Care Home www.chmonline.co.uk
May/June 2018
Management
Changing apprenticeships‌ How your home will benefit Advinia Health Care New home development plans revealed
GDPR New rules are less than a month away
Health + Care Show Come and see us on stand C82
Issue 73
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Editor’s Letter
Welcome to the May/June edition of Care Home Management
Care Home Management May/June 2018
Issue 73
Annual Subscription £30.00 Where sold cover price of £4 Managing Editor Ailsa Colquhoun Publishing Editor Steve Hemsley Design/Production Phil Cunningham www.creative-magazine-designer.co.uk Published by S&A Publishing Ltd Croham Lodge, Croham Road, Crowborough East Sussex TN6 2RH Tel: 01892 663350 Email: editorial@chmonline.co.uk sales@chmonline.co.uk Advertising Space Marketing Tel: 01892 677721 Email: naomil@spacemarketing.co.uk www.spacemarketing.co.uk www.chmonline.co.uk Copyright: Care Home Management Magazine 2018
The Publisher holds all copyright and any items within may not be reproduced in any way, for any purpose, without the written permission of the Publisher. While every care has been taken to ensure accuracy, the information contained within this publication is based on submissions to the Publishers who cannot be held responsible for errors and omissions. The publisher does not necessarily agree with the views expressed by contributors and cannot except responsibility for claims made by manufacturers and authors, nor do they accept any responsibility for any errors in the subject matter of this publication.
Care Home www.chmonline.co.uk
May/June 2018
Management
As you may remember from its March/April issue, Care Home Management magazine has changed hands, and I have the pleasure of taking over the editorial reins from Alan Rustad. S&A Publishing took over at the beginning of March, and so, by the time this issue – my first issue in the ‘hot seat’ – reaches you, I will have been in post for two months. And, my… what a busy two months it has been! To introduce myself a little, my professional background is mostly in business-tobusiness publishing, specialising in NHS pharmaceutical services, so I am no stranger to the challenges of medicines management – or to the pros and cons of those dosette boxes you receive from your pharmacy partners. Most recently, however, I was working within NHS commissioning – and, in fact, was working in CCG land on the very day that the Department of Health repositioned itself as the Department of Health and Social Care. That was an interesting day, for sure, and it was not long before the conversation turned to how the new integrated system might work on the ground, and who would be the winners and losers once the logistical details start to emerge. Over the past two months we have heard that the DHSC will wait until July to announce its response to its first-ever joint health and social care workforce strategy. The wise man might also like to put money on the green paper on the care and support of older people coming out then, too. A cynic might also like to suggest that the feel-good factor of the NHS’s platinum anniversary will be enough cover to sneak out a bad news story for social care. A highlight of my first two months in post has been to interview Dr Sanjeev Kanoria, chairman and co-founder of Advinia Health Care, which recently bought 22 former Bupa care homes. As you will see from our conversation, his business interests do not just lie in residential care provision, but in a mix of health service and technology development to support quality excellence in his care home business. For me, this is very much also the way health and social care needs to go. One sector cannot survive without the other, and both will need creative, innovative thinking if they are to cope with the ever-increasing ageing population, with more complex care needs, a workforce shortage surely to be exacerbated by Brexit and, of course, the funding gap that looks set to plague health and social care for many years to come. Care Home Management will be attending the Health + Care conference and exhibition, and the Care Home Awards ceremony, at the end of June, and I look forward to hearing how suppliers and providers intend to square this very difficult circle. We’ll be pleased to chat to you on stand C82.
editorial@chmonline.co.uk
Changing apprenticeships… @Carehomemanage
How your home will benefit Advinia Health Care New home development plans revealed
GDPR New rules are less than a month away
Health + Care Show Come and see us on stand C82
Issue 73
Ailsa Colquhoun Publisher/Editor
May/June 2018 | Care Home Management 3
Contents 6 Business profile Advinia Health Care talks tech and care home expansion 9 CHM Hall of Fame Who’s winning awards and making the headlines 11 Legislation Understand the big GDPR issues for care homes. It all starts this month! 14 Buying a business What to consider when purchasing a care home 15 HR The people pitfalls of a care home purchase 17 Alarms/security It’s time to start planning now for the digital age
17 4 Care Home Management | May/June 2018
6 21 Shows/expos Come and meet the new CHM editor at Health + Care 22 Media training Every word counts when you want to make an impression on prospective clients 25 Training Apprenticeships: it’s all change – get yourself up to date 27 Training Four top tips to make the most of apprenticeship funding 28 Engagement Important changes to the Workforce Development Fund
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29 Engagement It takes more than pay to motivate your employees 32 Engagement Future of Care conference reveals the secrets of outstanding care
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33 Recruitment How to employ the right people 34 Laundry How to cut the costs of your laundry bill 35 Keep in touch Important information if you want to keep reading CHM 37 Residents’ care New dysphagia standards aim to improve care home nutrition
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8 Product spotlights 3 CHM’s preview of this issue’s new products
Eleanore’s words to the wise Beating the workforce woes By Eleanore Robinson, former editor at LaingBuisson and freelance healthcare journalist The latest workforce projections suggest that the UK faces a “perfect storm.. never seen before” as an additional 710,000 care workers are needed by 2025 due to an ageing population and the impact of Brexit. Without these workers, a “severe” workforce shortage looms, according to Mercer’s Workforce Monitor. The vast majority of these workers will be required at entry level, being paid the ever-increasing National Living Wage rate and above. As people live longer, with more complex healthcare conditions, staff are faced with the challenge of providing more care provided higher up the acuity scale: for providers this means staff with more training to care for many years for people with, for example, severe dementia or another debilitating condition. On top of this, around 7 per cent of the social care workforce comes from European Union countries, who could
potentially leave after Brexit. As the criteria to employ people from outside these areas becomes more stringent, competition between care providers to get the best and most experienced staff can only be expected to ramp up. The old adage of a Tesco or Lidl opening and offering a glut of easier jobs on a similar salary, still rings true in many parts of the country, creating competition for the available workforce. With councils failing to offer care providers aboveinflation fee rises for the past five years, it is very difficult to compete with employers outside the sector. But there are solutions out there. It is no secret that working in a care home hasn’t the greatest reputation in terms of pay and the hard graft involved. But research shows the vast majority of long-serving workers come from referrals from other employees. So, encouraging existing staff to sell the good points of working in social care, particularly the satisfaction of helping clients, to family, friends and the world at large could make a difference. And when thinking of placing a job advertisement, take a minute to think of the alternatives. Social media can be an effective way of attracting new recruits to a care home, particularly younger ones. It is no secret that the workforce is ageing and a new generation of carers needs to be attracted into the sector. May/June 2018 | Care Home Management 5
Business profile
Advinia takes the high road in care home acquisition plan Becoming a top 10 player in the care home market is not enough to keep Advinia Health Care from wanting more, company chairman Dr Sanjeev Kanoria tells CHM editor Ailsa Colquhoun
By the end of this year the care home market will know Advinia Health Care as more than just an acquisitive care home operator. Not content with buying 22 former Bupa care homes and adding around 2,700 beds to its care home operation, the company is busy developing new tech that will support care home managers in resident care. Innovations such as medicines management software – perhaps, only three to four months away from market launch – aim to support staff with medicines compliance and reduce administration errors. Another project - possibly to be trialled in the company’s first ever home later this year – will see the introduction of culturally-sensitive robots. These aim to reduce agitation among dementia patients by offering culturally-appropriate care support,
Braemount, Paisley: one of the newlyacquired Scottish Bupa homes for example, relating to a resident’s religion. Around two decades after starting in a shed at the back of the Roseacres care home in Barnet, Advinia Health Care is now a top 10 UK care home provider with a bed count of around 3,250 and 38 homes in its portfolio. But that does not mean that the company is done buying care homes, promises company chairman Dr
