SEPTEMBER 2021
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A NEW VISION
Reforming regulation
Retirement villages
Pandemic learnings
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In this issue 05
Inside CQC Kate Terroni, Chief Inspector of Adult Social, updates on the next steps for implementing CQC’s new strategy including using people’s experiences of care in their regulatory model.
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CMM News
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Into Perspective Our contributors discuss how greater digital inclusion could improve people’s experience of social care.
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Celebrating Excellence The Care Workers’ Charity explains how the organisation has responded decisively to meet the financial needs of the social care workforce throughout the pandemic.
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Event Preview CMM shares what to expect at the Dementia, Care & Nursing Home Expo.
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Straight Talk September marks World Alzheimer’s Month and the Managing Director of Social-Ability, John Ramsay, says it’s a watershed moment to address missed dementia cases during the pandemic.
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FEATURES
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REGULARS
Social Care Insights Simon Bottery of The King's Fund reveals the latest statistics relating to social care vacancies in England.
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A new vision: Reforming regulation There has been a wealth of analysis on the CQC strategy. Neil Grant of Gordons Partnership LLP reviews the main themes of the CQC strategy and considers whether it signals a change in culture within the regulator.
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Pay scale: Recognising the true worth of support workers Social care charity Community Integrated Care is determined to make sure the Government acknowledges the dedication of the care workforce. The charity’s CEO, Mark Adams, explains the detail of the Unfair to Care report.
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Community connections: Supporting people with learning disabilities Steve Cox, CEO at Perthyn, a learning disability charity, and Clive Parry, England Director at the Association for Real Change (ARC), share case study insight from some of the people they support and explain their 'pathway out of lockdown' model.
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The future of retirement villages: What the pandemic has taught us Government guidance has been largely focused on care homes, causing other sectors to interpret their best approach. David Williams of the St Monica Trust makes the case for retirement communities and how they have protected residents from COVID-19.
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Resource finder CMM brings you information on some of the leading organisations to help you with your quality compliance. CMM September 2021
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EDITORIAL editor@caremanagementmatters.co.uk Editor: Olivia Hubbard Content Editors: Aislinn Thompson, Henry Thornton
CONTRIBUTORS
PRODUCTION Lead Designer: Ruth Keating Graphic Designer: Kieran Bitten 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
@blimeysimon
@CQCprof
@LlpGordons
@ComIntCare
Simon Bottery Senior Fellow in Social Care, The King's Fund
Kate Terroni Deputy Chief Inspector for Adult Social Care, Care Quality Commission
Neil Grant Partner at Gordons Partnership LLP
Mark Adams CEO of Community Integrated Care
@Ageing_Better
@DigiSocialCare
@ARCEngDirector
@PerthynUK
Kristina Leonnet Senior Innovation and Change Manager, Centre for Ageing Better
Katie Thorn Digital Engagement Manager at the Registered Nursing Home Association (RNHA) and Project Manager for Digital Social Care
Clive Parry England Director, Association for Real Change
Steve Cox CEO at Perthyn, a learning disability charity
@SMT_DavidW
@CareWorkersFund
@SocialAblty
David Williams CEO of the St Monica Trust
Karolina Gerlich Chief Executive at The Care Workers’ Charity
John Ramsay Managing Director of Social-Ability
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 18.6
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CMM September 2021
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SOCIAL CARE
INSIGHTS From Simon Bottery
Social care vacancies are climbing and yet thousands of staff may have to leave their jobs. The Government’s policy on compulsory vaccination is a real risk, says Simon Bottery. Every month since COVID-19 emerged in March 2020, Skills for Care has been publishing monthly data on vacancies in adult social care. It has to be treated with a degree of caution – it’s not necessarily representative but is still the best available data on sector trends. Overall, it suggests that, in the early stages of the pandemic, social care vacancies were low compared to their historic levels but have been climbing since. As of July 2021, they were just 1% below their level in April 2020. There are differences between sectors. Vacancies in care and nursing homes are still lower than before the pandemic (standing at 5.8% and 5.4% respectively) but vacancies in domiciliary care are
now higher at a whopping 11.6%. This surely reflects the upsurge in demand for home care services as people are put off using care homes. These rates are, of course, worrying – they were already too high before COVID-19 and are now creeping uncomfortably back to those pre-pandemic levels (indeed, some providers already talk about this being the worst time they can remember for vacancies). On top of this, however, the care home sector is now facing the V-bomb: the law requiring staff in homes to be vaccinated or, in most cases, leave their jobs by November 2021. The Government’s own impact analysis suggests that this will mean between 17,000 and 70,000 staff (with a central
estimate of around 40,000) leaving the care home sector, out of around 570,000 who work in it. The impact assessment accepts that a ‘potentially large number of replacement workers may be needed’ but says there are ‘plausible reasons’ to suggest ‘this may be possible’ (if you are thinking that this doesn’t sound like the author has complete confidence in his or her argument, you are surely right). It notes that the furlough scheme is ending, which may lead to a ‘possible [that word again] sudden increase in the size of the adult social care workforce entrant pool’. It argues that some people even choose to come into social care now because their workplace will offer an increased level of protection compared to others. And it thinks that some care workers will fail to get their vaccinations in time but then come back to care once they have. The document touches only briefly on potential local and regional differences in the potential impact on the care sector. That is surprising because a brief glance at the Skills for Care data shows that, while the vacancy rate in England overall stands at 7.5%, in London it
is 10.6%. That ought to start ringing a few alarm bells because take up of the vaccine among care home staff is also lower in London: as of 27th July, 78% of older people’s care home staff had had both doses, but only 74.1% in London (there is a similar difference among staff in younger people’s care homes). So, there is a risk that the area with the highest vacancy rate may also lose the most staff, yet there is no mention of that in the risk assessment. Perhaps the document’s optimism will be borne out by reality. Perhaps there will be less impact on staffing numbers than expected and there will be a compensating rush of new staff from outside social care to fill the gaps. Perhaps care home staff will move to home care (although the Government will consult on whether to extend the policy there as well). Perhaps. If not, the Government – which did not even provide the document in time for the Commons vote on the policy – will have a lot of explaining to do to the sector, its staff and, most importantly, the hundreds of thousands of people who rely on social care services.
Simon Bottery is a Senior Fellow in Social Care at The King's Fund. Email: S.Bottery@kingsfund.org.uk Twitter: @blimeysimon
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CMM September 2021
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Inside CQC K Hearing directly from people who draw on care is absolutely essential for us as the regulator, helping us to have a good understanding of quality and what it feels like to receive care. We already work hard to ensure the voices of people who draw on care are being heard. We currently do this through our inspections, Give Feedback on Care and our wonderful Experts by Experience programme. This is a good grounding but we want to do a lot more. I recently shared a blog and podcast on Social Care Future’s ‘I Pledge’. I pledged that, if I’m invited to speak at events, where possible I will request to share our platform with people who draw on care to enable the audience to hear directly from them. This has an impact on the audience in a way that I never could. Recently, I was delighted to be joined by Sam at an engagement session on hearing the voice of people who draw on care in how we regulate. His presentation on ‘Living the life I want to live’ took us on his personal journey, from receiving care in
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Kate Terroni, Chief Inspector of Adult Social at the Care Quality Commission (CQC), updates on the next steps for implementing CQC’s new strategy including using people’s experiences of care in their regulatory model.
visitors. Sam ended by reflecting on the ‘Making it Real’ statements and the one which meant the most to him: I have a place I can call home, not just a ‘bed’ or somewhere that provides me with care. Sam reminded us all why hearing people’s experiences of care matters so much, both
“Sam shared unacceptable experiences of services where his personal information was left in communal spaces, his environment was unsafe and restrictions were put on his visitors.” supported living services to having choice and control and living independently. He shared unacceptable experiences of services where his personal information was left in communal spaces, his environment was unsafe and restrictions were put on his
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for CQC and for individual providers. It’s the reason why I, and I’m sure many of you, get out of bed in the morning. We’ve now launched our strategy, which aims to put people and communities at the heart of everything we do and outlines how
we plan to change and transform to deliver more effective regulation. We’ve started to share early thinking about how we better use people’s experiences of care in our regulatory model. We want to make sure we bring people’s voices into every aspect of our work. You can watch a video on our YouTube channel to see a presentation on our early thinking. This includes our thoughts on: • Providing an inclusive service that listens to the public and meets their needs. • Our draft overarching principles. • A proactive, inclusive experience data strategy. This is also explored in our recent CQC Connect podcast. Our ideas are in no way fully formed – now is the time to really shape and influence our thinking on this and other strategy themes. You can feed back your thoughts on using people’s experiences of care in our latest project on our digital engagement platform. It’s been fantastic to hear your views so far. Thank you for taking the time to get involved at such a busy time.
Kate Terroni is Chief Inspector of Adult Social Care at the Care Quality Commission. Share your thoughts and views on Kate’s column on the CMM website. Visit www.caremanagementmatters.co.uk CMM September 2021
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DHSC publishes mandatory vaccination guidance The Department of Health and Social Care (DHSC) has confirmed that anyone working or volunteering in a care home will need to be fully vaccinated against COVID-19, unless exempt. The last date for care home workers to get their first dose so they are fully vaccinated by the time regulations come into force is 16th September – regulations will come into force on 11th November 2021. More than 1.26 million social care workers in England are now fully vaccinated. The DHSC has produced a toolkit of resources that is tailored for the adult social care sector. This is available online at Public Health England’s campaign resource centre. Support is also available through the Community
Champions programme which has allocated £23.7m of funding to 60 councils and voluntary groups across England. Matthew Wort of Anthony Collins solicitors said, ‘Regulations could be challenged on human rights grounds. However, it will now be left for employees affected by the regulations and their representative bodies to consider whether to challenge the new rules and, as of yet, we haven't seen any suggestions that a judicial review will be initiated. As a result, all care homes now need to urgently implement appropriate systems to comply with the new regulations.’ In relation to the impact on the workforce, Vic Rayner OBE, CEO of The National Care Forum, said, 'By their own assumption the Government have determined
that it is likely that 7% of the workforce will not be deployable as a result of this policy. The assessment claims that this is likely to mean that 40,000 staff are unlikely to be able to work in care homes within the next 16 weeks. In addition, the statement identifies an associated cost of £100m to recruit and train replacement staff. However, this assumption does not bear any reference to the costs of implementation of the policy itself.' Karolina Gerlich, CEO of The Care Workers' Charity, said, 'We cannot continue to put additional requirements on social care workers unless they are recognised as a professional workforce and paid wages that represent this professionalism.’
Charity and campaigners write to PM about COVID-19 inquiry John’s Campaign and the Relatives and Residents’ Association (R&RA) will apply for Core Participant Status at the public inquiry into the UK Government’s handling of the COVID-19 pandemic. The campaign group and charity for families with loved ones in care homes have appointed law firm Leigh Day to make their case for representation at the inquiry, when it takes place. Leigh Day partners Emma Jones and Tessa Gregory, both solicitors in the human rights department, have written to the Prime Minister, Cabinet Office
and Department of Health and Social Care (DHSC) to put them on notice that the organisations will be applying for Core Participant Status as soon as the process allows. Through a series of legal challenges, John’s Campaign, led by Julia Jones and Nicci Gerrard, and represented by Tessa Gregory and Carolin Ott, have forced the DHSC to change guidance to care homes in line with human rights laws. Both organisations have outstanding concerns about the continued requirement for people living in
care homes to isolate for 14 days on return from a hospital stay despite the wholesale lifting of restrictions in the rest of society since 19th July 2021. Helen Wildbore, Director of R&RA, said, ‘Older people have been failed by the very systems designed to protect their rights. They continue to be failed and left behind in the most appalling way whilst the rest of the country gets back to normal.’ John’s Campaign runs a UKwide campaign supporting people separated from relatives and friends in health and care settings.
Neurological care specialists PJ Care have appointed Lisa Andrew as their new Clinical Operations Manager. Lisa has more than 40 years’ experience in the healthcare sector both as a nurse and in the management of mental health and neuro-disability services.
