. The Japanese LTCI system is far from perfect, but it has become a cultural tentpole in Japanese society. The country faced a national demographic crisis and, through focused response and ongoing review, has been able to build something that provides care to vulnerable members of society and a sense of security and pride to younger generations who pay into it. Despite all its issues, the results have been a source of great national pride. The Nuffield Trust produced a Green Paper on this same topic two years ago. One of the major obstacles to UK implementation it identifies is a lack of public ‘buy-in’ or cross-party support to get reform of this scale onto the legislative agenda. A lot has changed in the past two years. The social care sector in the UK is in the spotlight in a way that it has never been before. We are at the forefront of the national consciousness by virtue of being on the front lines of a national crisis. There is no perfect solution, but there’s an awful lot of people calling for a new process, and we must act quickly to utilise this consensus to our advantage. CMM

Lorcán Murray is a Marketing Executive at CarePlanner Home Care Software. Email: info@care-planner.co.uk Twitter: @CarePlannerLtd How do you think Japan’s system could work in the UK? Is it a viable solution? Let us know your thoughts by leaving a comment on this article at www.caremanagementmatters.co.uk CMM February 2021

INTO PERSPECTIVE

HOW WILL THE NEW IMMIGRATION POLICY IMPACT ON SOCIAL CARE?

The dawn of the new year also sees the end of freedom of movement between the EU and the UK. This has stark implications for the country’s immigration policy.

Government’s new points-based immigration policy will render most social care roles ineligible to qualify for a work visa. In a sector underpinned by EU workforce, and where vacancies totalled over 120,000 in 2019, it seems that social care faces an uphill battle to overcome the challenges. It is important to remember that people joining the social care workforce from outside the European Economic Area (EEA) will be largely unaffected by the new policy. Likewise, people already working in the sector in England and the rest of the UK can remain. However, those moving from Europe will be subject to a revised immigration criterion, based on amassing enough ‘points’ to qualify for a work visa. Whilst the new rules are complex, the main criteria that must be achieved are: • Speaking English to a required standard. • To have a job offer from a licensed sponsor that requires A-levels or equivalent. • To earn over £25,600 annually. This is known as the skilled worker route. Alternatively, for those earning a minimum of £20,480, points can be earned through the possession of a PhD or a role on the ‘shortage occupation list’.

FALLING SHORT OF THE MARK The biggest concern for providers facing the prospect of recruiting from Europe under the new policy is that of money – salaries particularly. It is widely regarded that most current social care jobs in the UK do not pay the £25,600 minimum wage threshold, nor do they require A-level equivalent qualifications. This is compounded by the fact that

CMM February 2021

almost 90% of salaries in the sector were below the Real Living Wage in 2019. The issue associated with salaries in social care is nothing new. While Government insists on providers shifting investment towards their domestic workforce, rather than addressing the recruitment challenges posed by the new policy, the sector is concerned with the long-promised reform that will enable it to fulfil Government’s financial demands. Increasing pay in social care is a longstanding solution presented by the sector as a means of kickstarting reform. Not only would this make working in social care more attractive for people in the UK, it would also open the door for more EU nationals to qualify for a UK work visa under the new immigration policy.

WORKFORCE WOES It is feared that the new immigration policy will exacerbate issues faced by an already struggling social care workforce. In 2019, figures revealed that approximately 1,100 people were leaving their jobs every day. In 2020, the role of COVID-19 must be recognised for the part it played in both recruitment and retention. The pandemic placed the workforce under even greater pressure than it was already under, at a time when more staff are needed to facilitate a growing demand from an ageing population. Between 2015/16 and 2018/19, the older population increased by nearly 468,000. As we enter 2021, we are faced with a social care sector deprived of the funding it needs to invest in its domestic workers, coupled with a new immigration policy that will make it tougher for providers to employ from within the EU. CMM

It will be a challenging time

Change will happen slowly and powerfully

Tom Woodward, Specialist Employment Solicitor, Scott-Moncrieff & Associates

Charles Armitage, Co-Founder and Chief Executive, Florence

The most immediate pressing issue for many employers will be to secure the status of current workers/employees who are EEA nationals remaining in the UK into 2021. These workers will need to apply to remain under the EU Settlement Scheme rules by 30th June 2021. As matters stand, care workers wishing to apply to enter the UK or to remain after 30th June will now need a salary of £20,480 or more, among other qualifying criteria in a points-based system in which individuals will need to score 70 or more points to be granted entry, or the right to remain in the UK. It will be a challenging time as employers seek to verify the status of their employees and continue to provide adequate staffing for the services they provide. Complications may arise where contract termination is required, and legal advice should be sought. It falls to all employers to perform ‘right to work’ checks when taking on new recruits, to check the individual’s identity, nationality and immigration status. Fines or even imprisonment may be imposed upon employers who employ illegal workers. Follow-up checks will also be needed to ensure continued compliance with

immigration law. In most cases the employer will need to act as licensed sponsor for the employee. As a sponsor, the employer is subject to a number of duties, including: • Paying to apply for a sponsorship licence and the Immigration Skills Charge for each migrant. • Record-keeping duties – the employer must keep documents relating to each migrant worker. • Reporting duties – this includes reporting certain information about the migrant (eg if they fail to attend work) as well as the employer organisation (eg if it changes its name). • Complying with UK immigration laws and other legislation – the employer must comply with all relevant legislation and all parts of the Worker and Temporary Worker sponsor guidance. Moving forwards, employers will need to conduct a workforce audit to identify all EEA workers who entered the UK prior to 31st December 2020 and to apply for settled or pre-settled status under the EU Settlement Scheme on or before 30th June 2021. Employers should also consider applying early for a sponsorship licence if intending to employ migrant workers coming to the UK for the first time in 2021.

