Care Management Matters June 2014

CMM CAREMANAGEMENTMATTERS

JUNE 2014 £4.00

THE PREMIUM CARE HOME MARKET Analysing the trends

Medication management Is IT the answer?

Recruiting the right people Learning from the US

Business Clinic SureCare’s micro-franchises

Includes 4-page Skills Academy insert: Focus on Leadership: the achievements of the National Skills Academy – so far...

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in this issue

IN THIS ISSUE regulars 05

editor’s welcome

Is it just me...?

Guest editor, Debbie Sorkin, reviews recent reports on integration and argues that we can’t wait any longer for action.

07

News

10

Property News

12

Local Authority and Planning News

14

Corporate News

25

60 seconds with...

26

Business Clinic

35

Spotlight on...building, design and construction services

17

Ted Smith, Chairman of New Century Care.

SureCare’s new micro-franchises for unregulated services are discussed by the panel.

CMM profiles some of the leading names in building, design and construction.

44

Conference preview

45

What’s On?

features

46

Straight Talk

17

20

CMM previews the forthcoming Health+Care conference.

Colin Slasberg argues the case for changing personal budgets and its impact on providers.

Is technology the answer to medications management?

Andrew Willetts explores the role of technology in medications management.

20

Market trends in the premium care home market

Ben Hartley draws on a wealth of research and data to analyse trends in the premium care homes market.

29 29

32

Recruiting the best - learning from the US

Neil Eastwood and Debbie Sorkin look at recruitment and screening methods used

by US social care providers.

32

Creating a culture for care

41

Building a solid reputation

Theresa Morrison brings details of Skills for Care’s new Culture for Care toolkit.

Sophie Hunt explores the six principles of building and maintaining a good reputation.

Welcome to the June issue of CMM. The sector has been under the spotlight again with another Panorama exposé of abuse and neglect in care homes. The programme made for distressing viewing and has spurred on everyone to ensure these horrific incidents do not prevail in our sector.

In reaction to the programme, we have a number of related features. Debbie Sorkin and Neil Eastwood look at how we can ensure we’re employing the right people, caring people, to work with those we support. Values-based recruitment is a growing approach to employing staff and the feature on page 29 looks at tried and tested techniques from the US. On page 32, Theresa Morrison explores Skills for Care’s new Culture for Care toolkit which can help you to ensure you have the right, caring culture for your business and how to evaluate the culture you have.

Sophie Hunt, on page 41, explores the six principles of managing reputation.

With incredible focus on the practices of social care providers, building and managing a good reputation can help to transform the way the sector is viewed by the wider public.

Also this month, Ben Hartley delves into five years of research to analyse trends in the premium care market. The high end of the sector is particularly attractive to investors with no reliance on local authority fees. Ben’s feature on page 20 makes for interesting reading and uses exclusive data to draw his conclusions.

Finally, I’m always eager to find out more about you and what you think of CMM. As such, we’ve set up a quick online survey – I’d welcome your response. It only takes five minutes and could help us to shape the magazine, to make sure we keep delivering the information you want. You can find it online at www. surveymonkey.com/s/CMMQuestionnaire Emma Morriss Editor

Follow CMM on Twitter @cmm_magazine

CMM JUNE 2014 | 3

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contributors

CMM CAREMANAGEMENTMATTERS June 2014 EDITORIAL AND PRODUCTION editor@caremanagementmatters.co.uk Editor in Chief: Robert Chamberlain Editor: Emma Morriss News Editor: Des Kelly Deputy Editor: Heather Day Design and Production: Lisa Werthmann, Jamie Harvey, Nick Cade & Holly Cornell ADVERTISING sales@caremanagementmatters.co.uk 01223 207770 Advertisement Manager: Tracey Diplock tracey.diplock@carechoices.co.uk National Sales Manager: Paul Leahy paul.leahy@carechoices.co.uk SUBSCRIPTIONS info@caremanagementmatters.co.uk To request your free copy of CMM call 01223 207770 www.caremanagementmatters.co.uk Care Management Matters is published

by Care Choices Ltd who cannot be held responsible for views expressed by contributors. Care Management Matters © Care Choices Ltd 2014 ISBN: 978-1-910362-03-7 CCL REF NO: CMM 11.4

editorial panel Des Kelly OBE,

Mike Padgham,

Executive Director, National Care Forum

Chair, UKHCA

Professor Martin Green OBE,

David L Jones,

Chief Executive, Care England

Partner, Deloitte

Andrew Sidwell,

Paul Ridout,

Partner, GVA

Partner, Ridouts LLP

Andrew Barnsley,

Zoe Farrell,

Managing Partner, Nexus Corporate Finance LLP

Training Development Director, Catalyst for Care

contributors Andrew Willetts, Public Sector and Health Care Services Director, LloydsPharmacy Ben Hartley, Director, Carterwood Colin Angel, Policy Director, United Kingdom Homecare Association Colin Slasberg, Independent Consultant in Social Care Debbie Sorkin, Chief Executive, National Skills Academy for Social Care Gary Farrer, Managing Director, SureCare

Publications

CMM magazine is officially part of the membership entitlement of:

Neil Eastwood, Founder, Sticky People Ltd Paul Tarsey, Chairman, Bluebird Care Group Sian Lockwood OBE, Chief Executive, Community Catalysts CIC Sophie Hunt, Consultant, Insignia Communications

ABC certified (Jan 2012 - Dec 2012) Total average net circulation per issue 15,991

Ted Smith, Chairman, New Century Care Teresa Morrison, Area Manager, Skills for Care

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is it just me...?

Is it just me...?

Guest editor, Debbie Sorkin looks at recent reports around integration and argues that we must start immediately, we can’t wait for financial issues to be resolved.

In his April column, Robert Chamberlain endorsed the approach taken by Sir John Oldham and his team in the report One Person, One Team, One System, one of a number of recent publications exploring the realities of health and social care integration. Sir John was advocating relationships and culture, rather than systems change, as the keys to success.

As Robert is away this month, I thought it might be an idea to look at some of the recommendations in other reports that have come out since March, particularly the harder-nosed ones around funding; to reflect on how some of them appear to ‘accentuate the negative’; and to identify some early evidence pointing to how a combination of approaches, at a local level, can actually pay dividends.

The Commission on the Future of Health and Social Care in England, chaired

by Kate Barker, has taken a fundamentalist approach in its interim report, suggesting that the whole post-war health and care settlement was no longer fit-for-purpose, and proposing a move to a single, ringfenced budget for health and social care, singly commissioned for one service. This was despite their acknowledgement that the evidence for the financial benefits of integration was scant, and that this still left the question of affordability. Helpfully, they left answering this question to respondents, with options including increased charging for the NHS; increased charging for social care; cuts in other public services; or an increase in taxation in one form or another.

Another review raising more questions than answers has been the National Audit Banner ad_Layout 1 07/10/2013 16:09 Page 2 Office’s (NAO) Report on Adult Social

Care in England. The NAO wins the prize for best graph; in a design that is a model of clarity, they show how informal care is actually the biggest player in the system, outweighing State spending by a ratio of between three and five to one (depending on which estimate you take), and broadly equating to total spending on health care.

Equally clearly, the NAO makes the case for integration, although its approach is disappointingly one-dimensional, integration is seen as purely for public bodies and private sector providers are not even mentioned. For the NAO, however, the issue is that progress in practice has been slow; the timescale for the introduction of the Better Care Fund is breakneck; and the scale of savings from integration is unknown. On one page of the report, they set out progress in addressing barriers to integration. The ‘progress’ column of the page is much shorter than the ‘challenges’ one.

But I think there is another way, and one that doesn’t require us to quantify the unquantifiable before we start making changes. This more optimistic view is found in the King’s Fund’s Making our Health and Care Systems Fit for an Ageing Population. Not only does it champion the case for integration, noting that achieving improvements for older people has a positive effect on care for the rest of the population; crucially, it also provides practical advice on getting there and gives examples from different parts of the country. The advice includes finding common cause with partners; creating time and space to develop understanding; building integrated care from the bottom up as well as the top down; and being

prepared to share sovereignty – so everyone’s included and no-one has divine right to the leadership baton.

All of these lessons, as well as giving the independent sector a prime seat at the table, are part of systems leadership – an approach to developing integrated services that involves being willing to share leadership, information and resources with other people; recognising that there’s no single or best way to getting to integration; working with what’s happening in your area; being realistic and not trying to get there all at once; and being willing to live with partial solutions as long as these provide some degree of progress.

There are 25 programmes using this approach to developing integration, and there is evidence starting to emerge that in some places, they have made real strides, with commitments to pooled budgets and an approach that brings players together from across the private, not-for-profit, public and voluntary sectors to build services that put individuals at the centre.

The programmes have some funding, and I think this is essential. But the key thing is that they haven’t waited for every last financial issue to be solved beforehand – they’ve started from where they are. And that’s what we all have to do. The economy is unlikely to change greatly over the next 18 months: for the election, it’s not so much things are going to get better as things are going to ‘get similar’. But that doesn’t mean that we need to be the same. We can do things differently and we can start right now.

If you would like to comment please email editor@caremanagementmatters.co.uk

We buy and sell care businesses and land.

We provide consultancy and valuation advice.

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news

NEWS

APPOINTMENTS APPOINTMENTS AVANTE PARTNERSHIP

• Planning • Local authority • Corporate News editor - Des Kelly

Mark Lloyd has been appointed Interim Managing Director at Avante Partnership, replacing Chief Executive, Cedrick Frederick who leaves to explore new opportunities and challenges.

THE HUNTERCOMBE GROUP

Better pay doesn’t improve quality Care workers do demanding jobs for low pay and social care services are being delivered in an increasingly challenging environment, yet service users, their carers and families have increasing expectations about service quality and care workers’ skills and attributes.

Pay, conditions and care quality

in residential, nursing and domiciliary services, a ‘round-up’ report from think-tank the Joseph Rowntree Foundation, found that there is no conclusive evidence that increased pay improves care quality.

However, the research shows the importance of making staff feel valued, chances for

progression and managerial support. Care work’s low social status needs to be addressed and organisations need to understand the personal motivation of care workers says JRF. The report found that many care workers are loyal to the sector because they are motivated by a primary commitment to service users.

IPPR focuses on ‘generation strain’ A new report from the Institute for Public Policy Research (IPPR) says that social care could ease ‘generation strain’.

The report The generation strain: collective solutions in an ageing society says, ‘We need to transform our understanding of what ‘social care’ is in order to

help people live decent lives, to put in place the right building blocks to prepare for an ageing population, and to reduce future demand for care’.

Most care for older people is not provided by the state or private agencies but by family members, at an estimated value of

£55 billion annually. However, as the baby-boomer generation ages, a growing ‘family care gap’ will develop as the number of older people in need of care outstrips the number of adult children able to provide it. This is expected to happen for the first time in 2017 says the IPPR report.

Toolkit for learning disability providers The Foundation for People with Learning Disabilities and Association for Real Change have published a toolkit to enable providers to understand which values, knowledge and skills need to be in place to support people with learning disabilities as they grow

older so that their lives are as happy, healthy and fulfilling as possible.

The free resource Evaluation Toolkit for Providers will assist providers to draw up and deliver an action plan to improve the support provided to people as they grow older

and also access relevant resources to achieve best practice.

It also aims to enable providers to assess how well they are doing in relation to supporting people to have a good life; and access relevant resources to achieve best practice. www.learningdisabilities.org.uk

NCF’s international partnership The National Care Forum (NCF) and Aged and Community Services Australia (ACSA) have signed a Memorandum of Understanding (MOU) to share their resources and networks

and to encourage members within each organisation to collaborate on matters of mutual interest. Des Kelly OBE, Executive Director of the NCF and Professor John Kelly Chief Executive of ACSA

signed the MOU linking the two organisations when they met recently during the International Association of Homes and Services for the Ageing (IAHSA) conference in Shanghai.

The Huntercombe Group, has appointed Valerie Michie as Chief Executive Officer. She is currently Managing Director of Serco Health.

MD RETIRES AT ILC-UK After seven years, Noreen Siba, Managing Director of the International Longevity Centre-UK, is to retire.

BELONG WARRINGTON Phil Caine has been appointed as support manager at Belong Warrington.

NEW CARE PROJECTS LLP Elaine Miller has been appointed as Group Head of Occupational Therapy with New Care Projects LLP. LEONARD CHESHIRE DISABILITY Leonard Cheshire Disability has appointed a new director, Andy Cole, to lead the charity’s Corporate Affairs Department. Andy is currently the Chief Executive of Bliss.

FOUR SEASONS HEALTH CARE Four Seasons Health Care has appointed Jeremy Richardson as chief executive officer of its private care homes business.

He is expected to take up his new position with Four Seasons in May. SURECARE SureCare has strengthened its management team with the appointment of a childcare specialist. Leah Winter has joined as Children’s Services Business Development Manager.

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news

A new ‘top-up’ market in care homes?

The advent of the Care Act could herald an increase in so-called top-up funding by care home residents thanks to legislation which would legally allow council-funded clients to dip into their own savings in order to secure a bed in a more expensive long-term care facility.

Research by LaingBuisson suggests that despite plans within the Care Bill, which will bring about a dramatic shift in the number of clients who are eligible for local authority support, a move to allow greater use of third party payments to part-fund care places could mean that more people actively seek out care places which have a higher price tag than those typically funded by councils.

At present councils fund care home places only for those people who have personal assets of £23,250 or less. Following recommendations made in the Dilnot Commission in 2011, this

threshold will rise to £118,000 in 2016.

As a result of these two changes, new money could begin to run into the lower end of the residential care market or, if that is not the direction of travel, those care groups with client bases which are already primarily made up of councilfunded residents could see serious new threats as councils fee rates continue to lag far behind Fair Price levels.

LaingBuisson’s report shows that the fees paid by councils have fallen by 5% in real terms in the last five years and that the average fee councils pay for residential care in England, at a little over £500 per week, is about £30 less than the calculated Fair Price ‘floor’ for homes whose physical environment is adequate only.

This means that most care home operators have to rely on crosssubsidies from private payers.

CQC consultation The Care Quality Commission (CQC) is changing the way it regulates, inspects and rates health and care services. The CQC is consulting on its plans: what it looks at on an inspection; how it judges what ‘good’ care looks like; how it rates care services to help the

public to judge and choose care if they want to; how it uses information to help it decide when and where it inspects. A series of draft handbooks have also been published.