LOVELL LATER LIVING
Lovell Later Living (LLL) has strengthened its senior leadership team with the appointment of Teresa Snaith as Customer Experience Director. Formerly Head of Development at Home Group, Teresa has over 30 years’ experience in the specialist housing industry and is a wellrenowned and recognised figure.
TUNSTALL HEALTHCARE
Gary Steen has left TalkTalk after 10 years as Group Managing Director for Technology and been appointed by global market-leading health and care technology company Tunstall Healthcare as Chief Technical Officer to lead the way in the next generation of health tech solutions.
VALORUM CARE GROUP
Two senior appointments have been announced by Valorum Care Group with a new Chief Finance Officer and the creation of a Chief Operating Officer post. Marc Harding joins the group as CFO from the CareTech Group.
TURNING POINT
Turning Point has announced the appointment of two new non-executive board members to their board of trustees, Dr Victoria Tzortziou Brown OBE and Christian van Stolk. Both have decades of experience working in the health and social care sector and are welcome additions.
CMM September 2021
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NEWS
Nominations open for Markel 3rd Sector Care Awards CMM is delighted to announce that the nominations for the highly regarded Markel 3rd Sector Care Awards are now open. The Markel 3rd Sector Care Awards focus on creative arts, community engagement, innovation, quality improvements, integration, technology and governance. These categories and the entry criteria have always been based on specific strategies – from Government and the sector – and have
evolved over time to maintain relevance in an ever-changing landscape. You are eligible to enter the 3rd Sector Care Awards if: • You/the nominee are making a positive difference to people’s lives, whether they’re at the very beginning or very end of their lives – or anywhere in between. AND • You are working for/ nominating an organisation, team or group that is not making a profit, or that is
reinvesting its profits into the support it offers. Nominations for the 3rd Sector Care Awards will close on Friday 8th October 2021. Employees working at all levels are welcome to enter, from large organisations to those with just one or two members of staff. You might be part of a community group or be helping people to get out of their homes. Maybe you are supporting people who have experienced
domestic abuse, or you might be running a memory café for people with dementia. Lisa Werthmann, Director of Creative Operations at CMM, said, ‘Every year, we continue to be inspired by the remarkable and selfless work of this sector. The past year has brought with it an abundance of new challenges for those working in the 3rd sector. We believe that now, more than ever, hard work, dedication and creativity deserves to be rewarded.’
Free recruitment masterclass for providers Recruitment specialist Neil Eastwood has waived the enrolment fee permanently on a 120-lesson online video recruitment training course to support the social care sector. The Recruitment Masterclass covers areas such as care
recruitment fundamentals, the secrets of sourcing candidates in the local community, how to screen, select and interview applicants with the right values, the best ways of attracting the right applicants, optimising recruitment systems, and tips,
tricks and simple changes that reduce no-shows and how to make recruitment fun again. The course consists of video tutorials, international expert insight videos, downloadable resources, video interviews with top UK care organisations’
recruiters, quizzes and a certificate on successful completion of the course. Enrolment is now free to all care providers and their employees. Visit www.findandkeepthebest.com for more information.
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CMM September 2021
NEWS
Call for school leavers to consider career in care The National Care Group, one of the UK’s leading providers of care and support for vulnerable adults, has asked young people to consider a career in social care. The timely call was made on A Level results week. The organisation said they look for candidates who ‘understand life’s challenges’ and ‘share our passion for making a positive difference’ to individuals with mental health needs, learning
disabilities and acquired brain injuries, allowing them to be as independent as possible. Claire Leake, People Director at National Care Group, said, ‘A career in care is full of rewarding moments, and the past 18 months have been a testament to the vital role carers play in our society. If you have found joy in helping a family member or a neighbour during the pandemic, you may be the perfect candidate
for a career in care.’ Tara Currie, Registered Care Manager at 8 Acres care home in Attleborough, part of National Care Group, said, ‘Aged 18, I left college with a job application in each hand – one for the police force, the other for the care sector – and becoming a carer was definitely the right decision. I’ve never had a single regret. It was in this industry that I truly found my calling and, after 23 years’
experience, I have progressed from a support worker to management. ‘Over the years, I’ve been fortunate enough to support, and work alongside, so many incredible individuals – helping them fulfil their aspirations and unlock their potential is the most fulfilling thing about my job. I can’t wait to see what the future holds both for my own career and for those starting out in the sector.’
Professional Care Workers’ Week returns The Care Workers’ Charity has announced it will be hosting Professional Care Workers’ Week (PCWW) between 6th-10th September 2021. This year’s event marks the fourth time the event has been run and the second time it has been organised and led by The Care Workers’ Charity. Last year’s event was held virtually, and the
decision was made to do the same this year due to uncertainty around COVID-19 infections, and to ensure the event is inclusive and accessible to a wider audience. This year, Professional Care Workers’ Week will shine a light on the work happening in the social care sector; exploring some of the issues faced by the workforce, as well as challenges faced by the
sector as a whole. The aim this year is to highlight and increase wider understanding of what it means to work in social care – the charity looks forward to hearing directly from care workers and care managers, as it is important to the charity to have their voices central to its discussions. Collaboration is at the heart of PCWW, which provides a
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platform for people to share best practice, experiences and to have discussions about topics such as the future of social care, how to retain and build the workforce and the rise of technology. The Care Workers’ Charity said such collaboration is key to uniting the sector and is always a key aim of the event, which has a variety of panel discussions and workshops.
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CMM September 2021
NEWS
Skills for Care launches new strategy Skills for Care has launched a new three-year strategy, to help the adult social care workforce support people who draw on services to live the lives they choose. The strategy focuses on four areas for investment and growth over the next three years to help develop the values and competencies of the 1.5 million strong workforce, support reform of the sector and ensure that social care is seen by the public as
a valued and worthwhile career. The four strategic areas: • Increasing workforce capacity to make sure we have the right number of people, with the right values and behaviours, working in social care now and in the future. • Supporting workforce capabilities to ensure staff have the right skills, knowledge, competencies, values and behaviours to meet current and future needs in
our communities. • Supporting culture and diversity to ensure the workforce is treated equally, feels included and valued, and is supported to stay well and pursue their careers in social care. • Improving the social care system to ensure it is well funded, supports people to live the lives that they choose and attracts the right people to the workforce.
Skills for Care stresses that each strategic priority is of equal importance and achieving success in each area means it can help build a social care system that will meet future demand. Skills for Care CEO Oonagh Smyth said, ‘This new strategy was created in recognition that the way social care is delivered in England is changing, so it won’t be a static strategy but will evolve based on feedback and changes in social care.’
New National Disability Strategy launches The strategy sets out 100 immediate commitments supported by £1.6bn of funding alongside an ambitious agenda for future reform. The strategy builds on the Disability Discrimination Act, which enshrined protections for disabled people when it comes to employment, transport, education and provision of goods and services. All commitments are backed by the personal drive of the UK Government department’s Ministerial Disability Champion and progress will be reported on every 12 months. Findings from the UK Disability Survey, which had
over 14,000 respondents, showed many disabled people feel held back in their everyday lives by the negative attitudes of others, ranging from awkwardness and misguided empathy to outright hostility. DHSC has outlined the following commitments: • Put disabled people front and centre in social care reform. • Strengthen the data and evidence base to support policies that will transform outcomes for disabled people. • Tackle the stigma and discrimination that disabled people face every day to improve quality of life and reduce inequalities.
• Ensure that health and social care staff understand learning disability and autism to reduce health inequalities. Minister for Disabled People Justin Tomlinson said, ‘For the first time, we have real cross-Government focus, with clearly set out priorities and aims. We are absolutely committed to putting disabled people at the heart of Government policy making and service delivery. Their voices, insights and experiences are central to this strategy and our future approach. By engaging disabled people, their families, carers
and organisations, collectively we will deliver real and lasting change.’ Mark Ospedale, Director of People and Communications at United Response, said, ‘Placing people with lived experience at the heart of the strategy was a positive inclusive approach.’ Yet, despite the Strategy proving a welcome 'step', the charity awaits the practical steps. Mark Ospedale added, ‘Unfortunately, the strategy gives far too little detail on how specific Government departments aim to bring these plans to life and deliver positive outcomes for disabled people – both in the short and long term.’
CQC publishes care home deaths data The Care Quality Commission (CQC) published new data, outlining death notifications involving COVID-19 received from individual care homes between 10th April 2020 and 31st March 2021. More than 39,000 care home deaths were recorded over the period. The highest number of care home deaths over the period were registered in the southeast region of England (7,404), followed by the north-west
(5,748) and the east of England (4,943). The fewest deaths were recorded in London (2,635). The maximum number of care home deaths recorded at one individual care home was 44. Vic Rayner OBE, CEO of NCF, said the publication of this data is ‘a reminder of the terrible toll that has been felt by those who live in care homes’ and that the information published should be ‘handled with sensitivity and the greatest respect.’
With regards to what the information indicates, Vic Rayner OBE said, ‘Throughout the pandemic we have supported our members to be open and transparent. 'It is important that CQC recognises that the information published is not an indication of the quality or safety in individual care homes and that many of the notifications relate to deaths of care home residents which occurred in other settings.’
Kate Terroni, CQC’s Chief Inspector for Adult Social Care, said, ‘In considering this data it is important to remember that every number represents a life lost – and families, friends and those who cared for them who are having to face the sadness and consequences of their death.’ For more data insights, visit the CQC website and view the data dashboard on care home deaths. CMM September 2021
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CMM September 2021
NEWS / IN FOCUS
Call to extend consultation for Health and Disability Green Paper The Disability Benefits Consortium (DBC) and Disabled People Against Cuts (DPAC) have written an open letter to the Minister for Disabled People, Justin Tomlinson MP, expressing their concerns about the consultation period for the recently published Health and Disability Green Paper. The Green Paper was published on 20th July 2021, following a two-year wait, but the Government is only providing the standard 12-week consultation timeframe for feedback, leaving many disabled people without time to respond fully or even at all. Therefore, the organisations are calling on the Government to extend the consultation period of the Green Paper by six weeks, to ensure that this crucial feedback to its proposals can be properly heard. In a recent survey by Z2K, over
1,420 people with experience of the benefits assessment process were asked about their views on what was then the upcoming Health and Disability Green Paper. The research showed that: 88% of people are either ‘not at all confident’ (67%) or ‘not so confident’ (21%) that the Government will use the feedback they receive during this Green Paper consultation to make changes to the assessment process for benefits. 74% of people think Government won’t listen to the changes people who have been through the assessment process themselves want to see made to the assessment process for benefits. The letter is signed by Caroline Collier, CEO of Inclusion Barnet, and Ellen Clifford, on behalf of Disabled People Against Cuts.
Changing places toilets fund Councils are being urged to apply for a share of a £30m fund to install life-enhancing Changing Places Toilets (CPTs) in public places and tourist attractions. There are currently around 1,200 registered Changing Places Toilets in England – these are larger accessible toilets for people who cannot use standard accessible toilets, with equipment such as hoists, curtains, adult-sized changing benches, and space for carers. Over 250,000 people in the country need these facilities to enable them to get out and about and enjoy the day-to-day activities many of us take for granted. Research conducted by Research Institute for Disabled Consumers demonstrates that the top three places where people currently use and value CPTs are shops, hospitals and tourist attractions. Users, their families and carers would like to see future provision
in areas enabling them to ‘have a day out’ and undertake more recreational activities with dignity, confidence and freedom. The top four locations where these facilities should be made available were country parks, open spaces, tourist attractions and transport networks – the journey to the destination being a key factor in planning a day out. Lorna Fillingham from Ashby, a Changing Places campaigner, said, ‘Without these types of special facilities disabled children are having to be changed on public toilet floors or in the back of cars. In the 21st century, nobody should be isolated in their homes because of a lack of an accessible toilet in their community, and nobody should have to be laid on a public toilet floor.’ Expressions of interest must be submitted by 26th September 2021 – to apply for funding visit the The Ministry for Housing, Communities and Local Government website.