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On paper, this new system should have little effect on EU nursing recruitment in social care. However, in practice the increased administrative burden and misunderstanding around limits on free movement will reduce the number of EU nurses coming to the UK. At the same time, the majority of potential care workers from across the world will not be eligible. Given that almost the entirety of adult social care workforce growth in the last few years has come from non-UK EU nationals, putting a plug in this supply will significantly impact on our ability to scale the workforce to meet the demands of an ageing population. For those currently working in social care, it looks like there will be three key negative effects on their ability to perform their roles to a high standard: a cultural impact, a psychological effect and an increased risk of overwork and burnout. Culturally, it has been shown time and again that workforce diversity is beneficial for productivity and performance. Are we really happy to put a pin in this and say that we only want our care workers to be British? I think this will have concerning and long-standing cultural challenges.

Secondly, we are already hearing about the psychological impact of Brexit on our EU colleagues who report feeling unrepresented and unappreciated. If this is left to ferment, we could be storing up problems for the future. Finally, and perhaps most obviously, this policy will put extreme pressure on an already overstretched workforce. At a time when demands on the sector are at their greatest and we’re facing such a significant crisis in recruitment, any further deterioration risks widespread burnout of staff and a workforce exodus. If we can take one positive from this policy, it is the potential of improving access to immigration of non-EU nurses to the UK. By opening up this global talent pool, we may be able to offset some of the effects of years of underinvestment in UK nurse training. It will take time to realise the actual impact of the pointsbased system on the social care workforce. Like a glacier, changes to workforce demographics on this scale will happen slowly and powerfully – once those movements have started, it is very hard to change course. There will be a very bumpy road ahead.

Remote / Virtual Audits from Care 4 Quality We are now able to extend our auditing offering to remote and virtual audits.We are covering 4 key areas; • Infection Control Audit Remote – £285 (inc VAT) • KLOE Care Home Audit (excludes Caring Domain but covers 10% care plans) £585 (inc VAT) up to 50 service users / £685 (inc VAT) 50 service users and over KLOE Domiciliary Audit (excludes Caring Domain but covers 10% care plans up to 50 service users) – £585 (inc VAT) • Care Planning Audit – £495 (inc VAT) up to 25 service users / 25 service users and over £19.50 per extra care plan • Core Risk Audit (Focussing on Regulation 12 – Safe Care & Treatment & Regulation 17 Good Governance) – £485 (inc VAT)

CMM February 2021

Always looking for ways to better serve and support our care community

Throughout last year the challenges of the covid pandemic raised the bar on providing care in the home. As the restrictions of lockdown started to bite, demands on care providers everywhere increased as they became the day-to-day focus for care, contact and information, often resulting in them putting in long hours to cover shortfalls. OnePlan, a trusted and established ECM supplier of software solutions used by home care providers, was now needed to work in new and different ways. Not only to meet new covid processes but also to interact with increased third parties and systems. The team at OnePlan have worked tirelessly to provide modifications to solutions to help its care providers operate more effectively on the front line whilst maintaining excellence in all areas of the Key Lines of Enquiry and Council frameworks. As a result, the latest line of valuable new initiatives in trial now include:

Additional features have been added to both the Android and IOS OnePlan Applications designed to assist during these unprecedented times, along with extra support from dedicated customer Account Managers and extended on-call availability for all clients OnePlan prides itself in being an agile and forward-thinking organisation that understands the pressures faced by care providers, demands on their time, efficiency and worries from a budgetary perspective. The well-being of all care givers and vulnerable individuals along with providing a duty of care and maintaining compliance is all of the utmost importance to us all. OnePlan have been our rock, assisting us throughout the pandemic, giving us 24hour support, additional licenses and regular courtesy calls to see if they can do any more to assist us during this time of uncertainty. We know they are there at all times for us.

ďż˝ In-home technology for 24/7 augmented AI support. ďż˝ Direct DBS checking facilities. ďż˝ Highly secure, encrypted voice, messaging, video, chat and email mobile solution ensure simple and secure communications, compliant with GDPR/data privacy.

CMM February 2021

Sandy Bebb, MD Veraty Care Solutions

The critical driving force behind shaping our evolved solutions and forward thinking... dedicated, relentless care providers who never give up...

Thank You

CMM February 2021

: s d r o w e h t g n i d n i F

CMM February 2021

Having the confidence and skills to deliver devastating news to families is so important. How we communicate can have lasting impact on the people we help. Claire Henry MBE, Marie Cooper and Gina King at Claire Henry Associates provide some useful advice on what to think about when responding to grief and loss.

