Care Management Matters (CMM) Magazine October 2024
DE-RISKING RECRUITMENT
One piece of the puzzle
Care meets academia
Collaborative research
Enhanced family leave
Raising sector standards
Maintaining oral health
Taking the initiative
Social Care Insights
Richard Humphries predicts a tricky autumn ahead as the sector processes key policy withdrawals alongside ongoing financial constraints.
Inside CQC
Mary Cridge reflects on the progress of CQC’s local authority assessments following publication of the latest assessment reports.
CMM News
Into Perspective
In this issue, Into Perspective invites two experts to delve into the findings of Dr Penny Dash’s interim report examining the effectiveness of the CQC.
Celebrating Excellence
Jemma Sharratt, Support Manager at Belong’s Atherton care village, won the Social Care Nursing Award at the 2024 Markel 3rd Sector Care Awards.
Event Preview
CMM’s latest Insight conference travels to the East Midlands, focusing on the topics that matter to local care providers.
What’s On?
Straight Talk
Arguing that the current system cannot consistently deliver the care people living with dementia need, Dara de Burca calls for mandatory workforce dementia training.
In this issue
Strength in numbers: Tackling challenges through collaboration
Karen Spilsbury explains how the Nurturing Innovation in Care Home Excellence (NICHE-Leeds) partnership was formed and the difference it is making to people’s lives.
One piece of the puzzle: De-risking social care recruitment
James Sage, Amanda Marques and Neil Eastwood share ideas and best practice solutions for overcoming the key issues facing the sector’s workforce.
Enhanced family leave: Raising sector standards
Dr Olivia Curno recalls the rationale behind the provider’s new family leave policy and lays the groundwork for other sector organisations to follow suit.
Care Innovation Challenge: CMM meets the finalists
This month, meet Tim Robinson, Kirsty Youngs and Anna Lewkowicz from Team EVA and Sarah Holmes, Sarah Wight, Ruth Sime and David Grey from Team Care Coach.
Maintaining good oral health: Responding to a national shortage
Alexandra Kelly highlights the signs of poor oral health to look out for and the value of training the sector’s workforce in the absence of readily available dentist appointments.
CMM magazine is officially part of the membership entitlement of:
CONTRIBUTORS
Director of Adult Social Care, Care Quality Commission (CQC)
Paul de Savary Executive Chairman, Home From Home Care
Fae Mell Managing Director, Kata Care Solutions Ltd
Dr Olivia Curno Chief Executive, Elizabeth Finn Homes
Amanda Marques Director, Cohesion Recruitment
Cridge
SOCIAL CARE INSIGHTS
From Richard Humphries
Richard Humphries, Senior Policy Advisor to the Health Foundation, predicts a challenge-laden autumn as the sector processes key policy withdrawals alongside ongoing financial constraints.
Although the economy is now growing faster than expected, the Chancellor is widely expected to use her first budget to raise taxes and bear down on public spending. This is to fill the £22bn ‘black hole’ identified in the country’s finances, though much of this stems from funding above-inflation pay awards to public sector workers.
There are some crumbs of comfort. It is widely reported that Government recognises the financial pressures facing councils, saying it will consolidate different funding streams into the local government financial settlement and has begun a multi-year spending review to be completed by Spring 2025. However, there is no news yet of a Royal Commission or any plans to develop a National Care Service or fair wage agreement. We know more about what Government will not do than what it will.
In the meantime, care costs continue to outstrip what councils can pay according to a recent survey by the Homecare Association. Alarm bells should also be ringing at the 81% drop in health and care work visa applications between April and July, in the absence of any plans to boost the domestic workforce. Over 400,000 people are waiting for care
and support and if current levels of demand and costs continue, councils would need a funding boost of 4.5% a year in real terms just to stand still.
The auguries for social care do not look great, on top of the scrapping of funding reforms and withdrawal of the training and workforce fund. But beyond predictable expressions of disappointment, there is surely a bigger question about why our new Government appears to be giving no more priority to social care than its predecessors, with the NHS as ever seeming to absorb more time and attention. There are couple of clues to help explain this.
The first can be found in recent public opinion polling conducted by Ipsos for the Health Foundation. While 73% favoured better pay and conditions for domestic care workers over recruiting more staff from overseas at current pay levels, over half neither agreed or disagreed or did not know when asked whether social care services in their area were good.
When asked the same question about the NHS, this figure was just 23%. This reflects the fact that the NHS has a much higher public profile and is used by more of the population.
Despite problems with longer waiting times, it continues to enjoy strong public support. 72% thought that ‘the NHS is crucial to British society, and we must do everything to maintain it’.
The second clue arises from the widespread and sustained outrage that greeted the Chancellor’s decision to restrict the winter fuel allowance to the poorest pensioners. In comparison, reaction to the scrapping of the social care reforms attracted only fleeting attention. In striving to be given the same priority as the NHS, social care is disadvantaged by not being widely known, used and valued by large numbers of people, although demography is slowing changing that.
Autumn Budget speculation could well mean that once again everyone involved in adult social care may need to look beyond the Government for hope and ideas. Shouting at the Chancellor for more money is unlikely to be effective unless there is stronger public support for investing in a service that will eventually benefit us all. Campaigners should balance lobbying politicians with convincing voters that social care is just as important to our wellbeing as universal healthcare or education.
How could Government best use the Autumn Budget to support the sector?
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Mary Cridge, Director of Adult Social Care at the Care Quality Commission (CQC), reflects on the progress of CQC’s local authority assessments following publication of the latest assessment reports.
This year, we have progressed our local authority assessment programme and recently published the latest assessment reports. The reports highlight good practice and areas for improvement in each local authority by looking at nine areas spread across four themes to check how well each authority is meeting its Care Act duties.
We have heard feedback from local authorities that our assessments help them make immediate improvements, by identifying strengths and where gaps may exist.
We are currently seeing the following themes:
• A need for better unpaid carers’ support.
• A need for a greater understanding of equality and diversity issues in local populations.
• An increasing focus from local authorities to prevent, reduce and delay care needs for their local populations.
• Continued impact of recruitment pressures, particularly for occupational therapists.
We will be sharing more as our reports continue to publish over the coming months. Our aim is to drive improvement for care providers and people using services.
INSIDE CQC
Mary Cridge
Continuous improvement
Assessing how local authorities are meeting their Care Act duties is a new responsibility for us. Our approach has been co-designed with the Local Government Association (LGA), Association of Directors of Adult Social Services (ADASS), provider trade associations, voluntary sector organisations and people using services.
We have tested, fully piloted and evaluated our approach to incorporate any learning before beginning assessments. We continue to learn and iterate as we go to ensure our processes remain efficient and meaningful.
To continuously improve, we are considering how to greater capture providers’ views in our assessments. We will be seeking input on how we might refine our provider survey, which is an integral part of the assessment process and helps us identify areas for further consideration during on-site activity. We will be exploring this further in focused workshops during the autumn.
Our current focus is to establish a baseline of quality across all 153 local authorities with adult social care responsibilities. Following this, we will begin our longer-term approach to regular ongoing assessments and will look to our stakeholders to help shape this soon.
Improving operational effectiveness
In my last column, I updated on work to address the interim findings of the review into our operational effectiveness, led by Dr Penelope Dash. This includes increasing the number of inspections, increasing the number of people working in registration to
improve waiting times and improving our provider portal.
The purpose of the review was to examine the suitability of CQC’s new single assessment framework methodology. Although we are assessing local authorities against their Care Act duties using the single assessment framework, there are clear differences between our local authority assessments and provider assessments. We will be considering the final report’s findings relating to local authority assessments and how to incorporate them into our continuous learning and improvement.
Highlighting outstanding care
We are often asked what ‘Good’ or ‘Outstanding’ care looks like and have been delighted to share an example of this in a recent report following an inspection of a residential care home for adults with a learning disability and mental health support needs.
Azalea House was rated ‘Outstanding’ after finding a person-centred service where managers and staff ensured people received the best possible care. Leaders supported staff with robust policies and processes, enabling them to deliver safe, effective and compassionate care. The service’s consistent staff team meant it knew people living at the service well, providing support that met people’s needs.
This translated into positive experiences for the people living at the care home, who told us they felt valued, respected and cared for. Other providers may wish to look at our report to see if there is anything they can learn to promote improvements in their own services.
Mary Cridge is Director of Adult Social Care at the Care Quality Commission (CQC). Email: providerengagement@cqc.org.uk : @CQCProf
Sector responds to NHS report
The sector has responded to a new report on the state of the NHS. Commissioned by the Secretary of State for Health and Social Care and led by Rt Hon Professor Lord Darzi, OM, KBE, the report has identified several challenges facing the NHS and has highlighted key areas for reform and modernisation. In addition, the report has identified long-standing neglect of social care.
On social care, Lord Darzi has highlighted that, ‘Social care has not been valued or resourced sufficiently, which has both a profound human cost and economic consequences. In my examination of the social care system, the connection between inadequate social care funding and the strain on the NHS is glaringly clear.’
Responding to the report, Nadra Ahmed CBE, Executive Co-Chairman at the National Care Association, said, ‘We cannot continue to allow social care to be undervalued, as this has dire human and economic consequences. It is imperative that social care is resourced and restructured as an integral part of the health service, particularly as
our aging population grows and the prevalence of long-term conditions increases.
‘It is crucial that we tackle the growing backlog in assessments and mental health services, which leaves over a million people waiting for care many, for over a year. The report’s findings on the severe consequences of these delays, including their tragic impact on mortality rates, must spur us into action.’
Melanie Weatherley MBE, Co-Chair of the Care Association Alliance and Chair of the Lincolnshire Care Association, said, ‘We welcome the report published […] by Lord Darzi and the bold statement by [the] Prime Minister […], in which he announced a new ten-year plan to rebuild the NHS. Although social care was not directly included in Lord Darzi’s report, health and social care are two sides of the same coin. The proposed plan must also solve the social care crisis and tackle the issues around funding to relieve pressure on the NHS and reduce costs.’
To read the Independent investigation of the NHS in England, click here
Nominations open for sector awards
The Markel 3rd Sector Care Awards 2025 nominations are now open for people working in the not-for-profit care sector.
Organised by CMM, and developed in conjunction with the National Care Forum, the Markel 3rd Sector Care Awards are the perfect way to share the work you have been doing to support those who need it most. The Awards recognise individuals who are making a positive difference to people’s lives, whether they are supporting children or adults.
The Awards have been rewarding the hard work, dedication, innovation and excellence of everyone working in the sector since 2014. Anyone can enter themselves or nominate someone else in one of the categories – no matter what their position in an organisation. There is no charge for entries.
The closing date for nominations is Friday 25th October. Take a look at the previous winners and finalists to see what truly makes the Markel 3rd Sector Care Awards such a remarkable event.
Commenting on the launch of the Markel 3rd Sector Care Awards 2025, Lisa Werthmann, Director of Creative Operations at CMM, said, ‘It is a real privilege to organise the Markel 3rd Sector Care Awards – it is such a significant and uplifting event. I urge everyone working in this sector to nominate your colleagues and also recognise your own hard work.
‘I would like to take this opportunity to thank our sponsor, Markel, our dedicated judges, and everyone who has been involved in the Markel 3rd Sector Care Awards to date. We must keep recognising excellence. I look forward to reading the nominations as they come in and celebrating in person next year for what is going to be a truly spectacular celebration.’
Click here to find out more, including how to make a nomination and purchase tickets for the Awards ceremony. Sponsorship opportunities are also available.
Care Provider Alliance
Professor Vic Rayner OBE, Chief Executive Officer at the National Care Forum, has become the incoming Chair of the Care Provider Alliance (CPA), a coalition of national voices of adult social care providers in England. The role of CPA Chair rotates annually across each of its ten associations. Vic follows Dr Jane Townson OBE, Chief Executive Officer at the Homecare Association.