IN FOCUS Government autism strategy WHAT’S THE STORY? The Government has launched a new multi-million-pound strategy to help improve the lives of autistic people. Backed by nearly £75m in the first year, it aims to speed up diagnosis and improve support and care for autistic people. The funding includes £40m through the NHS Long Term Plan to improve capacity in crisis services and support children with complex needs in inpatient care. This strategy will align with wider Government work through the National Disability Strategy and the Special Educational Needs and Disability (SEND) review. The Government has said that it will ensure issues relevant to autistic people are considered as part of these programmes of work. The life expectancy gap for autistic people is approximately 16 years, on average, compared to the general population and almost 80% of autistic adults experience mental health problems during their lifetime. The COVID-19 pandemic has exacerbated challenges.
WHAT ARE THE AIMS? • Improve understanding and acceptance of autism within society: Developing and testing an initiative to improve the public’s understanding of autistic people – both the strengths and positives as well as the challenges, working with autistic people, their families and the voluntary sector. • Strengthen access to education and support positive transitions into adulthood: Testing and expanding a school-based identification programme based on a pilot in Bradford from 10 to over 100 schools over the next
three years. • Support more autistic people into employment: Improving the accessibility of job centres for autistic people, to get them the right help to find jobs or employment programmes. • Tackle health and care inequalities: Providing £13m of funding to reduce diagnosis waiting times and increase availability of post-diagnostic support for children and adults, and address backlogs of people waiting made worse by the COVID-19 pandemic. • Build the right support in the community and supporting people in inpatient care: Providing £40m as part of the NHS Long Term Plan to improve community support and prevent avoidable admissions of autistic people and those with a learning disability, and £18.5m to prevent crises and improve the quality of inpatient mental health settings. • Improve support within the criminal and youth justice systems: Reviewing findings from the Call for Evidence on neurodiversity and developing a toolkit to educate front-line staff about this, and the additional support people might need.
WHAT DO EXPERTS SAY? Caroline Stevens, Chief Executive of the National Autistic Society, said, ‘We’re really pleased to see concrete actions to tackle this in the first year of the new strategy, alongside other important commitments. The following four years will be just as vital. It's crucial that the Government invest in autistic people, and finally create a society that really works for autistic children, adults and their families.’ CMM September 2021
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Social Care leaders share workforce vision Adult social care leaders have come together for the first time to offer a collective vision of what should be in a workforce strategy for the growing sector. The leaders of Association of Directors of Adult Social Services (ADASS), Care Provider Alliance (CPA), Care and Support Alliance (CSA), Local Government Association (LGA), Skills for Care, Social Care Institute for Excellence (SCIE) and Think Local Act Personal (TLAP) represent people who draw down on care and support services, employers, workers,
inspectors and commissioners. They argue a strategy for the 1.5 million strong workforce must be driven by a shared vision. As Social Care Future put it, ‘We all want to live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us.’ To build and develop a workforce which makes this vision a reality, the leaders say there are clear priorities, which must be included in a national workforce strategy/people plan: • Staff recognition, value
and reward. • Investment in training, qualification and support. • Career pathways and development. • Building and enhancing social justice, equality, diversity and inclusion in the workforce. • Effective workforce planning across the whole social care workforce. • Expansion of the workforce in roles which are designed in co-production with people who draw on care and support, and in roles which enable prevention,
and support the growth of innovative models of support. Kathy Roberts, Chair, Care Provider Alliance, said, ‘The Care Provider Alliance is continuing to work with policymakers in central and local Government and the wider sector to tackle the structural and financial problems that our sector faces in terms of workforce planning. We believe that this sector-led plan, published today, articulates what we need now to ensure a consistent and fair approach to workforce planning across all care and support services.’
‘Misguided’ to focus on taxation, says Audley Group Nick Sanderson, CEO of Audley Group, believes that it is seriously misguided to focus only on taxation to solve the social care crisis. Nick Sanderson, CEO of Audley Group, said, ‘Hearing Sunak and Javid return to the age old solution of taxation to fix the social care
crisis gives me a familiar sinking feeling. Taxation might be one part of the solution, but it’s myopic to focus only on money when there are solutions that don’t stretch the public purse. And how often can we say that? The Government should be jumping
on anything that saves Treasury funds for other priorities. On 1st July, we saw the first Westminster debate on housing with care, and an acknowledgement of the need to grow the sector. Let’s focus on improving planning policy so that providers can build more units of
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CMM September 2021
these specialist properties with care facilities attached, which is proven to take pressure off the social care and health care system. The sector can then free up budget to plug those much-needed gaps in funding.’ Do you agree with Nick's comments?
NEWS
Achieve together acquires RNID’s support and care services Achieve together, a leading provider of specialist support for people with learning disabilities, autism and associated complex needs, is pleased to have completed the transfer of the residential and community services run by RNID, the national hearing loss charity. Achieve together, which has over 25 years’ experience in providing specialist support to over 2,000 people across England and Wales, will now operate RNID’s
care and support services in these countries, and welcome onboard many amazing team members who will continue their inspiring work delivering specialist support for people who are deaf or have hearing loss. Alongside building on Achieve together’s existing expertise in delivering specialist support for people who are deaf or have hearing loss, in line with RNID’s core aims the acquisition will also
enable further investment in team members, technology and the services to support them to grow, develop and to uphold the very best standards of care and support. Achieve together has already been undertaking a listening and co-production exercise, with involvement from team members across RNID’s services and Achieve together, the people supported and their families to ensure the services can transfer as smoothly as possible.
Emma Pearson, Chief Executive Officer of Achieve together, said, ‘We are incredibly excited and proud to be welcoming RNID’s care and support services, and dedicated teams, to Achieve together. We will be focused on collaboration and importantly, co-production, as we all work together to deliver the best specialist support through the amazing teams, our networks and our partnerships, including with families.’
Get Yourself Active launches activity packs Get Yourself Active, a programme led by Disability Rights UK and funded by Sport England, has launched a new online pack designed for carers, support workers and personal assistants who support disabled people and people with long term health conditions. Designed in conjunction with experts in the social care and physical activity sectors including
Durham University, Sport England, Sense, Sport for Confidence, Activity Alliance, Community integrated care and Mind, the pack aims to facilitate further disabled participation in physical activity by educating and empowering those who care to help disabled people get active in a way that suits them. The interactive pack offers practical help, tips and advice that
can be used to support disabled people to participate more in sport and physical activity. It is free and available online for all and is designed to be shared and consumed with the sole purpose of breaking barriers to disabled participation in physical activity. The pack shows that there are many ways to be active which can be easily included in anyone’s
daily routine. It also includes interactive worksheets that social care staff and the people they support can use to encourage conversations around the importance of physical activity and how they can make the next steps to live a more active life. You can join the conversation on social media by using the hashtags @GetYrselfActive @DisRightsUK.
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AI could help ‘diagnose dementia in a day’ Researchers at Cambridge University and Addenbrooke’s Hospital in Cambridge have developed an approach using artificial intelligence (AI) that can diagnose dementia from a single brain scan, as well as providing doctors with information about that person’s prognosis. An algorithm that is trained on a huge database of scans and clinical information from other patients has been built by researchers. That means when someone comes to the clinic with
symptoms of dementia, they can have one brain scan and the system can compare it to this large database and give the doctor more confidence in making a diagnosis. It will also give doctors a traffic light score of how quickly that person is likely to progress. If this real-world study is successful, it could be used routinely within the next five years. Prof Zoe Kourtzi, a researcher at Cambridge University and a fellow of national centre for AI and data science, The Alan Turing
Institute, developed the algorithm. Prof Kourtzi is also Scientific Director of Early Detection of Neurodegenerative Diseases Initiative (EDoN), a global research project Alzheimer’s Research UK is spearheading, which combines digital data from wearables to predict who may go on to develop dementia years before symptoms show. Dr Tim Ritmann, who ran the study, said, ‘The social care sector is under monumental pressure, and if we can alleviate some of this
using revolutionary technological advancements, it will help people live the best quality of life for longer. As Social Care Future put it, 'We all want to live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us'. If the machine learning algorithm works as we expect it to, it could save the NHS and care services half a billion pounds over the first five years.’
Care UK shortlisted in Catering Awards Care UK has been shortlisted for two awards at this year’s Public Sector Catering Awards, which recognise and celebrate the very special teams and chefs working in various catering establishments around the country. The Food and Hotel Services team at Care UK is a finalist in
the Care Catering category. The award recognises those that have transformed all aspects of catering for residents and recognises Care UK in particular for its ‘Dining with Dignity’ initiative. Further recognition comes in the form of Care UK’s second
shortlisting for Regional Roving Chef Andrew Mussett, who is a finalist for the Catering Manager Award. Andrew has helped in a variety of areas. From co-authoring a selection of Care UK recipe books for colleagues and relatives to use, to helping teams make continued
improvements to ensure the food for residents is the best that it can be. Care UK is the first care provider to work with Lifetime Training to create a national Chef Academy – a designated training package for its chefs of all levels to achieve NVQ 2 and 3.
the support they need now and in the future. Jeff Huber, CEO of Home Instead, said, ‘For years, our commitment has been to create the world we want to grow older in. This transaction adds fuel to that commitment. Combining the strengths of these companies moves our passion from aspirational vision
to inevitable impact.’ The Home Instead network will operate under the Home Instead name as a subsidiary of Honor. The Honor Care Network will continue under the Honor name. Seth Sternberg will continue in his role as CEO of Honor. Jeff Huber will report to Sternberg and continue to lead Home Instead as CEO, maintaining the brand that people know.
Honor acquires Home Instead Honor Technology, Inc. has acquired Home Instead, Inc., effective 6th August 2021. The acquisition brings together the world’s biggest home care brand – and UK’s largest home care network – with the leading home care technology and operations platform to transform the caregiver and client experience and revolutionise care for older adults.
To drive innovation, Honor will substantially increase its investment in research and development through engineering and technology. Honor and Home Instead also plan to extend their advocacy and social purpose initiatives. The combination will empower professional caregivers and enable millions more older adults across the globe to receive
Chelmsford hospice launches major new programme Farleigh Hospice in Chelmsford has launched a major new programme, funded by Essex Freemasons, to support residents at care homes across mid-Essex with critical end of life and palliative care. The programme will cost £33,000 to deliver, money donated by Essex Freemasons via the Masonic Charitable Foundation (MCF), and is urgently needed to support the care home sector which has been badly affected by 18
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the COVID-19 pandemic. In practical terms care homes can now work more closely with the hospice, helping to identify residents approaching the end of life who can choose to remain where they are or be transferred to the hospice for specialist support. The £33,000 grant is part of a £100,000 package of donations from Essex Freemasons and the MCF for hospices across
the county. Similar grants of £30,000 plus have been given to St Helena at Colchester and St Luke’s in Basildon. In addition to MCF grants of more than £450,000 donated to hospices nationally, Essex Masons traditionally supports local hospices across the county with combined donations exceeding more than £50,000 each year. Debbie de Boltz, Fundraising Manager for Farleigh Hospice, said,
‘We knew there was an urgent need to extend the hospice service into care homes but until now we never had the resources to make this happen. ‘This grant from Essex Freemasons has made all the difference and will allow us to strengthen our team, enabling us to launch this new programme, which in turn will provide the critical support needed for residents and staff at care homes.’
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A new vision:
Reforming regulation The Care Quality Commission (CQC) launched its new five-year strategy in May and described it as ‘purposefully ambitious’. In this article, Neil Grant of Gordons Partnership LLP reviews its main themes and considers whether it signals a change in culture within the regulator. CQC is in the ascendancy. The Government is reinstating powers for CQC to ‘performance assess’ local authorities – in terms of how they discharge their social services functions under the Care Act 2014. The Government also wants CQC to assess quality and leadership, in respect of the Integrated Care Boards and Partnerships being introduced on a statutory footing in England through the Health and Social Care Bill. The Integrated Care Boards will be the successor bodies to Clinical Commissioning Groups. These new responsibilities for CQC fit into its vision of being a regulator, not only of individual services but of populations and local systems. They align with CQC’s five-year strategy and its two core ambitions: (1) assessing local systems and (2) reducing inequalities in health and social care. How these new statutory responsibilities will be funded remains to be seen. The equitable approach would be to impose fees on local authorities and Integrated Care Boards, rather than pass them on to registered providers. Additionally, CQC is committed to a radical shift in the way it regulates individual services, moving away from a schedule of comprehensive inspections towards a more ‘real-time’ form of regulation which is supposed to be more targeted and flexible. In essence, it is a hybrid model of inspection combining remote data-driven working, backed up by site visits, if needed. CQC also wants to move away from dense inspection reports and move towards
publishing key information about services which will be more accessible to the public. The question is: Will this promote a new way of working within CQC? A way of working which is based on collaboration with providers and where both sides are prepared to listen to and learn from each other?