We have seen significant changes over the last year due to the pandemic. COVID-19 has reached into our lives in many ways, not just in how we live, but also how we attend to those in our care – be that in care homes, people’s own homes, or supported living. With enforced visiting restrictions in place, many staff are having challenging, yet important, conversations concerning the wellbeing of their residents and clients on the phone or virtually

rather than in person. Many families are having to cope with visiting their loved ones under restrictions; visits can often take place from a distance or through a screen. Because visits need to be booked in advance, and care homes must adhere to policy regulation, the opportunity for family members to just ‘pop in’ has not been possible. Families have had to rely on the staff to be their eyes and ears and, most importantly, entrust

CMM February 2021

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CMM February 2021

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FINDING THE WORDS: HAVING IMPORTANT CONVERSATIONS FROM A DISTANCE

even more their loved ones to those who care for them. Many of you will have had to have important conversations with family members over the phone or virtually. These conversations really matter and they can leave a

how we communicate and what we need to emphasise when on the phone. Over 50% of how we communicate is not verbal, even when on the phone. The tone, pace and the words we choose become even more critical in how

“Reflecting for a moment on what the family may experience on receiving the call will help you to stay grounded when faced with an array of emotions.” lasting impact on both the family member and you as the member of staff. During this last year, we have all had to adapt our practice and discover new and creative ways to support the family members of those individuals in our care. When family are unable to visit their loved ones, good communication skills are critical. Knowing what to say and how to say it can be challenging at the best of times. When we began our career, many of us were told that you should not give bad news over the phone. Thankfully, our understanding has moved on and we know that when it’s done well, breaking bad news or having to discuss concerns over the phone can be just as effective. However, it is not easy for all staff to do and therefore preparing staff and offering support afterwards is key. For example, ensuring staff understand grief and loss, so they are more prepared for different reactions, which could range from crying to anger or silence. Therefore, the need to attend to our skillset and build our confidence in such a scenario is key.

CONSIDERING THE KEY POINTS It is important to remember

our communication is received when on the phone. Always remember the family perspective. Think about what it must be like for them to be told their family member is deteriorating or has died. Reflecting for a moment on what the family may experience on receiving the call will help you to stay grounded when faced with an array of emotions. They may feel very overwhelmed or be very practical, expressing little – if any – emotion. Everyone will be different.

PREPARING YOURSELF • Are you able to find a quiet room where you will not be interrupted? • Are the family aware that their relative has been deteriorating or will this news come out of the blue? • Do you have all the facts to hand? • If the person does not answer the phone, do not leave a message. • There is much talk about a 'warning shot' when delivering bad news. Your tone of voice can be instrumental in preparing a relative to hear bad news. • The word 'die' can seem brutal, but it’s a compassionate choice

because it’s clear. Euphemisms such as 'not going to make it' can be misinterpreted, which can lead to confusion and consequently frustration or more upset. • Explaining that a patient is 'critically unwell’ or 'deteriorated significantly' is also unclear for a relative. A phrase that could be used instead is: 'They are so sick that it's possible they might die.' • Tone of voice, vocal clarity and verbal expressiveness make up 38% of the overall message, words (7%) and facial expressions make up 55% of the message.

WHEN ON THE CALL • Introduce yourself clearly and check with the person that they know where you are calling from. • Check where the relative is when you call. With so many people having mobile phones they could be anywhere, such as driving or in the supermarket. • Check who you are speaking to, as you wouldn’t want to speak to the wrong person. • Remember to speak clearly and slowly. • Find out what they know and when they last visited their loved one. • Pausing is one of the most empathetic things you can do to give a relative the chance to catch up with what you are saying. If the silence feels uncomfortably long, or you are concerned that the phone connection has been lost, you could say: 'Take your time - I'm here when you are ready to talk.' • Be clear with your message. If the person you are caring for is deteriorating, explain what the family could do, or if their loved one has died. • Any detail that you can offer a relative that demonstrates

that you see their loved one as an individual is so comforting as this will probably be a conversation that they will replay in their mind. This could be the name of the nurse holding their hand, something that they said, that they had asked for a particular piece of music to be played or that you conveyed a message from the relative to them. • Make sure you have all the facts as to what the family will need to do next. Can they visit? • Have an up-to-date information sheet on current restrictions due to the pandemic for your area and your local funeral directors. • Find out if there is someone you can ring to support the family member.

LOOKING AFTER YOURSELF AND YOUR TEAM Looking after yourself, whatever role you are in, has never been so important and you may like to read more about this topic in an article from an earlier edition of Care Management Matters Magazine. There are also some helpful resources and blogs on the Skills for Care website. Having the confidence and skills is vital in the care you deliver for the distressed and grieving family. Maya Angelou famously said, ‘I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.’ It’s important to remember that the person hearing the news may only remember how they felt on receiving that call – hence it is even more important to connect with them in a confident and compassionate way. The conversation you have could potentially stay with them forever. CMM

Claire Henry MBE is Director of Claire Henry Associates. Email: info@clairehenryassociates.com Twitter: @clairehenry_ Marie Cooper is Associate at Claire Henry Associates. Twitter: @mariecooper100 Gina King is Associate at Claire Henry Associates. How have you approached responding to grief and loss in your organisation? Tell us more about the training you offer staff. Do you think the sector should do more to improve how we talk about grief and loss to families? Let us know your thoughts by leaving a comment on this article at www.caremanagementmatters.co.uk CMM February 2021

CARE HOME OCCUPANCY:

Light at the end of the tunnel?

With the older people care home sector feeling the impact of 2020, will 2021 be the year of recovery for these providers? Tom Hartley, Director at Carterwood, forecasts the impact of the second wave of COVID-19 and discusses recent research into care home occupancy levels.