The consultation closes on 4th June. www.cqc.org.uk

IN FOCUS National Care Home Open Day – 20th June 2014 WHAT’S THE STORY? The National Care Home Open Day is an opportunity for care homes across the UK to unite and change the negative perceptions about the care sector. The day is an opportunity for care homes to connect with their local community through such contacts as schools and colleges, community groups, local churches, doctor’s surgeries or simply members of the community.

The day is a sector-led initiative which has the active support of representative bodies across the UK. All types of care home are able to take part, from big care providers to small, private providers and those run by voluntary organisations and local authorities. It was first held in 2013 when almost 3,000 care homes participated in the initiative.

This year the event has attracted involvement from care homes in Australia, South Africa and Malta who will also be taking part to demonstrate that care homes are fun and vibrant places where people live.

Dementia Friends campaign

WHAT IS THE PURPOSE OF THE DAY?

living with the condition.

People can become Dementia Friends by interacting with a new online video, developed

by Public Health England as a complement to the face to face information sessions run

by Alzheimer’s Society.

For more information on Dementia Friends and to sign up visit the campaign’s website www.dementiafriends.org.uk

The idea behind the open day is to improve the understanding of residential care services by local communities and to offer opportunities for care services to welcome local people into their facilities. It is intended to demonstrate openness and transparency by care providers; creating, reinforcing and maintaining

Public Health England has launched a Dementia Friends campaign.

Developed in partnership with the Alzheimer’s Society, the campaign aims to improve understanding of the disease and create one million Dementia Friends: people who know about the small things they can do to make a difference to people

links with the community; involving residents and their families whilst respecting their right to privacy and challenging the negative portrayal of care homes.

HOW WILL RESIDENTS BENEFIT? The open day will help homes connect with their local community and maintain links and networks. It will hopefully encourage people across the country to consider how they can support their local care homes perhaps by becoming volunteers.

HOW IS THE DAY BEING PROMOTED? Gloria Hunniford, a highly respected journalist and broadcaster, and keen supporter of issues that affect older people, has been announced as the ambassador of National Care Home Open Day. Gloria is aiming to raise the profile of the event to encourage people from across the country to visit their local care home on the 20th June 2014.

As part of her role she will challenge MPs to visit as many care homes in their constituency as possible on this year’s National Care Home Open Day.

WHAT HAPPENS NEXT? To register your care home, or to learn more about the day, please visit the National Care Home Open Day website www. nationalcarehomeopenday. org.uk

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property news

DC Care sell Roman Court Specialist healthcare agents DC Care recently completed the sale of Roman Court in Mexborough. The sale was managed through to completion by Clare Jones, Sales Negotiator based at DC Care’s head office.

Acting on behalf of the Joint Administrators, Stephen Grant and Anthony Cork of Wilkins Kennedy, DC Care secured the sale following a comprehensive marketing campaign resulting in a number of offers being made.

Commenting on behalf of DC Care Clare Jones said,

‘The successful purchaser was Mary Whitehead of Maricare.

One of the strengths of her offer was her ability to provide clear evidence of funding and experience as an existing provider. With the completion of Maricare’s third home, of which two have been managed

by DC Care, we are delighted that we have played a part in helping them build their portfolio.’

Developer eyes growth prospects The care sector has experienced resurgence in the last quarter, and with the property market now picking up, the GB Group is seeing an increase in both development and construction opportunities.

‘Finding funding for care home developments during the downturn has proved challenging,’ explained Glenn Mills, Director of GB Group’s development arm. ‘But we have delivered two schemes representing an investment of £14m in the South, which are both good examples of what can be achieved through non-

traditional routes to funding.’

Work has recently been completed on a £6 million project, to develop a luxurious care home in Horley, Surrey. GB Development Solutions forward sold the home to operator Gracewell Living once planning had been secured for the stateof-the-art building, where the team will specialise in dementia and respite services as well as residential and nursing care. GB Development Solutions also sold part of the original site to the Horley Baptist Church, securing planning for their new church as part of the deal.

HSBC lending risks ‘missing the point’ small firms. Head of Business Banking at HSBC Amanda Murphy told the BBC that 2014 would be a ‘turning point’ for lending.

Nick Baker, Director and Head of Business Mortgages at specialist commercial

HSBC is to set up a £6 billion fund for lending to small and medium sized businesses around the UK, according to reports. The investment is reported to have come amid a backdrop of claims that banks were not lending enough to

it is the stringent criteria being applied to such loans, especially over cautious debt servicing tests, which remains an issue - not the availability of capital. So, while the funding will hit the mark, it in some ways misses the point.’

mortgage broker Christie Finance says that while all new available cash for businesses is welcome, there are concerns.

He said, ‘Whilst HSBC’s announcement is undoubtedly welcome news for SMEs,

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property news

Buyers sought for care homes Following the appointment of Bob Maxwell and Julie Palmer as joint administrators of Dorchester Care LLP and its designated member Lyndale Healthcare Limited on 10th April 2014, buyers are being sought for three nursing homes.

Greenbushes Nursing Home on Weymouth Avenue in Dorchester, owned by Dorchester Care closed prior to the joint administrators’ appointment. The 42-bed nursing home is presently on the market for sale.

Avenue House Nursing Home in Dorchester, owned

by Dorchester Care, and

Windsor Court Nursing Home in Bournemouth, owned by Lyndale, are both continuing to run as normal while the businesses are marketed.

Upon their appointment, the joint administrators immediately put in place a reputable care home operator with whom they have worked before, Goldcare Future Management Ltd, to manage Avenue House and Windsor Court on their behalf.

The 33-bed Avenue House residential care home has been operating for nine years and is located on Weymouth Avenue, close to Dorchester town centre.

Established in 2002, Windsor

Court is located on Bodorgan Road, within a ten minute walk of Bournemouth town centre, and accommodates 59 residents.

‘Our key concern is ensuring that the care homes continue to operate efficiently with the minimum of disruption to residents,’ explained joint administrator Bob Maxwell.

‘For this reason, we have appointed a specialist healthcare management company whom we know well, and which has vast experience of managing care homes in administration, to oversee the smooth running of Avenue House and Windsor Court.

‘We, together with Goldcare, are working closely with the relevant authorities to maintain stability and ensure the smoothrunning of the care homes while buyers are sought for the businesses as a going concern.

A buyer is also being sought for the Greenbushes property which previously operated as a nursing home.’

Avenue House employs 36 staff; no redundancies have been made. Windsor Court employs 38 staff; four redundancies were made prior to Lyndale Healthcare being placed in administration. Greenbushes is closed employing no staff.

First residents welcomed at new £8 million care home Winchcombe Place in Berkshire has welcomed its first residents and appointed Michelle Sides as manager. The purpose-built care home from Care UK and investor MedicX will provide a

range of care services for older people, including residential and nursing care, specialist dementia care, short term respite care, and sensitive end of life care.

Home manager Michelle has

more than 20 years’ experience in the health and social care sector.

The layout of the home has been designed to support the formation of close-knit communities – a factor which has

proven particularly helpful for residents living with dementia – who benefit from calm, familiar surroundings. There are also plenty of safe spaces for relaxing outdoors.

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local authority and planning news

Castleoak’s final planning consent in Suffolk Castleoak’s £45 million Suffolk care home reprovisioning programme for Care UK and Suffolk County Council has reached an important milestone with planning permission granted for all ten new care home and wellbeing centre developments.

The final consent, an 80-

bed care home to replace the existing Glastonbury Court care home in Bury St Edmunds, has been granted approval by St Edmundsbury Borough Council.

The Glastonbury Court development is the second new care home and wellbeing centre for Bury St Edmunds, following

Davers Court, where Castleoak is due to complete construction in July.

Castleoak will start construction of the new Glastonbury Court development in September 2014, with the opening scheduled for November 2015.

New housing scheme in Middlesbrough An innovative new housing scheme in Middlesbrough has been designed to help older or disabled people live independently and pay for additional care while still retaining a property asset.

Coast & Country, one of the North East’s largest housing and regeneration companies,

purchased four bungalows from Taylor Wimpey under the terms of a section 106 agreement.

The properties were available under very flexible shared ownership terms enabling buyers who were older and possibly ill or infirm to downsize, freeing up capital to assist with care costs but still

enabling the individual to own part of the property.

All the bungalows were sold very quickly and the scheme was heavily over-subscribed, demonstrating the need for inventive and original thinking in the housing sector as the demographic of the population shifts.

Aspire and emh homes in Northampton Aspire, a national charity providing practical help to people who have been paralysed

by Spinal Cord Injury, has launched a new Aspire House in Northampton, in partnership with emh homes. Aspire Houses provide temporary accessible homes for people with spinal

cord injuries while a more permanent solution is being arranged. The house has been provided to Aspire by emh homes under a management agreement.

Nikki Chawda, Director of Housing and Neighbourhoods at emh homes, said, ‘We are proud to be working with Aspire

and raising the standard for accessible housing. This is the second home we have provided for them in Northampton, and we are also providing several more in Leicestershire. Helping people to live independently and safely is one of our principal aims.’

Northamptonshire closures delayed Joint Administrators Simon Thomas and Nicholas O’Reilly of Moorfields Corporate Recovery have advised that Redruth Nursing Home and Cedar Wood Nursing Home in Northampton are likely to close. Although this has been

delayed until the latest 18th June as the Administrators are endeavouring to find purchasers willing to take the homes on a going concern basis in the interim.

Both Redruth and Cedarwood are located in

Northampton and were placed into administration on 11th March 2014. Between them the homes provide care for a total of 69 although the actual number of service users in occupation currently stands at around 23.

Supported living in Renfrewshire Craegmoor, part of the Priory Group, is opening a new supported living development on the outskirts of Lochwinnoch, Renfrewshire.

Corsefield will provide support for 11 service users with autism

or learning disabilities. The service will provide accommodation in seven self-contained apartments, each with its own outdoor space and a smaller unit of four en-suite rooms with shared communal living areas.

Based on the former Garpel and Parkhill site, the unit will be managed by specialist autism, learning disability and positive behaviour experts, offering appropriate and evidence-based support 24 hours a day.

Warwickshire telehealth pilot The first telehealth pilot project based in an extra care scheme in Warwickshire has finished in Stratford-upon-Avon. The project was based at Briar Croft, Orbit Heart of England’s first mixed tenure Independent Living with Care scheme. It was a partnership between Orbit Independent Living, Rother House Medical Centre, Docobo, Baywater Healthcare (formerly Air Products Homecare) and Choice Health Care Group Ltd. Six customers at Briar Croft, took part in the pilot project with the aim of reducing doctors and hospital visits and improving their quality of life.

There are currently 15 million people in the UK suffering from conditions that cannot be cured but can be managed through medication. It is these patients who can be remotely monitored by doctors and nurses who will be able to view patients’ vital signs. These patients take up three quarters of all in-patient bed days, two thirds of all outpatient appointments and more than half of all GP visits, accounting for around 70% of the total spend on health and social care.

Colten Care Linden House will be home to up to 60 residents, living in one of four small ‘house groups’, each with a friendly atmosphere of safety, security and togetherness.

The home includes a café, retreat, hairdressing salon, cinema and even a ‘Linden Square’ complete with ‘shop fronts’ evoking the Georgian grandeur of Lymington.

Every physical detail of the 4,250-square-metre home has been designed with dementia care in mind including themed rooms, colour schemes, corridor and room features, and navigational aids.

It has created around 100 direct jobs including posts for nurses, healthcare assistants, activity organisers and care workers.

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corporate news

Target Healthcare REIT and Ideal Care Homes Target Healthcare REIT Limited has acquired a modern, purpose-built care home located in Flixton, Greater Manchester for approximately £3.8 million.

It has also exchanged contracts to acquire another care home in York, due to be completed and open this summer, for approximately £5.1 million.

The care homes will both be leased to Ideal Care Homes Group for 35 years and the transactions both represent an initial yield in excess of 7%. The rent payable under these leases is subject to an annual uplift in line with the retail prices index, subject to a cap and collar.

As part of the agreed

transaction, the Company is to provide a short-term loan facility to Ideal Care Homes in order to fund the completion of the York property. This facility attracts a paid interest coupon of 7% and will be repayable from the consideration proceeds on the completion of this York property. These transactions represent the Company’s 12th and 13th acquisitions since it listed its shares on the London Stock Exchange’s Main Market in March 2013. The Company has now invested approximately £59.3 million of the £95.7 million raised from institutional investors, wealth managers and private investors.

Cambian Group The Cambian Group PLC has listed on the London Stock Exchange valuing the company at £387.8 million. Cambian was

acquired by GI Partners in 2008, it was merged with Advanced Childcare, prior to the listing, creating the Cambian Group PLC.

ACH acquisition Montreux Capital Management, a Swiss investment firm and investment adviser to the Montreux Care Home Fund, and KTN Care, a multi-family office with expertise in healthcare, have purchased ACH, the learning disability care homes business with freehold real-estate backing based in the south east

of England.

Macquarie Lending, part of Macquarie’s Corporate and Asset Finance Group, provided a loan and minority equity against the deal. Montreux Capital Management will be the majority equity holder with KTN Care providing management expertise and minority equity.

European Care Group European Care Group has rebranded to become Embrace.

The rebranding coincides with the group being acquired by two investment firms Värde Partners and the D. E. Shaw Group. The acquisition ensures Embrace has a solid financial foundation for the future and marks the next stage in development, as the business looks to build on the high level of care and support it already provides.

The change of name is part

of a full corporate rebranding, which also includes a new visual identity and website.

The new brand was developed in consultation with people supported by the company as well as staff, relatives and commissioners.

The senior management team will remain in place whilst Chief Executive Ted Smith, will be moving to the role of Chairman. Trish Lee joins Embrace as the new Chief Executive.

The Social Care Commitment www.thesocialcarecommitment.org.uk The sector’s promise to provide people who need care and support with high quality services.

Signing up to the commitment is easy to do and can be done by employers and employees in working in care.

It proves your commitment and dedication to improving care and support and promotes your organisation publicly, as a provider of quality services. @carecommitment #qualitypeoplequalitycare

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corporate news

Barchester and Castleoak Barchester Healthcare has signed another 35-year lease agreement with leading care developer, Castleoak, this time for an 80-bed care home in Castleton on the outskirts of Cardiff. The £8.5 million home will be funded by the CarePlaces Fund, a joint venture between Castleoak and sustainable growth investor Bridges Ventures.

Castleoak’s development

team acquired the site and secured planning permission and construction is underway. Property and asset management services will be provided by Castleoak to the CarePlaces Fund for the duration of the lease term. Over the last 12 years Castleoak has built 22 care homes for Barchester Healthcare, the equivalent of more than 1,400 care beds.