THE KEY THEMES People and communities ‘Regulation that’s driven by people’s needs and experiences, focusing on what’s important to people and communities when they access, use and move between services.’ A criticism of regulation, since the first national inspectorate was created in 2002, has been a reluctance on the part of regulators to engage with people and families in relation to complaints about care services. Repeatedly, regulators have said over the years that they do not investigate complaints on behalf of service users and families in respect of regulated services. In one sense that is correct. CQC and its predecessors have never been given the role of complaint handlers. However, the adopted and longstanding position of health and social care regulators regarding complaints has caused confusion in the mind of the public and led to regulators failing in many instances to investigate concerns raised by service users and families. Instead, regulators
have often just referred complainants back to providers or to safeguarding. In doing so, regulators have failed to look at the concerns from the perspective of compliance with statutory requirements. It appears CQC is seeking to address this issue by placing a renewed emphasis on listening to service users and families and, importantly, acting on concerns which, following investigation, are judged to be valid. Significantly, CQC describes itself as an advocate for change on behalf of service users. Central to this role will be gathering more feedback from people using services, families and advocates. CQC says, ‘When people take the time to share their experiences with us, we’ll provide a response in the way people need it and explain how their feedback has informed our view of quality.’ If CQC does deliver on this commitment, it will mark a major change to how it works. Smarter regulation ‘Smarter, more dynamic and flexible regulation that provides up-to-date and high-quality information and ratings, easier ways of working with us and a more proportionate response.’ The move to a more real-time form of regulation has never been achieved before and is another radical statement of intent. CQC’s senior management has confidence in big data and says ‘We’ll use innovative analysis, artificial intelligence and data science techniques proactively to support robust and proportionate
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A NEW VISION: REFORMING REGULATION
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decision-making, based on the best information available.’ CQC is not planning to go back to pre-pandemic ways of working. Its intention is to continue with remote working, involving the ongoing analysis of data about care services. CQC says there will be more contact with registered providers, through telephone calls and virtual meetings. This is a continuation of the Emergency Support Framework and Transitional Monitoring Approach. On 13th July 2021, CQC introduced monthly reviews of care services. If the information in CQC’s possession about a service does not point to a need to reassess a rating or the quality of care, CQC will publish a short statement on the provider profile page of its website informing the public that ‘a review has taken place and that we had no concerns based on the information we held at that time. We will also communicate this with the provider by email prior to the public statement being published.’ If a reassessment is needed, CQC may ask for additional information. Where it believes ‘people may be at increased risk of poor-quality care, we may undertake an immediate on-site inspection and this may happen at any time. In these cases, we may update the rating for a service.’ For the time being it appears that changes to ratings will continue to be linked predominantly to on-site inspections, pending CQC deciding on the precise circumstances when it may be possible to change ratings without visiting a service. The strategy is light on detail about how this new system of smarter regulation will operate. It is apparent that CQC wants to tread cautiously rather than introduce a ‘big bang’ set of reforms. More evolution, than revolution. There is a concern that, with the move away from periodic comprehensive inspections, the bigger picture will be lost and replaced with a focus on risk. This is sometimes called the deficit model of regulation. It will be important for providers to supply CQC with information about innovation and creativity. However, this may well lead to increased demands on services in relation to capturing and supplying data. Research by NHS Digital suggests
71% of the sector has no digital access to people’s medications information. Approximately 30% of social care providers are partially digitised, with a further 30% still using entirely paper-based systems, which means approximately 15,000 CQC-registered care providers have limited or no access to basic digital infrastructure. Safety through learning ‘Regulating for stronger safety cultures across health and care, prioritising learning and improvement and collaborating to value everyone’s perspectives.’ This theme focuses on the importance of organisational culture in improving safety. It highlights the need for there to be open and honest cultures focused on learning and improvement in relation to safety. CQC highlights that it ‘wants staff to feel confident that we’ll also listen and act when they raise concerns with us, and we’ll intervene quickly where appropriate.’ It will be important for CQC to test what staff say, rather than just accept what is said as the truth. Sometimes staff will not have the experience or full information to understand why something happens in the way it does within a service. For example, staffing levels – a staff member may allege that they are insufficient; but there is evidence to show they have been deemed safe using an established dependency tool. Accelerating improvement ‘Enabling health and care services and local systems to access support to help improve the quality of care where it is most needed.’ At one point, CQC was canvassing opinion about becoming an improvement agency, possibly sending teams into services needing support. CQC has now realised that approach would compromise its independence to act as an investigative body and prosecutor. Instead, the focus is on encouraging improvement through offering 'a range of resources to support them to decide for themselves the best way forward.’ CQC adds, ‘We’ll build stronger ongoing relationships with services by having more regular contact with them’
and ‘our regulation will become more constructive and supportive – using what we know to help services to tackle problems early.’ It remains to be seen whether CQC will deliver on its professed desire to work more collaboratively with providers. One of the problems is that it is not clear when collaboration starts and ends. In Wales, the improvement agenda is embedded in the legislation with the clear statutory expectation that attempts at improvement will come first and, only if that fails, will enforcement action follow. Very often regulation comes down to the personalities of inspectors. Some are far more focused on the bigger picture with a desire to focus on the positive; others hone in on one or two perceived failures and downgrade the service as a result. It will be essential for CQC to performance manage its inspectors far more effectively to ensure they are promoting improvement and collaboration in the first instance, subject, of course, to consideration of risk within each service. One useful proposal included in the strategy is for CQC to offer analysis and benchmarking data to enable providers ‘to self-assess how they’re performing against similar services and areas. Our benchmarking information will also show us where we need to focus our work to drive improvement.’ Navigating what’s to come When starting out as a regulatory lawyer in 1992, one colleague described inspectors as guides and counsellors, as well as prosecutors. With the creation of the national inspectorates something of the former was, unfortunately, lost. It is hoped that CQC’s strategy will restore the balance in favour of collaboration and support. A focus on improvement and support is crucial as services rebuild after the pandemic. It remains to be seen whether a change of approach really does emerge over the next five years. With no clear plan, or timetable in place, providers will have to keep abreast of the changes as they are introduced. As the sector well knows, nothing ever stays the same in the world of regulation for long. CMM
Neil Grant is a Partner at Gordons Partnership LLP Solicitors. Email: neil@gordonsols.co.uk Twitter: @LlpGordons How did you react to the CQC’s five-year strategy? Which areas of regulation do you think need close attention? Share your feedback and response to this article. Visit www.caremanagementmatters.co.uk 22
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PAY SCALE:
Recognising the true worth of support workers The topic of care workers' pay has always been one of great debate and discussion but perhaps even more so during the pandemic. Mark Adams, of social care charity Community Integrated Care, comments on the charity’s latest report and shares the struggles faced by support workers.
PAY
When Priti Patel classed social care workers as ‘low-skilled’, a collective gasp of horror could be heard across the sector. For the Home Secretary to dismiss our highly skilled workers – the very people who kept the cogs of society turning throughout the pandemic – demonstrated a failure to recognise their indispensable knowledge and skills and invaluable service. It was a travesty. At a time when the sector was – and still is – losing workers at an alarming rate, with 112,000 vacancies unfilled at any one time, this stereotyping was shocking. Not only for our employees, who were offended by the disrespect, but for the sector and the long-term future of our country.
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When we write off some of society’s most essential workers as ‘low skilled’, what does that say about the value that our Government places on the very people they support?
LANDMARK STUDY This was one of numerous factors that led Community Integrated Care to develop landmark research that, for the first time, set out in economic, moral and social terms, the absolute value of front-line care workers. Over the past decade, the role of front-line support workers has changed substantially. With local authorities now only funding social care for those with the most complex needs, support workers are being called upon to apply ever greater levels of skill and understanding. However, rates of pay have not kept pace with the evolution of their role. We had long argued the moral case for fair pay, but to no avail. This time we needed more. We needed definitive proof of their skill and value in comparison across sectors. So, towards the end of last year, we commissioned Korn Ferry, renowned global experts in job evaluation, to apply their world-leading methodology for evaluating the complexity, content and renumeration of roles. We chose to assess the support worker role within Supported Living services, as it is a core role in the sector – replicated within thousands of care providers across the country. Korn Ferry’s research was extensive. It examined their responsibilities, skills and pay, and provided a robust comparison of these in relation to other industries.
“To be on equal terms with their publicly funded counterparts, support workers would need a 39% pay rise .” 26
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The resulting analysis, published in Community Integrated Care’s report Unfair to Care, was game changing. It demolished the stereotype propelled by Priti Patel. Far from being low skilled, social care workers were proved to utilise a wide range of skills and competencies.
INCREASED DEMANDS Support workers were found ‘to understand emotional triggers and behaviour specific to each individual in order to respond appropriately to their needs, as well as offer a high degree of empathy’. The research also noted ‘a requirement to adapt to "in the moment" situational change’ and deliver care ‘which is tailored to the needs of the individual without the immediate support of others’. It showed that this role carried a huge weight of responsibility. It was physically and emotionally demanding. In short, it was complex, comparable to – and often exceeding – the demands of roles such as police community support officers and NHS healthcare assistants. Most importantly, the assessment concluded that the median annual salary for equivalent roles in other public sector industries, including the NHS and local authorities, would be £24,602 – an incredible jump from the current sector average of £17,695 p/a for support workers in social care. To be on equal terms with their publicly funded counterparts, support workers would need a 39% pay rise in order to match the earnings of their peers in similar roles in other sectors. The parity gap with the NHS was even greater. The equivalent position in the NHS would be a Pay Band 3 position, with an average take home pay of £24,142. In addition, these NHS roles offer additional benefits such as enhanced pay for unsociable hours. When these entitlements are factored into the mix, their total package value increases to £30,092. These aren’t pay gaps with their counterparts in other public funded sectors – they are caverns. Little wonder then that social care has an annual turnover rate of 34.4% – double the 15% average turnover rate across UK employment sectors. The figures paint a depressing picture for the social care sector,
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which is dependent upon the skills, commitment and expertise of its colleagues. Care providers are desperately trying to stem the tide, retaining our valued colleagues whilst trying to attract new recruits to roles that pay less than the Real Living Wage. In the absence of the funding reform required to increase wages, many care providers are striving to find other ways to offer financial and practical support.