Hampton Grange and Gwen Walford Nursing Homes
Rebecca Protheroe has been appointed as the new Home Manager of Hampton Grange and Gwen Walford Nursing Homes. Beginning her career in a Forensic Rehabilitation Unit, Rebecca managed complex cases and developed care plans. Most recently, Rebecca managed a care home in Hereford. In her new role, Rebecca aims to build on the strong foundations already established at Hampton Grange and Gwen Walford.
Maplebrook Care Home
Kate Ingram has been appointed as the new Manager of Maplebrook Care Home to oversee its daily operations whilst supporting plans to increase occupancy and maintain standards. Kate moves into the role after serving as Assistant Manager for two months. Working as an Advanced Nurse Practitioner (ANP), Kate has known Maplebrook’s residents since admission, which provides familiarity and consistency as she moves into the new leadership position.
Workforce e-Learning resource launched
A new workforce e-Learning resource has been launched to empower care workers and personal assistants across the frontline. The resource has been developed by the Department of Health and Social Care (DHSC) in collaboration with the Royal Society for Public Health (RSPH) and key stakeholders from the sector.
The resource, Ten Public Health Tips for the Social Care Workforce, aims to enhance the confidence and skills of those in the social care sector by integrating public health approaches into their daily practice to contribute to effective and holistic care.
The e-Learning course has been designed to help care workers recognise their role in public health and how their work can improve health and wellbeing outcomes. The Ten Public Health Tips for the Social Care Workforce course offers guidance on how to improve health outcomes through public health approaches.
By the end of the course, learners will have had the opportunity to:
• Gain an understanding of public health and its connection to social care roles.
• Explore ten actionable tips to enhance
the health and wellbeing of those they support, tailored to different social care settings.
• Discover further resources to deepen their knowledge of public health and its critical role in social care.
The resource was developed in consultation with a reference group composed of representatives and experts by experience from key stakeholder groups. This collaborative approach set out to ensure that the content is accessible, relevant and practical, focusing on integrating public health approaches into routine practice. It has also been specifically designed to not place any additional resource burdens on care workers.
Commenting on the launch of the new workforce e-Learning resource, William Roberts FRSPH, Chief Executive at the Royal Society for Public Health, said, 'Prevention is becoming ever more critical to ensure we are healthy, happy and able to live well. Keeping people well, off waiting lists, and living independently is key to building a future. To get it right, we know it’s going to take a
whole workforce approach.
'Equipping our social care workforce with the knowledge and skills to integrate public health into their daily practice is not just a step forward—it is a leap towards a healthier, more independent future for the people and the communities we serve.
'Day in, day out, social care workers make a huge difference to people’s lives bringing a vast range of expertise and knowledge. We are committed to helping them go further. We encourage all social care workers to engage with this resource, developed in collaboration with a range of experts and stakeholders to meet their needs.'
Professor Jamie Waterall, Deputy Chief Public Health Nurse for England, said, 'The social care workforce already plays a critical public health role, but this new resource will support them even further to increase their knowledge and confidence in this area of care.
'The e-Learning resource provides practical tips and advice which aims to improve public health outcomes for both the workforce and those they care for across our communities.’
For more information and to access the resource, click here
Older people most likely to experience heatwave effects
Around three million people aged 65 and over in the UK living in properties between 45 and 80 years old, that are most likely to overheat, are among the greatest at risk of becoming ill in the event of a summer heatwave, the Centre for Ageing Better has warned.
"Previous heatwaves in England have led to a significant rise in the number of deaths among older people."
There are also more than three million people aged 65 and over living with cardiovascular and respiratory conditions who are statistically more likely to have their health impacted by a heatwave. Research also suggests that people from minority ethnic households, babies as well as people living in mobile homes or high-rise buildings are also at heightened risk during a heatwave.
Met Office figures show the UK had its warmest May and spring on record. The Centre for Ageing Better has called for greater support for people to help make
improvements to their home which might lower the risk of harm from a heatwave.
More than 488,000 households headed by someone aged 65 and above report their home overheating during summer months while national surveys have found that 1.9 million (8%) of all households report at least one part of their home gets uncomfortably hot.
Around one in six (15%) of all living rooms and one in five bedrooms (19%) in English homes overheat in summer. There were more than 4,500 heat-related deaths estimated to have occurred in England in 2022 with projections indicating that the average number of heat-related deaths will triple within 30 years.
Previous heatwaves in England have led to a significant rise in the number of deaths among older people. A heatwave in 2003 caused deaths among those aged over 75 living in London to increase by 59% while four days of heatwave in July 2022 led to more than 1,000 excess deaths for those aged over 65 in England.
The Centre for Ageing Better has called for the establishment of a national network of local one-stop shops called 'Good Home
Hubs' which would offer advice on home repairs and adaptations including where to find trusted tradespeople, identifying what work needs to be done, how to finance repairs and improve energy efficiency.
Millie Brown, Senior Evidence Manager for Homes at the Centre for Ageing Better, said, 'Climate change and heatwaves are here to stay, but that does not mean that we should passively accept the damaging effects and assume increasing loss of life as inevitable.
'As a country we're experiencing more extreme heat on a more regular basis throughout summer months, and this is only going to intensify in the future. We need to do more in terms of prevention and preparation in readiness for our changing climate, our growing ageing population, and our faltering housing stock. Inaction is not an option.
'To help ensure that homes do not exacerbate the threat of heatwaves, we need a national housing strategy and a national network of Good Home Hubs to ensure people have better opportunities to improve their homes.'
For more information about the Centre for Ageing Better's work, click here
New report on dementia in the Commonwealth
Believed to be the first report of its kind, Dementia In The Commonwealth has delved into the current state of dementia care and support, highlighting disparities and challenges, best practices and the urgent need for action to improve the lives of those affected by dementia.
Key findings include:
• 59% (33) of Commonwealth nations do not yet have a National Dementia Plan (NDP) or strategy in place.
• Only 11% (six) of Commonwealth nations have an NDP in place.
• 19% (10) of Commonwealth nations are in the process of developing an NDP.
• Shared challenges across the Commonwealth include the need to deal with the inequities in access to support, the workforce shortage and a requirement for a funding strategy.
• Communities and civil society are mobilising to create greater awareness
and dementia friendly spaces to reduce isolation and discrimination.
• Health and care professionals are working in partnership with other key stakeholders to find new ways of providing culturally appropriate care and support.
• Entrepreneurs from private and social sector, and committed enterprising individuals are also seeking solutions across key areas such as housing, residential care and technology.
This report is recommended reading for anyone involved in health policy, health, care and community development, service delivery and everyone who wants to find out what they can do for themselves, each other and their community.
Dr Emma Hodges, the report’s Project Manager, Chief Editor and author, said, ‘It is recognised that there are many competing priorities for governments, particularly for
Report explores finances at the end of life
A new Hospice UK report has explored how a person's financial situation can affect their experience at the end of life. The report, ‘It's a nightmare scenario’ – death, dying and financial hardship, is based on first-hand research with people who have lived experience of financial hardship at the end of life. It aims to ensure these people’s experiences are heard by decision-makers across the UK.
Commenting on the report’s publication, Katie Reade, Head of Policy and Public Affairs at Hospice UK, said, ‘We are determined to ensure these voices are heard by decision makers. People’s financial and social needs are as important are their clinical ones. It is important that the health sector and those in power recognise this and ensure those needs are met.’
A 2022 report by Marie Curie found that an estimated 90,000 people die in poverty each year. For these people to have a good death, their significant financial and social needs must be treated as seriously as their clinical ones, Hospice UK has explained. In contrast, Hospice UK’s report has
found that the current support available is inadequate, inaccessible and inconsistent. In addition:
• There is a significant mental and physical toll to facing death, dying and bereavement alongside financial hardship.
• There are significant visible and hidden costs for people experiencing financial hardship at the end of life. These include transport to and from care services, energy bills for medical devices and funerals.
• Individuals and carers often fall into financial hardship as a result of a terminal diagnosis.
• The complexity of the welfare system can make it hard to navigate, understand or access.
• Availability of advice and support is inconsistent and reliant on the voluntary sector. This leads to a 'postcode lottery' in support.
The report has recommended that:
• Governments should introduce legislation that safeguards against people falling into financial hardship before or after diagnosis. This should include expanding eligibility
low and-middle-income countries, including water/sanitation, food distribution, climate change and education. However, this report is a call to action for all stakeholders across the Commonwealth to come together and address the growing impact of dementia.’
Angela Raguz, Dementia Centre General Manager at Australian care provider, HammondCare, says the report is a significant opportunity for the Commonwealth to share the expertise and resources that exist to improve the lives of people with dementia and their carers.
‘As the Commonwealth turns 75 years of age, this report challenges us to consider the realities for its citizens in their 70s with dementia. I am looking forward to the opportunities for The Dementia Centre to collaborate with the many contributors to this report across the Commonwealth.’
To read Dementia In The Commonwealth, click here
criteria and raising the amount of financial support available through welfare schemes.
• Minimum standards of welfare provision should be introduced by governments and health systems. This provision should include monetary support and access to advice.
• Health and care professionals should ask patients about money worries at key trigger points and signpost them to local financial support services.
• Government departments with oversight of housing should reform housing legislation to stop people being penalised for losing a loved one.
• Local health systems and providers should improve physical access to their services. This can be done by improving access to transport or, in the case of hospices, providing outpatient services.
• Primary and secondary health and care services should develop close relationships, and collaborate, with local voluntary sector providers, including hospices.
To read ‘It's a nightmare scenario’ – death, dying and financial hardship, click here
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Statement published on responsible AI use
The Care Workers’ Charity (CWC), in collaboration with the Institute for Ethics in AI at the University of Oxford and Digital Care Hub, has launched the Care Workers’ Guidance and Statement of Expectations on the Responsible Use of AI in Adult Social Care. This document, informed by frontline care workers from England, Wales and Scotland, sets the foundation for the ethical integration of Artificial Intelligence (AI), particularly generative AI, in the sector.
According to the CWC, the statement is a significant milestone in the ongoing dialogue around AI’s role in adult social care. It outlines care workers’ expectations towards employers, AI developers, policymakers, local authorities and the Care Quality Commission (CQC). The aim is to ensure that AI is employed responsibly, with a
focus on enhancing care rather than replacing the human connection that is central to quality service.
Key aspects of the statement include:
• Ethical integration: Guidelines for employers and developers on the ethical development and deployment of AI in care settings.
• Policy recommendations: Suggestions for policymakers and local authorities on how to regulate AI to protect the interests of both care workers and service users.
• Peer guidance: Practical advice for care workers on the responsible use of generative AI tools, such as ChatGPT or Microsoft Co-pilot, within their daily work.
This statement marks the beginning of a broader research initiative. To learn more about the statement, click here.
Home Office immigration figures drop
New Home Office statistics have revealed that fewer people are seeking to come from abroad to work in the NHS and social care. The figures show that the Home Office approved 89,085 visas for the health and care sector in the year to June 2024 – more than 80% down on the year before. It is widely accepted that the fall has come as a result of the previous government’s tightening of immigration measures in December 2023. Most notably, preventing overseas care workers from bringing their dependants to the UK.
Commenting on the latest Home Office figures, Professor Martin Green OBE, Chief Executive at Care England, said, ‘Our dedicated workforce is social care’s biggest asset, and without the proper measures in place to draw in domestic recruits, the gap left by international recruits will reach an untenable level. Adult
New guidance to support independent living
The Social Care Institute for Excellence (SCIE) has published new guidance to help people live more independently after a hospital stay. The guidance has been published to help those who commission, manage and deliver reablement services to tackle key barriers that can prevent people from fully benefitting from the service.