Caring Homes Group has celebrated its 20th anniversary.

The Group, founded in 1994

by Helena Jeffery, Paul Jeffery and Craig Griffin, is responsible for providing care and support across a range of multi-award winning services through Caring Homes, Consensus Support Services and Curate Hospitals. Caring Homes Group collectively operates over 150 care homes, support

services and hospitals.

Helena Jeffery, a registered nurse, had worked for many years as a care home manager, until 1994 when she fulfilled her dream by owning and operating her own care home, Bradbury House in Braintree. Today, the Group which is based in Colchester, Essex provides care and support to over 3,600 people and employs over 4,500 staff.

Abacus Care (Ormskirk)

Eden Futures Eden Futures is the new brand name for Midlands and Yorkshire-based social care provider Eden Supported Living. The new name will also encompass its sister organisations Housing & Support Solutions and Essential Futures. In 2013, the three companies joined forces establishing themselves as a major provider in

Caring Homes’ 20th anniversary

the Midlands and South Yorkshire. The rebranding forms part of the integration plan and will streamline the group’s external and internal communications and ensure that stakeholders know that their individual services are supported by the wider group with a huge resource of specialist support knowledge and experience.

Administrators from The P&A Partnership have been called into a Lancashire care provider after increasing legislation and intense competition brought an end to the business, with the loss of more than 150 jobs.

Abacus Care Home Care and Nursing Services (Ormskirk) Limited supplied qualified nurses and health care assistants to care homes, hospitals, and secure units as well as providing

palliative care and specialist care, and personal and domestic care to clients within their own homes. A sister company, Abacus Care (Home Care and Nursing Services) Limited, also offered franchises providing care services around the UK. Despite two decades of success, the owners have now had to close both businesses. All 152 staff across both companies have been made redundant.

New accessible wet rooms from the leader in specialist bathing, Gainsborough Gainsborough Specialist Bathing, Europe’s leading choice in hi-lo baths, has launched a new range of assisted wet rooms suitable for a wide variety of long term care and acute care settings.

Suitable for new-builds or refurbishments, these accessible wet rooms offer healthcare managers, carers and specifiers with a flexible, yet exceptionally durable solution that meets the unique challenges of specialist bathing.

They incorporate a safe wet deck area with level access and slip resistant flooring so user accessibility and safety is maximised.

There is a choice of decorative wall paneling, thermostatically controlled shower units and either flat glass screen or half-height shower doors that include MicroGuard antimicrobial protection. An integrated, soft-touch padded shower seat with folding armrests is also incorporated along with a fluted grab rail.

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With a nationwide network of skilled fitters, Gainsborough also provides a complete end-to-end installation service from concept to completion.

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Is technology the answer to medications management?

Medications management is an integral part of every care service. Ensuring it is safe and that those being cared for receive the right medication at the right time is crucial. Andrew Willetts explores the benefit of technology for improved accuracy, adherence and patient safety in medications management.

Ensuring that a patient receives safe medicines administration at every stage of their life is imperative, not only does it improve or at least maintain health, safe medicines administration can also save lives.

Care home residents have a unique set of healthcare needs.

People are living longer and many have co-morbidities that require complex medication plans. As such, it’s encouraging to see more innovation entering care homes to enable staff, GPs and pharmacists to work together and more easily

to deliver more effective and safe medicines management in light of these increased needs.

NICE GUIDANCE This has gained further attention recently by the National Institute for Health and Clinical Excellence’s (NICE) guidance on Managing Medicines in Care Homes. Upon publishing the guidance, Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said, ‘Care home residents

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is technology the answer to medications management?

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are often vulnerable and often have complex medical needs requiring them to take a number of medicines.

This sometimes makes them particularly dependent on care home staff to help them take their medicines. This guideline provides clear advice on medicines management systems and processes that place the resident firmly at the centre of decisionmaking, ensuring that their needs are paramount and can be addressed safely and effectively.’

The report recommends that records should be shared and accessed more easily.

This would help patients and their families to make better informed decisions about their healthcare with their GPs, pharmacists and carers. The question now, is how?

THE ROLE OF TECHNOLOGY Technology is a key enabler to most aspects of life and the healthcare sector, as a whole, has been slow to maximise its benefits. The NICE guidance focuses upon a patient’s right to have a say in their course of treatment and that decisions only be made on behalf of a resident if it’s deemed absolutely necessary.

This is in line with the Mental Capacity Act and moves further towards a more person-centred approach to medications management with residents taking their own medicine wherever possible.

Empowering patients not only to be central to the decision-making process but also to allow them to selfmedicate is laudable – so long as it’s still audited efficiently as complications arising from issues such as dexterity or dementia need to be recorded and medicine management processes adjusted.

Introducing technology into medicines management

can ensure that data is instant, accurate and securely accessible. There is no argument that this makes it safer too. Managers gain a real-time view of medicines administration at the point of care, while directors and heads of governance have a comprehensive overview of medicines management and reporting across the network.

INFORMATION SHARING As well as ensuring patients are supported to play a key role in their medications, another crucial factor that should not be overlooked is the patient journey. Has that person arrived from another setting, such as a hospital? If so, how is the medicine management plan transferred? Has the medicines regime changed?

How has the individual reacted to medicines while in hospital? Without having this information readily available the patient is put at risk.

In addition, supporting the

NICE guidelines, the 2009 Care Homes use of Medicines Study (CHUMS) report called for better communication between all parties.

Pharmacists from additional clinical settings will also have patient knowledge that the care worker may not. For instance, the pharmacist may know that a resident has difficulty in swallowing; this is a crucial piece of information that can be added to electronic records to inform other healthcare professionals.

Communication is the key and electronic data needs to become the norm to ensure errors are reduced, the benefits to the resident are increased and safety is always at the forefront.

THE FIVE RIGHTS The Five Rights of medicines management - right patient, right drug, right dose, right route, right time - still exist and must continue to be the core focus of medicines

management. However, we must continue to review and evolve the processes and controls that support the Five Rights to ensure the everchanging patient needs and care plans are supported.

The introduction of one patient record and electronic health records can significantly support care home staff. It relieves the burden of reams of paperwork which can be overwhelming and prevent care staff from having valuable interaction with the residents in their care. As a recent Joseph Rowntree Foundation report asked, ‘Is an overload of paperwork preventing care home staff from looking after residents properly?’

Enabling care staff to have more quality time with the people in their care must be at the heart of everything we do now, and in the future.

MEDICATION ERRORS The CHUMS report highlighted some startling

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is technology the answer to medications management? statistics - that two thirds of residents in that study had been exposed to at least one medication error. While most errors are negligible, some in fact have potentially lifethreatening consequences.

Having a concise and electronic medicines history can provide vital information in a time-critical situation.

An electronic medicines administration records system can ensure that accurate medication administration systems, accessible management of information, automated stock management and a streamlined prescription process dramatically reduces human error. In turn, this frees up care staff time, improves medicines management, provides organisations with more transparency and improves the patient or resident’s experience.

By logging and managing medicines management and care through an online platform, organisations can view the performance and

quality of care across multi-site locations as well as feel more motivated because they are providing more direct care to the resident.

The alternative is to spend

burden or a drain on resource and time. By working closely with the right partner, change can become more manageable and mutual parameters can be set between trainer and trainee.

unnecessary ordering and the high costs associated with medicines wastage.

Not only can electronic medicines management improve patient safety and enhance the

‘Communication is the key and electronic data needs to become the norm to ensure errors are reduced, the benefits to the resident are increased and safety is always at the forefront’ vast amounts of time manually logging and recording information and having lengthy handovers with colleagues.

Secure and remote access of residents’ medicines records by healthcare professionals including their GP, pharmacist, hospital and care home ensures a quicker response in life-critical situations, a continuous improvement through effective performance management reporting and highlights areas of risk sooner.

The reports available from an electronic health record system can highlight trends enabling providers to put preventative measures in place before a medicines mismanagement issue occurs.

Furthermore, it improves patient safety and empowers the individual and their families to make the right decisions about their health and wellbeing – everyone’s collective goal.

A SMOOTH TRANSITION While the transition from paper-based to electronic MAR charts is widely-recognised by the profession as a huge step in the right direction, change often comes with challenges. These need to be addressed. Training, for example, needn’t be a huge

Likewise the implementation of new systems isn’t as complex as it may first seem and the benefits far outweigh any perceived challenges. We ourselves have observed a reduction in error rates in some cases as high as 87 per cent.

Turnover of care home staff can bring with it many challenges. By reducing paperwork and implementing centralised and accessible records new staff can ease into an effective system far easier. This is poignant given that NICE is recommending accredited learning providers should be sought by care homes and that staff who administer medicines have an annual review of their skills and competencies.

Stock control can also be simplified. Through an online platform, medicines can be ordered and remain in their original packaging and with the original Patient Information Leaflets – the dispensing label bar codes will already be scanned and logged into the system. We have seen instances within care homes where the simplicity of reordering saves on average 15 hours per month per home in stock handling alone - vital time that can be redeployed to the resident. This automated approach reduces

relationships between the care provider, GPs and pharmacists it goes a long way to helping a provider achieve its operational objectives. This also means that Care Quality Commission regulations are being met and embargoes are avoided.

It’s important to learn from our mistakes. Technology can act as a portal of information and learning and if standard operating procedures are built into electronic reporting the whole process becomes that much more robust. Although it is also important to consider how with increased safety and a better patient experience is linked to business growth.

By aligning the integration of new systems and processes to NHS policy, risks to the patient and blue-light scenarios are dramatically reduced while quality measures and reputation enhanced.

The consideration to move towards electronic medications systems must be weighed up but given this evidence and the guidelines from NICE there must be a case for the efficiencies, safety and benefits it can bring to care settings.

CMM Andrew Willetts is Public Sector and Health Care Services Director at LloydsPharmacy.

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Market trends in the premium care home market

Drawing on a wealth of data and research, Ben Hartley explores market trends in the premium care home market over the past five years.

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When looking at statistical information contained in individual pieces of property advice, it is sometimes easy to forget that a broader view of data trends, over a longer period of time, may also be instructive as a guide to what is happening in our industry. With this in mind, we analysed property data over a five-year period and found some interesting results emerge.

The source of this information is approximately 400 studies prepared on the elderly residential market between 2008 and 2014. In particular, these studies have focused on: • Demand and supply balance, • Sensitising catchment areas, • Wealth profile, and • Fee rates.

DEMAND AND SUPPLY To assess demand and supply, a combination of data sources have been used including: • The latest census data, currently 2011, • National Government projections, and • LaingBuisson’s Age Standardised Demand prevalence rates.

WHAT DO WE MEAN BY SUPPLY? Here we have assessed it as a function of the provision of ‘market standard’ beds (defined as a bedroom with en-suite comprising a minimum of WC and wash hand basin). This segmentation of the market is an easily understood means of defining quality. If you were to assess supply using total Care Quality Commission (CQC) registered capacity it would give a completely different result, and would not reflect the ‘quality’ segmentation used here.

Below are highlighted some key observations: Average shortfall

177 beds

Highest shortfall

1,211 beds for a scheme in Bromley

Highest overprovision

519-bed overprovision for a scheme in Surrey Heath

Most planned schemes

937 beds in the planning system, again for the above study in Surrey Heath

It’s clearly a plus for the sector that the average shortfall across the analysed projects came out at over 175 market standard beds, showing strong demand for additional good quality provision. However, different geographical areas throw up different results, giving rise to significant variances. It can be said of the South East that any overprovision of bedspaces is usually driven by the number of proposed beds in the planning system. This is clearly evidenced in the Surrey Heath market above, where if the planned provision of market standard beds were to be removed there would be a comfortable statistical shortfall.

In a significant minority of studies (23 per cent of those conducted) there was no planned provision, indicative again of the large variation from area to area. Overall analysis reveals there is a large divide between the main operator target areas, ie the Home Counties, where there is significant planned supply, and other parts of the UK, where the planned supply is much smaller and competition for sites is significantly lower.

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market trends in the premium care home market

Government Office Region Figure 1: Average statistical shortfall by Government Office Region

In the chart above (Figure 1), a green bar shows an average statistical shortfall, whereas a red bar represents a statistical overprovision of bedspaces. The horizontal line shows the market average shortfall of 177 bedspaces. It can been seen that: • The largest shortfall is to be found in London. Our view is that this is driven by a combination of factors, but principally high population density combined with difficulty in finding suitable, available and affordable development land within the M25.

• There is a cluster of high shortfall levels in West Midlands, Wales, the North West and the East Midlands; all with average regional shortfalls of 220 to 350 beds per study.

• The North East is significantly oversupplied. This is due to historic large-scale development during the 1980s and 1990s of purpose-built care homes, low land values and the ready availability of sites compared to other parts of the country.

• Scotland’s fee rate and funding structures differentiate it from the rest of Great Britain and have caused a number of anomalies as a result. The scale of individual care home development in the main conurbations of Glasgow and Edinburgh illustrates that larger-scale developments of 100+ beds are far more prevalent than in England and Wales, and this may account for the statistical over-bedding.

IMPORTANCE OF WEALTH

CATCHMENT SENSITIVITY ANALYSIS

Figure 2 shows the 384 elderly care home markets (illustrated by the pink dots) we have surveyed, and Figure 3 shows the average house prices across England and Wales. There is no comparable house price data available for Scotland hence it has been removed from the map. The maps clearly show the influence of high wealth values on market activity.

A quick glance shows a concentration of potential investment in and around London and the South East, along with the more affluent areas of East Anglia and the South West. This almost directly correlates with the areas of strongest underlying house prices. Of the quarter conducted outside of Southern England, there is still a close match to pockets of affluence in the West Midlands and the North West.

Figure 4 shows the top 10 counties, based upon number of studies. Surrey and Greater London lead the way comfortably, with the rest of the top 10 all located in the South West, South East or East of England, except Warwickshire, which is in the West Midlands.

When analysing supply and demand data, it is worth remembering that the precise catchment boundary for any one scheme is of crucial importance. Setting an overall catchment is, of course, necessary but in order to produce robust data it is prudent to carry out sensitivity analysis, typically by drawing at least two additional catchment areas within closer geographical proximity to a subject scheme. For example, a general catchment might be set at five miles, with additional sensitivity analysis conducted at three and one and a half miles radii.

Applying this methodology to the studies informing this article shows that in just over 30 per cent of cases a statistical bed provision shortfall within the wider catchment was contrary to the figures generated in the more localised catchments. There is generally a less favourable result obtained in the immediate location (ie a smaller shortfall), although this is more likely to be driven by the target market size in a smaller geographical area. Instances with a shortfall in the local area and an oversupply in the larger catchment area are rare.