SUPPORT FOR PROVIDERS Community Integrated Care has a Wellbeing Fund for colleagues experiencing financial challenges. Over the last few years, it’s been accessed by many colleagues who have found themselves struggling during difficult times. The stories have often been heartbreaking. The one common factor in each of these stories is that many front-line support workers have few savings to cushion the blow of unexpected costs. They’re living on the breadline, trying to make ends meet every day. Something as simple as a broken washing machine or a car problem can be enough to cause them significant hardship. Aside from financial support, we strive to offer robust practical and emotional support. We provide recognition schemes where employees can nominate hard-working colleagues for rewards; we use Yammer to create a sense of community in a 6,000-strong organisation and we take every possible opportunity to find creative ways of letting our teams know just how much we appreciate their efforts. Providers alone can only do so much. We need Government action. Progressive reform of, and investment in, social care is an absolute necessity with as equal an economic imperative as a moral one. Each year, this sector contributes
£46bn to the UK economy. Our colleagues live and work in local communities, reinvesting their earnings back into their local areas. Social care sustains other industries, such as medical supplies, transport services, fuel, education and training, food and drink, building maintenance services and financial services. We know that the sector is ripe for transformation, which we hope will come when the Government eventually publishes its social care review. Those of us on the ground already understand that considerable savings could be made to create the headroom for investment in the sector and pay, by better organising the integration between the NHS and social care. In Unfair To Care, we refer to the UK National Audit Office estimate that 2.7 million hospital bed days, between 2014 and 2015, were occupied by older adults unable to be discharged due to the poor availability of care home placements or homecare packages. The resulting cost to the NHS? A jaw-dropping £820,000,000. Then there are the many people – close to half a million, in fact – who have left the employment market in the past two years to care for family members. Social care is here, ready to support the nation’s workforce, to care for their relatives, to free-up hospital beds. But we can’t do it without investment. And we can’t do it without paying those people who are at the heart of the sector fairly. We know that pay is only part of the solution and, of course, much wider progressive reform and investment for the sector is needed. But it is essential. Without progress, the sector will be forever trapped in this cycle of turbulence. Visit www.caremanagementmatters. co.uk to read the Unfair to Care report. CMM
Providers can access support from a number of organisations. For wellbeing advice, explore resources and the NHS & Social Care helpline from the Samaritans charity, visit www.samaritans.org. The Care Workers’ Charity has a mental health support programme and offers financial and practical support, visit www.thecareworkerscharity.org.uk for more information. Citizens Advice also offers financial support and useful contacts, visit www.citizensadvice.org.uk.
Jordan Conroy, 26, is a Depute Service Leader in Portsmouth I work with people who have complex health and support needs. In my eight years in social care, I have seen a big shift in the needs of people who access support. Perhaps a decade ago, the people I support might not have been living independently in the community. However, the one constant is low pay. The charity that I work for does as much as it can to help its colleagues – providing mental health and employee assistance. It is constantly trying to find ways to better reward its teams, but I know that when it comes to pay their hands are tied without investment into the care sector. Thankfully, their employee wellbeing programmes were there for me when I needed them, when my dad passed away unexpectedly in December 2020. This was devastating to my three sisters and me. The average funeral costs around £3k-£4k, and neither my sisters nor I had that sort of money. My Dad had no savings or life insurance, so we were planning to sell some personal items or take out a bank loan. Fortunately, Community Integrated Care had a Wellbeing Fund for staff in financial difficulties, so I decided to see if the charity could help. When I found out I had been awarded the money, I cried with relief. We were able to give Dad the send-off that he deserved. I am so grateful that we were able to show him our respects, but we could only do that because of the added support within our charity. The experience of not being able to afford to pay for the funeral was devastating. I know how hard people work in social care and how skilled they are, so clearly the pay should be better. Being on a low wage can feel really degrading and we deserve more. We need action from Government – I hope that Unfair to Care helps make that happen.
Mark Adams is Chief Executive Officer of one the UK’s largest social care charities, Community Integrated Care. Email: Mark.Adams@c-i-c.co.uk Twitter: @ComIntCare In what ways does your organisation recognise the contributions made by support workers? Visit www.caremanagementmatters.co.uk to share your comments on the feature. 28
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INTO PERSPECTIVE
HOW CAN GREATER DIGITAL INCLUSION IMPROVE PEOPLE'S EXPERIENCE OF SOCIAL CARE? For people receiving care services who have become familiar with digital technologies, their experiences will have likely benefitted from improved access to information and care, greater convenience and more opportunities for autonomy over their care. There is a strong case in favour of using technology to improve people’s experience of social care, and greater digital inclusion is the key to unlocking its potential to permanently revolutionise the sector.
OVERCOMING BARRIERS
Digital inclusion is of paramount importance in today’s social care landscape. While several organisations are increasing their digital output to enhance service delivery, the case remains for preserving more traditional practices, especially for people who struggle to use technology, such as older people. There are clear barriers preventing people from embracing digital services and, until these are addressed, it is unlikely that technology will become a sector-encompassing tool for care service delivery.
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According to NHS Digital, 11 million people (approximately 20% of the UK population) lack basic digital skills, or do not use digital technology at all. These are likely to be older, less educated and in poorer health than the rest of the population. Furthermore, the UK Consumer Digital Index 2021 from Lloyds Bank outlines that there are 2.6 million people (approximately 5% of the UK population) who have not used the internet in the last three months. Working on overcoming these barriers is fundamental to enhancing digital inclusion, especially for the benefit of people experiencing social care. Key reasons for remaining offline cited in the formation of the UK Digital Strategy include access, skills, confidence and motivation. Older people were more likely to be digitally excluded than others according to the Government Digital Service’s digital inclusion scale. Lack of infrastructure, such as poor internet connectivity, often prevents digital inclusion. Secondly, without the basic knowledge of how to operate digital technologies, inclusion cannot be possible. Also, older people can be fearful of being taken advantage of through online crime, are distrustful, or don’t know where to start to get help. Finally, older people, especially those in care, may not see the point of the internet – how it can benefit their
lives and improve their experience of social care. There is certainly work to be done if the sector, and its users in their entirety, are to reap the benefits of embracing digital technologies. The Centre for Ageing Better calls upon Government to offer support to not only get people online, but also ensure that they develop the skills and confidence to stay online through personal and ongoing guidance. Universal internet access should also be rolled out to provide a secure platform for digital inclusion to expand and digital equipment should be made available in care settings to promote familiarity with technology.
IMPROVING EXPERIENCES Greater digital inclusion for people who are still offline should at least provide an opportunity for technology to improve people’s experience of social care. The Health Innovation Network South London explains that technology holds great potential to free up invaluable staff time in care settings. Digital solutions can manage administrative tasks usually undertaken by care workers, fostering increased independence amongst service users and allowing staff to conduct more flexible working patterns. The Care Quality Commission (CQC) expands by suggesting that technology will help care workers to prioritise and focus their attention on people who need it most. Technology’s capability to innovate communication in care settings can contribute further to improved social care experiences. Given the extensive COVID-19 shielding many care home residents have undertaken in the last 18 months, it is difficult to argue against the importance of ensuring technology continues to play its part in a rapidly modernising sector, designed to constantly improve the experience of its users.
Learn from the pandemic and ensure no one is left behind
Using technology to empower people
Kristina Leonnet, Senior Innovation and Change Manager, Centre for Ageing Better
Katie Thorn, Project Manager, Digital Social Care
During the pandemic, we witnessed the powerful role that the internet plays in keeping us connected – and we depended on it like never before. This was crucial for many older people, including those living in care homes. In Barnsley, the council refurbished over 100 old laptops and tablets and gave them to care homes to help keep residents connected. Not only did this help residents stay in touch with their friends and families, but it also allowed them to have online appointments with GPs who hadn’t been able to visit care homes. ONS figures show that internet use among over-75s has recently increased, nearly doubling from 29% in 2013 to 54% in 2020. However, three million people are still offline across the UK and the majority (67%) are aged 70 or over. Furthermore, Age UK figures show that while just under a quarter of over-75s in England have increased their internet usage since the pandemic, this is mainly existing users going online more often. As services and communities increasingly move online, millions of people who don’t use the internet risk being left behind. From health care
services to community groups, being online has a lot to offer people in later life: access to culture, connections with others, and fast access to information. Our research shows that one of the most significant barriers people face to getting online is a belief that they are not capable. Support for people to get online should therefore be tailored, flexible, and relevant to what people want and need to do. Support should go at people’s own pace, offering repetition and reflection. Jargon should be avoided, and support should be ongoing. Once online, building skills and confidence is key in enabling people to do more of the things they want. It’s clear that with people of all ages still without internet use, offline alternatives remain vital to ensure no one is shut out from accessing services or connecting with others. Hybrid services – with both online and offline options – could be a brilliant thing for increasing participation. But the pandemic’s digital movement has shown great potential for the lives of people in social care to be made easier with improved access to online services. Now we have seen the power of digital, we must make the most of it.
The use of digital technology has been on the rise within social care for some years – but the COVID–19 pandemic has led to a rapid expansion, with technology playing a crucial role in remote monitoring, information sharing, management and direct care. Digital Social Care believes that technology has the power to support people to live in the place they call home and to do the things they want to do. Traditional pendant and technology-enabled care alarms still have a place, but we are seeing an increase in the use of consumer technology, such as virtual home assistants (e.g., Alexa and Google Nest) and smart home technology, in residential care settings and in people’s homes. This smart technology can be very empowering for people using social care and for loved ones, as it can provide reassurance and peace of mind. These technologies are also often managed by people receiving care themselves, so they are empowered to make their own choices on the types of digital tools they use and who has access to the data they generate. Digital technology is also
enabling care staff to make more informed decisions about the care they are providing. Handheld devices enable care workers to record or check information when they are with their client. Emerging systems – such as shared care records and proxy access to GP and medication records – are enabling health and care staff to access the same information about the individuals they both support in real time. It’s more efficient – enabling care workers to spend time providing direct care, rather than chasing colleagues for information. Technology is, of course, developing incredibly quickly and we know from our research that it can be difficult for care providers to keep up to date. That’s why we work with care organisations to create success stories highlighting the technologies they are using and host the Hubble Project which enables care providers to learn from others who have introduced technology. Furthermore, the Better Security, Better Care programme helps providers to keep data safe, regardless of what technological and digital solutions they have in place.
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S: COMMUNITY CONNECTION
sabilities di g in rn a le h it w le op pe Supporting
How can we ensure people with learning disabilities are actively involved in decisions about their support? Steve Cox, CEO at Perthyn, a learning disability charity, and Clive Parry, England Director at the Association for Real Change (ARC), tell us more.
As we begin to see what life will be like once the worst aspects of the pandemic are under our control, many of us have a vision of the future that is different from the world we lived in before March 2020. This globally seismic event has prompted us to rethink what we knew, or thought we knew. Perhaps there are opportunities facing us now that, if we grasp them, will go some small way towards helping us to make sense of the awful loss of life we have witnessed. Pre-pandemic life for the adult social care sector, particularly for people with a learning disability and their families and loved ones, was largely misunderstood by much of our society, including some policy decision-makers. The wide-ranging support needs for someone with a learning disability – from a few hours a week to 24-hours a day care – were either not known about at all or were under-estimated. In 2017/18 in England, 150,100 out of approximately one million people
accessing social care were adults with a learning disability. Of these adults: • Approximately 147,920 accessed long-term support. • Approximately 2,180 completed short-term support designed to maximise their independence (NHS Digital 2018). If a policy maker’s understanding of these support services comes mostly from reading specification documents,
budgets or quality inspection reports, they are unlikely to come across descriptions of the links between a provider's staff teams and the local community, including shops, pubs, leisure centres and places of worship where people came together pre-COVID.
ACTIVE INVOLVEMENT Perthyn provides support to
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COMMUNITY CONNECTIONS: SUPPORTING PEOPLE WITH LEARNING DISABILITIES
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over 240 people living in the community across several local authorities in England and Wales, helping to develop their skills and independence and to enjoy a quality of life in their communities. There was a huge focus on communication for our approach during the pandemic. Firstly, our staff worked closely with a group of people we support to produce easy-to-read leaflets about COVID-19 and how people could keep themselves safe, whilst advising them on the Government guidance. Then, during the first easing of lockdowns, we produced a ‘Pathway Out of Lockdown’ document with people to help them understand how things were going to change. The team considered what we should do to help people to be able to return to doing normal things. At the same time, it was a chance for many to think about doing different things. Staff, who are used to using a range of person-centred planning tools, developed an approach we called ‘Getting My Life Back’ (GMLB). This followed two simple steps that people could fill in using words and/ or images: 1. What I’m doing right now, how I do it safely and the support I need. 2. What I REALLY want to do with my life once COVID-19 restrictions have lifted. Guidelines in the plan helped each person to use the Pathway Out of Lockdown leaflet to help them choose what they want to do depending on the restrictions in place. People were encouraged to think about things they wanted to do differently and not to feel they had to do what they did before the pandemic. Feedback from individuals, family and staff has been really positive and we have found people have used them successfully because: • The format is easy for people to use and for staff to support them. • How to do things safely is built
into the format, so the person can consider the need for PPE/social distancing etc. directly to the activity they are planning to do. • There are suggestions in the guidelines about how the person’s life could be different from before the pandemic. For example, in the guidance we highlighted things people need to think about such as how to keep themselves and others safe, and how they might need to plan to go out in a different way. • The timing was right – people have had plenty of time to reflect on their lives and think again about their future. • It’s exciting to plan for the future. Using this simple approach, the lives of many people we support have not only got back on track but have been enhanced. The people we support have been able to take up opportunities to do things in their community rather than going back to the day centre.