According to SCIE, despite being a core pillar of older people’s social care for almost 20 years, reablement services are still finding that people do not always understand what the
intervention is and those who are referred can be reluctant to engage fully with the service.
Researchers from the University of York have found that multiple factors affect whether someone engages with reablement, such as people not understanding the difference between reablement and ‘traditional homecare’, services that refer people for reablement failing to properly prepare older people and families for the intervention, reablement staff’s skills in managing conflict and securing engagement and
inadequate time allocated to reablement visits due to service pressures.
To help overcome these barriers, the research team worked with reablement staff, older people and carers to develop a series of evidence-based and practical recommendations to support reablement services, which has now been published by SCIE as an online resource.
Commenting on the publication of the new resource, Kathryn Smith, Chief Executive at SCIE, said, 'We are
social care needs a fully funded workforce plan, with boosted pay, terms and conditions, the change for career progression, parity of esteem with NHS colleagues. Without this, our sector risks not having enough staff to deliver the care and support this country’s needs now, or in the future.’
Mike Padgham, Chair of The Independent Care Group (ICG), said, ‘A fall in the number of overseas staff is the last thing social care needs at the moment, as we are struggling to fill shifts as it is. The last government’s brutal measures are working and the lifeline of overseas staff to help staff homecare and care and nursing homes has been cut.
‘The question is, what do we do now? As we warned at the time, no serious measures have been put in place to replace those overseas workers who have played such a key role in helping us to keep delivering care.’
pleased to be supporting this guidance from the University of York, which highlights important challenges the social care system must address if reablement is to succeed.
The practical nature of the recommendations provides a clear framework that will allow the sector to begin tackling the issue of poor engagement by users and family members in a consistent manner.'
To access Supporting engagement with reablement: a practice guidance resource for reablement services, click here
‘Care to Climb’ campaign launches
Paragon Skills has announced its new ‘Care to Climb’ campaign, aimed at empowering professionals in the sector to advance their careers, enhance their leadership skills and raise overall standards of care across the industry.
The ‘Care to Climb’ campaign aims to provide adult care professionals with a clear pathway to career progression through specialised apprenticeships, including the Level 4 Lead Practitioner in Adult Care and Level 5 Leader in Adult Care programmes. These apprenticeships intend to equip care workers with the knowledge, confidence and leadership skills needed to step into higher-responsibility roles, ultimately seeking to improve the quality of care provided to service users and residents.
In addition, the campaign has been designed to empower care workers at Levels 2 and 3 to ascend to senior roles by developing critical thinking, problem-solving and leadership abilities. The campaign focuses on fostering personal and professional growth for care professionals, with a view to transitioning into more complex roles and becoming confident leaders in their field.
One of the campaign’s core goals is to improve care standards by promoting continuous professional development. Paragon Skills recognises that well-trained leaders are critical to delivering high-quality care. Through the ‘Care to Climb’ campaign, care workers advancing to Levels 4 and 5 should acquire the expertise necessary to offer a higher level of service and guidance.
According to Paragon Skills, the campaign’s benefits extend beyond individual growth, directly impacting sector employers. By investing in their staff’s leadership development, employers should benefit from a skilled and motivated workforce. This approach can lead to higher retention rates and a pipeline of future leaders, working towards a stable and high-performing team.
For those entering the adult care sector, Paragon Skills’ Career Hub offers resources to help newcomers navigate potential career paths, understand qualification requirements and receive support in building long-term careers in care. Paragon Skills has highlighted that the ‘Care to Climb’ campaign is as much about guiding new talent as it is about empowering existing professionals.
The ‘Care to Climb’ campaign promotes the transformative power of leadership and advanced skills in adult care. By focusing on personal development and leadership, Paragon Skills is hoping to create a new generation of care professionals equipped to provide exceptional care and lead with integrity. Participants in the campaign will have the opportunity to not only gain recognition within their organisations but also position themselves as leaders within the sector.
As a leading provider of care apprenticeships, Paragon Skills is committed to fostering the growth of adult care professionals and helping employers build stronger, more capable teams. The ‘Care to Climb’ campaign strives to represent a vital step forward for the industry, improving care outcomes for service users while empowering individuals to unlock their potential.
For more information on the ‘Care to Climb’ campaign and to explore its Level 4 and 5 apprenticeship programmes, click here
IN FOCUS
Social care technology could save the NHS over £1.2bn
WHAT’S THE STORY?
The NHS could save more than £1.2bn through widespread use of new non-intrusive lifestyle monitoring technology in social care, according to a new independent report. More than two million hospital bed days could be saved, and the extra capacity created in social care could fund the equivalent of 10,000 additional full-time carers in the system by 2035. These findings are part of new analysis commissioned by health-tech company Lilli to make the case for urgent digitisation across the health and social care sector. The report uses data from multiple local authorities across the UK who are currently using the AIdriven monitoring technology to address the growing care deficit and mounting social care crises.
Entitled From passive to proactive: How monitoring technology can help to solve the health and social care crisis, the report follows recent social care promises from the new Government to accelerate the adoption of technology in health and care and highlights the ‘domino effect’ that proactive monitoring employed in social care can have not just on council resources but also the NHS and patient outcomes.
WHAT WERE THE FINDINGS?
If adopted by councils and integrated care boards, the report found that lifestyle
monitoring technology has the potential to deliver the following benefits between now and 2035:
• Freeing up of 94 million hours in carer time across the UK. These productivity benefits would be worth an estimated £1.8bn to councils, allowing vital resources to be redistributed to where they are most needed.
• The use of remote monitoring technology would save councils £3bn by preventing people going into more expensive care settings.
• A quarter of people receiving care at home could have monitoring technology as part of their care package – the equivalent to 147,000 people in the adult social care system.
• NHS savings of £1.8m each year through reduced hospital admissions from UTIs, due to earlier intervention. These savings could pay for half a million hours of nursing time.
WHAT DO THE EXPERTS SAY?
Kelly Hudson, Chief Executive Officer at Lilli, said, ‘Right now, the people who need care are not getting the help that they should, and the problem will only get worse as the population ages. The numbers in this report speak for themselves. The savings and productivity figures highlight the profound difference that an investment in technology now would have not just on the system but on the lives of people up and down the country.’
CQC prosecutions surge by 700%
The Care Quality Commission (CQC) is prosecuting care homes and registered providers more than ever before, new analysis from law firm Shakespeare Martineau has revealed. When comparing 2009-2013 and 20192023, prosecutions by CQC surged by 700%, from 11 cases to 88. They also more than trebled when compared with the five years spanning 2014-2018, during which there were 25 cases.
In addition, the total fines levied by the CQC have also risen. Between 2009 and 2013, prosecuted care homes and registered providers were fined a total of £650,973. However, in the five years leading up to 2023, the figure increased to more than £10.6m.
Commenting on the findings, Jordan Glackin, Healthcare Partner at Shakespeare
Martineau, said, ‘The significant increase in prosecutions reflects a growing emphasis on accountability in the care sector, while the substantial fines imposed illustrate the severe financial consequences of failing to meet regulatory requirements.’
The analysis also examined the impact of the pandemic on the CQC’s regulatory actions. Comparing pre-pandemic years (2018 and 2019) to the pandemic years (2020 and 2021), prosecutions increased by 63%. This trend continued post-pandemic (2022 and 2023), with prosecutions rising by an additional 22%.
Correspondingly, the total fines paid escalated from £922,115 pre-pandemic to £4.9m during the pandemic, further increasing to £5.1m post-pandemic.
Audley Group appointed to manage retirement village sale
Audley Group has been appointed by Galliard Homes and O’Shea Group to assume the sales and operational management of a new retirement village, Shiplake Meadows, in Oxfordshire. The village will bring 65 units to market, comprising two- and three-bedroom cottages and apartments, including penthouses. On Shiplake Meadows, Galliard and O’Shea were advised by Knight Frank and Howard Kennedy LLP.
Sustainability has been at the centre of the design of Shiplake Meadows with an energy strategy that aims to deliver a 60% reduction in CO2 emissions and a 50% reduction in energy costs for homeowners in the village compared to a standard gas-
fired home. There will be 35 cycle bays and 86 car parking spaces which are enabled to have an EV charger installed for those with electric vehicles.
Nick Sanderson, Chief Executive Officer at Audley Group, said, ‘The Shiplake Meadows site is beautiful and the demand in the local community is high for aspirational retirement living options with central facilities. Shiplake and the local area had long been on our list of potential sites for a village, so we jumped at the chance to work with Galliard and O’Shea who really understand the importance of creating more specialist housing for older people.’
For further information on Shiplake Meadows, click here
CARE FOR BUILDINGS | CARE FOR CLIENTS
Call to scrap single word ratings for social care services
The Local Government Association (LGA) has called for the scrapping of single word ratings in Care Quality Commission (CQC) assessments of councils’ adult social care services, following the recent decision to end single word ratings in Ofsted inspections.
The LGA, which represents 350 councils across England, said CQC’s existing assessment reports, which provide helpful narrative summaries and more detailed analysis by different themes, is sufficient and provide a useful and balanced picture of the quality of services.
This call has come in light of the recent decision to end single word ratings in Ofsted inspections, including for children’s social care teams and settings, with immediate effect. The LGA believes this judgement is relevant and should extend to CQC’s assessment of councils’
adult social care services.
Adult social care has faced over a decade of underfunding and unmet and under-met need has grown as a consequence. Councils believe single word ratings do not do justice to the complex and difficult state that adult social care is in.
The LGA said Government needs to provide immediate investment to end this crisis, address unmet and under-met need and urgently agree a long-term funding and reform plan to allow all people to access the care and support services they need to live an equal life.
Commenting on LGA’s call to scrap single word ratings for social care services, Cllr David Fothergill, Chairman of the LGA’s Community Wellbeing Board, said, ‘Local government fully supports transparency and accountability. But while
assessment and regulation are both important and helpful in driving improvements to services, single word or phrase judgements cannot ever adequately capture the complexity of adult social care and the work councils do to meet their legal obligations.
‘The Government must ensure that the assurance process is, and remains, productive and supportive for councils. Sufficient time must be given to learn the lessons from councils’ experiences as more go through the assessment process.
‘Working with people who draw on care and support, councils and care providers, the Government also needs to urgently develop and implement a fully costed, longterm, sustainable plan to fund social care. Investment and reform are critical for bringing
about real change and better outcomes for people.’
Mike Padgham, Chair of The Independent Care Group (ICG), said, ‘We are not looking to weaken inspection in any way and are committed to poor examples of care being identified. But what we need is a partnership approach to the inspection process and far more empathy when organisations are being reviewed.
‘In so many cases, these are people’s livelihoods the CQC is inspecting, and they have to appreciate that a swift, one or two-word rating can finish them overnight. We need a much more comprehensive and balanced rating system where efforts are made to support providers to improve shortcomings, rather than the “them and us” confrontational relationship that can exist at the moment.’
NEWS FROM ACROSS THE GLOBE
Funding to recruit and train New York’s care workers
Governor Kathy Hochul has announced three Workforce Investment Organisations (WIO) will receive awards totalling up to $646m over the next three years to implement the Career Pathways Training (CPT) programme, which will recruit and train thousands of new health, mental health and social care workers across New York. This programme will also provide new career advancement opportunities to many current healthcare workers throughout the State.
The designated WIOs under the CPT programme will use this new funding to:
• Conduct outreach and recruit thousands of new and current health, mental health, and social care workers for participation in the CPT programme.
• Support CPT programme participants with tutoring and other academic support such as apprenticeship and mentorship programmes.
• Make payments to support participants’
tuition programme fees, textbooks and supplies.
• Aid in job readiness and placement to meet service commitments.
• Hold educational programmes for new and current health, mental health and social care workers, including application and enrolment assistance.
• Form partnerships with educational institutions and other stakeholders to increase career opportunities for CPT programme participants.