Sanjeev Kanoria, who founded the company with his wife Sangita from that first care home in north London after mortgaging the family home. Dancing in the Scottish market In the latest Bupa deal, half of the acquired homes are located in Scotland, bringing the total number of beds operated there to around 1,000. Dr Kanoria describes the market north of the border as very “interesting” for future acquisitions, due to what he considers the significant barriers to competition, as well as the financial quality incentives for those who can meet the regulatory bar. However, for Dr Kanoria, who named the company Advinia Health Care - ‘a divine entity’ - to communicate a search for perfection, there will not be expansion for its own sake. In his view, 10,000 beds is about the limit for a single management structure if it is to avoid becoming too corporate and unable to innovate freely – to the detriment of care home quality standards. But with financial economies of scale coming into play from around 20,000 beds, he says, it takes organisational nous to achieve both. “Investors like big things, but the ‘mum-test’ can be hard to square with the need for economies of scale.” Accepting that residential care is a tough business, he understands why the market will continue to see home closures: managerial talent is hard to recruit and retain in a competitive market and there is an ever rising, and ever more costly regulatory environment. But, he says, the biggest problem facing care homes is workforce waste. Poor planning of leave or excessive sickness rates
6 Care Home Management | May/June 2018
combine to escalate a home’s agency costs – but he believes this is something that good management should be able to minimise. “Staff sickness is the first sign that something is going wrong,” he says. Some 20 years on from acquiring Roseacres (pictured below), the liver surgeon and former McKinsey business
consultant company founder is proud that Advinia Health Care’s first home should have a current CQC rating of good. And, he is already looking to resolve the quality issues in some of the homes inherited from Bupa. An example is the Bedford Care Home in Leigh, Lancashire, which has seen its CQC rating drop from good on all five measures in June 2017 to requires improvement on four measures by January 2018. He says he believes this is due to some of the divested homes not receiving the investment they need. He says: “It’s not our strategy to buy failing homes, nor do we buy with a view to close.” Quality management is already underway, he says. “Most issues are around training, so that’s where all our attention is focused.” Supportive business interests Back at head office, as well as preparing for an office move to accommodate the newly-expanded
care home business, plans are afoot in the company’s other commercial activities. As well as specialist dementia residential care – currently, Advinia Health Care‘s largest area of business – the company also trades in home care, healthcare (which specialises in developing public-private healthcare partnerships) and home health and care (health technology). With NHS finances facing “crunch point” Dr Kanoria believes his company needs a holistic model of health and social care service – something that he now sees as embedded in health and social care politics, with the formation of the Department of Health and Social Care, and the launch of the joint health and social workforce strategy. At the company’s level, the non-care home business arms are considered vital elements in building capacity and in achieving efficiencies. And in the same vein, health and social care also need to be viewed as a continuum: “Social care is often a health issue, and the vision has to offer the potential to allow both sectors to work more efficiently. But it is important that sufficient money is allocated to social care. The whole political process will have to be managed well.” Largest UK private care operators by beds and homes Company
Homes
Beds
FSHC
524
25,508
Bupa Care Homes
300
21,229
Barchester Healthcare
196
11,520
HC-One
241
c10,000
Priory Group
256
7,081
Craegmoor
204
4,221
Orchard Care Homes
69
3,868
Minster
119
3,843
Caring homes
112
3,265
Advinia Health Care
38
3,250
INTRODUCING THE STUNNING INTRODUCING THE STUNNING
Advinia Health Care’s new Bupa deal homes: Town/City
Beds
Care homes
Barrhead
94
Millview, Norwood
Clydebank
150
Hill View
Falkirk
116
Newcarron
Glasgow
297
Craigbank, Deanfield Golfhill, Haydale
Paisley
240
Braemount, Elderslie
Rutherglen
225
Rutherglen
Liverpool
330
Arncliffe Court Stonedale Lodge
Leigh
180
Bedford
Bury
120
Burrswood House
Manchester
143
Gorton Parks
Bolton
180
Mill View
Staffordshire
39
Burntwood
Dudley
260
Netherton Green Ryland View
Walsall
162
Parklands Court
Leeds
178
West Ridings Source Advinia Health Care
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CHM Hall of Fame
Proud to present… Find out who’s winning awards, and making local headlines for their care home excellence
Goodson Lodge Care Centre in Trowbridge has been awarded a Dementia Design Gold Award from the University of Stirling for its dementia-friendly design. Inside there are small, themed sitting rooms such as the music and travel rooms, to stimulate memories. Layout also allows total visual access for staff, which throughout the home allows them to discreetly observe residents from their place of work. For more information on the University of Stirling’s Dementia
…The Care Home Management magazine care home hall of fame
Design Audit Accreditation, visit: http://dementia.stir.ac.uk/design/ accreditation Chefs at Meallmore care homes, Auchtercrag care home in Ellon, and Meallmore’s Ivybank care home in Falkirk, will be fighting it out in the final of the National Association of Care Catering’s (NACC) Care chef of the year competition. Chefs John Grover and Brian Gollan impressed the judges with innovative and tasty two-course menus (a main and a dessert), which were also nutritionally-balanced, suitable for a care setting, cost no more than £2.25 per head for four portions and can be produced in just 90 minutes. Also battling it out in the final will be Sunrise of Cardiff head chef Stuart Pelham. Stuart’s award entry meal centred on traditional Welsh foods with a modern twist.
The national final will take place on Wednesday, 6 June 2018. For more information on the NACC Care Chef of the Year 2018 competition, visit www.thenacc.co.uk
Hallmark Care Home in Tunbridge Wells has won the title of ‘Healthcare Business Best New Care Home’ award in the Pinders Healthcare design awards. Entrants were judged on room and en suite sizes, use of outdoor space, ambiance and design, as well as facilities for care staff. These include an air-conditioned training room and kitchen. For more information on the Great British Care Awards, visit: https://www.care-awards.co.uk/
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Legislation
Care homes urged to prepare for data protection changes
A range of advice has been published to help health organisations prepare and comply with new data protection laws coming into force later this month The General Data Protection Regulation (GDPR) is a new set of EU rules which will replace the existing Data Protection Act and will become law in the UK on May 25, 2018. The new rules will require all
organisations which process personal data, including the NHS and independent health organisations, to meet strengthened standards for data protection. The legal processing of “special category data” is a particular concern to care homes (see page 13). The Information Governance Alliance (IGA), which is leading on GDPR implementation in the NHS, says that organisations that are performing well in their information
governance toolkit (IGT) scores “should have a good baseline to work from”. However, it warns that 2016/17 IGT requirements do not completely address the GDPR. Sector-specific information for health organisations has been published by the IGA to support the transition to the new legislation. This includes a GDPR checklist, FAQ section and general advice with links to further information.
The big GDPR issues for care homes. By Laura Clayton, solicitor, Wright Hassall
What can care homes do now? ■ Review data processing policies and procedures ■ Identify and address any noncompliance ■ Implement GDPR (data processing) training for staff
■ Add a website privacy notice to reflect GDPR provisions such as the lawful bases on which data is processed ■ Consider arrangements with any data processors (e.g. companies to whom a care home outsources the administration of payroll and any healthcare organisations with whom care homes
share data) as the GDPR requires that any contracts with third party processors include certain mandatory clauses ■ Ensure that any pre-ticked consent boxes are removed as these are banned under the GDPR ■ Eliminate the collection and maintenance of unnecessary special category data.
May/June 2018 | Care Home Management 11
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Care Homes
Consent: The GDPR raises the bar for consent, which must be specific and clear and offer individuals a genuine choice and control: individuals must be able to withdraw their consent easily. An issue for care homes is that vulnerable people in their care may not have the capacity to consent in the way that the GDPR requires. In which case, Information Commissioners’ Office guidance points towards using a different lawful basis for processing personal data, as set out below.
■ Your processing of the data is necessary to comply with the law ■ The processing is necessary to protect someone’s life (vital interests) ■ The processing is necessary for you to perform a task in the public interest or for your official functions ■ The processing is necessary for your legitimate interests or the legitimate interests of a third party (unless there is a good reason to protect the individual’s personal data which overrides those legitimate interests).
Capacity: The Mental Capacity Act 2005 (MCA) provides a statutory framework for a third party to give consent on behalf of an adult who lacks capacity to make decisions on their own behalf (or who may in the future lack capacity to make decisions on their own behalf). The MCA allows third parties with a lasting power of attorney or who have been appointed as a court-appointed deputy to give consent for GDPR purposes on behalf of an adult who lacks mental capacity. This allows an organisation to comply with the lawful basis for processing the personal data of an adult lacking mental capacity in these circumstances.
Security of data: The GDPR requires personal data to be processed in a way that is secure and appropriate to the risks presented by the processing activities. This includes protection against unlawful processing and against accidental loss and destruction. The security measures which can be used to protect personal data include passwords, encryption measures, keypads and locked cabinets. Security is particularly important in respect of special category data which requires greater protection, such as encryption for data management systems and documents, and locked cabinets in locked rooms.