Figure 2: Carterwood instructions –

Figure 3: Average house prices

England & Wales

(Land Registry) – England and Wales

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FINAL CONCLUSIONS Looking at data gathered over an extended period has real merit in providing information of real import. If the project instructions feeding into this analysis provide a barometer of the way the elderly residential market has been and is developing, then there is clearly a North/South divide, as exists in many

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Undertaking competitive fee analysis of the top competitor homes to any subject scheme will, over time, build a picture of the ‘best in market’ rates in any given area. In order to assess what constitutes the ‘Top 10’, it is possible to use a combination of criteria, including quality of accommodation, operator status and the likelihood of targeting the private fee paying market.

Looking at a sample with a quality spread would dilute the findings and would not achieve the best-in-market analysis.

Given that our analysis only captures the ‘top of the market’ it is, therefore, of particular interest to those operators/developers/ investors seeking to consider this type of product. The analysis should not be used as ‘typical’ of what an ‘average’ home could achieve, as the quality of the homes making up the analysis sample comprises the best that each market has to offer.

Given that much of the current stimulation of the market is being driven by overseas capital, and US REITs in particular, this focus on quality is particularly appropriate for ‘best in class’ analysis but not for comparisons with other national datasets and market benchmarks.

The first thing to notice is that these averages in Figure 5 dwarf the results reported in many national research databases – this we would expect, given that our sample of fees is restricted to the very best homes in the area and not those targeting local authority funding sources.

The South East and London offer the strongest fee profiles by some distance, at average rates of £961 and £906 per week for personal care and nursing, respectively. The average rates for the South West and East of England occupy a second tier at £796 and £777 for personal care and nursing, respectively. As indicated earlier in this article, it is no surprise that these four Government Office Regions occupy the strongest fee profiles, given the underlying house price wealth and the incredibly strong statistical correlation between fees and house prices at a regional level.

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FEE ANALYSIS OF ‘BEST IN MARKET’ CARE HOMES

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Figure 4: Top 10 counties by number of studies conducted

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aspects of the UK economy. The development market is also focusing on entirely future-proofed facilities, which is why we believe an approach towards demand and supply analysis and fee profiling, with that fact firmly in mind, is the most relevant in this market.

The message to operators, developers and investors is clear. If statistical shortfalls of demand and supply are the most important factor in your site selection process and you require a strong wealth profile to support high average fees, then head to London or the South East. The focus of development in that area has been a constant for our industry for some time and, at present, shows no sign of coming to an end. But this generates its own problem.

If everyone is looking in the same area, for the same target fees, where do you find the land?

We anticipate that developers and operators in the South East will have to begin looking at different site options. The rebound of the residential market will also mitigate against the care sector continuing to secure prime acreage. The strength of any due diligence work undertaken and the acquisition of high quality data will become more important than ever in determining the level of fees and occupancy these particular companies can expect to achieve going forward.

Ben Hartley is Director at Carterwood. Ben.hartley@carterwood.co.uk

Focus on Leadership: the achievements of the National Skills Academy - so far...

Welcome to the National Skills Academy for Social Care’s Leadership Section We are the only membership organisation that covers all of social care – the public, private and not-for-profit sectors; residential and home care; providers and commissioners; trainers and developers – and of course, our individual members, including over 1300 Registered Managers from Cornwall to Cumbria.

We have built our membership, and our position in the sector, on the basis of a steadily expanding body of services, all based around strengthening leadership across social care. This means strengthening leadership at all levels of the workforce, and amongst service commissioners, including people commissioning their own services At one end of the spectrum, our Front-Line Leaders programme now helps first-time managers develop their leadership potential; at the other, programmes for Emerging Leaders, Top Leaders and New Directors of Adult Social Services give leaders at strategic level tools and resources to work in the new integrated health and care landscape.

At the same time, we have reached beyond the workforce to bring leadership behaviours and capabilities to people using services, their carers and the communities in which they live and work.

The Leadership for Empowered and Healthy Communities programme enables people to recognise, and build on, the assets they have. Expanding on this, we are now planning a programme to develop people using services as leaders in their own right.

In the Leadership Qualities Framework for Adult Social Care, we have literally written the book on what good leadership looks like in the sector. On the back of

NSA_4page Juneindd.indd 1

This will be my last overview for this particular insert in Care Management Matters, before I go to my new role as National Director of Systems Leadership, bringing new leadership approaches to integrating services across social care, health, housing and other sectors. So I wanted to use this opportunity to reflect on what we have achieved at the Skills Academy. the LQF, we have now started to produce guides to using it in different areas, to help providers and managers show how they are meeting the CQC’s new standard for ‘well-led’ services. Sue Ascott describes overleaf how ACC, a training provider that has achieved the Excellence status through our unique Endorsement Framework described below, has worked with one of their members, Friends of the Elderly, to produce a case study that illustrates the ways in which the LQF has been implemented on the ground in one of their care homes.

Through the Endorsement Framework we have consistently championed the value of high quality social care learning and development, highlighted by Camilla Cavendish in her recent review.

The Skills Academy has been proud, for example to support the WorldSkills health and care competitions, and to demonstrate the value that people working in the sector, whether they are Graduate Trainees working in the front line or Registered Managers running multiple services, bring to their roles. And we were delighted to win WorldSkills Organising Partner of the Year for 2013, which is testament to the way in which we build and maintain good relationships in everything that we do.

Above all, we have championed the value of social care, and the excellence of so much of the provision and development in the sector. I will take this with me into my new role, and as it moves into a new phase, I know that the National Skills Academy for Social Care will continue to flourish and strive for leadership in our sector.

To find out more about the Leadership Centre and Debbie’s new role, visit www.localleadership.gov.uk

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Determined to be useful: Setting up the National Skills Academy Jennifer Bernard, Consultant and Founding Chief Executive, National Skills Academy In 2008 I took on with great enthusiasm the challenge of setting up a National Skills Academy for Social Care, getting it licensed and funded by the Department for Business Innovation and Skills and the Department of Health. The Academy project was supported by a committed and experienced Steering Group of social care leaders who gave unstinting guidance and support. Their message was simple: our Academy must be useful with the emphasis on what the Academy is going to offer to social care. Getting Academy status was a competitive staged process and the timescales were tight. We were up against other sectors throughout but in 2009 the NSA for Social Care was approved formally along with Academies for IT, retail and the nuclear industry.

Licence achieved, the next stage was to become useful.

The point of an Academy, representing employers, is to improve the status and opportunities for development in the sector. Our NSA was tasked with raising the status of social care and increasing the opportunities for leadership and development at all levels of the workforce and for users of services. That helped clarify the earliest projects for care staff, user-led projects, senior leaders and attracting graduates into social care as a worthwhile career. None of these had received this kind of attention before.

We started five programmes in the first few months of the NSA whilst developing it as a Membership organisation

belonging to social care. The NSA made a bid to WorldSkills to offer a competition for care and health staff within their international framework. The competition is now in its fifth year with finalists from earlier years now taking part as judges and trainers. The NSA was acknowledged as Organising Partner of the Year for 2013.

For 2014 the UK finals will be at the Skills Show at the Birmingham NEC in November.

The first graduates started their Management Training Scheme in 2009, hosted by organisations in the private, voluntary and statutory sectors. The Training Scheme continues with successful participants working across social care in England, who are ambassadors for the opportunities that social care offers for a worthwhile and absorbing career. Programmes have been delivered for New Directors, research conducted with user-led organisations and Registered Mangers, and work done on how best to endorse training organisations, to help social care organisations make informed choices about the standards they should offer.

I am proud to have been there at the start of the NSA and to have taken part in many of the programmes it offers. And seeing the way that colleges training health and care staff have taken on the opportunities offered

by WorldSkills to raise the standards of their students has been a joy.

Celebrating the success of the Skills Academy Jo Cleary, Chair, National Skills Academy

I have seen the National Skills Academy develop from an idea in the mind’s eye of Dame Denise Platt which she set out in The Status of Social Care1 report in 2007, to the dynamic, effective and engaging organisation that it is today. As a former commissioner, provider and regulator, I know how important it is that social care is led well, and effectively – as without this, people using services will not receive the support that they need and want. The Skills Academy was set up to directly address the leadership gap identified by Dame Denise, to identify and develop future leaders across the entire adult social care sector and raise the confidence of everyone working in our sector.

During my time on the Board, and as Chair, the Skills Academy has ‘punched above its weight’, establishing ourselves as a credible and loud voice on leadership in social care. Our robust research, Who Cares? on the reputation and perception of the care sector, and Everyday Excellence on Registered Managers and their careers, has influenced practice and informed new programmes. And the Leadership Qualities Framework, the first in the sector, emphasises that it is our behaviour that changes culture, and is used widely by members and non-members alike. I am also really proud of our Leadership for Healthy and Empowered Communities programme, co designed with people who use services and

NSA_4page Juneindd.indd 2

in collaboration with other partners. We are also about to launch work on strengthening the leadership capacity of people who use services.

Our programmes have attracted individuals that may never have considered a career in social care into the sector. From our Graduate Management Training Scheme participants, through the learners on the Moving Up Black and Minority Ethnic Leadership programme, to our World Skills medallists, we are attracting talent at all levels that we want to keep and grow.

As we move into a new phase of the Skills Academy by coming together with Skills for Care, I believe that the combined strengths of both organisations will embed leadership into the way we recruit, develop and retain people in social care.

As I step down as Chair, I can say that I am very proud to have led the Skills Academy, together with a Board of national social care leaders who are similarly passionate about making a difference, and an equally committed staff team led by Debbie Sorkin. I am confident that the National Skills Academy’s leadership offer to all employers will be sustained in the new merged organisation.

1: Platt, D. (2007) The Status of Social Care – a Review. Department of Health,

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From zero to..... the story of Membership at the National Skills Academy Terri Myers, Membership and Engagement Manager, National Skills Academy for Social Care Membership is essentially about engagement. It is a way for organisations and/or individuals to demonstrate their commitment to an interest, a cause, a community. In social care we are challenged by the fact that we are such a disparate sector, which makes offering a membership programme interesting, to say the least! One of our main drivers to launching our membership offer was to form a community of influence and interest, so we started with a select list that we wanted to be the cornerstone, our Founder Members. These represented a microcosm of the sector - small, medium and large employers, from a variety of fields, serving a wide community of service users. We added a sprinkling of individuals; after all, care comes down to the individual, whether giving or receiving, so their views were very important.

We secured an excellent group of Founders, who offered advice, views and feedback, and it is from there that we grew our Membership base, which now includes some of the largest and most influential in the field, as well as smaller providers who are committed to developing and delivering quality care. Size does not matter. There is no reason to join us (and hundreds of organisations representing thousands of individual establishments have done so) if quality of care is not a prime concern.

We have grown, developed and listened to what our

Members have told us they wanted. Over time, we have developed new Member segments, including our Registered Manager cohort. Supported by the Department of Health, this is the backbone of the RM Support Programme. With over 1300 Registered Manager Members in just over a year, we are dedicated to supporting this crucial group gain the recognition they deserve and the support they have told us through our Everyday Excellence report - they want.

We have done this by: • promoting the role of the Registered Manager, • offering funding to start networking groups; by offering RM centred events; • hosting a helpline for those times when an expert, impartial view is wanted and by offering over 200 resources to inform and educate.

And that is not all. We see this programme growing, not only in terms of benefits and offer, but in numbers and influence. As the role of social care in our society grows, so will the profile of all who work in it; particularly those responsible for delivering care.

Membership is about engagement, and now is the time for those of us who work in the sector to come together to raise make our voice heard. Nothing is more important than delivering high quality care to those that need it, in the way that they want it. Viva Membership!

Registered Managers – a key achievement of the National Skills Academy Philip Nightingale, Walsingham As a Registered Manager, I know only too well the challenges that the role brings. With a varied workload and multi-level responsibilities, Registered Managers were not being fully recognised or supported by the sector. That was before the White Paper, Caring for our Future1, specifically set out that Registered Managers perform a key leadership function, and that change was needed to provide better support.

As a part of its work programme with the Department of Health, The National Skills Academy for Social Care set up a research project in order to gather the evidence to form a basis of a new programme and membership offer for Registered Managers that would sit alongside existing work with Front Line and Emerging Leaders.

That piece of research, Everyday Excellence2 highlighted a number of things: • Registered Managers are passionate about what they do – their strong need to support others and contribute to their well-being is what took them into social care.

• Registered Managers are true professionals – 79% of those surveyed described their working environment as such.

• However, Registered Managers felt that their work could be isolating, stressful and frustrating.

• Time, money and bureaucracy were the biggest barriers to providing high quality care on a day to day basis.

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In order to address these and the many other issues uncovered by Everyday Excellence, Registered Managers identified the need for a network that would allow them to meet other Registered Managers in a safe environment, and obtain mutual peer-to peer advice and support.

The Skills Academy’s Registered Managers’ Programme has provided an excellent solution – as a member of the Programme Steering Group, I have been in the fortunate position of being able to help shape the work over the past year. We now have over 1300 Registered Managers signed up, with over 40 Regional Networks. These Networks are making a real difference to the lives and careers of Members. We have also set up a Registered Managers Mentoring Scheme, and have seen the value of mentoring to career progression and confidence.

The National Skills Academy has achieved a tremendous amount with Registered Managers. As the organisation moves into a new phase as it joins with Skills for Care, we envisage being able to reach even more Registered Managers, a key group of leaders in the social care workforce.

1:

2:

Department of Health (2012) Caring for our Future: reforming care and support.

Department of Health, London.

National Skills Academy for Social Care (2012) Everyday excellence: a research report into how Registered Managers view their careers in social care, and the changes required to better support them in their day-to-day roles. NSA Social Care, London.

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The National Skills Academy Graduate Management Training Scheme: the experience of a graduate and a host Joy Davut and Susan Brand, the Pembroke Group The Graduate Management Training Scheme was a step into the unknown. I wanted to learn about the sector, explore the ways in which I could make a difference, and gain real career progression; this is exactly what I achieved. The Scheme taught me the skills to be a confident leader, a positive role model and a manager with a holistic understanding of the sector. I was able to inject a fresh perspective, which supported me in developing and leading projects to enhance the quality of life for our residents.