• Perform data collection and reporting on CPT programme performance metrics, spending and other information.
The funding awarded to these WIOs has been possible because Governor Hochul secured an amendment to New York’s Medicaid Section 1115 Demonstration that allows New York to invest nearly $6bn of federal funding into it's
healthcare system over the next three years.
The waiver amendment is now allowing the State to make transformative investments. These include establishing social care networks to integrate health, behavioural and social care services. Such networks will connect high-need members to critical nutritional and housing support services, enhance access to coordinated and comprehensive treatment for substance use disorders, invest in primary care and make other long-term, sustainable investments in the State’s healthcare workforce.
Commenting on the announcement, Governor Kathy Hochul said, ‘The health of every New Yorker depends on a strong, stable and equitable healthcare system, and healthcare workers are its very foundation. This investment allows us to continue to retain and grow our healthcare workforce and ensure we deliver the highest quality healthcare for New Yorkers.’
Treatment.com AI and University of Edinburgh join forces
Canadian healthcare tech company Treatment.com AI Inc. has announced a collaborative agreement with the University of Edinburgh. The University is looking to utilise Treatment’s proprietary Global Library of Medicine (GLM) to jointly build applications within the ‘SET4 Systems Engineering to Transform Transitions in Health and Social Care innovation initiative’ (‘SET4’).
SET4 is a multi-million-dollar programme under development in the Usher Institute within the College of Medicine and Veterinary Medicine at the University of Edinburgh. It represents an innovation hub initiative including all relevant stakeholders, designed to deliver innovative data-driven solutions which improve problematic transitions in health and social care for people living within Multiple
Long-Term Conditions (MLTC).
Whilst initially focused on specific communities in Scotland, the goal now is to deliver meaningful change with sufficient evidence to enable wider adoption across the National Health Service (NHS), other social care settings and beyond. Beyond SET4, the parties will also work together to explore other relevant collaborative and commercial opportunities to positively impact healthcare system efficiency and enhanced care.
Commenting on the announcement of the collaborative agreement, Kevin Peterson MD, MPH, FRCS(Ed), FAAFP, Chairman and Chief Medical Officer at Treatment.com AI, said, ‘As a global leading university for industry and innovation, the University of Edinburgh provides a powerful academic partner for
Treatment AI in our mission to improve clinical care using artificial intelligence. We are delighted and proud to work with Edinburgh Innovations to discover new ways of improving the lives of people initially in Scotland and subsequently across the world.’
Julie Jacko Ph.D., Dean of Innovation and Engagement for the College of Medicine and Veterinary Medicine at University of Edinburgh, said, ‘Catalysing the transformation of health in UK society and globally is central to the mission of the Usher Institute. By prioritising people, populations and their data, the Usher Institute is at the forefront of discovery and innovation. Our partnership with Treatment. com AI will amplify the impact of our work, ensuring that health and wellbeing is improved for generations to come.’
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Five years after setting up the Nurturing Innovation in Care Home Excellence (NICHE-Leeds) partnership, Karen Spilsbury, Professor of Nursing at the University of Leeds and Academic Director at NICHE-Leeds, explains how the partnership formed and the difference it is making to people’s lives.
Preparing for inspections used to be stressful. With QCS Quality Centre, Sarah runs online audits and mock inspections, keeping her ready for anything.
NICHE-Leeds is a partnership between academics at the University of Leeds and care home staff, residents and their families. The partnership brings together experts from the caring profession and those working in research to address the questions that matter for care homes.
The impetus was about making sure the voices of people living or working in care homes were heard in the process of generating research and evidence that would really make a difference for those people.
NICHE-Leeds replicates the Living Lab in Ageing and Long-Term Care at Maastricht University, the Netherlands, which has been running for 25 years. The model is based on building research projects around questions generated by the care home sector and fostering genuine collaboration.
During the first two years, we built relationships, helping people living and working in care homes to understand what we were trying to achieve, and why and how it would benefit them, and those conversations have led to the development of a number of research projects. This method ensures we are asking the right questions.
Some care home staff and family members are co-applicants on some of our National Institute for Health and Care Research (NIHR) grants. They have a say in the actual delivery of the research and help us consider how to share results with the people we need to influence to have the greatest impact.
How it works
The model, established in 2018, is a partnership between the University of Leeds and care providers Westward Care and Springfield Healthcare, working also with Leeds Care Association and Leeds City Council. In 2023, HC-One, Britain’s largest care home operator with almost 300 care homes across England, Scotland and Wales, and Leeds Beckett University also joined the partnership. A university researcher acts as a scientific linking pin, funded by the care organisation and working in the care home one day a week. A care home staff member acts as a practice linking pin, facilitating the researcher’s work in the care home and ensuring stakeholders are
involved in the generation of research ideas. The university provides infrastructure – how we leverage those ideas and attract funding – and the management of the grants. So far, we have been associated with grant income of around £6.5m on different projects. Sometimes commissioned calls come from funders, which gives us an opportunity to ask care homes whether there is something they'd like to do on this topic. However, quite often the ideas come from care homes, and we wait for the right opportunity or funding pot to become available.
Residents and the public are involved from the get-go. Not everything raised is a research question – it is really about audit or best practice, and it is something you could implement tomorrow. Sometimes we know evidence exists and we can share that knowledge with those who are asking for it.
Bringing together scientists and people delivering care in the care home environment is a massive win and a lot of the projects we’re doing are just coming to delivery. These are ideas that care home staff are saying are really important and useful to them. In the future, these projects will start to make a difference every day.
Recently, we held a five-year celebration event where carers spoke about their experiences. Senior managers described having queries about medication for example, and being able to get in touch with us to get answers quickly and learn from our academic expertise.
The impact is increased care home staff confidence; it helps them value what they do and understand it is alright to have questions about how to do things better. Senior care home staff can access extensive knowledge that may otherwise have been closed off to them.
Research projects
REcruiting and RetAining nurses, and carers in Care Homes: What works, for which staff, under what circumstances, and at what cost? The REACH Realist Review.
This research project focuses on attracting, recruiting and retaining nurses and carers to care home work. Using evidence from
research articles, reports, policies and other relevant materials, it will build an explanatory framework which will describe what is needed to attract, recruit and retain staff and why, as well as describing the differences between staff and outlining the costs involved in staff recruitment and retention.
Key to the project are the views of people working in care homes. Registered nurses and care workers have been interviewed about their experiences and their views have contributed to building a picture of what is needed and why to attract and keep nurses and carers in care home jobs. During the project, researchers have met regularly with care home residents, relatives, staff and people working in social care. Their involvement is helping to ensure the research messages are relevant and reflect the views of people who live and work in care homes.
The project is due to be completed this year and the findings will be shared with care homes across the country and published in research journals. Through NICHE-Leeds, the researchers will work with partnering care home organisations to support them in implementing the findings into practice.
Maintaining and improving mouth care for care home residents: A participatory research project
This project was developed after a care home worker asked researchers how to help residents with mouth care, particularly when they resisted that care, as is common among people with dementia. As well as promoting mouth care for residents, the project aimed to bring about mouth care practice changes in its partner care homes, if needed.
The project explored existing literature to develop accessible guidance on strategies that staff could use to support residents to maintain and improve oral care. The review was used to determine knowledge levels within the care team, which highlighted skills and knowledge gaps, and the training needed to address this. Resources were developed for care homes from the project and informed a larger study, which will be published later in 2024.
Future of the partnership
We are gradually growing the number of partners, which takes time. We are also widening the net so other care homes know they can be part of our projects and benefit from our expertise and resources, even if they are not part of the partnership.
In the future, we hope our work will make a difference to people living in care homes, and support people working in these environments to understand best practice informed by research. We hope staff will have confidence in what they do and know they can ask questions when they do not know.
The NICHE-Leeds model provides a blueprint of how research should be done, acknowledging that collaboration is essential if research is to have any chance of making a difference for people in the sector.
Partner perspectives
‘Joining the NICHE-Leeds research partnership has improved standards of care, as well as staff skills and knowledge, and has raised our profile as professional care providers in the health and social care community. NICHE-Leeds has given access to a whole new world of knowledge, and the participatory research approach has improved work culture, with staff telling us they feel valued as recognised professionals.’ Peter Hodkinson, Managing Director, Westward Care Ltd.
‘We have been part of innovative developments relating to the management of COVID-19, gained support when implementing our digital care planning system, enhanced our oral care delivery and supported our staff to understand the impact of activities on residents’ wellbeing.’ Angela Randle, Head of Kindness Care and Quality, Springfield Healthcare.
‘Over 70% of care home residents have dementia and doing research that helps care homes to deliver the best quality care to this vulnerable group is really important. As well as the opportunities to do research together to directly impact practice change, NICHE-Leeds is also exciting because it is building capacity and interest in research in the care home sector, who traditionally have had fewer opportunities than NHS staff to engage in this.’ Claire Surr, Professor of Dementia Studies, Leeds Beckett’s Centre for Dementia Research.
‘NICHE-Leeds provides a great opportunity to bring researchers and care staff and residents together to find out what the issues are and use research help to identify a solution.’ Michelle Atkinson, Chief Officer, Leeds Care Association.
‘Often such research remains academic and does not impact on day-to-day practice. The NICHE-Leeds approach results in practically useful outcomes that improve quality by changing practice. One clear example is the oral hygiene work we have been involved in, which has been well received by staff and because of this has impacted on the wellbeing of residents; similarly with the work around dementia.’ Richard Graham, Care Quality Team Commissioning Programme Leader, Leeds City Council.
‘Working as a Practice Linking Pin since 2023 in the NICHE-Leeds Partnership offers HC-One the opportunity to really explore what matters to our residents and staff. Colton Lodges in Leeds, a large nursing, resident and dementia care home with 130 beds over four units, has welcomed this partnership.
‘We are finding out what really matters by being curious, searching the literature for credible evidence to support best practice and being creative, formulating ideas for change. Currently we are exploring stress and destress behaviours, which is such an important subject with the care home sector.’ Allyson Sanderson, Regional Senior Nurse – Northeast, HC-One. CMM
Karen Spilsbury is a Professor of Nursing at the University of Leeds and Academic Director at NICHE-Leeds. Email: niche_leeds@leeds.ac.uk : @SpillersK
What research questions would you like the opportunity to explore? Visit www.caremanagementmatters.co.uk and leave a comment on this feature or join the conversation to share your thoughts.
ONE PIECE OF THE PUZZLE: De-risking social care recruitment
James Sage, HR and Employment Partner and Head of Health and Social Care at RWK Goodman, Amanda Marques, Director at Cohesion Recruitment and Neil Eastwood, author of Saving Social Care and Founder of Care Friends, lead the Social Care HR Leaders’ Network, a collaborative group for HR leaders in care. Here, James, Amanda and Neil share ideas and best practice solutions for tackling the sector’s key workforce challenges.
As the sector’s recruitment difficulties persist, more providers have embraced overseas recruitment. This has been a lifeline for employers struggling to recruit; however, it creates additional legal risks which require mitigation. A continued focus on domestic recruitment strategies also remains vital.
Challenges remain
The latest Skills for Care workforce data reported a 14.5% year on year decrease in the number of vacant posts in the sector. However, there are 131,000 vacancies and the >
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reduction has been driven by international rather than domestic recruitment. Furthermore, the number of overseas workers coming to work in care has significantly reduced since restrictions on bringing dependants were introduced.
Compliance risks
Becoming a sponsor licence holder exposes you to a new and onerous compliance regime and recent enforcement action indicates that providers are struggling to comply, resulting in sponsor licence suspension or revocation.
In addition, HMRC recently announced it was targeting the care sector for National Minimum Wage (NMW) compliance audits due to perceived high levels of non-compliance in the sector. An NMW breach in respect of sponsored workers carries the additional risk of sponsor licence revocation.