Special category data: Special category data is defined in the Data Protection Act 1998 and includes data on physical and mental health, ethnicity and sexual life. The GDPR adds genetic data and biometric data to this definition where they identify an individual. To lawfully process special category data, care homes must have a reason to process special category data – most likely, the provision of health or social care or treatment or the management of health or social care systems and services – and must meet one of the lawful bases from the following list: ■ The individual has said you can process the data (consent) ■ You have a contract with the individual in relation to which the processing is necessary
Storage of data: Storage limitation is one of the key principles underpinning the GDPR. This principle means that data must be kept in a form which allows identification of individuals for no longer than is necessary (for the relevant purposes). Therefore, care homes should think about how they store their data and their use of filing systems, care plans, daily records and charts. They should also consider whether they can anonymise any data after a certain point to avoid the risks of noncompliance. Data Protection Officer (DPO): The GDPR states that both data controllers and data processors must appoint a DPO in three situations: ■ Where they are a public body ■ Where core activities require regular
and systematic monitoring of personal data on a large scale ■ Where core activities involve large scale processing of special category data. Many care homes will need to appoint a DPO, either because they are a public body or because their core activities require large scale processing of special category data. ‘Core activities’ are likely to be the key operations to achieve the organisation’s objectives. For example, processing health data (e.g. patient records) is one of a care home’s core activities. ‘Large-scale processing’ will be determined by factors such as the volume and range of the data, the duration of the processing and the number of data subjects. Guidance states that hospital patient data is an example of large-scale processing (and a parallel can be drawn with care home resident/patient data). Appointing a DPO will mean that care homes have a key person to monitor compliance with the GDPR, help with data protection impact assessments and maintain records/ accountability. DPOs must be selected for their knowledge of data protection law and professional qualities but they do not need to be legally qualified. It is worth noting that DPOs can be either an employee or an external consultant. Data Protection Impact Assessments (DPIAs): It will be important for care homes to conduct DPIAs as they undertake high risk processing i.e. large-scale processing of health-related personal data. DPIAs provide a way of helping care homes identify and reduce data protection risks and deal with any issues at an early stage.
To view the guidance for care homes, visit the Information Governance Alliance website at: https://digital.nhs. uk/information-governance-alliance/ General-Data-Protection-Regulationguidance
May/June 2018 | Care Home Management 13
Buying and selling
What to consider when purchasing a care home – The legal aspects owners through limited companies. Therefore, you need to consider at the outset whether the transaction should be undertaken by way of a purchase of the shares in the company or by way of a purchase of the business and assets of the company.
Faisal Dhalla If you are about to embark on a care home purchase, you should carefully consider the following: Structure Care homes are often operated by their
Due diligence As a buyer, have you undertaken sufficient ‘due diligence’ on the care home? Have you looked at critical things such as whether the care home has a satisfactory CQC report or whether the care home has been the subject of any litigation or major investigations? CQC As a buyer, you will need to be registered with the CQC before you can take over the care home. This process can take several weeks. However, if the
14 Care Home Management | May/June 2018
purchase will be undertaken by way of a company share purchase the process is a lot smoother as the company should already be registered with the CQC. Financing your purchase If you are seeking bank funding for the purchase, you will need to ensure that you fully understand the terms of any loan documentation you will be required to enter into with your bank. If you are using a limited company for the purchase, your bank may require a personal guarantee from you. Contact: Faisal Dhalla, Partner, Hempsons T: 01423 724019 E: f.dhalla@hempsons.co.uk Faisal specialises in the sale and purchase of health and social care businesses – including care homes.
The people pitfalls of a care home purchase
Q: What will I learn from this feature? A: How to protect yourself from an expensive HR mistake when you buy a care home
Buying a care home can be fraught with difficulty – not least because you inherit the staff as well as the balance sheet. Employment law expert Barry Warne, a partner at hlw Keeble Hawson, highlights some of the HR issues you should consider as part of your due diligence One of the ironies of buying a business is that often the things you think about towards the end of the process can turn out to be some of the most important. This is certainly the case when it comes to staff, who today have a significant amount of protection when moving to a new employer as part of an acquisition. The first issue for a buyer to consider is your obligation under the Transfer of Undertakings (Protection of Employment) Regulations, known as TUPE. Designed to stop staff being exploited by a new employer, TUPE requires you to replicate their terms and conditions of employment. This includes honouring the length of service, which automatically means that anyone with two years’ unbroken service has full protection under employment law. Of course, you can always reorganise your staff base over time, in line with good HR practice, but for budgeting purposes as part of an acquisition it is good practice to assume continuation of the existing headcount. A lesser-known aspect of TUPE is that the buyer of a new business also inherits any underlying staff issues, even if they happened before the purchase. So, for example, if a member of staff claims unfair dismissal from your employment due to something that happened prior to the acquisition, the responsibility will rest with you. For this reason it
is always worth taking a belt and braces approach by backing up your employee due diligence questions with carefully constructed warranties protecting you from future actions. The transfer of pension arrangements used to be a complex legal minefield, but the introduction of auto enrolment has simplified the process significantly. In effect, buyers today just need to budget for a scheme that meets the auto enrolment criteria, unless the seller’s scheme is more generous than auto-enrolment requires. It is always good practice in the care home industry to consider any agency or locum contracts that might be in place. If a member of locum staff has a permanent arrangement, it is likely they will be protected by TUPE but if they don’t, it pays to be extremely clear on what their contractual rights are. Agency staff won’t have much employment protection but you will need to assure yourself that the business could still function effectively if any agency arrangement was to stop. Watch out for immigration rules Ensuring that you don’t unwittingly fall foul of immigration rules is another key consideration. Ignorance is no protection against prosecution, so even if the seller declares as part of the purchase that all overseas staff
have the right to work in the UK, it is worth getting a warranty to that effect. The consequences of not doing so could run to a £20,000 fine for each staff member found to be working illegally. Finally, it is important to invest time in understanding the pay structure of the organisation. Minimum wage is a complicated area of the law and it is often the case that employers, particularly in the care sector, find ways to meet their obligations through perks such as staff accommodation. Whatever arrangements went before, it will become compulsory on the completion of a sale for you to be paying at least minimum wage to all members of staff.
There can be many hidden liabilities in a care home sale, ranging from planning consent breaches to incomplete medicine compliance. However, having a comprehensive picture of the HR issues from the outset is one of the most effective ways to avoid costly fines or damaging litigation.
May/June 2018 | Care Home Management 15
16 Care Home Management | May/June 2018
Alarms/security
Planning for the digital change-over Care homes need to start planning now for the digital age of care home security, says Alyson Scurfield, chief executive of TSA (TEC Services Association) By the end of 2025, organisations across the UK will have to deal with the ‘shift to digital’ – when all analogue telephone systems will be switched off. In some cases, this will mean that vital connected systems such as alarm systems linked to a remote-control centre and many older telecare systems simply won’t work. The move to internet protocols and 5G mobile will mean that a lot of the tech systems currently in place will have to be updated or replaced. The questions to ask now As the industry heads towards 2025, it is important to review the various technologies used in your care home environment and to consider your home’s technology-enabled care (TEC) offering. Questions managers should be looking at include the following: ■ When were existing systems installed and last updated? ■ Are any devices or systems linked electronically to an external site, such as control centre, home-worker, social care or NHS? ■ Have you checked with suppliers and third parties to review whether current devices and systems meet any proposed standards and will still operate after the digital changeover?
■ Is a secure wifi network in place which has advanced levels of cybersecurity? This is particularly important if there are external links to NHS and social care services ■ What specifications and requirements are being set by regulators and service commissioners? ■ Can residents and staff use their own personal devices on care home systems? ■ If systems need to be updated, who will pay – care home, residents, commissioners, social care, NHS? ■ Is the care home part of a wider group and, as a result, will need to have common systems and procurement arrangements? ■ Is the care home able to draw on expert advice and useful information from suppliers? ■ Does your home have a technology procurement policy, with a preferred provider, or is there a much freer approach that mixes different tech components? Help at the touch of a button There are many advantages to investing in digital systems: smart devices, sensors and apps can help care home staff communicate with experts, and seek urgent help. Technology is becoming more intelligent by learning
Q: What will I learn from this feature? A: How residential security will be affected by the digital switch-over from its environment and data from other users – care is now reaching the point where health crises can often be prevented through careful monitoring. Sensors can monitor health vital signs as well as residents’ movements to reduce the risk of falling and connect them to on-site supervisors or remote monitoring centres. We can also expect to see more ‘robotic’ devices and voice assistants in care homes for therapy, rehabilitation, exercise programmes, dementia support, companionship as well as scheduling appointments and reminders. The NHS may provide personal monitors (for diabetes, heart conditions for example) and there is a growing number of people who have remote patient monitoring which can flag up early problems to clinicians who can advise, help or provide additional support. Reducing social isolation Technology has a vital social role, and many residents will have their own personal devices – smartphones, tablets, and smart speakers that they consider vital to their quality of life.