During my year, I spent time with frontline staff and the Care Manager, getting to know staff routines and working with them to improve efficiency and quality of our services. I was also responsible for organising events such as Dignity Days, the daily Social Activities programme and National Care Home open day. I developed working relationships with local schools to create a Volunteering Scheme that benefited both residents and students. One of my proudest achievements at Pembroke Care Group was winning a government capital bid to improve the environment for our residents. Our residents live full lives and enjoy being able to interact with their environment, especially in their garden. With the funding we built a raised patio space and a glass veranda that spans the entire length of the garden. The residents are absolutely thrilled!

My passion for this sector has only grown through the Scheme, and this was recognised by the Pembroke Care Group as I am now their Operations Manager. I have been able to

continue working with the Management Team to implement innovative methods of improving the quality of life of our residents, and I work strategically to ensure standards of care are raised and maintained. I will continue building relationships within the local community raising awareness of social care.

Without the National Skills Academy there would not be the possibility for graduates, like myself, to become a part of the social care sector which is such a vital but undervalued part of society. This scheme has allowed me to play an important role in successfully changing this perspective.

HOST PERSPECTIVE I was delighted when I was selected to be a Host organisation for one of the Graduates on the 2013 cohort of the Scheme. The thought of having an enthusiastic, intelligent graduate with an interest in the sector excited me.

I was impressed with Joy’s sunny disposition, natural enthusiasm for her work and her commitment to improving quality of life for our residents. Joy demonstrated her abilities in the many roles she performed, and her success was measured by the positive impact it made on the organisation, our residents and the staff team.

We are pleased to still have Joy with us as our Operations Manager, and we are grateful to the National Skills Academy for providing this excellent Scheme which is having a profound effect on driving up standards in the care sector.

A view from an Excellent Endorsed Provider Sue Ascott, Director of Learning and Development, Aged Care Channel (ACC) ACC is a membership organisation providing training and learning for those who work with older people in residential care homes. We write, film and edit televisual learning programmes covering a wide range of topics to be used in the care home settings. This enables the care home management to provide training in a familiar environment where the learner feels comfortable. Our ongoing support for care home training coordinators ensures that the benefits of ACC membership are maximised through a continuous learning approach.

We were delighted to receive the National Skills Academy Recognised status when it was launched back in 2010.

However, we were then excited by the challenge presented through the change of focus at renewal stage, so when our three year period came to an end in 2013 we decided to work towards the Excellence status.

This was by no means an automatic ‘renewal’ and we found the rigorous process to be quite a challenge! But along the way we learned a lot about our own organisation and we built even stronger links with colleagues at the National Skills Academy. In total, it took us six months to achieve the Excellence Award. The process encouraged us to look inward at our own policies and procedures, at our quality improvement processes and as a training provider, perhaps most importantly, it required us to have a good look at our

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evaluation process. Through gathering feedback from our members, explaining our business model to the National Skills Academy team and updating our own quality assessment processes, we were delighted to achieve the Excellence status.

We are passionate supporters of the Endorsement Scheme as a quality standard that employers can trust.

Having achieved Excellence status, we are keen to work with the National Skills Academy to promote the Endorsement Scheme and the Leadership Qualities Framework. A good example of this is in the recently published case study where we worked with one of our members, Friends of the Elderly, and looked at how they have used ACC training to embed the Leadership Qualities Framework in their organisation.

The case study showed clear evidence of how the team at Friends of the Elderly have used the ACC learning materials to good effect. Corrine Goodson RN from the Friends of the Elderly’s care home The Old Vicarage said: ‘The results of our training have been amazing. We have revitalised our Supervision process and fully empowered staff who enjoy learning and developing using both the ACC programmes and real life situations as part of their reflective practice.’ By linking ACC learning to the Leadership Qualities Framework, Friends of the Elderly have made excellent progress in bringing leadership to life with their staff at all levels.

16/05/2014 11:17

60

60 seconds with...

SECONDS WITH...

TED SMITH Ted Smith is the newly-

appointed Chairman of New Century Care.

WHAT ROLES HAVE YOU HELD?

I spent the first twenty five years of my career in UK retail, holding senior positions with Boots the Chemists, WH Smith, the Big Food Group and the British Retail Consortium. I always stayed close to the healthcare sector, having originally qualified as a Pharmacist, and in parallel to my retail career holding positions with my local Family Health Services Authority, as well as sitting on the council of the Royal Pharmaceutical Society for three years. In 2004, I joined Craegmoor Healthcare as Chief Operating Officer and in 2005 took over as Chief Executive. After selling Craegmoor to the Priory Group in 2011, I was appointed Chief Executive of European Care and this year I moved into the role of Chairman at Embrace.

ARE BIG CHANGES EXPECTED?

The day to day operation of New Century Care (NCC) is in a very good shape, which is documented by excellent CQC ratings and a high occupancy rate. Our main focus is to preserve the excellence in care and develop it even further. Our work will be centred around upgrading the back office and support processes and to evaluate extensions of existing homes where possible. This work will be supported by the founder and co-shareholder Paul Warren.

HOW DO YOU FEEL ABOUT YOUR APPOINTMENT? I am delighted with my appointment, the business has great potential and I am looking forward to working with the whole NCC team and my new colleagues at Anchorage Capital.

WHAT’S YOUR FIRST JOB? My first job as Chairman is to start with what really matters - the people we support. I need to understand how we support people to have the best experience they can and, if possible, to make that experience even richer.

WHERE DO YOU SEE THE COMPANY GOING?

The company is operationally in a good shape. The NCC platform will serve as a basis for further acquisitions. Subsequently, these acquisitions have to be integrated and run to the same high standards of care and customer service as NCC, in order to create a company that we all can be proud of.

WHAT CHALLENGES ARE THE COMPANY FACING?

I think the big challenge we face as an industry is to ensure consistently high quality of care across our services in the face of pressure on fees. I want to believe that we live in a country that supports older people, treats them with dignity and provides proper funding for that support.

It doesn’t always feel that way.

WHAT’S THE BEST ADVICE YOU WERE EVER GIVEN? Two pieces of advice have stayed with me over the years.

A very senior director once told me that you should be careful what you ask for - you might just get it. That advice has served me well over the years.

Secondly, during a time when my confidence was not high a colleague once told me that I was ‘no greater than anyone - nor any less’. It is those last three words that we sometimes forget...

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business clinic

MICRO-FRANCHISING UNREGULATED SERVICES

SureCare, a well-established domiciliary care franchise is launching micro-franchises offering unregulated services. Is this the next step for diversification of the homecare market?

Although the homecare market has consolidated over recent years, franchises have grown. With successful franchises covering large swathes of the country, where there is demand, supply can arrive in the form of a neatly packaged and supported franchise.

However, pressure on domiciliary care is rising. A recent BBC investigation by File on 4 discovered that most councils in England pay below the industry recommended minimum for homecare. Only four of the 101 councils surveyed under the Freedom of Information Act met or exceeded the United Kingdom Homecare Association’s £15.19 per hour recommended minimum to cover wages, training, travel and overheads. Some councils pay as little as £10 per hour. Competition is also fierce in the self-pay market. It is no surprise that in this market innovation and diversification is required. But with traditional homecare being so competitive and a drive

for localised community services, where are the opportunities?

LOCAL DEMAND FOR LOCAL SERVICES This is where SureCare, the domiciliary care provider with 27 franchises and three branches in England, has seen a gap in the market. Owned by the newly-named Housing & Care 21, it has expanded over the last 18 months under the helm of Managing Director, Gary Farrer. It offers home services, childcare, holiday care and respite care. Added to that it is launching the UK’s first ever micro-franchises offering unregulated services to local communities.

The services could include home services such as DIY, gardening and cleaning, as well as babysitting, holiday clubs and a mobile

crèche service for weddings and other events.

Gary Farrer, Managing Director of SureCare explained, ‘Our new microfranchises have been created out of a need to diversify the business, but also to provide older people with a comprehensive range of unregulated home services which are essential in helping them to remain independent and continue living in their own homes into their later years. Existing franchises cannot always deliver these services as they don’t have the time or they’re not worthwhile when they’re servicing their region’s homecare market.’

SURECARE LOCAL The micro-franchises, known as SureCare Local, will allow more people to become franchisees, while providing more targeted, unregulated services in local communities.

Where SureCare franchises exist, they’ll

No reason why it won’t work in the sector

Welcomed but with some reservations

Colin Angel Policy Director United Kingdom Homecare Association

Paul Tarsey Chairman Bluebird Care Group

The franchise model has grown rapidly in the homecare sector, with providers generally focusing on selffunders. Well-run franchise operations offer intensive support, pre-prepared resources and marketing materials to help new entrants to the market to reduce the extended set-up time before they can begin trading.

Care services undertaking ‘unregulated’ care aren’t new, but currently represent a smaller part of the homecare sector, which tends to focus on personal care. The Institute of Public Policy Research has recently reported on the increasing numbers of people who will be needing support but don’t have family members available, so we should expect demand to increase steadily in coming years. Establishing this sort of service now could offer a competitive advantage, while recognising that established homecare agencies are also thinking about diversification as council-funded care becomes increasingly unattractive.

I would encourage franchisees

to be creative and really listen to the services that people want to purchase that will help them to remain at home. This is an area to demonstrate a ‘can-do’ attitude to be really effective. My word of caution is that franchisees must understand the criteria that would bring them into the scope of statutory regulation, to avoid the risk of trading without being registered.

Councils rarely purchase unregulated care without some personal care attached, so prospective franchisees will need to be sure that there is a local market from self-funding customers and those in receipt of direct payments to be sustainable. Advice from the local franchise operator should be helpful.

There is no reason why a microfranchise won’t work elsewhere within the sector. A useful question for prospective franchisees will be what their options are once their business needs to expand beyond its franchise area.

I welcome SureCare’s initiative in addressing the problem of rising prices in home care although I have a few reservations about the viability of their micro-franchise scheme.

Traditionally in the area of business where people are paying for their own care, they already buy a wide range of different services and don’t tend to go from ‘unregulated services’ to those covered by a regulator including the Care Quality Commission.

People who are receiving personal care at home may well want to go out to the shops, visit friends and have some housework done.

I am, therefore, unclear as to where SureCare will be able to draw the line between the various services and just how the relationships between SureCare’s existing 30 offices and these new micro-franchisees will develop or how they will be managed.

All of Bluebird Care’s 185 offices

are providing a full range of services and customers enjoy the personal contact and a feeling of security which familiarity brings.

Whilst I do not believe for one moment that Gary Farrer and his team are part of a headlong ‘race to the bottom’ by providing this service, we as an industry must be careful that we maintain high standards of care for all our services whether they are regulated or not.

Twenty five years of experience in care and franchising has taught me that easy-in schemes where there is minimal capital requirement, can also be, almost by definition, easy-out as well.

If we take a high-level view of this, the worst possible thing that this could bring about would be ‘copycat’ operations who do not have SureCare’s experience or ethics and who see an opportunity to climb on the bandwagon without the hassle of regulation.

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business clinic

support the micro-franchise creating a synergy between the two. Gary continued, ‘The micro-franchise concept allows us to provide our clients with a more localised service while, at the same time, creating opportunities for more people to become their own bosses. Micro-franchisees will work alongside master franchisees with initial start-up support and training from SureCare head office, the two will then work together, meeting regularly to create a cohesive service in an area.’

The cost of becoming a SureCare microfranchisee will be from £7,000, covering a population of around 100,000 people. This compares to £28,000 for a full SureCare franchise covering a much wider geographic area and offering services regulated by the Care Quality Commission.

Gary estimates that on a population of around 100,000 people the micro-franchisee could make in the region of £56,000 a year and employ up to five people. Micro franchises are designed to appeal to people who want to work locally, have control over their employment and know their local area.

By offering working with an established franchise to offer local services to local people in their local community, where they are likely to have connections and an

understanding of the population’s needs, they can comfortably become their own boss for a smaller outlay.

The lower cost compared to full SureCare franchises can be more attractive to people uncertain about the investment amounts involved in larger franchises. Gary continued, ‘With a number of Government schemes available to help new business start-ups, we are hoping our micro-franchises will appeal to a wide range of budding entrepreneurs.

‘Each micro-franchisee will have the ongoing support of an experienced head office team in Chester who are able to advise on areas such as sales, marketing, finance, HR and operations. Where they work in an area with an established SureCare franchise they will be supported by the master franchise to help work in conjunction.’

scope for SureCare Local franchises to undertake training to deliver more regulated services in an area where the master franchise is unable to due to location, capacity or time.

Gary concluded, ‘In areas where there aren’t master franchises or they are unable to work with micro-franchises we could even create module franchises offering a wealth of services beyond the traditional home care, that don’t conflict. It’s about seizing the window of opportunity.’

Gary Farrer finished, ‘The care sector is going through enormous change and companies such as SureCare have to respond to this challenge by looking to continually innovate and develop new services and ways to meet the needs of our communities.’ CMM

CONTINUITY OF SUPPORT

Given the need to draw together all-round support to people in the community, is this a logical move for the sector as a whole? Will SureCare Local fit neatly into a growing portfolio of personalised services going beyond traditional social care? Does this open up a new avenue for providers (domiciliary or otherwise) to diversify to offer more non-regulated support? Would more regulated services work on a micro-scale?

Or would it be too small for many to consider it worthwhile? What do our experts think?

With people becoming familiar with the brand before they need formal care services, it has the scope to create a continuity of support as needs increase. With SureCare Local franchisees working with SureCare master franchisees clients can be referred across where a need is identified, enabling a synergy between the two. There is even

Over to the experts...

Of interest to commercial enterprises Sian Lockwood OBE Chief Executive Community Catalysts CIC Community Catalysts works with community entrepreneurs to deliver health and social care services and support to other local people.

The majority of the community micro-enterprises that we work with are delivering services that fall outside regulation and 30 to 40 per cent are delivered at no-cost or low-cost. Only about 10 per cent of our enterprises are delivered on a more commercial basis and some of these are delivering domiciliary care services to people in their community.

The micro-franchise opportunity offered by SureCare may be of interest to some of these more commercial enterprises although the £7,000 fee may be a barrier.

Brand-recognition may help to address local authority concerns about quality and make it easier to attract custom from people with managed budgets. It may be of less value in attracting customers with direct payments or buying services

with their own money as in our experience these customers are attracted by local reputation and word-of-mouth recommendation.

The majority of very small community enterprises are tailored to the needs of a small number of people and so are difficult to replicate. People buy services that allow them to live their lives and many fall outside the social care and health sector. In our view micro-franchising may provide a useful route for some local entrepreneurs but is likely to be of limited value in a truly personalised world where people have real choice of services.