PERSON-CENTRED PLANNING • Individuals with higher support
PERSONAL REFLECTIONS People have enjoyed new experiences and are learning new skills. Here are some of the reactions from people we have supported: Richard – ‘I always wear my mask and apply hand sanitiser when I go into shops in my local area. I am careful to keep socially distanced from other people. I like to take a packed lunch as then I can avoid going into takeaways. ‘I would like to go to the countryside more, to go for a walk and to take some more photographs. I will wear my mask if I need to go indoors. I would need to take hand sanitiser with me as there is unlikely to be any
needs who live in residential homes or Supported Living services, should be able to access activities in their communities alongside people with similar interests who want to do things together. • Providers will deliver individual community-based activities in a person-centred way, the details of which were decided upon by the supported individual themselves, both in residential and day services. • Successful community-based support will always be driven by the wishes, preferences, priorities, and choices of supported people. • Providers will be clear and concise in the ways they communicate with supported people and their families and will work with supported people, so they are involved and engaged. • Providers will produce information that is accessible using person-centred planning tools and will review and update plans regularly involving supported people. When requested, providers should available in this area. I would need to keep my distance from other walkers.’ Penelope – ‘I can now get the chance to go horse riding more often. I will need to contact the riding stables and see if I can book a lesson, wear my mask in the car on the way there, follow the riding school rules on social distancing, have my staff as walkers next to me to give reassurance, and take hand sanitiser with me to keep my hands clean after.’ Ed – ‘I now have the chance to visit more museums and learn about old transport. I will phone up the museum I would like to go to and visit and check their safety measures and what availability
involve their family/carer in their reviews.
BUILDING BACK BETTER Day services have been especially hard hit, firstly by the pandemic and then, in some but not all cases, due to funding cuts imposed by local authorities. We must seek to redress this quickly or the contribution to our communities will be lost forever, negatively impacting on the independence of the supported people who enjoy and benefit from day services and their family members. As we think about ‘building back better’, we must look at how people were being supported before the pandemic to be actively involved and contribute to their communities and how that can happen again. The best people to ask what the future should look like are the supported people themselves, their families and the staff who know them so well. The relationships between supported people, families, carers, providers and their local communities are vitally important; they really matter. CMM they have. I will try and visit on a weekday as I think this is when it would be less busy. I would ensure I take all PPE such as face masks, hand sanitiser and anything else my staff think I will need. I will need to make sure I keep a safe distance from people and try not to touch things. If I do touch things, I will make sure I use hand sanitiser to keep me safe. ’ Nick – 'When doing my canal work, I am working outside. I will wear gloves to use any of the tools and I will need to keep a safe distance from members of the public when they are walking down the canal. I like to shake hands with people, but I won’t be able to do this now.’
Clive Parry is England Director at Association for Real Change (ARC) Email: clive.parry@arcuk.org.uk Twitter: @ARCEngland Steve Cox is CEO at learning disability charity, Perthyn. Email: steve.cox@perthyn.org.uk. In what ways do you involve people with learning disabilities in their care and support? What tools do you use and what has been the impact? Visit www.caremanagementmatters.co.uk and share your comment on the feature. 34
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THE FUTURE OF RETIREMENT VILLAGES: What the pandemic has taught us Retirement villages and extra care housing schemes have grown in popularity during the pandemic, according to the St Monica Trust. Here, David Williams, CEO of the Trust, gives an update on leading a major research study and shares how his organisation responded to the pandemic.
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The aim of the Re-COV research project is to better understand the experiences of retirement villages and extra care housing during the pandemic, including the effectiveness of measures taken to protect the health and well-being of residents and staff. History and narratives are often rewritten by politicians, and we’ve already seen this happening in terms of the conversation around care homes. It was important for us to put a red flag in the sand to say: ‘this was the reality faced by the sector’, `this is how we reacted’ and `this is how we compared to the general population’. We had to move away from subjective case studies to quantitative data, which was essential for us in order to share information, learn lessons and help plan for future pandemics.
EVIDENCE OF SAFETY The main findings of the Re-COV study, which was funded by the Dunhill Medical Trust and supported by the Housing LIN, showed that 0.97% of retirement village and housing scheme residents died from confirmed COVID19 from March to December 2020. This was less than the 1.09% of people with the same age profiles who died from COVID-19 living in the general population in England and residents of retirement village-only operators also had the lowest COVID-19 death rate of 0.51%. The evidence from the research points to what we knew all along: that older people are safer and age better living within a retirement
village than they do in the wider community. The Trust has seen an unprecedented level of demand for its accommodation following the second wave of coronavirus. Our sales team have heard lots of anecdotal evidence from people living within the general population, who have realised how isolated they were and how little support they could draw on when compared with friends who were living in retirement villages. Older people living among the general population didn’t have the level of support that we were able to deliver for our residents living within our environments. The control measures that we put in place meant that there were fewer infections and our residents were able to isolate safely within our communities, due to the services we could provide for them.
DESIGNING A LIFESTYLE In terms of the future design of retirement villages, there’s a real danger that this and future pandemics may cause the sector to revert to designs that lock the community out. Our most recent development, The Chocolate Quarter in Keynsham, combines retirement living with a range of facilities which are open to the public and, uniquely, office space for local businesses, such as Pukka Herbs and IVC, plus a GP surgery. The Chocolate Quarter was designed by the people who use our services and its success lies in encouraging all the different generations to interact together and
promoting mutually beneficial relationships with the wider community. Yet in our response to the pandemic, we still found that we were able to lock down The Chocolate Quarter and protect its residents and staff as successfully as we were our more traditional, ‘gated’ communities. Our customers and residents have told us that they don’t want to live in gated communities. We need to ensure that new developments are designed around the principle of living well with COVID-19 and the best way to do that is through open and integrated communities. Moving forward, we need to have more retirement villages being built in this country. We’ve shown that in extreme circumstances, retirement villages keep people healthier and there needs to be real investment in terms of providing retirement villages and Housing with Care schemes. A change in planning regulations is required and retirement villages need to be seen as fundamental to any new housing developments being built. A positive step would be to make developing retirement villages VAT exempt, particularly for notfor-profit organisations. We’re not funding our retirement villages through grants – we’re doing it through bank loans and VAT exemption for retirement village developers would aid us to do much more and help meet increasing demand. I would also call on the Government to resolve the disparity between health
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'The evidence from the research points to what we knew all along: that older people are safer and age better living within a retirement village than they do in the wider community.'
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THE FUTURE OF RETIREMENT VILLAGES: WHAT THE PANDEMIC HAS TAUGHT US
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and social care services and the NHS. We need to treat people in health and social care the same as NHS staff, in terms of being paid appropriately, having the same career opportunities and recognition for work they do. It can’t stop at clapping outside of front doors and the Health and Social Care Act is where we hope to see positive action from Government in resolving this. We’re now more than 18 months into the pandemic, with no clear end in sight, and people are shattered. There’s a huge amount of investment needed to allow staff in our sector to recover.
TRUST APPROACH In terms of the Trust’s response to the pandemic, we operated from the principle of putting anything we needed in place to keep our residents and colleagues safe and there were times when we went beyond Government guidelines. Whatever measures we took also needed to be understood by our residents and colleagues and clear, open and honest communication was vitally important to achieve that. Considering there are 100,000 people living in retirement communities in England, we were disappointed at the absence of clear Government guidance aimed at the sector. This was in marked contrast to the guidance issued for care homes. It felt as if the Housing with Care Sector was only being addressed as an after-thought. We found ourselves in the position of having to take the guidance for care homes and interpret it ourselves for our supported living environments. The Trust was fortunate in that we had our own Quality Team and a dedicated Communications Team. That meant that we were able to monitor all the information available from trusted sources, implement them as part of our coronavirus response plan and communicate the details quickly and clearly to our residents, their families, St Monica Trust colleagues and customers. We were also quick in terms of working in partnership with other providers and organisations at a local level to share information and resources. The National Care Forum (NCF) and The Associated Retirement Community Operators (ARCO) were also a
great source of help in terms of giving us advanced warning of what guidelines were being released by the Government, so that the necessary preparatory work could be undertaken. Working with our residents we took an early decision to lock down our retirement villages. We also went early with regards to making the wearing of face masks mandatory and put air sterilisation units in communal spaces. Our Catering Development Manager was quick to realise that pubs and restaurants closing meant that their suppliers would have excess food. Through his contacts, we were able to negotiate and source boxes of fresh food and meat for our residents at a time when there were shortages in supermarkets and people couldn’t get home deliveries. Free tablets and IT support were provided for residents to ensure that they were able to stay in contact with their friends and families. We also negotiated delivery slots with local supermarkets and placed orders for our residents, plus arranging pharmacy collections. In the space of three weeks, we recruited and trained more than 150 temporary members of staff to undertake non-care duties that freed up our front-line staff and helped us cover staffing shortages caused by the pandemic. We provided our residents with PPE and when there was an outbreak, our executive team would go from door-to-door, advising them on the situation, reassuring them and seeing what assistance they required. The Trust was in a privileged position with regards to the resources we were able to deploy against COVID-19. However, there are certain things that all providers can do to prepare for future emergency situations, no matter what their size or resources.
team to managers, to front-line colleagues and to residents and relatives quickly, is also vital in keeping people informed and on board with the decisions you take. From a personal perspective, this has been the most challenging experience I’ve faced in my entire career in health and social care and, at the same time, also the most rewarding. I’ve always believed that the best of human nature will see us through the most difficult of times and, despite all the heartache and hardships, it’s been so heartening to see our sector unite behind the common goal of keeping one another safe. The very real sense of community that has come out of our sector’s response to the pandemic – how people have worked so effectively in partnership and regularly gone above and beyond what is expected of them – has been a true privilege to witness and be a part of. CMM A full version and summary of the St Monica Trust’s Re-COV research study is available for download on the St Monica Trust website.
FUTURE PREPARATIONS I would recommend ensuring that crisis planning is included in your organisation’s business continuity plan. Spending time on your pre-planning is vitally important and it should cover all eventualities, including locking down services and dealing with large-scale outbreaks. Establishing the correct communications structure to enable you to get out communications from your executive
David Williams is the Chief Executive at the St Monica Trust. Email: David.Williams@stmonicatrust.org.uk Twitter: @SMT_DavidW Will your organisation be developing further crisis plans and do you agree with David’s claims that retirement communities help people to age ‘better'? Share your comments on the feature and visit www.caremanagementmatters.co.uk
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Phoenix Specialist Risk Solutions, Office 1, The Design Quarter, 129-130 Edward Street, Brighton, East Sussex, BN2 0JL Phoenix Specialist Risk Solutions Ltd are authorised by the Financial Conduct Authority – FRN: 809579, as an Appointed Representative of Exchequer Risk Management Ltd – FRN – 616500
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CMM September 2021
Resource Finder CQC Compliance
Compliance is a foundation for all care services and sometimes seeking external help could help fill in any gaps when it comes to impressing regulators. Here, a series of expert organisations share how they can help you and the services they offer.
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RESOURCE FINDER: CQC COMPLIANCE
Bettal quality consultancy Tel: 01697 741411 Email: info@bettal.co.uk Website: www.bettal.co.uk
SECTORS • Care homes. • Homecare. • Supported Living. • Learning disability services. • Mental health services.
SERVICES • Quality Management Systems (policies and procedures). • Support with new registration. • Home care digital management. • Audit tools.
LEAD INDIVIDUAL Albert Cook is a former manager and principal inspector of care services and is responsible for more than 200 adult care services. The company is now recognised as one of the leaders in providing Quality Management Systems (policies and procedures) to the care sector. As a fellow of the Chartered Quality Institute, Albert is committed to quality in care.