Bluebell pagers offer staff greater flexibility for care (see case study on page 18) May/June 2018 | Care Home Management 17
But, live streaming of online movies, video calls and other facilities such as voice assistants can put a lot of strain on local connected systems which are also used by staff for care management as well as supporting the building’s fire and safety systems. These devices can also present cyber security concerns. To counter these challenges, many care homes have already moved beyond the essential safety and security systems to implement TEC. This offers the potential to provide, among other things, additional alerts, long-term condition monitoring, video consultation, connectivity to wider health and care records, and access to wifi for internet access. However, investment decisions need to be properly evaluated for costeffectiveness: it is likely that upgrades will need to be made to broadband and local wifi systems. Cybersecurity also needs to be in place and personal devices assessed to ensure that critical systems are not compromised.
Case study:
How technology is helping staff and managers at Bushell House Bushell House is one of the longest-standing residential care homes in the UK, with a heritage that dates back to 1722. Situated in the beautiful village of Goosnargh, three miles north of Preston, Bushell House now homes up to 31 respite, convalescence and permanent residents, after opening its doors in 1743 as a charitable trust to care for the elderly. The home now uses the Touchsafe Pro wireless nurse call system from Aid Call, which comprises waterproof Bluebell pagers, which staff can use while bathing residents. For the home manager, staff log in to the pagers with their own ID at the start of each shift, giving visibility over the location of staff and how long certain tasks are taking. Bushell House registered manager Sue Barr said: “All that information is logged and readily available for me to review which has been great for monitoring purposes. The entire system is so easy to use and both the staff and residents are very pleased with the decision to upgrade.”
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New dementia unit utilises smart care technology Green Park Care Home in Warrington has recently opened a new 18-bedroom home for residents with dementia. The SMART care technology is among the new home’s initiatives to provide residents with outstanding care. Orchard Care Homes, which runs Green Park, designed a new Dementia+ unit to create an enhanced setting that meets the needs of residents with advanced dementia and more complex needs while developing a positive working environment for staff. Reminiscence rooms in the facility have been set out as a parlour and a cafe, while a multi-purpose room will allow for ‘mood-boosting activities’. Additionally, residents will be able to gain easier access to the home’s garden area. Courtney Thorne, the UK’s leading care technology provider, was chosen to design and install a Nurse Call
system which also enables residents to call for assistance whilst they are on the move anywhere in the site. Wearable technology is part of the Altra Care – SMART wireless nursing call system. It ensures that staff are automatically alerted in the event of a fall and identifies the person and their location. This means residents will be able to enjoy new activities feeling safe even if they are outside in the garden. David Williams, interim head of regional operations at Orchard Care Homes, who led the project at Green Park Care Home said:
“We are delighted to open the new Dementia+ unit at Green Park, which we are confident will play an important role in the care landscape of the local area. The use of wireless assistive technology will be key in providing a high level of quality care in a setting that has been designed specifically for those living with greater medical needs. The data captured by the nurse call system such as response times will complement our own new initiative around eCare planning, which enables us to quickly access accurate care records and ensure compliance in aspects of clinical governance.”
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0800 068 7419 Find out more at www.c-t.co.uk May/June 2018 | Care Home Management 19
BUILDING A BETTER FUTURE FOR CARE N EW C o policy u ntent, leading pdates, supp l ie rs.
REGIST E TODAY R
THE ONE EVENT WHERE EVERYTHING JUST CLICKS Make sure your service is always the number one choice by attending Health+Care 2018 on 27th and 28th June at ExCeL London, where over 4600 owners, directors and senior managers from care providers gather to gain access to a world class conference, products and services that will help you achieve more positive outcomes. Find solutions to your challenges, and how the long-term integrated healthcare plans will effect your care business.
OVER 400 LEADERS in the sector WILL BE SPEAKING, INCLUDING:
Andrea Sutcliffe Chief Inspector of Adult Social Care, CQC
Matthew Swindells National Director: Operations & Information, NHS England
Norman Lamb Former Minister of State for Care and Support, Lib Dem MP for N. Norfolk
REGISTER NOW TO ATTEND FOR FREE to boost your business and improve levels of care healthpluscare.co.uk/CHM or call 0207 013 4688 Health+Care is run in association with
20 Care Home Management | May/June 2018
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Prof. Martin Green OBE CEO, Care England
Rt Hon Stephen Dorrell Chairman, LaingBuisson
Jane Silverster Associate Director - Social Care and Leadership, NICE
Incorporating
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Organised by
Shows/expos
It’s show time! Come and meet the CHM team on stand
C82 The Health + Care 2018 conference and exhibition, the host event for this year's Care Home Awards, is shaping up to be the focal event of 2018 in the care home operator’s calendar Taking place at London ExCel on June 27-28, Health + Care expects to attract some 4,600 owners, directors and senior managers from care providers as they come together for a packed two days of high quality conference and exhibition. In total, they will hear over 400 expert speakers deliver 240 world-class conference sessions, among whom are highprofile names such as Andrea Sutcliffe, chief inspector of adult social care at the Care Quality Commission and Sharon Allen, CEO of Skills for Care.
Lucky for some…
It’s been a tough job but at last the Care Home Awards’ panel of 13 expert judges has decided the winners of this year’s Care Home Awards. Now in their second year, the awards continue to celebrate and promote innovation and excellence in the care home sector, and it is clear that standards are rising throughout our field. Judging panel chairman and former editor of Care Home Management magazine Alan Rustad said: “This year, we had a record number of entries and the quality is unprecedented. It’s great to see the awards establishing themselves as a celebration of genuine innovation for the benefit of residents as well as their families and carers.” So, it’s congratulations to all 32 finalists, and just under two months to wait until all can be revealed at the 2018 Care Home Awards ceremony. This takes place alongside Health + Care at ExCel, London on June 27. Find the full list of finalists online at the Care Home Management website, https://chmonline.co.uk/care-home-awards-finalistsannounced/ Innovation and excellence… all under one roof Under one roof, the co-hosted exhibition gives unrivalled access to a range of suppliers, showing the very latest products and services to support care home excellence. If that’s not all, invited guests will find out at long last who has won the coveted Care Home Awards for 2018. Other highlights for the 2018 conference and exhibition include two new transformation in action theatres, which are designed to help care home operators unlock
funding through programmes such as step-down care. There will also be an interactive, purpose-built care home in the heart of the show floor, where delegates can see, touch, hear, smell and, even, taste a care home ‘experience’. Come along to learn about new technologies, products and activities that can help you improve your level of care and staff morale. It’s not too late to register to attend for free. Just visit www.healthpluscare.co.uk/reserve or call 0207 013 4688
May/June 2018 | Care Home Management 21
Media training
First impressions count
The Care Quality Commission’s CareAware campaign shows just how important it is for homes to make a good impression, and getting the media on side is an important step in the right direction, says media trainer Steve Hemsley Launching its CareAware campaign to help people choose a care home, the Care Quality Commission (CQC) recently highlighted that many people find choosing a care home for a loved one more stressful than selecting a school for their children. With this in mind, the media’s portrayal of incidents at specific care homes or within the wider care sector can have a huge influence on a family’s decision. At the Future of Care conference in London in March one of the panel discussions covered the need for care homes to be more proactive and to get better at telling their positive stories. This is essential to ensure they pass what has become known as the ‘mum test’. Families rightly ask: ‘Would I like my mum to live there?’
Be media savvy Even if your care home works with a public relations firm it is important owners, directors and managers are effectively media trained before before
22 Care Home Management | May/June 2018
doing interviews with journalists. They need to understand how the media works, why journalists ask the questions they do and what messages should be conveyed.