Sponsor licence duties
Non-compliance is often unintentional and caused by either a failure to grasp the full extent of sponsor licence holder obligations, a lack of care in exercising compliance duties or not keeping up with changing legal requirements.
Common failures include:
• Not reporting changes to sponsored employees’ employment status (within 10 working days). For example, dismissals, maternity leave or where an employee does not start the role within 28 days.
• Not keeping compliant records, including right to work checks, DBS checks and salary and skill level documents.
• Not conducting right to work checks properly or completing follow-up checks when employees’ visas expire.
• Not understanding minimum salary requirements in the context of overall salary and hourly rates.
• Not providing employees with the correct number of hours because work is not available and therefore paying below the minimum salary threshold.
• Not assigning the correct occupation code, such as assigning a senior care worker code when the employee’s duties are more in line with a care worker role.
• Not issuing a new certificate of sponsorship if an employee is promoted to a senior care worker role.
• Allowing employees to undertake other roles not permitted by their visa.
• Allowing employees also sponsored by another organisation to carry out supplementary work without carrying out appropriate checks in relation to the additional role.
• Failing to report an organisational change, such as a change in ownership of the business.
Effective compliance training will help avoid these common pitfalls and regularly reviewing your organisation’s compliance will highlight any errors so that they can be rectified before a Home Office audit.
Over-leveraging
Local authorities are raising concerns about providers being over-leveraged with overseas employees due to the additional risks this poses if a sponsor licence is suspended or revoked. Ensuring that you retain a suitable balance between the number of domestic and sponsored employees is key to mitigating risk.
If you have high dependency on sponsored employees, you should provide assurances and evidence that you have sought to mitigate the risk, to avoid funding contracts being suspended or terminated. Appropriate business continuity plans and evidence that you have undertaken compliance training and mock audits to minimise the risk of non-compliance, will help to alleviate concerns.
Licence revocation
If your sponsor licence is revoked, the Home Office will write to your sponsored employees curtailing their visa. They will be given 60 days to find alternative sponsorship or must leave the UK.
Home Office guidance requires revocation in a number of circumstances, some of which may be caused by a simple administrative error or oversight. However, the Home Office must act proportionately in implementing its enforcement powers, so it is worth taking advice on whether you have grounds to challenge a decision.
A licence is usually suspended before being revoked and you will have the opportunity to make written representations before a final decision about revocation is made. It is crucial to provide a substantial response at this point as it the only opportunity.
If the licence is subsequently revoked and you wish to challenge this through a judicial review application, the court will only consider what has already been submitted. New arguments cannot be raised at that stage.
NMW compliance
This affects domestic and sponsored workers equally. However, non-compliance for sponsored employees can lead to sponsor licence revocation.
Common areas of non-compliance include:
• Making deductions from pay which reduce it below the NMW, including deductions for uniform, mandatory training, UK driving assessments and vehicle costs where driving is a requirement of the role and certificate of sponsorship costs.
• Providing accommodation to a worker and deducting rent (including the cost of utilities) over the Accommodation Offset Allowance of £69.93 per week could reduce pay below the NMW.
• Including ineligible payments within NMW calculations. For example, overtime enhancements and shift premiums cannot be included, neither can on-call or sleep-in allowances.
• Failing to account for all working time within NMW calculations. For example, working outside rostered time (e.g. to do a handover), training time, relying on estimated travel time records that do not reflect actual travel time and failing to account for waiting time between home care assignments.
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Domestic opportunities
Appropriate risk management requires a balance between international and domestic recruitment. The first way to improve your domestic recruitment strategy is to invest in better recruitment activity.
“Finding people with the right values should be a core part of your attraction strategy.”
Boost your recruitment efforts within the local talent market. Get to know your communities locally, and make sure you are known to offer opportunities that reflect local needs. Good recruiters know how to understand the local market and workforce, create compelling recruitment messaging and tell you how you compare to other local employers.
Local community-based recruitment should not just focus on those actively seeking a job; you also need to reach those who are not actively seeking a change of career or had not considered social care. Finding people with the right values should be a core part of your attraction strategy.
Be flexible and accept feedback
Prioritise flexibility, ensuring you have a diverse range of people who can adapt to changing demands. Implementing flexible working hours, offering part-time positions and creating a supportive environment can help attract and retain a more versatile workforce. Target hotspot locations with bank recruitment campaigns to keep agency spend down. Make sure you know the reasons people leave. New starter, retention, stay and exit interviews are non-negotiable. Partner with a third-party retentions expert for consistency and honesty and act on feedback. Consider if the majority of those leaving your organisation are staying in the sector rather than leaving it. If so, could there be a problem with your culture?
Futureproof with early talent
Invest in the next generation by creating flexible part-time work for young people as a preview of the sector. Consider work experience, apprenticeship programmes, placements and partnerships with educational institutions.
Early engagement with young talent helps secure a steady pipeline for the future. Many students already studying health and social care cannot secure jobs in our sector and are too often told that they are too young, do not have enough experience, or are not flexible to meet the needs of a full rota pattern.
Gen Z unemployment is 13.4%, and it is significantly higher than that in some parts of the country. As a sector we need to create opportunities for positive pass through and a well-managed bank is a proven way of doing this, as exemplified by the NHS.
Look at the data
Utilise data to identify trends, strengths and areas for improvement within your organisation. What are your current recruitment metrics telling you (cycle times, conversions, pipeline)? At what point do people leave (experienced vs. new to care)?
How diverse is your employee pool? Analysing this information can guide your recruitment and retention strategies, ensuring they are data-driven and effective. Demographics paint a grim picture for the future. 29% of the workforce are over 55 and only 8% are under 25.
Optimise your process
Streamline your recruitment and onboarding processes to enhance efficiency and candidate experience. This could involve leveraging technology, simplifying application procedures and ensuring a smooth transition for new hires, which can significantly improve retention rates.
Start by polling those who have recently joined. What could be improved? Try to break down each recruitment stage and identify improvements – aim for incremental gains.
Prioritise existing connections
People who have some kind of connection to social care are many times more likely to apply and then go on to enjoy the work. The two main examples are people who were recommended to try care work by a friend or family member, or people who have current or previous family caring responsibilities.
A core part of any attraction strategy should therefore include operating an effective employee referral scheme and outreach to those with family care experience.
One thing is clear – international recruitment has made a significant impact recently, but it is only one piece of the puzzle and with reducing supply and the associated legal risks, a continued focus on optimising domestic recruitment is crucial. CMM
James Sage is an HR and Employment Partner and Head of Health and Social Care at RWK Goodman. Email: james.sage@rwkgoodman.com : @RWKGoodman
Amanda Marques is a Director at Cohesion Recruitment. Email: info@cohesionrecruitment.com : @Cohesiontalk
What strategies have you implemented to avoid over-reliance on international recruitment? Visit www.caremanagementmatters.co.uk and leave a comment on this feature or join the conversation to share your thoughts.
Neil Eastwood is the author of Saving Social Care and Founder of Care Friends. Email: info@carefriends.co.uk : @CareFriendsApp
INTO PERSPECTIVE
How must the Care Quality Commission (CQC) respond to the findings of Dr Dash's interim report?
In this issue, Into Perspective invites two experts to delve into the findings of Dr Penny Dash’s interim report examining the effectiveness of the CQC. Our experts also put forward key recommendations for the regulator’s future.
Government has been forced to act after the release of the interim report which has highlighted numerous failings at the CQC. The regulator has been instructed to take immediate action to restore the confidence of health and care providers and the public.
The report was conducted independently, with Dr Penny Dash taking the lead, from May 2024. In the subsequent two months, Dr Dash spoke to roughly 200 senior managers,
caregivers and clinicians across the health and social sectors. Over 50 senior manager and national professional advisors at the CQC were also spoken to throughout this time.
Dr Dash’s report has found that:
• Of all the locations the CQC has the power to inspect, it is estimated that one in five have never been inspected.
• Some organisations had not been re-inspected for several years – with the oldest rating for a social care provider dated back to 2015.
• There was a lack of experience among some inspectors – including a care home inspector who had never met a person living with dementia.
The report has also identified significant failings within the CQC that are actively hampering its ability to effectively judge the quality of health and care services. In addition, the report
has found inspection levels were still below pre-COVID levels, clinical expertise among investigators and consistency in assessments were lacking and problems with the CQC’s IT system. Furthermore, the report has revealed that many social care providers have been waiting too long for their registration and rating to be updated after the inspection.
In the aftermath of the report’s publication, Wes Streeting, Secretary of State for Health and Social Care, said, ‘I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings. It’s clear to me CQC is not fit for purpose. […] We cannot wait to act on these findings, so I have ordered the publication of this interim report so action can begin immediately to improve regulation and ensure transparency for patients.’
The Secretary of State promptly announced four immediate steps to be taken by Government and the CQC:
• Re-appointment of Professor Sir Mike Richards, by the CQC, to review CQC assessment frameworks.
• Improving transparency in terms of how the CQC determines its ratings for providers.
• Increased Government oversight of the CQC, with regular updates to the department on progress.
• Requesting Dr Dash to review the effectiveness of all patient safety organisations.
Dr Dash said, ‘The contents of my interim report underscore the urgent need for comprehensive reform within CQC. […] By addressing these failings together, we can enhance the regulator’s ability to inspect and rate the safety and quality of health and social care services across England. Our ultimate goal is to build a robust, effective regulator that can support a sustainable and high-performing NHS and social care system which the general public deserves.’
Helen Wildbore, Director of Care Rights UK, said, ‘We are pleased to see the new Government acting so swiftly on the failures at CQC. […] We have been calling on the CQC for many years to act to protect people relying on care services, telling them how their lack of action is leaving people’s lives and dignity at risk. We hope now they will be forced into action. For the people we support, in the most vulnerable of situations, this cannot come soon enough. They desperately need the regulator to do their job.’
A predetermined and unfettered path
Paul de Savary, Executive Chairman, Home From Home Care : @HFHC_LTD Email: communications@homefromhomecare.com
CQC’s response must be proportionate to the scale of its failure, which with personal experience of six inspections I can summarise as historic and existential. The failings to be addressed include poor organisational culture, unsuccessfully managing inspections and consistent outcomes, HR processes with inspectors ranging from engaged to incompetent, plus an ineffective complaints process.
The single assessment framework (SAF) is the product of people who I believe do not clearly grasp the practical realities of delivering care. In my opinion, there appears to be no meaningful baseline data and no comprehension that binary data highlights issues but not causes. The sense data is the all-important – what the eyes see, the nose smells, the ears hear and the brain processes during an inspection.
Strategically, the regulator should review its interactions with safeguarding, local environmental and health protections teams and leverage them intelligently, not overburdening them through effectively duplicating workloads.
It must also cease being a market shaper, given that 2017’s Registering the right support hampered innovation, creativity and
investment in new services for the most complex individuals, thwarting Government policy to shutdown Assessment and Treatment Units, where over 2,000 individuals remain confined. Seven years on, the SAF’s implementation, in my view, is the product of a regulator that pays lip service through consultation but continues along a predetermined and unfettered path.
The regulator needs to create teams familiar with specific areas of care, including autism and learning disabilities. In addition, regulation’s focus needs to change from being biased against finding ‘good’ whilst favouring ‘bad’. It also needs to be proportionate about the impact of poor commissioning and underfunded placements, attributing failure between all parties, not just the home manager. Adopting a proven ‘just culture’ approach, an area of expertise that we have drawn on, is key.
The CQC should suspend the SAF, reverting to its pre-pandemic approach. It should also announce the inclusion of providers and other professionals to develop new, fit for purpose regulation. Lastly, it should be mindful that if these were the failings of a provider, the shareholders or trustees would exit its board.