If larger providers want to support micro-diversity, there are other routes. Community entrepreneurs would find access to accommodation, IT, finance, HR and other back office functions invaluable - and as sub-contractors could provide richness and diversity to the offer made by the provider to local people with support needs.

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16/05/2014 09:14

Care Conference

Supported and organised by Care Management Matters

FOR YOUR 2014 DIARY! Focusing on the future of care and commissioning BOOK NOW! 2014 2014 2014 JUNE JUNE JUNE

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Nottingham Belfry, 4 June 2014

THE FUTURE OF CARE & COMMISSIONING Mercure Dunkenhalgh, 18 September 2014

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In association with the Lancashire Care Association

What to expect from these events

Delegate profile

• The day will include presentations from high-level sector representatives, along with an exhibition and a choice of workshops

Owners/Directors/Senior Management from the Independent Care Sector within Residential and Domiciliary Care and other sector professionals

• An agenda that has been put together in partnership with the relevant local care associations, providers and opinion leaders in the region meaning that it totally reflects their needs

• 94% of delegates said the event had fulfilled their needs and expectations

• Networking opportunities with high-level decision makers and like-minded colleagues from within the independent sector

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07/05/2014 10:44

Recruiting the best -

LEARNING FROM THE US

abuse te a ic d ra e to s can help e lu ent and a v m ir it e ru th c n re t o a d staff base Sorkin look re ie a b c b e g D in it d ru n viders. a ro d p Rec o re o a tw c s l a t. Neil E est US socia b e th y and neglec b d ethods use m g other well-documented incidents of poor in n e re sc practice due to poor recruitment do not The recruitment of suitable social care staff is a ‘live issue’ at the moment. The recent Panorama programme showing abuse and poor treatment of older people by some care workers made for shocking and disturbing viewing. The sector faces a real challenge if we are to ensure that these and

happen anywhere else.

Ensuring that staff teams have the right values to care is crucial. Leadership is grounded in everyday behaviours which reflect people’s true values so it’s vital, if we’re to get better leadership in social care, that we have people with the right

g

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recruiting the best - learning from the US

g

values coming in from the start.

To ensure the right people with the right values are employed, the National Skills Academy is currently piloting a Values Based Recruitment Toolkit (VBRT) which provides employers with a set of ‘tools’ including the Leadership Qualities Framework, a personality profiling test and the Skills for Care Finders Keepers tool.

Similar tools and techniques have been developed in the United States, where providers wrestle with the same social care challenges. The best US social care providers use practical and easy to implement recruitment and screening methods, which we think should be of interest to UK providers, especially those who are already engaged with the VBRT or reviewing their current processes.

RECRUITMENT IS SEEN AS A PRIORITY ACTIVITY The best American care providers put as much thought and effort into attracting candidates as they do into winning new business. They recognise that getting recruitment right will generate more referrals, a stronger reputation and build a platform for sustainable growth. In order to get this right they break the recruitment process down into its various parts: attraction, screening, interviewing and onboarding and test different approaches to maximise the effectiveness of each element.

STUDYING THE HABITATS OF NATURAL CARERS Too many US care providers were dependent on untargeted ‘passive’ channels to find new staff. These included internet job boards, state job banks or centres and advertisements in the local paper. These methods only reach active jobseekers and almost guarantee a highly variable quality of applicant.

The best US care employers augment these traditional approaches by searching their local community to find prospective staff. For example, experience has taught them that in the US there is a strong correlation between religious belief and compassion, so a number of providers actively engage with local churches and religious groups to add to their candidate pool. Equally, with the young mum demographic tapering off, they found it can pay to network in places where active retirees gather, such as leisure centres and community groups.

‘The best US care providers learned to observe interviewees in order to ascertain their friendliness and willingness to help others.’

Some of those that have recently retired do not have the restrictions of looking after children and can have greater empathy with older people. Also, they are usually reliable and may be able to step in at the last minute.

The US providers identified that some of the most successful care staff shared previous experience of caring for a loved one, so getting involved in, for example, local hospice events gave them access to their supporters, many of whom will know what’s involved in caring for others.

REFERRALS: MAKING THE MOST OF THIS VALUABLE NETWORK Most US care employers already incentivise existing staff to refer a friend, although many didn’t realise the value to the business of this source of high quality candidates.

In recent US research it was discovered

that after three years only 14 per cent of staff who were sourced from internet job boards were still in place, compared with 47 per cent of those who joined because of an employee referral.

Furthermore, US providers approach existing or past clients’ families to ask if they could recommend someone who could join their organisation. People coming from this source could be well worth interviewing.

JOB ADS: WHAT WORKS? Simply using the same old job advert wording, headed up by the job title and hourly rate, was found to be unlikely to attract the best applicants.

Many job advert wording combinations were tested in the US and the most effective at attracting the best candidates had a common theme. They led with a

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recruiting the best - learning from the US telephone interview time directly into the manager’s calendar if they ‘pass’ an initial set of online application form questions, thus reducing ‘no-shows’ and increasing applicant commitment.

ENSURING THEY’RE THE RIGHT CANDIDATES Once US providers had developed these techniques to increase both the quality and volume of applicants, they then turned their attention to enhancing their chances of adding only reliable and compassionate staff by using the following simple tips.

MAKING THE OPENING PHONE CALL WORK HARDER An initial screen of applicants over the phone is commonplace, but only the best US care providers make the most of this interaction. Simply confirming the candidate’s ability to work for them - the so-called ‘killer questions’ - is just the start.

Although it sounds obvious, it was found to be valuable to explicitly ask the candidate if they are happy with the hourly rate on offer.

If they were earning much more at their previous job, this was seen as a potential red flag that the candidate would move on again for a higher paid role. Most importantly, US providers use this call to probe if the candidate had cared for a loved one. This was the single best predictor of success in a care role if the candidate had no previous paid care experience. question focused on the reader’s experience of caring, such as, ‘Have you cared for a family member or loved one?’ or highlighted the intrinsic rewards of the role, ‘A rare opportunity: Could you make a difference to the life of an older person?’

ACTING QUICKLY IN A CANDIDATE’S MARKET The recruitment, vetting and training process in social care is long enough on both sides of the Atlantic without employers being unnecessarily slow to engage potentially suitable applicants.

Posting an application form out in response to a candidate’s initial approach was identified as simply increasing the chances of them being poached by another employer. There are ways to speed up the process and there is even technology available to allow candidates to book a

AUTOMATED TOOLS HELP ASSESS SUITABILITY FOR A CARING ROLE Interviewing in social care is challenging wherever in the world you operate.

Limited information from past employers’ references and a lack of interview training can make it stressful and difficult to make the right choices consistently. Using a suitable psychometric screening tool can help answer a critical element of success in care: how well suited is the person’s personality to the requirements of frontline care? Many providers in the US use the PeopleClues personality screening tool which was developed by the sector over eight years ago. In one example, annual staff turnover at a three branch home care provider was reduced from 45 per cent to 23 per cent due to the introduction of this type of screening.

Easy to use, low cost and sector-specific internet-based personality or values-based profiling tools such as Profiles4Care and PeopleClues are now becoming available for social care employers in the UK, and there are high levels of interest from providers and individual employers to incorporate this approach into their screening process.

SCREENING FOR SAFEGUARDING RISK Care providers have a duty to protect vulnerable members of society in their care. In the highly litigious US market, employers have long been anxious to reduce the business risk of unwittingly hiring an aggressive, negligent or dishonest member of staff. In addition to introducing personality screening, they also assess workplace attitudes and the potential for counter-productive behaviour. US employers recognised that as well as identifying candidates with the right values or personality types to deliver quality care, it was just as important to ensure they were going to be reliable and not present a safeguarding risk.

MORE PRE-INTERVIEW CHECKS Many interviewees put on a performance for the interviewer but can be caught off guard by other members of staff. The best US care providers learned to observe interviewees in order to ascertain their friendliness and willingness to help others.

One method is to seat the interviewee near a closed door and get a member of staff to carry a large pile of empty files past them towards the door and see if the interviewee leaps up to open it. Or do they look up disinterestedly and go back to texting their boyfriend or girlfriend?

Getting the right people in the right roles with the right values can be a tricky process, however all care providers face the same challenges. Whether in the US or the UK, sharing expertise and trialling tried and tested approaches can help you to recruit effectively.

CMM Neil Eastwood is the Founder of Sticky People Ltd, the sole UK provider of PeopleClues care-specific psychometric assessments.

Email: neil@stickypeople.co.uk Debbie Sorkin is Chief Executive of The National Skills Academy for Social Care.

Email: debbie.sorkin@nsasocialcare.co.uk

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CREATING A CULTURE FOR CARE Recent high profile cases of poor practice have highlighted the need for organisations to really focus on their workplace culture so people working at all levels are supported to be responsive to the needs and preferences of those who need care and support. Teresa Morrison explains how you can create a culture of care in your organisation.

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T

hinking about your workplace culture means focusing on the ‘behind the scenes’ activity that happens in the dayto-day life of organisations, employers and critically their employees. It involves stepping back and taking a long, hard look at your workplace culture. This provides an opportunity to use a more flexible and personalised approach to understanding your workplace.

A positive workplace culture can have a significant impact on relationships between managers, care workers and the people who need care and support. It puts compassion, dignity, choice and control at the heart of everything your workforce does. These elements should be central to the role of a caring organisation.

Positive workplace cultures are increasingly recognised in our sector as important in contributing to the effectiveness of any workplace and one of the most important building blocks in providing high quality care and support. A positive workplace is essential to adult social care to provide high quality, flexible care and support.

CREATING CULTURE However, it is an area than can be overlooked, as people see it as something that is intangible and complex or just focused on structures and systems. This is why Skills for Care has developed Culture for Care: your toolkit.

Launched by Care and Support Minister Norman Lamb MP at Skills for Care’s annual conference, the toolkit is for all social care and support employers, regardless of size or type of services delivered.

It has been developed to be as relevant to individual employers who employ their own personal assistants as it is to a large employer with many staff. It is a practical toolkit supported by good practice examples drawn from employers from across the sector. It integrates with other resources, qualifications and frameworks, from both Skills for Care and partners, including the Social Care Commitment.

Using real life scenarios from employers, and key messages from other national bodies, employers will be able to use the toolkit with their staff and to help put in place the foundations for a positive workplace culture.

It will help employers not only develop but maintain positive workplace cultures. Workplaces that have a positive culture show signs of improved quality, consistency and personalisation of services. As one provider noted, ‘a positive workplace culture is essential for sustainable exceptional performance.’

LEARNING FROM OTHERS The toolkit has been developed in consultation with employers from around the sector to make sure it will make a real difference to those who use it. It is designed to be a practical tool that includes activity sheets, scenarios and examples.

It also features comments and helpful tips from other

providers and individual employers that can provide those using it with ideas that they can take into their workplace. New Key, a small employer involved in the toolkit, explain how their positive workforce culture is focused on people feeling proud of their own work and what they achieve so they feel valued members of the workplace.

Heathfield Residential Home believe that, ‘a positive workplace culture is essential for sustaining exceptional performance. The way we encourage this culture is by making sure everyone has a clear job description, understands and agrees what ‘excellent’ looks like, and has the training and support to realise their potential.’ This helps with lower staff turnover and improved morale within the workplace.

ACHIEVING YOUR ASPIRATIONS The toolkit also helps you to identify any difference between what your organisation aspires to be and how it is actually perceived by those who use it. This is directly addressed by providing an activity in which non-workers - including family, inspectors and people who need care and support - can be asked for their view of the workplace culture. This can help identify any practices that may need to change to improve workplace culture.

There are many practical benefits that a positive workforce culture can bring, including a reduction in staff turnover, fewer staff absences, a confident workforce that has the ability to cope when facing external challenges and a more engaged workforce.

As home care service, Care 4 You explained, ‘Our culture ensures that we have great staff retention and we can recruit the best staff. It means we don’t look for staff they ring us up and want to join us.’

Developing and maintaining a positive workplace culture involves bringing together many elements like managing change, establishing clear lines of communication and identifying norms and expectations.

According to individual employer Nina Osborne, ‘workers need to know they can voice concerns, worries and suggestions to me their employer or line manager as a collaborative partner without feeling afraid of repercussions or that their contribution won’t be valued.’

To help you identify these issues, there is an activity sheet that uses the practical approach based on the concept of ‘analyseplan-do-review.’

As Norman Lamb MP noted, ‘A good positive culture doesn’t happen by accident. It takes time to develop, which is why this Culture for Care: your toolkit is such an important development.’

CMM For more information on Culture for Care and to request your free copy of the toolkit visit www.skillsforcare.org.uk/culture.

Teresa Morrison is Area Manager for Skills for Care.

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www.carechoices.co.uk 34 | CMM JUNE 2014

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SPOTLIGHT ON...

BUILDING, DESIGN & CONSTRUCTION SERVICES

Whether you are renovating, extending or planning a new build if you’re considering building work or changes to your property you will need to know the organisations in our sector who can help you to achieve your vision. This month CMM turns its spotlight onto specialist services to cover all your architectural, design or building needs.

BUILDING CONSTRUCTION PARTNERSHIP

Building Construction Partnership Ltd (BCP), is a construction company that provides a range of quality building and associated construction services to a varied client base in the care sector, specialising in nursing homes, specialist care, mental health, residential homes, dementia care and care villages. BCP offers turnkey design and build carefully managed with budgets to ensure cost assurance; from land sourcing and feasibility, through the planning process to completion, including furnishings and equipment, offering a variety of solutions for financing projects.

Established in 2001 as a specialist care contractor, BCP has a large portfolio of nursing,

BRIAN BULLOCK

Managing Director

Brian is a Chartered Builder who has been in a management role within the building industry for 30 years and over 20 of those exclusively specialising in nursing homes and the healthcare industry. He has been instrumental in developing designs seen in many of our modern homes. One of the strengths Brian brings to BCP is his use of those years of

mental health and specialist care homes across the UK. The company was built on the keen knowledge and experience of Managing Director Brian Bullock, who personally holds over 30 years’ construction experience in the sector. A great measure of BCP’s reputation and quality is the returning clients and relationships built within the industry.

The directors at Building Construction Partnership have been working with a limited number of specialist suppliers and operators for over 25 years, maintaining continual ties with industry leaders, and have a client base of individual and national operators throughout the UK and the Isle of Man. BCP has worked on nursing homes, specialist care, mental health, residential homes, dementia care and care villages throughout the UK. experience to work with clients’ specific needs to advise, design and build homes that meet all the requirements of a modern home, fit for the future but within the budget constraints necessary to bring a project to fruition.