For example, this may sound strange but you are never talking to the journalist during an interview. You are always talking to the journalist’s audience. If a reporter is from a local paper, everything you say must be 100 per cent relevant to the local community. You will be asked the type of questions that local families would ask if they had the opportunity. The questions will be different if the reporter is from a national newspaper or TV channel where the audience is much broader. A good media training session will provide you with a tool box of tips
and techniques so you can confidently control any interview situation. What is crucial is being able to tell a story that will engage the reporter and ensure your messages are conveyed effectively. Not only does talking about real-life resident examples or case studies make your interview more interesting, it tells the journalist that you are someone they should talk to more often. During an interview you need to focus less on WHAT the care home does and to talk more about WHY and HOW it does it. This is the information that differentiates
you from your competitors. So, think about what examples you have to illustrate the points you are making. If you want to talk about how your care home is innovative, give the journalist an example of how and when you were innovative. Were you the first to launch something? Have you just introduced a great new service? It can certainly be worth talking to a local public relations firm to help you draft your story. Stories open doors because they make journalists and other influencers want to speak to you, make time for you and talk about you in a positive way. To find out more: CHM’s publishing editor Steve Hemsley is a leading media trainer working as an associate for some of London’s top media training firms as well as for a large number of PR companies. To find out how he can help your organisation please email editorial@chmonline.co.uk CQC CareAware campaign: http:// www.cqc.org.uk/help-advice/yourstories/care-aware
It is crucial front-line care home staff also understand how and when to speak to the media Robert Davies is a public relations He urges managers to stress specialist at London law firm Stephensons Solicitors LLP and he says that public-facing administrative staff are likely to be the first point of call for a journalist enquiry. “They will understandably be nervous about doing so and there will be a fear of saying the wrong thing which can lead to rash decisions,” he says. “It is not uncommon to hear stories from the care sector where administrative staff have simply hung up on journalists rather than be put on the spot for a comment.”
to frontline staff that they are not spokespeople and are not permitted or expected to respond on behalf of the organisation. “Their only function in this instance is to politely and efficiently get the enquiry where it needs to go, namely to the organisation’s designated media spokesperson. It is therefore important that telephone staff are aware of who the appointed media spokesperson is and how to contact them, even if they are not on the premises at the time.”
May/June 2018 | Care Home Management 23
Successful procurement result for Complete Care Agency Ltd with them as an equal to ensure that we are improving systems of communication between the hospital, community and at Clinical Commissioning Group level. With an increasing population with evermore complex needs, this partnership is essential to not only the NHS but the service user.” Louise suggested that “Care homes now need to evaluate the changing dynamics of the National Health Service and local government and look at how they can also become specialists in their field. Care homes have a lot to offer and traditional models are need to evolve and see where the need is greatest.”
Louise Ellis-Copley Managing Director of Complete Care Agency Ltd discusses recent procurement success in the sector, also, how this can have positive impacts on the National Health Service and the Care Home sector. Successful bid writing “In 2017 we submitted two bids to the National Health Service procurement team and have been successful in both submissions. In total these contract values are a staggering £95m over 3 years with the option for a 2 year extension. The award of these contracts have shown that the National Health Service recognise that we have the specialist skills to deliver the complex needs in the sector. Furthermore, Complete Care Agency Ltd have been consistently expanding adding more than 20% gross revenue year on year. We are now not only providing a highly complex care service for the NHS and its patients, but we are also on huge recruitment drive, creating a large number of employment
opportunities. ” said Louise. Louise added: “The National Health Service recognises that there needs to be a grater focus on a more skilled workforce that is able to deliver far more specialist care outside of the hospital. This increases the need for traditional nursing care to be delivered in the home. There are noted benefits to the person receiving the care, their family and also better value to the National Health Service. Louise said that “it is this recognition of highly trained and skilled staff that has proven successful.” Partnership working “Complete Care Agency provide a support system to the National Health Service. We work in partnership
24 Care Home Management | May/June 2018
Communication and transparency There has long been a reluctance for honest and transparent communication with the struggles of business to deliver what the National Health Service and local government requires. There seems to be much more open dialogue now and involvement of the independent providers prior to the procurement is essential. This ensures that those writing contracts understand they are realistic and deliverable. I have been involved in a number of strategic groups developing and identifiying the barriers of independent providers, delivering the needs of the National Health Service and local government. It has been uplifting to see that these have been recognised and implemented. Contract delivery As we work through the mobilisation process I hope that there are opportunities to try to engage with care homes in supporting Complete Care Agency Ltd and the National Health Service. I believe there is an important role for them to play.
Training
Q: What will I learn from this feature? A: How apprenticeships are changing to offer a more rigorous qualification as well as career development for more senior level staff
Apprenticeships: it’s all change! Two new higher-level apprenticeships are among the changes to affect social care training in 2018, explains Victoria Collier, Skills for Care project manager In September, two new apprenticeship qualifications will become available to care home staff: For managers, there is the new leader/manager in adult care (level 5) apprenticeship standard, which replaces the level 5 higher apprenticeship in care leadership and management. This is suitable for newly-registered managers of care teams and those in equivalent positions. Apprentices will complete the new level 5 diploma leadership
and management in adult care. For senior care workers, there is the new lead practitioner in adult care (level 4). For the first time, this offers development training for senior care workers to progress and specialise, in preparation for, or instead of, a move into a management position. This includes the completion of the level 4 diploma in adult care. Other important changes include that apprenticeship standards are replacing apprenticeship frameworks.
The changes in a nutshell Standards are short descriptions of how a worker is expected to behave, and what they’re expected to know and be able to do, on completion of their apprenticeship. This builds on the former framework-based model, which simply consisted of a collection of qualifications.
Also, apprentices must now pass an end-point assessment, to ensure competency. The end-point assessment makes the new standards more rigorous.
Apprenticeships: all you need to know Apprenticeships are work-based training programmes for people aged 16 and over. They last for a minimum of 12 months and combine ‘on-the-job’ and ‘off-the-job’ learning. The following FAQs will help you understand the opportunities for your
home and your staff: Q: What apprenticeships are available? In addition to the two, new qualifications available from September, the following apprenticeships are available:
■ Adult care worker (level 2): to develop workers (care assistants, support workers) providing direct care for vulnerable adults. Adult care worker apprentices will complete the care certificate standards and the level 2 diploma in care. Continued overleaf May/June 2018 | Care Home Management 25
■ Lead adult care worker (level 3): development for adult care workers (care supervisors, senior care workers, or community support workers) who have additional responsibility for providing supervision, frontline leadership, guidance and direction for others, or who are working autonomously, exercising judgement and accountability. Lead adult care worker apprentices will complete the care certificate standards and the level 3 diploma in adult care.
Q: How can apprenticeships support my workforce development? Apprenticeships are available to both new and existing staff and demonstrate your commitment to staff development, as well as business resilience (see the Anchor case study see below for more information). To understand how apprenticeships can work for you, imagine interviewing someone who has had little or no experience in the
care sector, but demonstrates the right values and behaviours: ■ To start, you could recruit them as an adult care worker apprentice ■ In time, they could train to supervise and work more autonomously through the lead adult care worker apprenticeship ■ Ultimately, they might want to specialise using the lead practitioner standard, and/or move into management through the leader in adult care standard.
Anchor case study: A winning apprenticeship programme on agency spend. Some 14 per cent With a deficit of 750,000 care workers forecast by 2025 and only 10 per of Anchor’s workforce is now aged between 16-24 years, which is an cent of young people working in care, increase of 2.6 per cent since 2015 and care homes face a tangible human resources challenge. At Anchor, a nothigher than the 10 per cent benchmark for the sector. Around 30 per cent for-profit provider of health and social of homes now have an apprentice. care for people aged over 55, the need Recognition has also come from the is for 1,500 care workers annually to Skills for Care Accolade 2017 awards, maintain business as usual (BAU) for its 40,000 customers. in which Anchor won the category of best social care apprentice employers. To achieve the company’s strategic goals, Anchor accepts it must widen its talent-pool and bring in apprentices. At the 130home and 1,000-plus housing locations provider, 30 per cent of its registered managers are aged over 55 and only 10 per cent of the workforce are under 25. “This means we need to recruit futureleaders now,” says qualifications and apprenticeships manager Katie Rankin. Graduation ceremony in front of colleagues So, in 2015, the Anchor Company ethos Apprenticeships Academy (AAA) was Anchor’s ethos is to grow its own talent, launched, following an investment of £1 through training and development million over two years (1.8 per cent of opportunities, with qualifications income). available at every stage. Young people With a business strategy to double are also involved in the design and income to £500 million by 2020, promotion of recruitment materials. Ms Rankin says: “The AAA isn’t a Interviews are staged to detect an nice to do, it’s essential. It’s critical applicant’s ‘caring gene’ rather to our business strategy.” Already, the than focus on qualifications or good investment is paying dividends with an application form/interview technique. 82 per cent retention rate, well above For example, Paige from Mapledene the industry average of 67 per cent went in at Christmas/New Year to visit (level 2 apprenticeships 2015-16). The residents, help cook Christmas dinner and company says it has saved £25,000 26 Care Home Management | May/June 2018
support colleagues. She said: “If I hadn’t joined the Anchor Apprenticeship Academy I would never have had the opportunity to travel the country like I have.” The apprenticeship offer, which is housed within the AAA, is also wider than just patient-facing care roles: training also is available in support services roles including catering and housekeeping, customer service and digital marketing. There are also multiple entry routes including: • Work experience • Volunteering • Traineeships (seven-week programme with role rotations) • Step In2 Care (two-day job-skills programme) • Apprenticeship entry. Trainees are encouraged to see their qualification as just the start, and in-house career pathways booklets have been published to highlight how apprentices can develop from care assistants to district managers, detailing the relevant training and development along the way. Two apprentices often work together for support, with one day a week dedicated to completing training. Key milestones, which encourage progression include: • Competitive starting wage • Pay increases after six months and 50 per cent course completion • Opportunity to complete additional hours/achieve a permanent role after six months.