The time for half-measures is over
Fae Mell, Managing Director, Kata Care
Solutions Ltd
: Search ‘Kata Care’
Email: fae@katacare.co.uk
The CQC has been called out, and honestly, it's about time. The interim report highlights major issues, including endless registration delays and a worrying lack of sector expertise. As someone who spends their working life supporting care providers with registrations, quality and compliance matters, I’ve seen firsthand how these inefficiencies create unnecessary challenges for care providers and impact the quality of care.
The CQC is meant to be the backbone of health and social care regulation, but right now, it’s bogged down by bureaucracy and losing sight of what really matters – ensuring quality care for those who need it most.
The time for half-measures is over. The SAF needs an overhaul. As it stands, it's more about ticking boxes than measuring real outcomes. We need a system that focuses on the bigger picture –how care affects people’s lives, not just whether it meets a checklist.
Let’s not forget data. The CQC has access to a wealth of information but isn’t using it to its full potential. In today’s world, data is one of the most powerful tools we have. If the CQC doesn’t adopt modern analytics to gain
real-time insights and target inspections where they’re needed most, it risks falling further behind. Care is evolving rapidly, and regulation needs to keep up.
"The CQC has a golden opportunity to reset."
The biggest issue, though, is trust. Care providers have lost confidence in the CQC. To rebuild that trust, the CQC needs inspectors with real, hands-on experience in the sector. They should know what it’s like on the ground to make fair, insightful assessments. This is no longer just about inspections; it’s about helping providers improve and thrive. Transparency and clear communication are also crucial. Providers need straightforward feedback on how to improve. The current system leaves too much in the dark.
The CQC has a golden opportunity to reset. By focusing on outcomes and acting now, it can restore its credibility and become a real force for quality improvement. It’s time to seize that moment.
Enhanced family leave: Raising sector standards
In this feature, Dr Olivia Curno, Chief Executive at Elizabeth Finn Homes, explains the rationale behind the provider’s new family leave policy and lays the groundwork for other sector organisations to follow suit.
Elizabeth Finn Homes operates eight care homes across England and employs over 750 staff, all of whom are paid a Real Living Wage. We are a wholly owned subsidiary of the charity Turn2us and were founded by Elizabeth Finn, a pioneering philanthropist, who set up the Distressed Gentlefolks’ Aid Association in 1897. Although we run on a commercial basis, 100% of our rent and profit passes to Turn2us to support its work addressing financial insecurity across the UK.
Progressive policy
In line with Elizabeth Finn Homes’ commitment to being an outstanding employer, and with the full support of our charity owners, we have launched a progressive family leave policy that aims to provide all employees who become parents the opportunity to take time to bond with, support and raise their child during the first year of the child’s life, or in the case of adoption, the first year of an employee becoming a parent to the child.
The policy is the first major step in our new strategy since I took over as Chief Executive in Spring 2023. I am passionate about both excellence in care and
addressing financial insecurity and have a long history of involvement in the charity sector, previously as Chief Executive at sight loss charity, Vision Foundation, and earlier, I led fundraising and communications at children’s mental health charity, Place2Be, and autism research charity, Autistica.
A bigger social purpose
Elizabeth Finn Homes is an exceptional organisation. We are a leader in quality care, with 100% of our homes rated ‘Outstanding’ or ‘Good’ by the Care Quality Commission and heartwarming reviews from residents and families. We are an award-winning employer, offering unrivalled career opportunities. We offer unique, heritage properties in beautiful grounds across England, and to top it all, everything we do is driven by a bigger social purpose.
We invest first in our homes and staff to ensure a best-in-class experience for residents and families, but then all profit goes to support those facing financial insecurity across the UK through the work of Turn2us. Despite the success of Elizabeth Finn Homes, our >
Board felt there was still more we could do to ensure the happiness and wellbeing of our residents and staff and to set new standards as an exemplar for the sector.
In particular, we were keen to ensure that the voices of residents, their families and frontline workers were heard, and to then incorporate this feedback in the group’s new five-year strategy, Where People Flourish, launched in April this year.
Recognition of care workers
There were several objectives at the heart of the team’s vision for the company which we have worked to implement over the past year. One key goal is for Elizabeth Finn Homes to be a leading advocate in calling for change and encouraging others in terms of the support and recognition of care workers. Already proud to be a Real Living Wage employer, offering generous staff benefits and pension schemes, we felt there was more that could be done. Taking a lead from feedback received from staff and residents, we worked with our parent charity, Turn2us, to lay down a family leave policy that would greatly improve financial security and work-life balance.
As well as clear moral imperative to allow carers to care for their own families, this policy also makes great business sense. If employees do not feel valued, they can simply go and work for your competitors – or leave the care sector altogether. This results in vacancies which impact care, plus recruitment and agency spend. In this, like so many areas, being a caring business also means being a successful business.
Outstanding and inclusive careers
The new policy also reflects our commitment to listening to our residents and relatives in all strategic decisions. Our residents have told us that the loving staff who support them every day hold an important place in their hearts and knowing that we are an ethical employer is fundamental to their own happiness in our homes.
This marks a significant milestone in our
strategic objective to provide outstanding and inclusive careers in care, operating as an exemplar employer. This policy is a firm commitment to supporting staff who are about to embark on the journey of parenthood, whether through pregnancy or adoption, whether birth parent or partner.
The new policy is more in line with parental policies outside of the care sector and is greatly enhanced in comparison to statutory requirements. Current statutory maternity pay is six weeks at 90% of standard pay and then 33 weeks at statutory pay which is currently £184.03 a week – this means that most employees who go on maternity are ‘losing money’ compared to their standard pay.
Indeed, according to findings issued by Maternity Action in 2023, 71% of women on maternity leave worry about money. To reduce spending, three-quarters turn their heating off or down and a quarter skip meal – with one in 20 going without food for a whole day. Today, the basic rate statutory maternity pay is just 47% of the National Living Wage, in comparison to 2021 when it was 62.5%.
In contrast, our new policy will pay staff for 13 weeks at full pay, followed by 13 weeks at 50% of pay and then 13 weeks at statutory, meaning our employees will be significantly better off than on the statutory minimum. The eligibility criteria of the new policy also seeks to be more inclusive, and includes birth parents and partners regardless of gender, as well as people planning to adopt. Supporting our staff during this important phase of their lives aligns with Turn2us, our charity owners' own vision of financial security for all.
Positive experiences
Early indicators from our most recent staff survey show an increase in positivity amongst younger staff members and women in comparison to 2023 feedback, which we feel may be attributed to the improved parental policy, alongside wider commitments to prioritise the wellbeing and development of our employees. The percentage of staff who would recommend Elizabeth Finn Homes as a place to work has jumped from 70% to 80% in just eight months. New parents already
benefitting from the new policy have also been keen to share their positive experiences.
Jessica Walters, Home Manager, said, ‘I have worked for Elizabeth Finn for 14 years and the implementation of the new family leave policy is amazing. I am starting my maternity leave in September and this policy has given me and my husband financial security and made things that little bit easier when our whole world is about to turn upside down with our first baby.
‘The company have always looked after its staff, but this is setting a real example to the wider health and social care sector. I am proud to work for a company that nurtures its employees and look forward to returning after nine months to continue to work for such a supportive company.’
Michael Taylor, Receptionist, said, ‘I recently became a father and can't thank Elizabeth Finn Homes enough for their support and understanding. The new policy has meant I am able to have six weeks paternity leave which can be taken anytime. This way I have been able to support my partner in the early challenging days, as well as being able to bond with my son.
‘We both learned together about the baby, how to raise a child, and the approach we would take as parents and how to be part of that process together. It has helped me to return to work feeling energised.’
Time to step up
We are so keen to see other care home operators follow the lead of Elizabeth Finn Homes – and to hear what others are doing in this space. The margins in care are incredibly tight, and we work in a chronically underfunded sector trying to meet ever mounting needs and costs. But, short-changing new parents is a false economy. Compared to care sector spending on agency staff and recruitment, excellent family policies might be just the investment we should be making to keep care workers –81% of whom are women – healthy, happy and retained by our sector. CMM
What other workforce initiatives would you like to see introduced to support new families in the sector? Visit
to leave a comment on this feature or join the conversation to share your thoughts.
Dr Olivia Curno is Chief Executive at Elizabeth Finn Homes.
Hosted by The National Care Forum (NCF), the Care Innovation Challenge (CIC) 2024 took place on 29th-30th June at Coventry University’s TechnoCentre. CMM caught up with the five CIC finalists to find out more. This month, we hear from Tim Robinson, Kirsty Youngs and Anna Lewkowicz from Team EVA and Sarah Holmes, Sarah Wight, Ruth Sime and David Grey from Team Care Coach.
CARE INNOVATION CHALLENGE
CMM meets the finalists
CMM meets Team EVA
CMM: How does your product work?
Tim: EVA is a phone chat assistant who will call clients and patients and walk them through some questions about their care needs. It’s for low-care needs, asking questions about taking medication, general physical health, mental
health, challenges and so on.
It has a discussion and tries to alleviate some loneliness and isolation problems of people living at home but creates reports for carers so that they have a general report history for care managers.
It solves problems for three different levels – organisation, individual carers and people in receipt of care. We've seen so many other opportunities for different scenarios too.
CMM: How did you find the process of teaming up during the weekend?
Tim: I came into the weekend with a technical idea, but I didn't have a background in care. There were lots of gaps in my understanding so I’m grateful for Kirsty and Anna. They’ve been suggesting great questions EVA could ask I would never have considered. Their experiences of being on the front line, the sort of questions
to ask and how to deliver compassionate care are just making things so much better.
Kirsty: My background is in care and support and I’m aware of the issues within the sector. I met with Tim and thought his idea was really good. I could see that being used in the workplace and other scenarios. It’s a good skills match between the team.
Anna: I came with a passion for care, innovation and making a difference. Hearing Tim’s idea, there’s so much potential. As much as he came with his idea based on his personal experience, it has so many applications. That passion of ours shines through Tim’s idea.
CMM: Did you receive any advice from mentors?
Tim: A lot of the discussions were about
framing the pitch. We knew what was important, but it was how to deliver that message effectively.
Anna: It was about how to showcase it and ask what the selling point is. It's that connection that brings something different. We don't want to expand too much on EVA yet because I think it needs to be just consistent at the moment. We all feel that if we concentrate on one area of use, then we can start exploring different opportunities.
CMM: How did you find the weekend overall?
Kirsty: It was really good just to step out of your comfort zone and do something completely different. That coupled with the challenges in the care sector, you feel like you've been useful. It was interesting to meet different people and hear about all their ideas because you don't do that in the normal workplace.
Tim: I'm hugely grateful for the session and for the opportunity to connect with Anna and Kirsty for giving me their incredibly valuable and undervalued time to try and make things a bit better.
CMM: What would you like to highlight at the final?
Tim: We need clear engagement with people who can help us to bring this to a broader audience. We should clearly demonstrate the return on investment and potential benefits case for the solution. I’ve already had people reaching out to ask if EVA could help in different situations, so I think we've got an opportunity to land the message.
Anna: We can also show how the report will be generated following conversations with EVA, present what information she's gathering and possibly expand on her knowledge and how she learned about someone she's interacting with.
CMM meets Team Care Coach
CMM: What is your idea in a nutshell?
Sarah H: Care Coach is a care co-ordination app designed to link tasks, people, support and help for those with lower-level support needs. At Affinity Trust, we get a lot of referrals from people who only have very small care budgets we have to refuse for various reasons.
We want to develop a viable solution that enables us to start saying yes to those referrals that can lean into community assets and relational networks a person has. It might include some assistive tech or direct paid support from a PA or a support worker that our organisation employs. David has developed an app that enables people to co-ordinate care pools using their relational network.
CMM: How did you find coming together as a team on the day?