Care 4 Quality Tel: 01579 324787 Email: admin@care4quality.co.uk Website: www.care4quality.co.uk
SECTORS He has supported companies and organisations to improve their care services using the Bettal Quality Management System, Cared 4 in the UK and Europe, including services in England, Scotland, Ireland, Germany and Poland. The Bettal System complies with the requirements of CQC.
COMPANY INFORMATION Bettal Quality Consultancy has been supporting the care sector for more than 25 years. Company Director Stuart Cook has supported hundreds of companies to achieve registration and he ensures the Bettal Quality Management System is kept up to date to comply with the CQC KLOE and Fundamental Standards. Key to Bettal’s success is an affordable CQC-compliant quality management system, developed by people with proven expertise backed up with first-class customer support.
Albert Cook Managing Director BA, MA, Fellow Chartered Quality Institute Tel: 01697 741411 Email: Albert.cook@bettal.co.uk
• Care homes and nursing homes. • Domiciliary care. • Supported living. • Hospices. • Respite and day centres. • Mental health services. • Complex care.
SERVICES • Mock CQC inspections. • Auditing (health and safety, good governance, internal). • Action planning. • Enforcement action support. • NOP/NOD support. • Factual accuracy challenges. • Ongoing support. • Crisis management. • Registration.
LEAD INDIVIDUAL Helen has over 20 years’ experience in management of health and social care services. Helen has managed a range of services including residential, nursing, day care and dementia care. She has been the area manager for several homes, responsible for co-ordinating them and ensuring compliance across the board. Helen set up Care 4 Quality in 2012, starting as a care consultant to several homes, then expanding to the whole of the UK, building up a base of expert consultants to attend care services and support them as required. Care 4 Quality has since become one of the leading care consultancy companies in the UK and now has a panel of over 30 consultants and supports several hundred services across the UK.
COMPANY INFORMATION Care 4 Quality’s services are tailored to your needs. Consultants across the UK can offer specific expertise to suit your service. We work with individual care services and care home/ service groups, carrying out mock inspections and assisting with quality monitoring in partnership with the service itself. Quarterly compliance visits are becoming popular with our clients, ensuring that the areas of Safe, Effective, Caring, Responsive and Well Led (in England) are audited fully, and improvements are evidenced. We carry out the same across the other regulatory bodies. Customers who book quarterly visits are provided with interim support so can be assured help is always on hand if it's needed. We also offer one-off, ad-hoc inspections for those services just wanting a compliance review. We help providers and managers with start-up advice and registrations. We also offer support with factual accuracy challenges, enforcement action, warning notices and notices of Proposal/Decision issued by CQC. These can be tailored to your service. We work with several regulatory solicitors and lenders across the UK as necessary. Care 4 Quality can create bespoke packages for you as needed, working together to achieve the service's requirements.
Helen Fuller Founder and Director Tel: 01579 324787 Email: helen@care4quality.co.uk
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Join the National Care Forum
NCF is the leading voice for not-for-profit care providers Our growing number of members benefit from:
A trusted voice, representing members and voicing concerns to decision makers in central and local government Dedicated digital transformation officers Management and interpretation of the plethora of information MEM B
Staying connected; invaluable at all times and particularly through the pandemic
ERSHIP
Lobbying for the amazing work in social care to be recognised and supported
• N O T- F O R - P
But don’t take our word for it “We think it’s really important that not-for-profit care providers have a strong voice in the many debates about social care that are happening” Jane Ashcroft CBE, CEO, Anchor Hanover
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“NCF isn’t just another membership organisation. It is one with true benefits and has a powerful and meaningful voice as their lobbying skills have also demonstrated throughout the pandemic” Tim Walker, Director of Operations, Frances Taylor Foundation
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“We’ve benefitted from some really technical expertise particularly around our digital care planning strategy and also legal advice. If you’re thinking of becoming a member, don’t hesitate… the expertise around that table is priceless.” Rachel Peacock, CEO, Making Space
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Get in touch today We look forward to welcoming you
LE • IN N O VAT I O N • Q U A L I T Y •
NCF works directly with not-for-profit care & support providers across the UK. We support members to improve social care provision & enhance the quality of life, choice, control & well-being of people who use care services. 44
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RS ADE
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www.nationalcareforum.org.uk @NCFCareForum info@nationalcareforum.org.uk 02475 185 524
RESOURCE FINDER: CQC COMPLIANCE
Solicitude Training Ltd
SWIFT MANAGEMENT SERVICES LTD
Tel: 01256 242272 Email: info@solicitudetraining.co.uk Website: www.solicitudetraining.co.uk
Tel: 0208 087 2072 Email: info@swiftmanagement.org.uk Website: www.swiftmanagement.org.uk
SECTORS
SECTORS
• Care homes. • Nursing homes. • Domiciliary care. • Local authorities. • Hospitals. • Schools.
SERVICES • Mock inspections. • Compliance support. • Preparation of action plans. • Care consultancy. • Audits. • Training needs analysis. • Training (face to face or virtual). • E-learning. • Competency assessments of staff. • Staff coaching, mentoring and development.
LEAD INDIVIDUAL Jenny has over 30 years’ experience working as a nurse within the health and social care sector. She is a qualified nurse (RGN), holds a nursing degree BSc (Hons), as well as management, teaching (PGCE) and assessing qualifications. Jenny has held positions from volunteer through to Director of Nursing and Specialist Adviser for CQC.
Jenny has many years of experience of undertaking training needs analysis within services and then providing training that is relevant, enjoyable and engaging to the delegates attending, to ensure that learning is optimised. Having worked as a registered manager, Jenny also understands the dilemmas and complexities that managers are faced with and, due to this, is able to offer the appropriate support. She has supported services that have been rated Inadequate to improve their practice and go on to be rated as either Good or Outstanding.
COMPANY INFORMATION Working alongside Jenny is a team of professionals who have many years of experience working within the health and social care sector. These include nurses (both paediatric and adult based), care managers and social workers. The team is able to offer a wealth of experience and can offer a complete package to support a service to improve both the quality of care that is delivered as well as compliance, either in the form of crisis management or on an ongoing basis.
Jenny Gibson Director/Nurse Consultant Tel: 01256 242272 Email: jenny@solicitudetraining.co.uk
• Care homes and nursing homes. • Supported living and extra care. • Domiciliary care. • Independent hospitals and clinics. • Respite care. • Local authority and private providers.
SERVICES • Mock CQC inspections and compliance audits. • Compliance support. • Preparation of action plans. • Enforcement action support. • NOP, NOD support. • Factual accuracy responses. • Training (face to face or virtual). • Crisis management. • Registration support. • Coaching and mentoring. • Competency assessments of staff. • Policies, procedures and forms.
LEAD INDIVIDUAL Christopher set up Swift Management Services Limited over three years ago to provide a comprehensive support service to registered care providers. Christopher has substantial experience of working in the public and private sector in a variety of roles and is passionate about making a difference. He has worked in healthcare for over 33 years and has held many roles including Chief Operating Officer for a leading national care charity. Christopher has worked with all the regulators in the UK,
whilst maintaining his nursing registration. He holds a PGDip in Healthcare Management, as well as many other essential qualifications. Christopher acts as an expert witness for both civil and criminal cases and can quickly understand the situations and challenges faced by providers on a daily basis. He helps providers by delivering support and guidance. Christopher has supported providers that have been previously rated Inadequate to improve their CQC service rating to Good or Outstanding.
COMPANY INFORMATION Swift Management Services Limited provides expert support through a network of highly experienced healthcare professionals. Our innovative action plans have proven especially popular with CQC, because it is easy to evidence progress and improvements through our ‘You said – we Did’ information programme. We can support your service through a crisis or on an ongoing basis with our retained consultancy service package providing regular one-to-one coaching and development, quality monitoring reviews, mock KLOE inspections, unlimited telephone and email support, tailored service improvement plans and access to a dedicated care consultant to work in partnership with you to drive sustainable improvements.
Christopher Stringer Director Tel: 07973 925262 Email: christopher.stringer@swiftmanagement.org.uk
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CELEBRATING EXCELLENCE
Markel 3rd Sector Care Awards
IN INNOVATIVE QUALITY OUTCOMES The Care Workers’ Charity won the Innovative Quality Outcomes Award at the Markel 3rd Sector Care Awards 2020.
The Care Workers’ Charity was the deserving winner in this category, standing out from the crowd due to the unrivalled can-do attitude of its leadership and persistent determination to provide much-needed support to the sector, particularly its workforce, at a time of great need. Continuing in a series of features celebrating this year’s winners, Karolina Gerlich, Chief Executive at The Care Workers’ Charity, explains how the organisation has responded decisively to meet the financial needs of the social care workforce throughout the coronavirus pandemic.
CLEAR LACK OF SUPPORT The Care Workers’ Charity has over a decade of experience in giving out crisis grants to prevent social care workers from falling into financial hardship. Despite their incredible work, those in the social care workforce are often undervalued and underpaid. Too often, their wages barely cover the costs of the basics: household bills, childcare, food and rent. The COVID-19 pandemic exacerbated the existing challenges faced by care workers, as they put themselves in harm’s way to care for others – often lacking Government support, access to testing or PPE to keep themselves and their loved ones safe from infection. It is estimated that half a million care staff were off sick or self-isolating during the early months of the pandemic – without proper sick pay compensation. This was a catalyst that saw many care workers fall into poverty and crisis – as they struggled to survive on this meagre income. Our COVID-19 emergency fund was set up in 46
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response to pleas for help from our social care workforce who were unable to access support elsewhere. Through this grant, The Care Workers’ Charity provides emergency funding: • To support care workers who have to self-isolate, shield or are unwell themselves with COVID-19. • To pay the funeral costs of a care worker who has passed away – the expense of which their own next of kin is unable to meet. • To contribute towards the cost of additional childcare incurred as a result of the pandemic. • To cover costs of shifts lost as a result of potential side effects of the COVID-19 vaccine. The amount given varies depending on circumstance, but can be up to £2,000 per applicant.
STILL WORK TO BE DONE It is important to us that we are as responsive as possible throughout the grants-making process, as crisis situations can rapidly snowball in their severity. Our COVID-19 emergency grant stream has been consistently fine-tuned since its launch and we are proud to say that we boast a high quality of support and quick turnaround for all applicants. Demand since the grant launched has remained at an all-time high and the charity has ensured it is responsive to influxes of applications as a result of: • New waves of infection (leading to a dramatic increase in care workers infected by COVID-19, and thus having to self-isolate). • Changes to Government policy and guidance
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(e.g. the policy limiting the movement of the social care workforce which threatens livelihoods and salaries). • The limitations of existing provision (e.g. the Infection Control Fund) in supporting social care staff. • The need to mitigate the impact of care workers having to take time off work due to post-COVID-19 vaccine side effects.
VISIBLE RESULTS As a result of our innovative, new COVID-19 emergency grant stream, and the continued provision of our long-standing crisis grant fund, the charity paid out an incredible £2.2m in 2020 – representing an increase of 1,150% in grant-giving activities compared to the previous year. This has had a life-changing impact for our applicants and benefited the social care sector more broadly by ensuring our social care workforce is supported. One of our successful grant beneficiaries, John, who faced financial crisis when he tested positive for COVID-19, said, ‘For the two weeks that I had to self-isolate, I was only entitled to Statutory Sick Pay of £92 a week, which barely covered rent, never mind anything else. With this grant, I can actually now go food shopping and not have to rely on food banks. I really thought that care workers were the forgotten kind and then you guys turn up... I honestly cannot thank The Care Workers’ Charity enough.’
A TEAM EFFORT Such immense achievements would not have been possible had it not been for the dynamic team working behind the scenes. Joining the charity at the very start of the pandemic in March 2020 in my role as CEO, I sought to reshape the charity and its team, bringing on new staff members in grant-giving, fundraising and social media roles – ensuring the survival of the charity and, moreover, support for care workers. The Care Workers’ Charity team went on to optimise internal processes, making operations more efficient, and building our capacity to support more of the social care workforce with grants. These changes included improvements to payment processes and a new CRM database. We also sought sustainability in cutting down our overheads, including by securing free office space so more of our income could be directed towards our beneficiaries.