‘The design and development of care homes has moved on a long way over the last 20 years and it has been good to be involved with care home development and to work with people who really care and want to do their best for the people who live in the homes we build.’

Telephone: 0800 019 9750 / 01924 910815 • Email: info@building-construction-partnership.co.uk • www.building-construction-partnership.co.uk

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spotlight on…building, design and construction services

CASTLEMEAD

Castlemead Care provides turnkey new build solutions for nursing home, primary care and assisted living operators throughout the UK. As a developer-contractor, we can accommodate individual occupier’s requirements, from site acquisition and planning approval to design and construction, leaving the care provider free to concentrate on their core business.

We take a proactive approach to sourcing prime sites. This starts with a detailed analysis of the operator’s proposed care plan. We then produce a detailed design brief and competitor market analysis.

Our in-house land managers source opportunities and together with our architects and planning consultants deliver prime sites with planning approval, protecting the operator

from potentially abortive planning and design costs.

Our clients range from government bodies and charities to national and local private equity backed care providers. We add value to all these groups by ensuring that we not only deliver best practice design and build quality that meet current requirements but produce facilities that offer the flexibility to adapt to future changes in care delivery.

Tony Cole Business Development Director leads the development team at Castlemead and previously developed a new build pipeline at Bupa Care Homes.

Tony considers, ‘In the care sector, one size does not fit all. Whilst Castlemead can share best practice across the industry, the key to our success is in understanding the passion individual operators have for their business and translating this into a bespoke building that enables them to achieve their goals.’

Telephone: 01978 669000 • Email: tcole@castlemeadcare.co.uk • www.castlemeadcare.co.uk

CASTLEOAK

Castleoak has specialised in care accommodation since 1996, delivering more than 180 care homes, 9,000 care beds and 3,000 extra care apartments across the UK. The £60 million turnover group is widely regarded as the leading development and construction partner to the care sector.

Covering care homes, care villages, specialist care and extra care, Castleoak’s design and construction services are at the forefront of sustainability and range from project inception through to furnishing and equipping.

The Castleoak team has extensive experience of reprovisioning programmes to deliver both care homes and extra care accommodation, including nine projects for Oxfordshire Care Partnership and ten projects for Suffolk County Council with Care UK, for example.

As well as design and construction, its specialist team undertakes the full range of

MELVILLE KNIGHT

Group Chief Executive

Melville joined Castleoak in 1993 and has been instrumental in the company’s growth into a £60 million turnover group.

As Group Chief Executive, Mel is responsible for Castleoak’s overall strategic direction. He also plays a pivotal role in the development of funding solutions for new care home and extra care developments.

development tasks, including sourcing sites in prime locations, thorough, site-specific market analysis, completing acquisitions and achieving planning permissions. Turnkey sale or lease agreements are reached with customers ahead of its design and build team starting on site. Flexible funding solutions are also offered.

Having previously won the HealthInvestor Property Developer of the Year Award, Castleoak is once again a finalist with the 2014 winner to be announced in June.

Castleoak develops long-term partnerships with its customers which include leading private care operators, not-for-profit organisations and housing associations including Barchester Healthcare, Care UK, MHA, Anchor Trust, Saxon Weald, Richmond Villages, Housing Solutions and many others.

Castleoak is committed to improving the image of the care sector and enjoys strong working relationships with key sector bodies, including the National Care Forum, Care England and Housing LIN. Mel is a strong believer in collaborative working and long-term partnerships. He is actively working with care providers to help improve the image of the care sector and is a founding Director of independent care home survey, Your Care Rating.

He says, ‘Close collaboration and effective communication are essential ingredients for working successfully with your development partner. In my experience long-term relationships yield the greatest benefits including continuous improvement, knowledge sharing and greater efficiency.’

Telephone: 029 2054 8000 • Email: enquiries@castleoak.co.uk • www.castleoak.co.uk

DOBSON-GREY

Under the Construction (Design and Management) Regulations 2007, it is mandatory to appoint a Construction Design and Management (CDM) Co-ordinator on all notifiable projects. DobsonGrey endeavours to ensure that you, the client, are provided with the reassuring support to enable you to guarantee your project complies with the right focus on health and safety.

Dobson-Grey has the competence and necessary experience to ensure compliance with the CDM regulations on any size of project large or small. Experience includes local authority regeneration, new build and residential projects, refurbishments, commercial retail developments and the care home sector.

Darren Grey is the Health and Safety Director of the Risk Management Team at DobsonGrey. Darren has over 17 years’ extensive experience in the Health and Safety industry and is a Chartered Member of the Institution of Occupational Safety and Health (IOSH).

‘Commitment, care and consistency are at the core of our service.’

Darren has expertise in: • H&S Consultancy. • H&S Inspections and Management Audits.

• CDM Co-ordination. • IOSH Managing Safely.

• Accident investigation and reporting.

Telephone: 01789 298006 • Email: Dgrey@dobson-grey.co.uk • www.dobson-grey.co.uk

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CMM JUNE 2014 | 37

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spotlight on…building, design and construction services

LNT GROUP

New build care home development has suddenly become fashionable again. Operators and developers have been frozen out of the market for some time due to lack of appetite for property development funding in general. The drivers of demand have always been in place, ageing population, increase in dementia, dated care home stock and lack of credible investment in new provision. One company, however, has managed to maintain a strong pipeline of schemes and bucked the trend over the last five years by also being able to generate sales for its TOK homes. Steered by Lawrence Tomlinson, the LNT Group has managed to skilfully navigate the choppy recessionary waters and land a number of highly successful care home developments, not only into its own operating company Ideal Care Homes, but also delivering set piece designed schemes to third party customers such as Avery, Sanctuary, Nugent Care and a clutch of private operators.

LAWRENCE TOMLINSON Chairman, LNT Group

LNT Group has built 52 care homes since 2009. Its own operating company, Ideal Care Homes, runs 36 purpose-built care homes with 2,000 beds and is still growing. It ranks as the 24th largest major operator of long-term care in the UK according to LaingBuisson (18 of the top 25 companies having

between 2,000 to 5,000 beds). More significantly, however, it is the only provider with completely purpose-built care homes having 100% single rooms with en-suite facilities.

Historically considered as a mainly local authority funded provider, Ideal has today 45% of its income from private fee paying clients and still does not charge third party top ups.

Spearheading the land acquisition and development process, Andrew Long and Nick Broadbent of LNT have arguably put more deals together for sites and new build care homes than the combined efforts of external sales agencies. ‘In terms of planning applications, LNT is second only to McCarthy and Stone in the elderly sector,’ comments Andrew Long, a Chartered Surveyor who has worked with Lawrence Tomlinson for nearly 14 years. ‘The Group strategy has always been simple but effective. Build high quality assets, standardise as much of the design and process as possible and sell at good value.’ LNT’s Turnkey Plus package comprises a complete inventory of equipment plus support from LNT’s marketing and commissioning team leading up to professional and public open days. Including the Coolcare management software, no-one else can offer such a comprehensive development and business support package.

The company has a development pipeline of 12 schemes going ahead at present. ‘We are now developing our portfolio in the southern half of the country and Home Counties,’ explains Nick Broadbent, also a Chartered Surveyor at LNT. ‘Operators recognise the simplicity and convenience of working with us. We have pre-sold a new 64 bed scheme in Aylesbury to Anchor and are doing another for them in Peterborough.’ LNT Group has sites secured in various locations and buyer interest on virtually every scheme.

Telephone: 0113 385 3865 • Email: Andrew.long@lntgroup.co.uk • www.lntgroup.co.uk

TANNER & TILLEY

Tanner & Tilley specialises in providing planning consultancy services to the care industry and advises clients on a wide range of specialist care facilities, including care villages, care homes, extra care accommodation, brain injury units and family group homes for people with learning disabilities.

Tanner & Tilley can help clients to optimise their development objectives with the following services:

• Site appraisals and feasibility studies.

• Care needs assessments, demographics and analysis of existing care provision.

• Preparation and submission of planning, conservation and listed building applications.

• Community consultation, public exhibitions and lobbying.

• Planning appeals, written representations, hearings and public inquiries.

• Property portfolio assessment and advice on alternative development potential.

In recognition of Tanner & Tilley’s outstanding services to the retirement housing and care sector, the company has been presented with the award for ‘Best Performing Planning Consultancy’ in November 2011 for the second year running.

Telephone: 01202 430348 • Email: planners@tanner-tilley.co.uk • www.tanner-tilley.co.uk

WILDGOOSE CONSTRUCTION

Wildgoose Construction Ltd was founded in 1896 by the current Chairman’s Great Grandfather and is proud to be recognised as a specialist, innovative and leading care sector contractor that has delivered many successful projects throughout a wide geographical area.

traditional through to contemporary.

Whatever a client’s requirement, we can offer full refurbishments or extensions to existing facilities, or new builds that include care homes, retirement villages, health centres and care apartments.

Our vast construction experience, through the utilisation of innovative and competitive design solutions ensures the delivery of a quality product provided in a collaborative environment; where our client’s satisfaction is our key consideration.

Our clients include many well-respected care companies including Avery Healthcare, Restful Homes Group, Maria Mallaband Care Group, The Salvation Army, Porthaven Care Homes, Ashley House Plc and many more.

Our service offers design and build, build only or a full turnkey option and our multidisciplinary team can offer cost-effective design solutions on a range of designs from the

Wildgoose Construction would be delighted to assist further clients in ensuring that their future plans meet with their expectations.

Telephone: 01773 546400 • Email: info@wildgooseconstruction.co.uk • www.wildgooseconstruction.co.uk

WRIGHT & WRIGHT ARCHITECTS

in the cultural, education, housing and office sectors. A key element of the practice’s work focuses on developing designs to support those with a range of special needs.

Wright & Wright is an award-winning architectural practice based in London. Formed in 1994, the practice has built a strong portfolio of projects in the UK for prestigious clients

All projects are underpinned by a commitment to delivering the highest quality buildings and to supporting clients through every stage and aspect of a project.

Telephone: 0207 428 9393 • Email: ww@wrightandwright.co.uk • www.wrightandwright.co.uk

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SPEAKER

SPEAKER

SPEAKER

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Catherine Murray-Howard, Deputy Chief Executive, Community Integrated Care

Joe McGilligan, Chair of East Surrey CCG & Co Chair of Surrey’s Health and Wellbeing Board

Trevor Brocklebank, CEO and Co-Founder, Home Instead Senior Care

Andrew Azzopardi, Managing Director, Sunnyside House.

SPEAKER Directors of Children and Families services

Dr Toyin Ogboye, Public Health Specialist, Specialised Commissioning NHS England

Health+Care is the only national event where health meets social care Health+Care returns on the 25- 26 June 2014 at London ExCel. More than 7,000 professionals will gather from all over the country for 14 theatres of world class conference programmes, with dedicated ‘Home and Residential Care’ theatres, delivered by expert speakers and policy makers.

In addition to the 14 theatres of content, there will be a new Care Commissioning and Public Health conference, a centralised hub for technology – Technology First, and new features for 2014 for you to follow your own specialist learning needs.

Health+Care is the only event to bring together the entire health and social care sector on a major scale, making the event your best shared learning and networking opportunity. Plus the 400 exhibitors will enable you to source and compare the latest innovations.

In just two packed days, you can update your knowledge and meet more people than you could from months of research in your office.

Your complimentary delegate pass will allow you to:

>> Get advice on how to influence your CCG and local authority to ensure its strategy works for your organisation Source practical cost saving ideas for driving efficiencies Prepare for new-style CQC inspections Discuss updates on policy and liability developments and political thinking Debate issues surrounding the Better Care Fund Meet the people that can award you budget available from the Step Down Care initiative >> Gain insight into new opportunities and threats in the reformed health and social care system >> Learn economy of scale to compete for new contracts >> See new innovative pricing mechanisms and ways of setting contracts >> Debate the role of regulation in improving quality Plus much more! Attend the show - save time + save money

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Passes are usually £699+VAT* but senior social care and care provider professionals can get complimentary passes that are available.

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BUILDING A SOLID REPUTATION Sophie Hunt explores the six principles of building and maintaining a good reputation in difficult circumstances.

T

here’s no doubt the last three years have been tough for the reputation of the care sector. The sudden demise of Southern Cross, coupled with scandals like Winterbourne View and the more recent Panorama programme focusing on the abuse and neglect of older people in care settings, as well as a succession of other negative media stories, have cast a shadow over the industry which is unlikely to disappear in a hurry.

Yet against this challenging backdrop life has to go on. Quality care is prevalent and has a vital role to play in today’s society. The sector needs to be able to build and protect its reputation in the face of increased public and regulatory scrutiny.

According to Warren Buffet, a man widely regarded as the 21st Century’s most successful investor, ‘It takes 20 years to build a reputation and five minutes to ruin it.’

It’s a sobering thought, but it’s one that reinforces exactly why it is so important for care providers to focus on protecting and sustaining their reputations.

g

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building a solid reputation

g

SIX PRINCIPLES OF MANAGING REPUTATION

Successful reputation management requires adherence to the following six principles.

1

BUILD AND NURTURE TRUST – ITS VALUE IS AT AN ALL-TIME HIGH

With any given commodity, scarcity increases value and this applies just as much to trust as it does to gold or oil. Given that trust, amongst the wider public, is currently in short supply in the care sector, providers must nurture, cherish and preserve it.

This means taking a long-term view when making any decisions which may undermine trust. It also means practising what you preach.

If you say you specialise in providing high quality, personalised care make sure you can tangibly demonstrate how you live up to this claim by showcasing examples of best practice. If you can’t, don’t say it, as you risk destroying trust rather than building it.

Encourage your staff to view every interaction with another person as an opportunity to build trust. Whether it is carrying out routine daily care or discussing sensitive issues with family members, behaviour gets noticed. By acting and communicating authentically with one person, you will start to build trust and an enduring reputation with many.

2

EXPECT YOUR EVERY MOVE AND WORD TO BE PUBLIC KNOWLEDGE

Panorama showed that the care sector is susceptible to hidden cameras and undercover reporting - this wasn’t the first instance of this happening and it won’t be the last. That’s why, in a truly transparent world, your organisation needs to act and communicate in a way that you would be proud to see splashed across the front page of every newspaper in the country or beamed into your living room.

From award wins to 100th birthday celebrations, develop a bank of goodwill by actively promoting positive news and celebrating successes in local media outlets. Alongside this, set clear standards amongst staff for expected behaviour, monitor performance against these and take decisive action where necessary. Any other behaviour carries a significant risk of reputational damage.