Training Q: How do I choose a training provider and end-point assessment organisation? Apprenticeship training providers must be registered on the register of apprenticeship training providers at www.gov.uk/guidance/register-ofapprenticeship-training-providers. End-point assessment organisations must be registered on the register of apprenticeship assessment organisations at www.gov.uk/ government/collections/register-ofapprentice-assessment-organisations. Choosing who to work with is a matter of research: ■ Check their reputation and customer feedback ■ Find a provider with whom you can agree the structure of the programme: who will deliver what elements of the training, and how, including up to the end-point assessment, and how much it will cost. Did you know? In 2016 91,630 adult social care workers started an apprenticeship Source: Skills for Care Q: How are apprenticeships paid for? Learning and development budgets are often tight, so access to government funding for apprenticeships is a great benefit. Non-levy paying organisations: approximately 98 per cent of adult social care organisations will not pay the levy. If this is you, your organisation will only need to invest 10 per cent of the cost of the apprenticeship training – the government will pay the rest (up to an agreed cap). Levy paying organisations: organisations with an annual payroll of £3million+ will automatically pay the apprenticeship levy, 0.5 per cent of the bill over £3m. They can then use their levy account to pay for apprenticeship training. The money is only available for two years though, so ‘use it or lose it’. However, from 1 April 2018, levy paying organisations are able to
transfer some of their levy funds to another employer – the full guidance is available at www.gov.uk/guidance/ transferring-apprenticeship-servicefunds. Find out more about funding for adult social care apprenticeship training at www.skillsforcare.org.uk/ apprenticeshipfunding Q: How can you support and prepare the apprentices? Check that your apprentices have all the support they need; not just from their line manager, but from colleagues, mentors and supervisors too. Q: Is an apprenticeship the only learning and development programme? Apprenticeships are not always right for everyone or every organisation. Perhaps a learner doesn’t need a significant amount of time ‘off-the-job’
to develop their knowledge and skills because they already have experience. Perhaps, the end-point assessment is too far out of someone’s comfort zone? High quality training alternatives are, of course, available and these can include the following options: ■ Qualifications – diplomas or smaller, specialised qualifications ■ Workshop sessions on specific subject areas ■ Shadowing a more experienced worker, or someone in a different role ■ Being mentored to develop particular skills ■ E-learning to update knowledge. Q: Where can I find out more? Visit www.skillsforcare.org.uk/ apprenticeships where you’ll find lots of useful information.
The apprenticeship levy: it’s here to stay – so make the most of it! It’s the smart businesses and business leaders who recognise the opportunities of the levy, and embrace apprenticeships to help grow their business, says Dan Rees, commercial director at YMCA Training. He believes there are four top tips to make the most of apprenticeship funding: • Look at your business plan and the resources/staff needed to deliver continued growth and success • Identify recruitment and training gaps • Be prepared to meet investment requests with a plan for business efficiencies • Educate your team to ensure full engagement from top down In the last quarter of the 2017 academic year the take-up of apprentices declined 59 per cent, compared to the same period in the previous year. A survey conducted by the British Chamber of Commerce found that nearly a quarter of businesses (23 per cent) paying the levy did not understand it and more than half (56 per cent) do not expect to recover any or a portion of payments made to the government. But, by paying into the levy account, employers should now have a vested interest in their apprentices. Mr Rees continues: “They should strive to create worthwhile roles that see individuals grow in their role, so they add real value to the company.” May/June 2018 | Care Home Management 27
Engagement
Important changes to the Workforce Development Fund The WDF is a Skills for Care fund set up to help increase the level of skills within the care sector. Care homes can apply for money to help pay for training and qualifications for their staff. This includes:
Goodbye QCF, hello RQF The major change is the replacement of the Qualifications and Credit Framework (QCF) by the Regulated Qualifications Framework (RQF). This means that:
■ Health and social care qualifications, such as the NVQ in Health and Social Care
■ The list of qualifications available to be funded has changed. It’s important that you understand which training and qualifications the WDF will now fund.
■ Apprenticeships ■ Learning programmes. Open the door to the WDF, and you could train your staff and maintain CPD programmes at zero (or nearly zero) cost to you. However, the fund is limited and must be applied for. What’s changing? For 2018/19 several changes affect care homes that want to apply for WDF funding:
■ Only full qualifications will be funded – you won’t be able to claim for individual units, and funding will be dependent upon qualification. ■ You will need to provide a copy of the learner’s qualification certificate to claim WDF funding. ■ The 60-unit limit has been removed. Now, you can claim against the qualification with the highest funding value for any learner in a single year.
■ ■ ■ ■
28 Care Home Management | May/June 2018
The financial impact The key change for many care homes that currently use the WDF to fund their training and CPD will be financial: homes can now only claim against completed qualifications you might find that: You need to fund training in your current financial year, and not be compensated until your next financial year. This could impact your bottom line, and cause budgeting to become considerably more difficult. Should an employee leave before completing a qualification being taken, you will not be able to claim for the training and learning to date. This will need to come from your own funding. For more information on the WDF, and how it can benefit your training, contact Skills for Care on tel: 0113 245 1716 or go online to: www.skillsforcare.org.uk
Engagement
It’s not just about the money
Q: What will I learn from this feature? A: How to motivate your workforce to stay in your organisation
Long hours, low pay and the emotionally draining world of social care do not need to result in sickness absence or a P45, says Ryan Gay, HR manager at The HR Dept So, how do you motivate your workforce?
Most care workers are driven not by financial rewards but by a genuine passion for caring for the vulnerable, which means that care home managers are among the privileged few of employers who can call on a workforce that will put up with a lot if staff feel appreciated, that is. Efforts to minimise staff turnover are well-spent: they can reduce the burden of recruitment costs, cut the annual cost of agency staff and avoid the expense of repeated training. Staff continuity also creates a better quality of care, higher ratings from regulators and a tendency to win contracts as a result.
1. Effective line management There’s a tendency in the care sector to promote from within, so employees with experience of that company become first in line for promotion. It’s not a bad thing and it’s often seen as a reward for service. But, when an individual moves up the ladder, their responsibilities start to change and line management duties start to come into play. Companies often fail to address the emergent gap in the skills required to be a good carer and those for a good manager. Without support, training or development to grow, the new manager can feel demotivated and can fail to provide the managerial support needed by the more junior team members - which can affect their desire and motivation, too.
2. Training and development It’s not enough to think about mandatory training. ‘Softer’ skills are important too, particularly, those that allow an individual to progress within a company. 3. Pay With most contracts coming from local authority level, low pay in the care sector is a difficult issue to overcome. But there are ways in which you can reward staff – both in remunerative and non-remunerative benefits – which cost the company very little but can improve engagement. Service-related pay increases are a good example. These are pay rises for staff who have been with the company for a certain amount of time. The motivation is two-fold – firstly to demonstrate gratitude for long service and secondly as a motivator for staff to stay with you.