CMM February 2021

CARE HOME OCCUPANCY: LIGHT AT THE END OF THE TUNNEL? The last nine months have been extremely challenging for the older people care home sector, to put it mildly. The COVID-19 pandemic has caused a loss of life on a tragic scale and pushed those who deliver care to the limit of their endurance. I know from speaking to operators on an almost daily basis throughout this crisis just how difficult it has been to protect residents, reassure relatives, keep employees safe, and to safeguard the future of their businesses. The fortitude displayed in such trying conditions has been incredible to witness. As we enter 2021, the recently approved Pfizer and AstraZeneca vaccines (along with a pipeline of others) bring hope that the new year will mark a turning point. If 2020 was about resilience, 2021 feels like it could be the year for recovery. Our new analysis on the impact of COVID-19 on the older people care home sector in England supports this view. It simultaneously shines a light on the sobering human impact of the pandemic, while showing a path to occupancy recovery as soon as November 2021 – less than 12 months from now.

A DIFFICULT WINTER AHEAD We believe that the profile of the second wave of care home deaths will be wider and flatter than the first wave. We do foresee an inevitable impact from the national rise in infection rates in the wider community over the last few months – and I know that infection rates and mortalities from COVID-19 in care homes are currently creeping up across the board – but the policies and procedures put in place by care providers throughout 2020 have been demonstrated to protect older care home residents effectively. The typical seasonal trend of ‘excess winter deaths’ will serve to elongate the duration of this second wave, but thanks to the continued efforts of operators and their staff, we believe that it will be significantly less severe than the first wave. Overall, we are forecasting a total of 27,982 excess deaths of older people in care homes during the course of the COVID-19 pandemic. The scale of this tragedy is almost impossible to comprehend and our thoughts are with everyone who has lost loved ones during the pandemic.

THE RETURN TO PRE-PANDEMIC OCCUPANCY We estimate current occupancy levels in England at between 80% to 82%, with a trend of slow recovery from a low point of 78.8% in June 2020. The next few months will, in our view, remain challenging, with occupancy falling slightly away from current levels as care home deaths increase in line with the second wave. However, a more sustained recovery will manifest itself during 2021, driven by pent-up demand and the slow but ultimately decisive impact of the vaccination programme that we now know should take place in quarter one. Overall, we’re pleased to say that we believe average occupancy across the sector in

England could return to pre-pandemic levels of 87.3% as soon as November 2021. For the financial health of the sector, this recovery cannot come soon enough.

A STABLE AND RESILIENT PICTURE Despite a positive outlook for occupancy recovery, it is sadly inevitable that for some operators, the financial and staffing pressures, localised COVID-19 impact and asset obsolescence will take their toll and force closures. Overall, we expect a total loss of 35,700 existing elderly care home beds between November 2020 and December 2024. We have assumed no change to new bed additions, as there is no evidence to the contrary, and our model assumes a net bed loss across the market equivalent to pre-COVID-19 levels of around 3,000 beds per annum from mid-2022 onwards. Taking all the above into account, the next five years paints a stable and resilient picture for older people care home demand. The long-term

“The short-term picture remains challenging but a return to pre-pandemic occupancy levels is in sight.” demographic profile remains compelling and the sector has been remarkably resilient in the face of material levels of bed loss over the past few decades. We estimate a shortfall of between circa 57,300 and 64,300 market standard beds by December 2024, and between 221,600 and 228,600 wet-room beds.

A BRIGHTER PICTURE Having worked in the social care sector for over ten years now, my characterisation of those who run care homes is one of grit, determination and, above all else, a refusal to accept failure. This indefatigable spirit has been central to minimising the inevitably severe impact of a pandemic that has turned the world on its head, and I am in awe of the efforts of operators and their teams. That’s why I’m pleased to be able to say that we believe there is light at the end of the tunnel. The short-term picture remains challenging; but a return to pre-pandemic occupancy levels is in sight, and the investment case for the sector as a whole remains compelling in the longer term. CMM Tom Hartley is Director at Carterwood. Email: tom.hartley@carterwood.co.uk Twitter: @CarterwoodLtd How has COVID-19 impacted on your occupancy levels? Have you experienced a drop, and how soon do you think you can recover? Share your views on the CMM website, www.caremanagementmatters.co.uk CMM February 2021

RESOURCE FINDER

TECHNOLOGY Technology has played an important role during the global pandemic, with developments happening all the time. This resource finder gives you information on some of the sector's leading providers, to help you enhance your digital offering and stay ahead.

CMM February 2021

ATLAS eMAR

Care Vision

Tel: 0117 200 1474 Email: info@invatechhealth.com Website: www.invatechhealth.com/products/atlas

Tel: 0208 768 9809 Email: info@carevisioncms.co.uk Website: www.carevisioncms.co.uk

SECTORS

COMPANY PROFILE

• Care homes. • Care homes with nursing.

SERVICES • Medication management. • Barcode technology for ultimate safety. • Operational efficiency. • Full integration with pharmacy. • Full integration with electronic care planning. • Manage stock, optimise therapy and simplify prescription tasks. • Monitor performance in real time.