3

PLAN FOR THE CHALLENGES THAT SOCIAL MEDIA BRINGS

Social media has revolutionised the way people interact with each other. Facebook, Twitter, Instagram and Snapchat have become standard tools for communicating snippets of information and in this fast-paced arena it is all too easy for professional boundaries to become blurred.

To preserve reputation in a social media age, care providers need to evaluate and assess carefully the existing resources they have in place. For example, do you have a robust social media policy and are your staff familiar with it?

Have you made people aware of the rules surrounding client confidentiality and taken action if people have used social media inappropriately?

As well as making sure your employees understand how social media fits into their professional lives, you also need

to have procedures in place so you can respond effectively if things go wrong.

Comments and rumours can spread like wildfire if they capture people’s imagination. Equally, the ability to post unauthorised content in real time is forcing organisations to rethink their attitudes to social media and react even faster.

Faced with a barrage of uncontrolled information, organisations need to be able to move quickly to redress the communications balance and position themselves as the credible source of information, rather than outside observers.

However, a timely response should never be at the expense of accuracy, nor should it lead to speculation. In a world where a hard-earned reputation can be shattered in a matter of minutes, it’s better to issue an accurate, considered response than a fast, inaccurate one.

4

EMBRACE THE OPPORTUNITIES THAT SOCIAL MEDIA PROVIDES

Despite what you might fear, it’s not all bad news when it comes to social media. Used well, it can help you build relationships, engage your stakeholders and communicate in the authentic, human way that people have come to expect.

One of the most important things to remember about social media is that it’s personal. If you can post interesting content that has genuine value, people will engage with it. It will also help to build trust and provide an ideal platform to showcase good news.

5

PREPARE FOR THE WORST

Evidence shows the care sector is highly vulnerable to attack so clinging to a four-leaf clover and hoping that bad things will happen to the next man rather than you is not a prudent strategy.

Effective reputation management is all about preparation.

If you have processes in place and a well-trained crisis management team capable of enacting them, you stand more chance of emerging from a difficult situation with your reputation intact. Ensuring operational processes and procedures are effective and staff are fully trained and appropriately managed will also help minimise overall risk.

6

BE TRUE TO YOUR VALUES WHEN CRISIS STRIKES OR SUFFER THE CONSEQUENCES

A crisis is the acid test of an organisation’s leadership. When the chips are down, do you act in accordance with your culture, values and reputation? Or do pragmatism, short-term financial considerations and expedience take precedence? The choice you make will have enormous ramifications for your reputation – and organisational success – in the future.

OPPORTUNITIES EXIST Without question, managing and protecting reputation in the care sector is tougher today than ever before. But for those organisations that understand the new context and embrace the principles above, there is a real opportunity to build trust and emerge with their heads held high.

CMM Sophie Hunt is a consultant at Insignia Communications.

Email: sophiehunt@insigniacomms.com

42 | CMM JUNE 2014

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12/05/2014 15:01

Boots Pharmacy Care Services Let’s look after your residents’ health needs We believe that 25 years of dedicated, local service from a brand you can trust can make a big difference to your organisation, your employees and the care you give to your residents.

Boots Care Services give you the support and tools you need to deliver the best possible healthcare. From expert advice from our dedicated Care Services team to providing a unique training service for your care workers – there are lots of ways we can help everyone in your organisation feel good.

We can offer your Care Home: Free access to our unique Boots Care Learning eLearning website*, an ever growing resource of information and training that’s relevant to Care Homes and their residents, including: • Care of Medicines Foundation and Advanced level courses – accredited by the Royal Pharmaceutical Society • Monitored Dosage System (MDS) – covering the Manrex system • Diabetes, which affects 26% of Care Home residents. To help Carers and Nurses care for residents affected by this condition, we’ve created two courses, covering: – Building an understanding of your residents’ conditions and their needs – Giving great care to residents with Diabetes • Dementia – for Carers and Nurses, following the story of two fictional dementia sufferers • Parkinson’s – bite-sized learning for Carers and Nurses, including symptoms and medication • Cancer – supporting those working in care to understand the condition and support available • Respiratory – covering Asthma and COPD to help Carers and Nurses provide compassionate care • Heart Health – helping carers and nurses to keep residents’ hearts healthy • Patient Pack Dispensing (bottles and boxes)

• Pharmacist Advice Visits, including Antipsychotic medication audits, where appropriate • Expert support and advice from your dedicated Care Services team • Dedicated, purpose-built care service rooms in our stores • 28-day delivery of medication • Daily delivery of medication with two cut off times to meet emergency and mid-month medication requirements – we can supply the majority of our customers on a Saturday • Advice and support 7 days a week

Our eLearning is available to all care homes.

Call 0115 949 5740† for details

• Free prescription management from collection to delivery • Patient information leaflets

For further information please call us on 0115 949 4047† or email care@boots.co.uk *There’s no charge for Boots eLearning if you receive your residents’ monthly medicines from Boots †Call charges apply, please contact your service provider for details

boots.com/carehomeservices 00107590.517 BTS Pharmacy Care Services Advert_Feb 2014_297x210_edited.indd 1

13/05/2014 10:09

conference preview

HEALTH+CARE

25/26 June London The Residential Care stream brings into focus how leading organisations are working with commissioners to transform the sector’s role, offering vital services that balance cost, quality, choice and value-for-money. Pioneers are also exploring new opportunities with personal budget holders and hospitals, and offering insight into this evolving role will be a major theme in the speaker programme.

Delegates will be able to build their own programme from the range of streams to reflect their own interests and learning needs. Keynotes around the theme of integrated care will draw these strands together, including topics such as Is personcentred care possible?, Are 15-minute care visits acceptable? and The Better Care Fund – Better for everyone?.

Dr Nikki Kanani, Integrated Care Lead at Bexley CCG and a keynote speaker on the debate - The Better Care Fund – Better for everyone?, explains why she is attending this year’s Health+Care, ‘It’s the only place to discuss the big – and small – issues facing health and social care over the next year, with opportunities to learn from experts and each other in an unparalleled way.’

Health+Care returns to Excel London on 25th and 26th June 2014, with more than 7,000 professionals gathering from all over the country to take part in the UK’s largest social and primary care conference. Essential for all those interested in the integrated care agenda, it includes 14 theatres of world class conference programmes covering integrated care, public health, care commissioning and residential and home care.

Current and former health ministers the Rt Hon Norman Lamb MP, the Rt Hon Stephen Dorrell MP and the Rt Hon Andy Burnham MP will lead the integrated care debate. Speakers in the Residential Care stream include: Des Kelly, OBE, Executive Director, National Care Forum; Dr Glen Mason, Director of People, Communities and Local Government, Department of Health; and Robert Black, Managing Director of CLS Homes.

Joined by hundreds more expert speakers, they will help delegates improve the efficiency of their businesses and effectiveness of their care. With presentations ranging from business and financial planning to management and training, delegates will have the opportunity to learn from the trailblazers and develop the hallmarks of successful, personalised residential care.

CMM is supporting the event and there are over 400 exhibitors at this year’s show. This is a great opportunity for networking and sourcing projects more efficiently as you have the chance to see all the key players in one place.

44 | CMM JUNE 2014

Programme Director, Mike Broad explained, ‘Even before the doors closed on last year’s event, we have been working hard with our partners to build a programme that blends hard-hitting policy updates with real life experiences from the front-line of care. From provider owners and managers, care commissioners and heads of service, to ministers of state; there will be updates, advice and ideas from every corner of care provision.’

Speaking about the 2013 event, the Rt Hon Stephen Dorrell MP said, ‘What’s important about this conference is that it brings together the CCGs, the NHS and the social care world.

It gives people an opportunity to think about these problems outside the traditional silos. Until we start doing that the rhetoric about integration will remain just that.’

Highlights from the Residential Care, Integrated Care and Home Care streams include: • Social care reform – what will be the impact on your workforce?

• The Social Care Bill – how will it impact care providers?

• How can creative leadership improve care outcomes?

• What should you know about the findings of the DEMOS Commission?

• Master-classes on finance and employment law for care providers.

Passes are free for senior care providers, but you need to register in advance here http://closerstill.circdata-solutions. co.uk/Microsites/HC14/

CMM CAREMANAGEMENTMATTERS

what’s on?

KEYS

WHAT’S ON? Event:

Date/Location: Contact:

Tackling Long-Term Conditions: Coordinating Care, Delivering Improvements 29th May, London Open Forum Events Limited, Tel: 0161 376 9007

Just tell us the number on the lockface and we’ll post the keys to you today!

Event: Date/Location: Contact:

Healthcare Buildings Forum 19th/20th June, Warwickshire Stable Events, Web: www.hb-forum.co.uk

We have a loyal customer base ranging from the largest hospitals to the smallest care home, actually anywhere that has things which need to be kept locked.

Event: Date/Location: Contact:

Managing Long-Term Conditions Conference 23rd June, London Capita Conferences, Tel: 0870 400 1020

Visit our website for more details and to order your keys securely online:

Event: Date/Location: Contact:

5th Eden Alternative UK Conference 24th June, Heathrow Eden UK, Tel: 01225 309238

Event: Date/Location: Contact:

Health+Care 2014 25th/26th June 2014, London Closer Still Media, Web: www.healthpluscare.co.uk

PLEAS E Lost your keys? No Problem!

www.keysplease.co.uk

Contact us to see how we can help you

The Key Replacement Service Tel: 020 8343 2943 Fax: 020 8343 2994 Email: sales@keysplease.co.uk Colton House • Princes Avenue • Finchley • London • N3 2DB

Event: Date/Location: Contact: Event: Date/Location: Contact:

Event: Date/Location: Contact: Event: Date/Location: Contact:

The Autism Show 27th/28th June 2014, Manchester Tel: 01538 755623 Care Home Ethics Conference 8th July 2014, Oxford The Orders of St John Care Trust, Tel: 01522 810524 Learning Disabilities Conference 11th July, London Capita Conferences, Tel: 0870 400 1020 The Care Bill: Delivering Reform across Health and Social Care 22nd July, London Westminster Briefing, Tel: 0207 593 5744

CMM EVENTS Event: Date/Location: Contact:

Event: Date/Location: Contact: Event: Date/Location: Contact:

Derbyshire and Nottinghamshire Care Conference 2014 4th June, Nottingham McCullough Moore, Tel: 01293 854401 North West Care Conference 2014 18th September, Clayton-le-Moors McCullough Moore, Tel: 01293 854401 Berkshire Care Conference 2014 16th October, Reading McCullough Moore, Tel: 01293 854401

Please mention CMM when booking your place.

CMM JUNE 2014 | 45

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16/05/2014 09:58

straight talk

straight talk Colin Slasberg argues that personal budgets need to change and considers the impact of the current system on providers.

COLIN SLASBERG

INDEPENDENT CONSULTANT IN SOCIAL CARE

A group of leading academics, activists and practitioners recently wrote to all directors of social services to draw their attention to recently published evidence in relation to the personal budget strategy. This evidence shows the strategy to have comprehensively failed. Not least that the up-front allocation of resource, the cornerstone of the policy to enable people to plan their own support, has failed to replace the allocation of resource following individual assessment of need.

Personal budgets, defined by the up-front allocation, do not actually exist. Claims that targets for a personal budget have been met derive from performance gaming behaviour by councils.

How much heed sector leaders will pay to the advice remains to be seen. Sector and political leaders are maintaining a public face that the policy is working. However, the published evidence shows not only that the policy is failing, but that it is due to fundamental flaws. That suggests it is only a matter of time and either sector leaders make an explicit decision to change direction, or the strategy will wither on the vine. The signatories to the letter strongly urge the former, as that will require the accompaniment of a re-envisioned strategy to promote personalisation of services.

The implications for providers are significant. The original vision of personal budgets was that all service users would become empowered consumers. This would result in one of two possibilities, more people would opt to leave the regulated market and employ their own personal assistants (PAs) or, alternatively, having control of their budget would empower them to determine from the provider the price and quality they desired. Authentic market conditions would, at last, be created.

The failed strategic commissioning function of councils would become redundant. The council’s role would become passive merely collecting ‘market intelligence’ and ‘facilitating’ market development.

But none of this has happened. Optimism that large numbers are employing PAs is giving way to realism. In 2012, PAs were reported to have formed the largest part of the domiciliary workforce based on an increase in the numbers with a direct payment and an assumption that each of them employed their own staff. In 2013, this was revised down to 50 per cent, with the other 50 per cent using their direct payment to pay for regulated services. This remains an estimate. Skills for Care reports a 4 per cent increase in staffing within regulated services based on

actual data. Within a diminishing number of service users, it is unlikely that there is an increase in numbers of both PAs and staff in regulated services. The recent increases in numbers of service users with a direct payment – now standing at about 13 per cent of all service users – is likely to be mostly people simply paying the provider’s bills. There is no evidence that this changes anything other than increasing transaction costs.

The reality that up-front allocations have not happened means that the creation of an authentic market has also not happened.

I believe the theory was always dubious anyway. However, belief that all would be about to change has meant that sufficient attention has not been paid to the need to reform the way councils carry out their commissioning function.

It is now clear that the great majority of people will opt for regulated, commissioned services. The question is - what needs to happen to ensure everyone receives a personalised service that promotes wellbeing? The political line is that responsibility for a ‘one-size-fits-all’, ‘low wage’ and ‘15 minute visit’ culture rests with providers. They must try harder. However, no explanation is offered as to why providers, owners, managers and their staff, would choose to behave in this way in such large numbers. It is, of course, a line that deflects from the more compelling, but politically uncomfortable, view. Councils drive how providers function given that they hold the money.

Councils have two key challenges. Firstly they have to work within a cash limited budget. But needs for social care are unpredictable in volume and highly variable in cost. Secondly, the cash limit is invariably, well below the amount required to meet all needs. They have addressed this by commissioning providers to deliver fixed outputs at fixed cost and used price competition to drive down prices.

If political leaders are serious about personalisation of services, they will seek a transformation in the way councils deliver this function. Councils need to work with their providers to make the right link between price and quality. They need to ensure the quality element is based around flexibility and responsiveness to each individual. At the individual level, they must commission on the basis of meeting the service user’s personal outcomes and with a sufficient level of resource to do so.

This will all cost money, potentially several billions. Until that is fully available, councils should be honest and share responsibility with providers in addressing the shortfall in quality.

DO YOU AGREE WITH COLIN? PLEASE EMAIL YOUR THOUGHTS TO EDITOR@CAREMANAGEMENTMATTERS.CO.UK 46 | CMM JUNE 2014

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12/05/2014 15:34

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13/05/2014 10:28