BUMPS IN THE ROAD However, this period of innovation has not been without its challenges. COVID-19 drastically affected our fundraising capabilities, as over 20
in-person conferences were cancelled and all high-value fundraising events were postponed. Furthermore, care providers from whom we receive partnership funds were themselves experiencing financial difficulties. It was against this backdrop that we had an increase in grant applications of more than 1,000%. Nevertheless, we utilised this period to dedicate significant time towards creating and building on relationships with new and existing care provider partners, social care organisations, corporate entities and funders (among other stakeholders). The generosity of donations given through these relationships is a point of pride for the charity. We look forward to nurturing these valued relationships in the months and years to come. Additional challenges included the employment of numerous new charity staff members and having to work digitally in lieu of the ability to collaborate and meet in person. Despite this, the team rose to the challenge and, with their dedication to the charity’s mission, have worked phenomenally together to facilitate a life-changing impact for our beneficiaries. In addition, we made the most of our reliance on technology, using it to further optimise and increase the efficiency of our internal and grant-making processes. In particular, our focus on growing our social media presence has been central to creating awareness of our organisation and the support we offer – in addition to increasing fundraising potential and opportunities to connect and collaborate with a variety of stakeholders, inside and outside of the social care sector.
MARKEL
3RD SECTOR CARE AWARDS
MOVING FORWARDS Over the past year our platform has increased exponentially, as has the need for the assistance we provide. Just as the social care sector has shown incredible resilience in the face of the pandemic, so will we to strive to positively impact on care workers throughout the UK. The Care Workers’ Charity will continue to support as many care workers as possible, in as many ways as possible, creating an holistic offer of support through the provision of our crisis and COVID-19 emergency grant streams, alongside our recently launched mental health and wellbeing programme. We are proud to champion the social care workforce as the skilled and talented professionals that they are – and we will continue to advocate for them to be valued and supported in the way they deserve. CMM Karolina Gerlich is Chief Executive at The Care Workers’ Charity. Email: karolina@thecwc.org.uk Twitter: @KGerlich777
Headline Sponsor The Markel UK 3rd Sector Care Awards is run specifically for the voluntary care and support sector. Visit www.3rdsectorcareawards.co.uk to view the 2020 event winners and find out more about next year’s event. Sponsorship opportunities are available. With thanks to our supporting organisations: National Care Forum, Learning Disability England, The Care Provider Alliance, Association of Mental Health Providers and VODG. CMM September 2021
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EVENT PREVIEW
DEMENTIA, CARE & NURSING HOME EXPO 15th – 16th September 2021 The Dementia, Care & Nursing Home Expo, hosted at Birmingham’s NEC, will be taking place on 15th and 16th September 2021. This year's event will see hundreds of suppliers, speakers and like-minded professionals gather to share their visions and solutions on how care home businesses can overcome current challenges. The expo remains the UK’s only free event dedicated to growing the social care industry and supporting businesses to achieve a sustainable social care model.
SECTOR-DEFINING CONTENT The expo will focus on six key areas of social care – dementia care, business growth, care development, training and recruitment, care environment and technology-enabled care. Each area will be explored in depth through a series of Continuing Professional Development (CPD) accredited seminars and industry-leading masterclasses, all hosted by expert speakers from across the sector. Eight distinct theatres will host the comprehensive seminar programme, tackling a diverse range of topics and opening the floor to the sector’s most pressing questions. Quality Compliance Systems will manage the invaluable masterclass schedule, designed to provide industry professionals with tangible learning outcomes. The innovative Virtual Dementia Tour will also be returning to the expo, offering delegates the opportunity to experience what life is like for someone living with dementia. A particularly valuable experience for those who work with people
living with dementia every day, this tool supports care professionals to think about the correct provision of dementia services.
INTERACTIVE TRAINING All seminars at the Dementia, Care & Nursing Home Expo are CPD accredited. Ensure you have a record of which seminars you have attended and their contents. After the event, the CPD service will be notified of your attendance. Following this, you will receive an email from CPD to finalise the process and your certificate will be sent via email within 60 days. The dedicated training and recruitment theatre will share some of the latest methods to develop and support your workforce. Learn how to improve staff retention, boost mental health and wellbeing, and promote diversity and inclusion amongst a social care workforce under increasing pressure. Speakers will address the concerning skills shortage facing recruiters and the lack of recognition for the skilled work undertaken by today’s workforce. Delegates will be encouraged to contribute their thoughts and experiences, coupled with expert input, to identify current issues and solutions.
EXHIBITOR DEMONSTRATIONS The Dementia, Care & Nursing Home Expo offers networking opportunities for exhibitors and delegates alike. The expo will showcase a wide range of sector-specific exhibitors, covering essential topics such as delivery of care, software, transport and more. Over
4,000 care, nursing and residential home owners, directors and senior management teams are expected to attend the event, providing exhibitors with crucial face time with suppliers and demonstrations of emerging technology and equipment, that can help inspire business growth and sustainable social care models. Headline demonstrations featuring at this year’s Dementia, Care & Nursing Home Expo include the CQC Inspector Hub, the Activities Arena sponsored by the National Activity Providers Association (NAPA) and Care Tech Live. Representatives from the Care Quality Commission (CQC) will be on hand to answer your queries relating to registration, inspection and driving improvement. Delegates are encouraged to book an appointment in advance and will have access to several insightful resources to take away from the stand, including the latest State of Care report and the CQC’s publication on oral health care in care homes. The Activities Arena will be running live and interactive demonstrations from activities providers throughout the expo will aim to inspire and motivate delegates to expand and improve activity provisions in their homes. Lastly, Care Tech Live will provide a unique platform for social care business owners and management teams to receive education and source the latest care technology via a panel of industry-leading speakers and exhibitors. Book your free ticket today by visiting the Dementia, Care & Nursing Home Expo website. CMM
Look out for announcements about
CMM Insight events happening in 2021 @CMM_Magazine 48
CMM September 2021
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CMM September 2021
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JOHN
R A M S AY
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MANAGING
September marks World Alzheimer’s Month and the Managing Director of Social-Ability, John Ramsay, says it’s a watershed moment to address missed dementia cases.
Isolation and disruption to people’s support during the pandemic means that many living with Alzheimer’s disease – the most common cause of dementia – have experienced a deterioration in both their mental and physical health in recent months. A year and a half on from the start of the first lockdown, this World Alzheimer’s Month is an important time to take stock. With reports suggesting that one in 10 dementia cases went undiagnosed during lockdowns, there is an urgent need to reflect on the impact this could have on the social care sector. But, in addressing the backlog, people's wellbeing must remain the first priority.
ONE IN 10 CASES MISSED Findings suggest that GPs made 50% fewer dementia assessments in the six months to April 2021 compared to the six months leading to March 2019, and 33% fewer referrals to memory clinics. With the coronavirus pandemic placing renewed pressure on elderly care providers, it is deeply concerning to see reports that as many as 50,000 people living with dementia could be in the dark about their
DIRECTOR
condition. Already, people living with dementia have been deeply impacted by the pandemic and, in new research by the Alzheimer’s Society, 56% of people with dementia reported feeling completely isolated since the beginning of lockdown. But this is not simply a ‘pandemic problem’. A third of people living with dementia said they felt lonely even prior to the pandemic, which can also have a serious impact on people’s physical health. In fact, according to recent research, loneliness can increase the likelihood of mortality by as much as 26%. Most worryingly, reports of a backlog in diagnoses suggest these impacts could be even more widely felt than previously thought.
THE IMPACT FOR SOCIAL CARE For providers of care to the elderly, the delay in diagnoses risks increasing pressure on a sector already under grave strain from the pandemic and awaiting reforms to social care funding. Yet, even before lockdowns, the need for new approaches to prioritise wellbeing amongst people living with dementia and Alzheimer’s disease was clear. According to research by the Alzheimer’s Society, there has been a 27% increase over the past four years in avoidable illnesses and injuries for people living with dementia, while nearly two thirds of emergency admissions amongst people living with the condition could have been avoided. Further, with estimates suggesting that dementia cases could triple globally by 2050, there is an urgent need to address this current backlog for the wellbeing of the social care workforce. By investing in effective training and therapeutic programmes that can ease the burden for people working in social care, providers can drive long-term improvements in support – both for people with dementia and those who support them.
NEW APPROACHES FOR BETTER SUPPORT Put simply: we cannot allow a backlog in missed diagnoses to increase pressure on the social care workforce or cause a new
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epidemic of loneliness for people living with the condition. Ensuring people have access to vital services such as memory clinics is the first step, but now is also a watershed moment for providers of care to the elderly to invest in long-lasting partnerships for therapeutic interventions that reduce over-medication, support nutrition and, most importantly, foster connections for people living with dementia. The Happiness Programme is one such example, combining interactive light technology with structured training for staff around its use. At the Grace Care Centre in Bristol, for example, we have seen first hand the benefits this can bring in improving people’s wellbeing. Like all providers of care to the elderly during lockdown, staff found it difficult to provide meaningful and stimulating activities. It was during this time that sessions using light projection technology were so crucial, helping to reduce agitation and encouraging residents to engage with each other. For one individual suffering with anxiety which affects his speech, the interactive sessions have even helped to improve his communication. Further, using PRN medication (medicines that are taken as needed) has side effects and can also impact on people's mobility, so being able to reduce its use is incredibly important to the team at the Grace Care Centre – especially as the number of people living with dementia continues to rise.
WHAT NEXT? Having lived with dementia in my own family, I know how great an impact the condition can have on individuals and their loved ones. But while a backlog in diagnoses has created new challenges for elderly care providers, these are not insurmountable. What is crucial is that people’s wellbeing is not overlooked. Now is a watershed moment for social care providers. This Alzheimer’s Awareness Month, I hope they will be inspired to invest in new forms of support, partnerships and therapeutic interventions that can fight loneliness and support people’s mental and physical health for the long term.
John Ramsay is the Managing Director of Social-Ability. Email: social-ability@sapiencecomms.co.uk Twitter: @SocialAblty. 50
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Save Time, Save Money, Stay Safe and Compliant Paperless Systems for Improving the Quality of Care Because We Care The simple software for audits that everyone can use! CAREAudits ensures everything is checked as and when it should be with real time evidence and compliance all seamlessly and simply managed. It’s the ideal auditing tool for ALL Care Service Providers. Care Homes, Residential Disability & Specialist Autism Services, Day & Respite Service & Outreach Services covering Intellectual Disability Autism as well as for Domiciliary Care providers. CAREAudits assists inspections by CQC and Ofsted as all the audits and checks are in one place, compliant and evidenced in full. CAREAudits can be used out of the box, or you can simply add and edit your own audits across all care service providers.
e: apps@careaudits.co.uk t: 01482 238887 www.CAREAudits.co.uk
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“Changing the Culture of Care” The Eden Alternative is a training & culture development programme, designed to eradicate loneliness, helplessness and boredom in care homes, through building loving companionship, developing care ‘partnerships’ and enhancing wellbeing – through maintaining vibrancy, spontaneous meaningful activity & close relationships. Eden’s flagship programme runs online over 7 x 1 hr weekly sessions, aiming to train and develop 10% or more of a Home’s staff – some of whom will likely become Eden in-house trainers themselves. The programme is designed to enhance the fulfilment of the Home’s staff, the team ethic and underpin the Home’s values. It is also designed to empower residents, support residents own family members and build the Homes reputation.
It’s common sense • It’s empowering people • It’s focussed on leadership
Call today on 01626 868192 or visit www.eden-alternative.co.uk
Stay informed. Stay in control. Join Care England.
Keeping abreast of the key issues in policy and regulation is a challenge for care providers.
At Care England we provide our members with a daily flow of policy news, regulation changes, media updates and more. This gives access to the latest information and advice from one well connected, reliable source. Wouldn’t that save time and worry in your care business too?
To find out more about the benefits of membership, visit www.careengland.org.uk, email Info@careengland.org.uk or call 08450 577 677. @careengland
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