COMPANY PROFILE ATLAS is the only electronic medicines management system in the UK proven to increase resident safety and improve care home efficiency. Our mission is to improve patient outcomes, reduce NHS costs and enhance the way healthcare professionals deliver care. We aim to do this by developing well-designed, intuitive software solutions that put pharmacy at the heart of healthcare so it can play a

more central role in medicine management. Medicines management processes within institutional settings such as care homes are often complex and involve a multi-disciplinary approach. Our Atlas eMAR solution helps improve patient safety and reduce the risk of medication errors. Atlas has been the most successful electronic medicines management solution proven through independent research.

At Care Vision we believe care may never be the same again. Outstanding care truly is at the heart of everything we do, with a clear purpose of less admin, more care. Growing up working in a family-owned care home, Rishi Jawaheer saw first-hand the main needs in the care sector; to cut down on the burden of manual paperwork while maintaining good practice and to encourage people to become more involved in care. Using his experience as a registered manager, with some of the smartest minds in tech, Rishi was driven to create Care Vision, an all-in-one cloud-based care management system, incorporating all your care and admin into one easy-to-use system. Care Vision acts as a bridge which uses technology that organises care work and ensures a safer, better, more intimate experience for every member of the community, from administration, to family, friends and the people we care for. Care Vision provides a variety

of uses such as: • An easy-to-use system for care workers, managers, and relatives; bringing care and admin into one platform, to manage time, attendance, rotas, HR, housekeeping, maintenance etc. • An eMar system, reducing medication errors. • An intuitive daily notes section. • A pictorial food order system that allows the individual to choose from a menu. • Daily reminders in the form of care routines. • Care plans/risk assessments/ life stories. • A family app that allows families to keep track of their loved one’s wellbeing. Care Vision gives you the freedom to access it using mobile, tablet, laptop, or PC in real time whilst safely securing and storing data within the platform. Built flexibly to adapt to services of any size, large or small, Care Vision’s structured, interactive features engage care workers in sharing information with the end user and their family.

CMM February 2021

RESOURCE FINDER: TECHNOLOGY

Carefree Management

CarePlanner Tel: 0117 214 0585 Email: info@care-planner.co.uk Website: care-planner.co.uk

Tel: 01924 667598 Email: info@carefreegroup.com Website: www.carefreegroup.com

SECTORS • Home care. • Supported living. • Residential care. • Reablement care. • Live-in care.

SERVICES • Rostering. • Care management software. • HR. • Time and attendance. • Staff and HR records. • Training compliance. • Invoicing. • Payroll. • Scheduling system. • Care management software. • National minimum wage. • Holiday pay. • Extensive library of reports. • Mileage calculator. • Allocation and skills matching. • Carer/family portals. • OnCall. • Digital care planning.

COMPANY PROFILE ‘One Team, One Solution.’ CareFree is a cloud-based all-inone rostering, care management and finance system helping streamline processes and allowing home care providers to run their business more efficiently, whilst reinforcing Care Quality Commission (CQC) compliance. With over 20 years’ experience, we offer our customers a professional and reliable software solution so they can successfully

CMM February 2021

SECTORS manage their business, which keeps them fully compliant and connected to their staff and customers. We understand the industry challenges and have a variety of products specifically developed to meet the needs of today's domiciliary care provider. Whether it’s a call monitoring system to ensure a call is never missed, an eMar system or the need to manage your business remotely, we can offer a tailored solution for you. Save time and stress with Ci, our Digital Care Planning System. Our cloud-based, customisable form-builder enables you to get crucial data for your client which is instantly sent to office staff. At Carefree, we firmly believe our customers are the most important thing. We take pride in going above and beyond to ensure they get the best service. We fully understand each company will have their own requirement. Each customer is assigned a dedicated Account Manager who will manage each process from start to finish. This includes a tailored consultation, demonstration, customised training delivered by our TAP qualified team and unlimited support from our highly acclaimed team. • Over 2,500 active users. • 1,000,000 visits rostered per week. • 23 staff, over 150 years of industry experience. • 98% customer retention rate.

• Domiciliary care. • Recruitment agencies.

SERVICES • Rostering. • Invoicing and timesheets. • Call administration. • Record keeping. • Reports.

COMPANY PROFILE Care is all about people. That’s why we built a system that puts people first. CarePlanner gives you the tools to create staff rosters, client schedules, invoices and timesheets with ease and efficiency. With robust reporting, personalised recommendations, and up-to-date call monitoring, we can help save you time and

money that you can invest in frontline care. We pride ourselves on reflecting the outstanding ideals of the care industry in our own business practices. This means that alongside offering a topof-the-line software solution we also provide a first-class onboarding and technical support experience for all our clients. Each CarePlanner client is assigned their own account manager, ensuring that CarePlanner has been set up in the best way for your company. Our dedicated support team is on hand to offer specialised support whenever you need it. We know how stressful co-ordinating and delivering care can be, and the passion it requires. That’s why our focus is on taking care of you, so you can focus on taking care of your clients.

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CMM February 2021

RESOURCE FINDER: TECHNOLOGY

Intelligent Care Software

Coolcare Tel: 0113 385 3853 Email: info@coolcare4.co.uk Website: CoolCare4.co.uk

SECTORS • Administration. • Care home management. • Residential care. • Supported living. • Nursing homes.