Sarah H: We got chatting to David and he was doing something similar to what we were looking for in tech innovation.
Sarah W: Without having the Challenge, I don't know if our paths would have ever crossed. David has experience, both with family, but also as someone who is well versed in coming up with solutions that are new to our sector.
Sarah H: The whole process over the weekend was co-productive. It helped us to draw on our individual strengths and spot where our gaps in knowledge and understanding were. David brings his knowledge of technology and other areas of social care. When we teamed up, we came up with a brilliant solution and we're excited about it.
CMM: Have you conducted any market research?
Sarah H: Elements of our idea are being addressed, but we haven't seen anybody bringing the whole thing together as a model. Specifically for the learning disability part of the sector, I don’t think anybody's doing anything like that. The people who are ageing are still looking after their sons or daughters and they’re going into crisis. So, they’re ending up with big packages when they aren’t needed which is making them more dependent.
CMM: How did you find the Challenge weekend?
Ruth: It's quite out of my norm of a week, so it was nice doing something refreshing and completely different. It motivated me again. I found it useful and helpful, and it was great working with the team.
Sarah H: It's valuable to be in a room together in a solution-focused atmosphere because we don't get that very often as a team. It was really positive. You could feel the energy in the room because of the fast pace.
David: It was a great weekend overall. It encouraged cross-collaboration and was extremely powerful because Affinity brought so much knowledge of the commissioning process, the process of getting grants and other funding so it was quite eye-opening for me. Having this epiphany about wider adult social care was very useful for me.
CMM: What are you hoping to showcase at the final?
Sarah W: We all have a shared vision of engaging the audience. It's a fantastic opportunity to push further for innovation in social care. We need more people doing more of this.
David: The Care Show also gives us an opportunity to draw attention to our solution with opportunities for collaboration and funding. CMM
For the five finalists it all comes down to the next few weeks and the continued mentorship they will receive as they prepare for The Care Show at the Birmingham NEC on 9th and 10th October. Follow @CareInnovHub and use #CareInnovationChallenge for updates.
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MAINTAINING GOOD ORAL HEALTH
Responding to a national shortage
Dedicated to improving care home residents’ oral health by overcoming lengthy waiting times and limited availability of community dentists, Alexandra Kelly, Oral Health Champion at Silverpoint Court Residential Care Home, part of Nellsar Care Homes, shares the signs to look out for, the impact of poor oral hygiene and the value of training.
Oral health is often overlooked within the care sector. While efforts are made to provide residents with proper nutrition and correct medication to support their physical and mental wellbeing, dental care frequently remains neglected.
The focus on more immediate concerns, such as managing the common illnesses associated with ageing, including Alzheimer’s disease and dementia, can overshadow the importance of maintaining good oral hygiene.
However, maintaining high standards of oral hygiene is crucial, as it has been shown to reduce the risk of developing more serious health issues. Ensuring proper dental care is an essential component of overall health for older adults.
A large-scale issue
According to the British Dental Association, around 5.4 million people have given up trying to get an appointment in the past two years >
Regulations are constantly changing, but QCS keeps Sarah’s business compliant, giving her peace of mind.
and another 5.6 million attempted but failed to see a dentist. These figures highlight a concerning decline in the public’s ability to take care of their oral health, increasing the risk of infections and undiagnosed issues.
Older residents in care homes are particularly susceptible to dental problems due to their limited access to dental care, the physical challenges of maintaining oral hygiene and the absence of regular check-ups.
As an Oral Health Champion, I strongly believe that everyone should have regular access to dental care, even if they feel confident in their oral hygiene already. After dedicating long hours, I successfully enrolled a dentist to visit our home every six months to perform oral care checks for willing residents – a service that has proved to be very beneficial.
My first piece of advice is to secure a professional to help wherever possible, as it eases the burden on team members who already have so many responsibilities. I will go on to provide further advice including how to identify signs of poor oral health and improve overall dental wellbeing among residents.
Monthly check-ins and assessments
It is important to incorporate oral care into a resident’s care plan and conduct monthly equipment checks – ensuring that toothbrushes are in good condition, with the correct bristle shape, replacing them if needed, while making sure there is enough toothpaste and mouthwash available for each resident.
Every month, I update each resident’s dental hygiene scores. This systematic approach allows me to closely monitor and quickly identify people who may require additional attention. By tracking these scores over time, I can observe patterns and intervene early if a resident's oral health is declining.
The Care Quality Commission’s (CQC’s) 2019 report, Smiling matters: Oral health in care homes, outlined several recommendations for improved oral hygiene, including the establishment of an Oral Health Champion in every home to promote good practice and provide a link between care homes and dental professionals, oral health check-ups for all residents upon admission and better signposting to local dental services.
Despite the regulator’s recommendations, following the publication of a progress report in 2023, it was found that only 28% of 50 care homes visited between April and June 2022 to contribute the report’s findings said they had appointed an Oral
Health Champion. While this statistic only represents a small number of providers, it suggests that there is still work to be done to enhance the visibility of oral health as a priority for care providers.
To maintain a favourable CQC rating, it is important to conduct health assessments every six months, even for residents who choose not to register with a dentist. It is also important to maintain a robust evidence base of these assessments should they be called upon during an inspection.
Signs of poor oral hygiene
Poor oral hygiene can cause a range of symptoms that significantly impact overall health and wellbeing. Common signs include persistent bad breath, gum disease and tooth decay, which manifests as red, swollen or bleeding gums, cavities and tooth sensitivity. Plaque and tartar build-up are also indicators, often resulting in yellowing or discolouration of the teeth.
“Facilitating regular dental care can play a vital role in ensuring residents feel comfortable, confident and socially engaged.”
As oral health deteriorates, individuals may experience mouth sores, ulcers and increased sensitivity to hot, cold or sweet foods. A dry mouth, due to insufficient saliva production, can exacerbate these issues by raising the risk of tooth decay and gum disease.
Toothache is a frequent symptom, signalling potential infections or cavities, while more advanced problems like loose teeth or changes in bite alignment can occur if poor oral hygiene persists. These symptoms not only cause discomfort and pain but can also lead to behavioural changes, such as irritability or fatigue, due to persistent pain. Maintaining proper oral care is crucial to prevent these issues and ensure both mental and physical health.
In addition to the physical health implications, there are psychological and social benefits to maintaining oral hygiene. Poor dental health can lead to pain, discomfort and embarrassment,
>
which may result in social withdrawal and a decline in mental wellbeing.
For residents in care homes, this can exacerbate feelings of isolation and negatively impact their quality of life. Therefore, encouraging and facilitating regular dental care can play a vital role in ensuring residents feel comfortable, confident and socially engaged.
Causes of poor oral hygiene
The causes of poor oral hygiene can vary depending on individual circumstances, but generally, they include failing to brush and floss regularly or properly, which can be interconnected and influenced by the ageing process.
One significant cause is the decline in physical mobility, such as people struggling with arthritis which makes it difficult to perform daily tasks like brushing and flossing effectively. As a result, these individuals may not be able to maintain the same level of oral care they once did.
Cognitive impairments, such as Alzheimer’s disease and dementia, also play a major role in poor oral hygiene. Residents with these conditions may forget to brush their teeth, lose the ability to perform oral care routines or become resistant to assistance.
In addition, medications commonly prescribed for older people can reduce saliva production, leading to a dry mouth, which exacerbates the risk of tooth decay and gum disease. The lack of sufficient saliva to naturally cleanse the mouth means that food particles and bacteria remain longer, contributing to poor oral health.
Consistency and training
Maintaining oral health in a care home setting requires thorough training for team members on what to look for during both daily interactions and oral health assessments. Team members have regular contact with residents and are more likely to notice subtle health changes that older people may struggle to communicate themselves or may pass off as part of ‘old age’.
All team members must follow the same
protocols and share a unified approach to oral hygiene, as this consistency is key to maintaining high standards of care across the home.
As a result of proactively advocating for oral health in care homes, I was approached by the NHS for advice and assistance in setting up a new scheme for all care homes.
Since its inception, around 33 dentists in Essex have joined the scheme to visit other care homes. It is encouraging to see the NHS focusing more on this initiative and working towards improving standards, and things do look promising for the future in this area.
Upon reflection, the main thing I have taken from this opportunity has been the importance of shouting about all the positive initiatives that are happening within a care home, as it can help to encourage local authority and community involvement, creating an integrated system that produces mutually beneficial relationships.
Sharing best practice
One of the best habits to get into for promoting good oral health in care homes is to learn from others in the sector, share best practices and repeat and reinforce the guidance. At Nellsar Care Homes, we like to share information across all our 13 homes across Kent, Surrey and Essex. We find that this is a great way to learn from one another and support each other in a journey towards a common goal.
In an ideal world, I would like to get to a point where every home follows the same procedures and paperwork, ensuring a standardised and comprehensive approach to oral care across the whole of the social care sector. As members of the sector’s workforce, we can step up to help by creating more Oral Health Champion roles, who can take the lead in promoting good oral health within care homes.
By prioritising oral health, we are not just treating symptoms, but enhancing the overall quality of life for residents in our care. We are proud to be at the forefront of this important initiative and hope to inspire others in the sector to follow suit. CMM
CELEBRATING EXCELLENCE IN SOCIAL CARE NURSING
Jemma Sharratt, Support Manager at the Atherton care village of the not-for-profit organisation, Belong, won the Social Care Nursing Award at the 2024 Markel 3rd Sector Care Awards. Drawing on this experience, Belong’s Chief Operating Officer, Susan Goldsmith, shares leadership lessons for successfully building teams of skilled and dedicated nursing and support workers and showcases some of the initiatives launched.
The Belong village model was designed to bring together a range of housing and support options for older people and, from a nursing perspective, this has created the opportunity to approach nursing differently, closely linked to the organisation’s approach to enabling people to age in situ.
24-hour care is provided in six extended family-sized households of up to 12 people. These are arranged around a village hub with extensive amenities, including a bistro, hair salon, specialist gym and an entertainment venue with licensed bar.
The result is a nursing model that is more aligned to community nursing, whereby nursing care moves to the resident, rather than moving residents to specific ‘units’ in line with their needs. It empowers nurses by affording them the autonomy to operate as an independent practitioner, helping to provide our enhanced model of care that truly puts people at the centre of what we do.
Maximising this opportunity, Jemma has fostered a culture whereby nurses cascade knowledge and skills to the wider support team, delegating non-clinical tasks to provide seamless and effective care for individuals, under appropriate supervision and direction. Spearheading initiatives designed to develop the next generation of nurses as well as promote better outcomes for residents, Jemma’s work has since attracted the attention of Professor Deborah Sturdy, leading to her being awarded the Chief Nurse Adult Social Care Gold Award.
Inspiring excellence
Closely linked to this culture of empowerment and skills development, Jemma is passionate about developing nurses of the future through compelling career development pathways. This includes creating well thought-out programmes for students, as well as working
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closely with the village practice development facilitator to identify opportunities to upskill our qualified nurses.
This is a subject particularly close to Jemma’s heart, as someone who has grown her own career within the organisation, taking advantage of our commitment to training and learning. She joined Belong in 2004 from an NHS background, originally as a support worker, before completing her nurse training externally in 2019 and then returning to us to begin her career in social care nursing.
Before being appointed Support Manager of Belong’s Atherton care village earlier this year, she worked through the ranks to become Village Nurse Manager (VNM) in 2022, heading up a team of seven nurses who care for up to 72 residents, approximately two-thirds of whom have nursing needs.
Multi-disciplinary approach
Externally, Jemma has forged close relationships with local colleges and universities, whereby we facilitate practical opportunities for nursing and social care students, and others in related disciplines, in addition to our learning agreement with the Royal College of Nursing. We are therefore now involved in a multi-disciplinary programme where we support students from various specialisms within the sector.