May/June 2018 | Care Home Management 29
Engagement 4. Benefits Employee benefits like childcare vouchers, or salary sacrifice programmes, holiday buy-back or sale schemes can be offered at a really low cost – and can reward staff massively keeping them from browsing the jobsboards. Employee engagement is a £1.7 million benefit A new report from the King’s Fund, Employee engagement, sickness absence and agency spend in NHS trusts, has found that, on average, NHS Trusts could save £1.7 million on agency staff costs, if they get staff engagement right. The report, which was commissioned by NHS England, finds clear associations between employee engagement and sickness absence; and between employee engagement and agency staff spend. Furthermore, the improvement in employee engagement can be small – what the King’s Fund terms a single standard deviation increase – to result in a substantial
Case study: Aspirations Support Bristol Ltd Aspirations Support was established almost a decade ago on the edge of Bristol with just two houses, since when it has grown to encompass 15 houses and a day service. Following the fall-out from the widely-publicised problems at the nearby Winterbourne View care home, Aspirations took on one of the residents and has since developed a specialism in supporting individuals with mental health issues. It’s proved a challenging experience for management and staff and five years ago employee turnover was as high as 40 per cent. However, after a review of services, and with input from the staff, staff turnover has fallen dramatically. Colin Ivey, Aspirations Support director of services, explains: “We found that two areas to focus on were pay and benefits, and management support: we have introduced a blanket pay rise, incremental pay increases and pay bands to reflect the challenges of working in mental health, as well as an overhaul of the benefits package. We’ve changed our internal culture to being low on blame and high on transparency and reportability.” In addition, there have been improvements to the recruitment process: cherry-picking staff is now out, and properly advertised vacancies are in. “Everyone has the chance to apply,” he says. reduction in agency staff spend. Commenting, NHS chief executive Simon Stevens, said: “[This report] confirms, empirically, what common sense suggests should be true: that staff engagement is not only good for employees’ health but reduces trusts’
cost and reliance on agency staffing. “So doing the ‘right thing’ also helps trusts with their budget pressures. As such, this report offers important practical lessons for the whole NHS.” The King’s Fund report is available online at: https://tinyurl.com/yb8fj73o
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30 Care Home Management | May/June 2018
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Learn, connect and be inspired at the Care Forum The Care Forum is the premier event for senior care professionals looking for new ideas and inspiration to take their businesses forward Taking place on July 2nd and 3rd at Heythrop Park, Oxfordshire, it is entirely free for care professionals to attend. As one of just 65 VIP guests, you will be provided with a bespoke itinerary of pre-arranged, face-to-face meetings with suppliers who match your requirements and upcoming projects. It’s a unique format that means that there’s no time wasted and no hard sell. In addition, you’ll have the opportunity to attend a series of seminars hosted by industry thoughtleaders. They include: Why leaders (and managers) need to master storytelling – by William Montgomery, Chief Executive, TEN This talk will show how narrative can spark the imagination and galvanise people into action better than dry data alone. That makes storytelling a tool leaders and
Meanwhile, you will also enjoy complimentary hospitality, including all meals and refreshments, overnight accommodation and an invitation to our gala dinner with entertainment.
managers can use to transform numbers, research and analysis into compelling, motivating images. Serving many masters… and other problems – by Andy Farrell, Director, Management & Safety Training The care sector has more masters than just the CQC, but who are they and what do they want? And are there other key issues that managers need to consider?
To find out more, visit thecareforum. co.uk. Alternatively, contact Liam Cloona on 01992 374089 or via l.cloona@forumevents.co.uk. If you are a supplier to the care sector and would like to meet with 65+ senior care professionals, contact Carly Walker on 01992 374055 or via c.walker@forumevents.co.uk
Quality improvement model for preventing pressure ulcers in Long Term Care Settings – by Siobhan McCoulough, Tissue Viability Specialist Nurse, Clinical Support Manager, OSKA Using technology to support quality frameworks – by Steven Strange, Chief Executive Officer, Health Metrics May/June 2018 | Care Home Management 31
Engagement
Learning from day one is key to outstanding care Care homes can improve staff Mr Goyal said the induction period retention levels and create outstanding should not be for only a few weeks care by improving their induction or months. “It should move into training and ensuring employees enjoy continuous learning and development continuous learning and development. of a team member. Managers are Hallmark Care Homes’ managing director Avnish Goyal told the Future of Care Conference in March that the industry’s approach to training is often a case of ‘the Emperor’s new clothes’. “Care providers can think their training is amazing because people tell them that it is, but often it is not, and this leaves them exposed,” said Mr Goyal. He added that Hallmark focuses heavily on the induction process and ensures line managers and senior executives are closely involved in it. “A good induction needs to be often too busy or they do not know created by the line manager with support from other functions within how to do things and therefore they the business,” he said. “This needs to don’t happen.” include appropriate training and any Mr Goyal’s presentation at the developmental needs that have come Future of Care conference was all out of the interview.” about how outstanding training can Southern Care qe:Layout 1 24/04/2017 17:17 Page 1
lead to outstanding care. He warned care homes against following the crowd and switching all their training to e-learning. He urged them to take a blended approach to learning and development. “We are seeing a return to more face-to-face and experiential training so that learning remains relevant to residents’ needs. Learning also needs to be fun and linked to the company’s core values to engage staff.” He said it must be easy for employees to access training, and chosen providers should be able to tailor their courses for specific care homes’ needs. “Ultimately senior leaders must create a learning culture and have a relationship with the learners and the providers so that they understand what people are being taught and why. Competencies must also be measured so you know whether knowledge is being transferred to the learner’s day to day work.”
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32 Care Home Management | May/June 2018
‘Finding and keeping workers’ is a new, online resource which supports adult social care providers of all sizes with their recruitment and retention challenges. Hosted on the Skills for Care website, it contains a wide range of resources and good practice which have been gathered from across the whole of adult social care. Information is grouped into four key themes: ■ Attract more people ■ Take on the right people ■ Foster talent and increase skills ■ Keep your colleagues For more information visit: www.skillsforcare.org. uk/findingandkeepingworkers
Recruitment
How can you tell if you are employing the right people? According to Lee Biggins, founder and managing director of CV-Library, their CV should demonstrate five key skills: Team working: Look out for examples of working well with others - and watch out for anyone who tries to take credit for doing all the work in a team because this may indicate that they don’t cooperate well with others. Effective communication: Has your candidate led a team, mentored someone or worked one-to-one with others? Look out for examples of volunteering, work experience in a care home environment, or even a part-time job in another industry. Drop your candidate a phone call if you can’t decide. These verbal skills can be
easier to recognise when having a conversation with someone. Organisation: Good organisational skills will enable an employee to manage their workload, which may be heavy at times. Someone who is disorganised may struggle to do all their duties on time. A tell-tale sign of a disorganised personality is if they haven’t followed all your application instructions correctly. Attention to detail: This is crucial when it comes to handling medications and important care documents. You can spot good attention to detail straight away typos, spelling mistakes or sentences that don’t make sense are great giveaways of a casual attitude to detail. Candidates should also be asked
for specific examples of detailorientation, for example, where they have created checklists, followed a procedure or listened to instructions. To find these individuals a tip is to focus on keywords that highlight attention to detail such as ‘examined’, ‘analysed’, investigated’ or ‘performed’. Compassionate attitude: Hiring candidates in this industry is not all about the technical skills. If your candidate can’t connect with people you’re heading for big problems with your residents. It can be difficult to show compassion on a CV so look for examples of where candidates have been supportive and caring to others. There’s no one way a candidate might display this, but examples of volunteering experience may be a good indicator.
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Laundry
Q: What will I learn from this feature? A: The value of an investment in a watersoftener
Down scaling your laundry burden If stubborn stains are a problem on wash day, perhaps, it’s the hardness of your water to blame, says Kevin Johnson, managing director at Monarch Water In any care home setting the process of cleaning dirty laundry can seem like an eternally troublesome task, but by reviewing water quality care home operators can make this arduous process easier and more economical. With hard water affecting over 60 per cent of the UK, limescale build-up can be a real problem when it comes to cleaning dirty laundry. Not only can limescale impact on wash results, but it makes machines less energy efficient while increasing the need for detergent – hiking up the cost per load. In the UK it’s estimated that limescale costs £1 billion through replacement, servicing and maintenance, with hard water responsible for around 70 per cent of equipment failures. With commercial and on-premise laundry operations using high volumes of water it’s vital
that care home operators consider water treatment when reviewing their laundry set up, to reduce potential future costs due to limescale. A commercial application using just 2,000 litres per day in a hard water area of only 300ppm will use water containing 233kg of scale in just one year. That’s nearly a quarter of a tonne. When it comes to water softeners one size does not fit all therefore it’s important that care home operators review the hardness of their water in addition to the machine´s capacity and consumption of water to ensure they make the right choice of water treatment system. A thickness of just 0.5mm of scale pushes fuel costs up by 9.4 per cent and 1mm to 12 per cent more. Investing in a water softener will not only prevent any further build-up, but remove any existing residue from the machines. It will also provide constant protection from aggressive minerals to help extend the working life of equipment – increasing efficiency and therefore reducing energy bills.
34 Care Home Management | May/June 2018
It’s not just the machines’ longevity and running costs that will benefit from soft water either. Improving the softness of water aids stain-removal over and above using more detergent or increasing water temperature. In fact, decreasing the hardness of water was found to be 100 times more effective than these commonly-used measures. It’s also worth noting that the life of a garment can be lessened by up to 40 per cent when washed in hard water and some linen and fabrics may have to be discarded before wearing out.