SERVICES • Rostering. • Time and attendance. • Staff and HR records. • Training compliance. • Resident records. • Occupancy management. • Enquiry CRM system. • Resident invoicing. • Petty cash. • Home ledgers. • Virtual notice board. • Business analysis and reporting. • Staff portal. • Agency cost management.

COMPANY PROFILE CoolCare saves care homes time and money by automating administrative tasks. It helps to prevent unnecessary overspend on items such as care home staffing, as well as boosting revenues through effective occupancy management and accurate invoice processing. Whether a single home or a multisite group, CoolCare enables easy care home management and improves the profitability of your business. Our years of experience in running care homes means we know the complexities of key operational processes, such as

CMM February 2021

invoicing, and understand the pressures of running a 24/7 business. We truly get the needs of care home businesses and our software has been designed based on those decades of operational expertise. As a result, care home and head office staff alike find CoolCare very easy to use. Its exceptional user-friendliness comes from that deep understanding of what a day in the life of a care home is really like. We understand the way care homes work and how staff will want to use the software to your business’ advantage. The software’s careful design therefore ensures our customers’ care home management is as simple and efficient as possible. That also encourages more usage of the system and improved accuracy, which in turn makes business analysis and planning easier. Any information that requires action by your staff will be brought to their attention through their personal dashboard. Your staff’s time can therefore be better focused, giving them time to spend with residents and preventing potential errors. CoolCare can be accessed through any device, from anywhere in the world, as long as you have internet connection. It is quick and easy to get started on CoolCare, and your business will be reaping the financial and operational benefits of more efficient care home management within weeks of getting set-up.

Tel: 01424 400060 Email: info@careis.net Website: www.careis.net

SECTORS • Care homes. • Care homes with nursing. • Domiciliary care. • Supported living.

SERVICES • Care and support. • Quality assurance. • Policy, training, supervision and appraisal. • eMAR. • Rota and roster.

COMPANY PROFILE Intelligent Care Software Limited designs and promotes intelligent, intuitive, and cost-effective solutions for care home and domiciliary care management. We aim to produce applications that are simple and easy to use, work seamlessly together, and provide the information and detail that is required to ensure regulatory compliance and a high quality of service. From enquiry through assessment and care planning to care delivery, CAREis helps to develop the care plan and to provide relevant and up-todate data for quality assurance purposes. Care planning and provision is person-centred and updated in real time. Care workers know exactly

what is required and when to deliver support, with simple and detailed recording of any intervention. By extracting data from throughout CAREis in real time, quality assurance reviews and monitoring are far more efficient. This app provides audit templates for all areas of regulatory requirement, and ensures important inspections, audits, and actions are addressed in the specified timeframe. Analysis and action planning are streamlined and effective in reducing paperwork time and improving quality and compliance. We provide policies and procedures based on the latest regulatory and governmental guidelines to ensure that your practice is up-to-date, relevant, and compliant in an easy to read format, improving knowledge of policies and procedure significantly throughout the organisation. Supervision and appraisals are completed within CAREis with updated matrices and prompts. CAREis also offers integrated eMAR to ensure accurate medication dispensing with built in audits and reports, as well as its integrated Rota and Roster that produces timesheets and reports for payroll and bookkeeping.

RESOURCE FINDER: TECHNOLOGY

Oasis Ai Ltd t/a PredicAire

PainChek UK Tel: 0333 577 3397 Email: info@painchek.com Website: www.painchek.com/intelligent-pain-assessment-tool-uk

Tel: 01502 507349 Email: hello@predicaire.ai Website: www.predicaire.ai

SECTORS • Care homes.

SERVICES • Care planning. • ‘Flo’ the virtual nurse. • Quality assurance. • Family connectivity. • Nutrition. • Activities. • Maintenance. • Accounts. • Staff management. • Rota planning. • Administration.

COMPANY PROFILE PredicAire is reimagining the delivery of care within a care home setting. It is the first end-to-end AI-powered care management solution under one data ecosystem able to predict person-centred outcomes to help prevent unnecessary outcomes with real-time data provision. Delivering better care and better outcomes are at the core of PredicAire’s solution, overcoming the challenges and frustrations experienced by users and providers of care: • Large amounts of timeconsuming administration. • Paper-based systems, which can lead to reporting and recording errors. • Inaccurate or incomplete

SECTORS information shared with medical professionals. • Lack of communication between care providers and residents’ families unless they are visiting.

• Care homes. • Nursing homes.

PredicAire’s founders have experienced both sides of care provision and use their knowledge to inform and test the features of PredicAire, which will ensure better outcomes for everyone. The founders also have significant experience in data science and a thorough understanding of how structured data can provide meaningful insights. Their core advisory team of senior experienced managers, nurses, team leaders and care workers ensure that the whole care family has a personal experience. PredicAire brings together superior digital care management in an intuitive, easy-to-administer, holistic way to support effective regulatory compliance and maximise care delivery. PredicAire is a seamless, single-sign-on, cloud-based system which gives everything care providers need in one place without the need to purchase additional products. It is available on multiple devices including desktop, tablet, and mobile devices, which allows the specific user to have the right tools at their fingertips to feel empowered to provide enhanced care.

COMPANY PROFILE

SERVICES • Digital pain assessment tool.