As an example of this, Jemma piloted the Trainee Nurse Associate (TNA) role in conjunction with the University of Salford and has been instrumental in building this into an operational function. Her learnings and guidance have influenced both the roll-out of the TNA position at other villages, as well as the wider nursing strategy across the organisation. It is an area of work that is attracting attention across the sector, as a way of offering a route for interested support workers to transition to nursing roles.
Under Jemma’s management, we have also seen the first physiotherapy student placement at Belong. Collaboration with our nursing and specialist exercise teams means that resulting insights and knowledge of best practice can be shared across departments, thereby developing other colleagues' skills for the benefit of our residents.
Beyond learning and development, Jemma has also worked closely with the primary care team to develop a relationship with local GP surgeries that reduces unnecessary burden on our services. After actively consulting all
stakeholders, she created an action plan that crucially involves weekly GP visits to the village and clear lines of triage.
Overall, Jemma is a fantastic advocate for student nurses and the feedback she receives for mentorship demonstrates how passionate and invested she is in developing the workforce of the future.
Industry challenges
The retention, as well as recruitment, of student nurses is critical to address skills shortages in our sector. With this in mind, Jemma reviewed the journey students take within nursing care and the skills they need, using this information to create a student handbook.
This offers a clear overview of their professional development in terms of what they should have achieved at a given stage, ensuring a positive learning experience and inspiring them to take charge in managing their learning. The handbooks are now given to student nurses across the organisation as standard.
Taken together, all these initiatives are helping to transform the perception of social care nursing and the opportunities it offers for career development, while also giving nurses the time and space to develop closer relationships and continuity with the people they are supporting and their families.
Dying matters
A crucial part of this nursing picture is ensuring high-quality end of life care, and this is another area in which Jemma has driven standards through her proactive approach. Networking with GPs and external nurse practitioners, Jemma has co-ordinated bespoke training administered by Wigan and Leigh Hospice, ensuring all colleagues are engaged and motivated with this aspect of care.
Other initiatives include coaching care teams to feel confident in discussing end of life care with residents and understand the need for a ‘Best interest approach’. Jemma played a key role in Belong Atherton attaining Gold Standards Framework accreditation and her engagement with GP services ensures that best interest wishes are also recorded within NHS processes.
Spearheaded by Jemma and the experienced day team at Belong Atherton, Hospice UK’s Dying Matters Week was marked at the village with a successful advanced care planning coffee morning event. Residents and
tenants were invited to have an open and frank conversation about their thoughts and fears for the future, with Jemma able to signpost support as needed.
On a more personal level, Jemma supported her mother to make the life-changing decision to move to Belong Atherton for end of life care, with the nursing team caring for her directly and Jemma overseeing their work.
Though this was exceptionally challenging for Jemma emotionally, it served her professional experience by providing her with a true insight into the experience of our residents and their families. This has served to enhance her existing passion and enthusiasm for her vocation to provide the very best standard of care.
Looking ahead
We must continuously strive to improve our nursing provision, and Jemma is often at the forefront of initiatives to support this.
She is currently leading the development of ground-breaking guidance around the administration of liquid medication for residents who require a modified diet, as well as looking to showcase our nursing model at conferences so that others might benefit from these approaches.
We look forward to watching her future career with the organisation, and I have no doubt that she will continue to be involved in innovations that improve the lives of people living at Belong villages. CMM
Susan Goldsmith is Chief Operating Officer at Belong. : @BelongVillages Email: enquiries@belong.org.uk
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CMM INSIGHT EAST MIDLANDS CARE ASSOCIATION ALLIANCE CONFERENCE 2024
Tuesday 5th November
CMM’s latest Insight conference travels to the East Midlands, focusing on the issues that matter to local care providers.
Care Management Matters (CMM) is looking forward to welcoming delegates to the East Midlands Care Association Alliance Conference 2024. The conference, sponsored by leading health, social care and charity lawyers, Hempsons, and digital-first creative agency, SM92, will take place on 5th November 2024 at Pride Park Stadium, Derby.
The conference aims to continue CMM Insight’s long-standing objective of bringing the quality of a national conference to a local stage. As such, CMM is thrilled to be delivering the conference in association with the East Midlands Care Association Alliance, East Midlands Care (EMCARE), Lincolnshire Care Association, Derbyshire Carers Association, Nottinghamshire Care Association, Northamptonshire Association of CQC-registered Care Providers (NORARCH) and the Leicestershire Homecare Alliance.
The day will include presentations from high-level sector representatives, offering expert insight into the local picture, along with an exhibition of carefully selected services and products. There will also be networking opportunities with like-minded providers and senior decision-makers from the independent care and support sector to learn more about delivering best practice in a changing market.
Meet the speakers and exhibitors
Confirmed speakers at the East Midlands Care Association Alliance Conference 2024 include:
• Melanie Williams – Corporate Director, Adult Social Care and Health Nottinghamshire County Council and Association of Directors of Adult Social Services (ADASS) President.
• Dr Clenton Farquharson CBE – Associate Director, Think Local Act Personal (TLAP).
• Greg Rielly – Deputy Director of Operations – Midlands, Care Quality Commission (CQC).
• Philippa Doyle – Partner and Head of Social Care, Hempsons.
Throughout the day, delegates will have the opportunity to meet individually with exhibitors to seek out solutions for their business and to learn about the latest training, technology and innovations shaping the sector. Confirmed exhibitors at the East Midlands Care Association Alliance Conference 2024 include:
• Ally.
• Arquella Ltd.
• Blue Stream Academy.
• Care Line Live.
• Caring Works.
• Croner i Limited.
• ilecs Lift Consultants.
• InVentry Ltd.
• Montane Care.
• Social Media 92.
• T L Dallas & Co Ltd.
• Wippet.
Take home advice
The conference’s keynote speech will be delivered by Melanie Williams, Corporate Director, Adult Social Care and Health Nottinghamshire County Council and ADASS President. Melanie will discuss the current state of social care and what the future holds, providing a robust platform for other speakers to build upon throughout the day. To hear more from Melanie, catch up with the latest
2024
episode of CMM OFF THE PAGE, where the sector-specific implications of the general election outcome are examined.
Following this, Greg Rielly, Deputy Director of Operations – Midlands at the CQC will provide a post-election update from the regulator, covering its new inspection regime and what is to come from the organisation following the publication of the interim review into its operational effectiveness. Continuing the conversation on this timely topic, Philippa Doyle, Partner and Head of Social Care at Hempsons, will evaluate how the CQC’s new inspection regime is working in practice, helping you to navigate evolving regulatory requirements.
In addition, Dr. Clenton Farquharson CBE, Associate Director at TLAP, will investigate how the sector can collaborate effectively to create a brighter future for people working in and drawing upon adult social care. The conference’s morning sessions will culminate in an interactive panel discussion and group exercise, providing an opportunity for further knowledge sharing. As always, the conference will end with a roundup of the day’s action, and you will also have a chance to pose any final questions to our keynote speaker.
Book now
Book your tickets today and visit the CMM website for more information. Join the conversation on X by tagging @cmm_ magazine and using the hashtag #CMMInsight Sponsorship and exhibiting opportunities are still available. Visit the CMM website to secure your place at the East Midlands Care Association Alliance Conference 2024. Please note, all exhibitors, speakers and presentation topics are subject to change. CMM
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Care Show Birmingham 2024 9th-10th October 2024, Birmingham www.careshow.co.uk
Care Roadshow South 15th October 2024, Epsom https://careroadshows.co.uk
Commissioner masterclass: Measuring the impact of prevention activity 16th October 2024, Online www.skillsforcare.org.uk/news-and-events
LGA Annual Conference and Exhibition 2024 22nd-24th October 2024, Harrogate www.local.gov.uk/events
NCA Winter Conference 7th November 2024, Dartford https://nationalcareassociation.org.uk/ news-events
Housing quality and people’s health: making the case for improving health through housing 20th November 2024, Online https://ageing-better.org.uk/events
NCF CEOs and Directors Conference 2024 25th-26th November 2024, Wyboston www.nationalcareforum.org.uk/events
National Children and Adults Services Conference 2024 27th-29th November 2024, Liverpool www.adass.org.uk/events
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Date/Location: Contact: East Midlands Care Association Alliance Conference 2024 5th November 2024, Derby www.caremanagementmatters.co.uk/event/ east-midlands-care-association-alliance
Please mention CMM when booking your place. Sign up online to receive discounts to CMM events and for more information on our upcoming events in 2024.
Dara de Burca, a registered social worker and Executive Director of Dementia Support and Partnerships at Alzheimer’s Society, calls for mandatory workforce dementia training.
The current system cannot consistently deliver the care people living with dementia want, need and deserve. People living with dementia make up around 60% of those who draw on home care in the UK and 70% of people living in residential care homes in England. Yet, most people living with dementia do not have access to the care and support they need, with more than 400,000 currently on adult social care waiting lists and no existing standard for dementia training across the UK.
Dementia training is important to ensure every person living with dementia receives personalised care and support that meets their needs and recognises the complexity of the condition. But this is currently not being delivered. A 2022 inquiry by a cross-party group of MPs found that less than half (44%) of people living with dementia rated care
staff’s understanding of dementia positively. Sadly, the picture remains similar today.
A recent Alzheimer’s Society survey into people’s experiences with dementia found that less than four in 10 are satisfied with the support available for people living with dementia and, when asked what would best help to improve the lives of people living with dementia, 65% of people said more care workers who are skilled in caring for people living with dementia.
While shocking, these statistics are perhaps unsurprising when coupled with our finding that only 45% of care staff are recorded as having any kind of dementia training. The devasting impact of this is felt beyond the statistics; I regularly speak to people who have experienced care that is not up to par, often due to a lack of training or knowledge around the complexities of dementia care.
Things need to change, and I am hopeful that they will. I was delighted to be involved in Skills for Care’s recent A Workforce Strategy for Adult Social Care in England, a sector-wide collaboration which recommended that all social care staff should have mandatory dementia training aligned with the Dementia Training Standard Framework This is a necessary step towards building a sustainable future workforce. All stakeholders playing a role in improving social care must take the strategy’s recommendations forward,
including Government, local authorities, integrated care systems and care providers.
We cannot afford to ignore this any longer, with dementia prevalence predicted to rise by 45% by 2040 (from 982,000 today to 1.4 million people). Improving social care specifically for people living with dementia means training the workforce so it is equipped with the skills and understanding to meet the specialist needs associated with the condition. High-quality dementia training for all care staff, mapped to the Dementia Training Standards Framework or equivalent, must be an integral part of the workforce.
Our workforce is invaluable to all those who draw on care and support, proving its unwavering dedication in the most challenging circumstances. Having the right support and training to deliver personalised care makes a huge difference to both carers and people living with dementia who rely on support, allowing care to be much more than a transaction.
Our message is clear – make dementia the priority it needs to be, implement the new workforce strategy and introduce mandatory dementia training for the care workforce. This must be underpinned by long-term, targeted and sustained investment to achieve real impact and enable people living with dementia to make the most of life at every stage of the condition.
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FREE TO ATTEND
LUNCH & REFRESHMENTS are included
East Midlands Care Association Alliance Conference 2024
5th November 2024 • 09:00 - 16:30
Pride Park Stadium, Pride Park, Derby DE24 8XL
Bringing the quality of a national conference to a local stage.
The EMCAA Conference is a FREE event, focusing on the issues that matter to providers in the East Midlands region.
Join us to hear from...
• Melanie Williams – Corporate Director, Adult Social Care and Health Nottinghamshire County Council & ADASS President
• Dr. Clenton Farquharson CBE – Associate Director, Think Local Act Personal
• Greg Rielly, Deputy Director of Operations, Midlands, Care Quality Commission
• Philippa Doyle – Partner and Head of Social Care, Hempsons