Keep in touch
Don’t miss out on the daily news from Care Home Management
You don’t have to wait two months to read the latest news and views from the care home world. Care Home Management magazine is supported by CHM Online, our website, where you can find news and views from the care home world that are updated daily. Just a small selection of the news items we have published since our last issue in March are included on this page, with links you can revisit if you missed the news the first time around.
Our daily newsletter We also publish a daily newsletter with updates from around the world, giving you a highly informed view of what’s going on in our industry. You may be aware that the General Data Protection Regulation (GDPR)
comes into force on 25 May and we need your consent to continue to send you digital news and information. You can read more about the GDPR, and what this means for you on page 11 of this issue. Care Home Management has new owners and a new editor and these are exciting times for the magazine and we don’t want to lose you. To keep receiving the latest news via our digital channels please visit https:// chmonline.co.uk/myinfo We hope you continue to be a Care Home Management reader or email subscriber. If you take no action you will not receive any emails from us after 25 May.
You can visit our website anytime at: www.chmonline.co.uk
Why care homes must start improving indoor air quality Care home managers all want to offer residents a safe, clean and comfortable environment that enhances their quality of life. However, in order to improve all areas of care home environments for their residents, decision makers must start discussing indoor air quality. Between October 2016 and April 2017, of 1,055 respiratory illness outbreaks reported to Public Health England, almost 80% (78.3%) occurred in care homes. More worryingly, of 34,300 excess winter deaths in the UK, over a third were caused by respiratory illnesses. Despite the majority of the care home industry washing, cleaning and changing bed linens regularly, many still need to ensure think about clean, filtered and high-quality air. To safeguard residents from potentially fatal illnesses we should be looking to invest in technology to get rid of airborne bacteria.
Darryl Brunt, Country Head of UK & Ireland at Fellowes AeraMax Professional, said: “Now is the perfect time for care home managers to assess the quality of air in their facilities. The Fellowes AeraMax Professional range of air purifiers not only cut out 99.9% of airborne contaminants, but they also remove odour and pollens, creating a safer environment for asthma sufferers and those with other long-term respiratory illnesses.” The spreading of illness is caused by airborne droplets or by indirect contact, like bacteria left on an object. However surface cleaning is only surface deep and many need to take into account the primary cause of
viruses: airborne bacteria. By investing in Fellowes AeraMax Professional air purifiers, you can protect residents and staff from potentially deadly diseases which affect those with weaker immune systems.
Now is the time to take action to prepare for the year ahead. Simply, implementing new technology to protect residents now could mean they live longer, healthier lives. Find out more at: www.aeramaxpro.com/uk
May/June 2018 | Care Home Management 35
HARD WORK DONE. NOW LET YOUR HAIR DOWN! The celebrations start 12 noon Wednesday June 27, 2018 in the Platinum Suite, ExCeL London Book your tickets online: carehomeawards.com/ceremony More information: helen.burgin@carehomeawards.com
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36 Care Home Management | May/June 2018
Residents' care
New dysphagia standards aim to improve care home nutrition
Cupcakes are an appetising option for people with dysphagia Many care home residents have difficulty swallowing their food and are missing out on tasty meals and vital nutrients because of it. By the age of 75, 20 per cent of women (source: www.softerfoods.co.uk) and one in six men will have suffered a stroke in the UK, and 37 per cent of them are predicted to develop some form of dysphagia. Today, the condition affects 22 per cent of over-55s. There is a perception that it can be costly and time-consuming to devise special diets for those with dysphagia, yet those with the condition are at a greater risk of malnutrition because they can struggle to eat independently and often lose their appetite. Sufferers can also lose their sense of taste and smell and feel embarrassed at meal times, especially if staff puree their food. To try and simplify the situation for care home caterers and chefs, the International Dysphagia Diet Standardisation Initiative (IDDSI) has unveiled new standards for the texture and thickness of foods and liquids being served. IDDSI is a global idea to support the 590 million people with the condition worldwide. Its latest standards create seven descriptors and eight levels of
texture, and now include liquids and regular food. The descriptors are: ■ 0 – Thin: flows fast like water and can be drunk through any type of teat, cup or straw ■ 1 – Slightly thick: thicker than water but requires a little more effort than liquids ■ 2 – Mildly thick: pours quickly from a spoon, but slower than thin drinks ■ 3 – Liquidised/moderately thick: can be drunk from a cup but cannot by piped, layered or moulded on a plate as too thin ■ 4 – Pureed/extremely thick: usually eaten with a spoon and can be piped or layered but does not require chewing ■ 5 – Minced and moist: can be eaten with a fork or spoon and can be scooped and shaped on the plate ■ 6 – Soft and bite-sized: can be eaten with fork, spoon or chopsticks and can be mashed and broken down with pressure from a fork ■ 7 – Regular: Normal everyday foods of various textures One supplier supporting care homes to improve meals for dysphagia sufferers is Premier Foods, which is offering training to care home chefs and caterers.
It has launched the second phase of its Dysphagia Solutions Programme and produced a 20-page guide with easyto-follow recipes and tips for catering for residents with dysphagia. There is also advice on how to add flavour and thicken up meals and present them in an attractive way. There are recipes for a full English breakfast, vegetable korma, minted lamb casserole, a roast chicken dinner, tomato truffles and apricot crumble, for example. Premier Foods launched its first healthcare solutions programme to improve the standard of catering for dysphagia sufferers in 2012. Food service channel controller Mark Taylor says it was important to demystify this area of care home catering. “Care home chefs and caterers need help to fully understand the new standards and the recipe possibilities that come with them,” he says. “There is training available to build chefs’ and caterers’ knowledge so that those who suffer from dysphagia can dine with dignity.”
Premier foods: Improving standards
May/June 2018 | Care Home Management 37
Product spotlight
NURSE CALL ALARMS Hold your doors
Hold your fire doors open legally with an Agrippa acoustic fire door holder. This fire door holder is ideal for care homes, it is hygienically fitted to the top of a fire door and offers a wireless solution to maintaining fire safety in your setting, whilst ensuring ease of movement for staff and residents. On hearing the sound of your fire alarm, the Agrippa acoustic fire door holder will release the magnetic connection between door plate and keeper, allowing the fire door to swing shut, preventing the spread of fire. For more information on the Agrippa acoustic fire door holder please contact us on 0800 978 8726 www.safelincs.co.uk
Radio Nurse Call Leads the Way! With today’s technology, it is possible to upgrade an old Nurse call system in under a week. Gone are the days of engineers installing cables and being on site for weeks, as with the new Radio Nurse Call a call point can be fitted in a resident’s room in minutes. Flexibility is another benefit as units can easily be repositioned when necessary, and multiple displays can be positioned around the care home to ensure staff never miss a call. Southern Care Maintenance Ltd, SCM, was established in 1987 and are a specialist independent company for the Service and Maintenance of Nurse call, Fire and Nursing equipment. They have many years’ experience in both fitting and servicing Nurse Call systems covering Kent, Sussex, Surrey, Essex and South London. This month they are launching mySCM, a new online customer portal, free of charge to all service contract customers, so that they can access service records, certificates and invoices securely 24/7. For more information see southerncare.co.uk and follow the link to the Nurse Call Page. You can also download a case study of a customer using Radio Nurse call or ring 01580 890089
The Alzheimer’s Show 2018, Olympia London The Alzheimer’s Show will be at Olympia London on Friday 8th and Saturday 9th June 2018. The two-day event is set to attract care professionals, family carers and those with an interest in learning more about dementia. The two day conference and exhibition will feature a full speaker programme across three theatres with leading professionals, industry experts, carers and individuals with dementia, question time panel sessions, practical activity workshops, advice clinics and a wide range of dementia and care exhibitors. The Alzheimer’s Show is a valuable event for those working in the care sector wanting a better understanding of dementia, the challenges it can bring as well as providing access to fellow professionals and the latest and best information, products and services to help those living with dementia. For further information and to book tickets visit www. alzheimersshow.co.uk. Tickets cost £15 online, £20 on the door.
What do all these people have in common?
They illegally wedged open a fire door and could be serving a custodial sentence or heavy fine for breaching fire safety regulations.
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May/June 2018 | Care Home Management 39 Ref: CHM18
Do you need to upskill your current workforce? If so Woodspeen Training can help, we deliver apprenticeship qualifications in Health & Social Care to meet industry standards These apprenticeships assess the development and knowledge of skills relating to Adult Social Care and confirms knowledge and competence in the Health & Social Care sector We can offer • L2 Adult Care Worker standard • L3 Lead Adult Care Worker • L5 Diploma in Leadership for Health & Social care For more information call 01484 429359 and ask for Claire Baxendale Email: enquiries@woodspeentraining.co.uk www.woodspeentraining.co.uk
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