PainChek’s mission is to provide a voice to those who cannot verbalise their pain, such as people living with dementia and other cognitive impairments. Its smartphone-based medical device uses facial-analysis and Artificial Intelligence (AI) to identify involuntary micro-facial expressions indicative of pain. Combined with other non-facial indicators, PainChek® enables fast, effective, and reliable pain scores, with the whole assessment process taking less than two minutes to complete. Pain and dementia share a complex relationship, and understanding this relationship is key to effective pain management. In the UK, around 70% of care home beds are occupied by residents living with a form of Alzheimer’s or dementia. Of this group, 80% experience pain at any one time, with 50% experiencing persistent pain. PainChek® is fast and easy to use. The smartphone camera

records a short video of the person’s face then analyses the images using facial recognition analytics. It automatically recognises and records facial muscle movements that indicate levels of pain. The caregiver then uses PainChek® to observe and record pain-related behaviours, such as movement and how pain is vocalised by the person. Finally, PainChek® calculates an overall pain score and stores the result. This allows the caregiver to monitor the effect of medication and treatment over time. PainChek® is a world-first pain assessment medical device – with regulatory clearance in Australia, Europe, Canada & New Zealand.

CMM February 2021

The National Care Forum (NCF) COVID-19 resources – for members and non-members. Make sure you are aware of all the latest guidance, thinking and intelligence in response to the fast changing situation with COVID-19 Visit the NCF website: www.nationalcareforum.org.uk

• The latest from PHE, DHSC & NHS England • PPE guidance, Infection Prevention & Control • Hospital Discharge, Critical Care guidance & Commissioning • Information Governance & using Technology & Data • Regulation & Legal – Care Act easments, DoLS & DBS • Workforce - Terms & Conditions & Recruitment • Supported Housing & Homeless • Wellbeing • Volunteering • Practical Activity Resources

EMB ERS TW NE T • HIP • NOT FOR PROFI

NCF members benefit from: • Weekly Zoom Calls and Regular Briefings • NCF is also working closely with CPA & other members of the All-Party Parliamentary Group on Adult Social Care (APPG) to influence parliamentarians • #HereToCare Campaign - NCF is ensuring the amazing work happening in the sector is being recognised at national & local government and in the media

•

NCF innovations: • The Hubble Project: digital innovation hubs offering care providers the chance to learn how other have introduced, used and evaluated a range of digital technology to improve care • IPC Compliance Assessment Tool – developed using the most recent information from CQC and others • Covid-19 Checklist to help people navigate care home choices during the pandemic Get in Touch & ask about receiving our Regular Mailings – we want as many providers to be informed as possible

RT I

H • IN ERS D A E N O VA TION • QUALITY • L

NCF is the leading voice for not-for-profit care providers

www.nationalcareforum.org.uk @NCFCareForum info@nationalcareforum.org.uk 02475 185 524

NCF works directly with not for profit care & support providers across the UK supporting members to improve social care provision & enhance the quality of life, choice, control & well-being of people who use care services. 46

CMM February 2021

RESOURCE FINDER: TECHNOLOGY

Person Centred Software

XperiSoft (CV Minder)

Tel: 01483 357657 Email: hello@personcentredsoftware.com Website: www.personcentredsoftware.com

Tel: 01634 202101 Email: enquiries@cvminder.co.uk Website: www.cvminder.co.uk/care

SECTORS

• Residential care homes. • Nursing homes. • Dementia care homes. • Supported living/care villages. • Mental health. • Learning disability. • Local authority.

SERVICES • Digital care planning and monitoring. • Fully mobile and icon driven. • Clinical hand held device. • Effective handover and staff messaging. • Works online and offline. • Built-in speech to text. • Accidents and Incidents. • Observations and Charts. • Fluid and Nutrition Monitoring. • API integration and reporting. • Electronic medicines management integration. • Body map/wound care. • Electronic activities evidence. • Relatives Gateway. • Group Reporting. • GDPR compliant record-keeping.

COMPANY PROFILE Mobile Care Monitoring is the most widely-used digital care system and most widely referred software provider within social care. Mobile Care Monitoring is the first fully mobile and easy to use digital care management system, used by over 2,000 care homes. Care staff using the icon-driven software evidence, on average, over 50 care notes per resident per day, which just isn’t possible on paper or many other systems. Our person-centred digital care system reduces time spent on paperwork with care interactions evidenced as they happen, achieving the company’s

aim of giving staff more time to spend with residents, supporting regulatory compliance and improving the quality of care for residents. Nikki Thompson, Assistant Director for Practice and Development at the Salvation Army, said: 'Going digital has reduced staff workload and more time is now spent with residents instead of completing paperwork, which boosts morale and happiness across the homes. 'Having all the governance and compliance information in one place and accessible at all times is great. The integration is transforming our care homes and we’re so thankful we’ve gone digital!' Our agile product can be quickly adaptable in times of crisis. New Coronavirus-specific features were added at the offset of the Coronavirus pandemic. The Relatives Gateway keeps relatives informed about the health and wellbeing of their loved one when they can’t be there. Person Centred Software is leading the way in joined up care, being the first to send the Hospital Pack electronically from within the software to urgent care providers, and working directly with GP Connect at NHS Digital to bring GP information to English care homes. Person Centred Software is certified with Cyber Essentials and Mobile Care Monitoring is a secure solution to keep your personal data safe with infrastructure that exceeds GDPR’s requirements. Book a demo today to discover how our digital care system can benefit your care home now and in the future.

• Homecare. • Care homes. • Hospices. • Specialist care.

SERVICES • Applicant Tracking System (ATS).

COMPANY PROFILE Reduce recruitment costs, save time and improve hiring results with CVMinder ATS. It’s a complete recruitment system for care providers, from the smallest to the largest. Make the journey from advertising to placement quick, convenient, and professional. Be surprised by our low-cost subscriptions, too. Let CVMinder ATS upload your jobs to free advertising options like Indeed, Monster, GOV Find a Job, CVLibrary and Google. Spend less advertising and attract candidates sooner. Connect to your subscription job boards, and select just the adverts you want CVMinder to upload. CVMinder ATS makes job posting quick and accurate. Let jobseekers apply for your vacancies on job boards, your website or on social media posts. All applicants are organised for you in CVMinder ATS and you’ll

receive all the personal details you require. You can ask for a CV, statement, criminal convictions, work history with gaps explained, equal opportunities, referees and more. You’ll have control over what you request and when you request it. Shortlist centrally or spread the load to hiring managers. You’ll get fine control of each user’s permissions so you can build and protect a fair, compliant recruitment process. Hide sensitive information from others and deploy name-blind recruitment if you prefer. Your users see only what they should see at each stage. Send updates to applicants using your own personalised templates. All communication is quick, easy, and professional with CVMinder ATS. Schedule interviews with confidence by requesting candidate confirmations. Send offers of employment, request references, and manage employment checks all in one convenient solution. It’s all so easy with an Applicant Tracking System that’s made just for you. Customers agree that CVMinder ATS is the best applicant tracking system for care providers. They enjoy big savings, recruit successfully, and receive great support. Call us to find out more.

CMM February 2021

EVENT REVIEW

LESS COVID WEBINAR 14th January 2021 On 14th January, CMM hosted a free Zoom webinar on behalf of the National Care Forum, calling on all providers to share their experiences of COVID-19. Liz Jones and Julienne Meyer (Policy Director and Research & Development Adviser respectively) of the National Care Forum (NCF), presented an insightful webinar to discuss the findings of the LESS COVID: Learning by Experience and Supporting the Care Home Sector during the COVID-19 Pandemic report. Funded by the Dunhill Medical Trust, the report was created in collaboration with the University of Leeds and Nurturing Innovation in Care Home Excellence (NICHE) Leeds.

illness trajectory of COVID-19 in older people; what worked well, or what more was needed, for care and treatment; and lessons learnt for supporting infected older people to recover or die well. It was then stated that the second phase of work involved consultation with senior operational and quality managers in care homes to determine both the impact and relevance of the first phase's findings, and strategies for managing the risks associated with COVID-19 in care homes for the benefit of all, namely residents, relatives and staff.

A CLEAR PURPOSE

At this point, the narrative shifted towards summarising key findings from the report and Professor Karen Spilsbury posited seven themes used to categorise outcomes: 1. Clinical presentation: COVID-19 does not always present as a cough and fever in older people. 2. Unpredictable illness trajectory. 3. Managing symptoms and providing supportive care: no ‘magic bullet’. 4. Recovery and rehabilitation: promoting physical, cognitive and emotional wellbeing post-virus. 5. End of life care: being prepared and supported. 6. Infection prevention and control: ensuring relevance, preventing complacency and promoting confidence among care home staff and residents. 7. Promoting partnership through cross sector working and support. The report’s conclusion was dominated by an

The webinar began with an informative pre-recorded presentation, introducing the research as well as its motivations, methods and ultimately, its outcomes. Liz Jones had co-narrated the presentation with Professor Karen Spilsbury of the University of Leeds, who explained that the NCF’s fundamental aim was threefold. Firstly, to lead research into the experiences of frontline care home and NHS staff during COVID-19. Secondly, to share lessons learnt from working in the pandemic and explore strategies to overcome presenting issues. Finally, to co-create useful resources to ensure continued learning and improvement in the sector. The report’s method identified two phases of work, which Professor Karen Spilsbury continued to explain. Outcomes would first be led by a series of interviews with frontline care home and NHS staff to obtain an extensive understanding of the clinical presentation and

DISSECTING THE REPORT

urgent call to action. Much like the report’s fundamental aim, the call was also threefold, demanding decisive action from key stakeholders in the nation’s COVID-19 response – namely the sector, Government and researchers and funders. The report calls for the sector to impart its knowledge in order to thrive, for Government to fulfil duties that are beyond the control of the sector, particularly in the creation of sufficient policy and guidance, and for researchers and funders to target their work towards those whom it will directly impact – care home residents, their relatives, staff and care provider organisations.

QUESTION TIME As the webinar drew to a close, the presenters opened the floor to questions from those in attendance. Several talking points were raised, generating an extensive conversation about the personal experiences of attendees. Both Liz Jones and Julienne Meyer responded to questions, citing relevant conversations they had been part of since the report’s publication. Finally, a brief poll was launched to those in attendance to obtain some quickfire feedback about the usefulness of the report. The responses were unanimous in favour of a ‘useful’ verdict whilst also validating the necessity of the report itself, due to 100% of respondents agreeing that the report’s findings reflected their personal experiences. For more information about the LESS COVID report and to access the full research findings, visit www.nationalcareforum.org.uk/ less-covid CMM

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Care Management Matters February 2021

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A year of reform, hope and humanity

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