Caring Times, October 2024

A business built from scratch

From arriving in the UK without speaking English, to running five care homes

Legal & regulatory

Sector experts forecast the future of the Care Quality Commission

Leader’s spotlight Orchard Care Homes’ Hayden Knight on five years as chief executive Reaction

Social care’s biggest names analyse the Darzi review

Sam

Chief executive officer

Alex Dampier

Chief operating officer

Sarah Hyman

Chief marketing officer

Julia Payne

Editor-in-chief

Sam Lewis

Features editor

Charlotte Goddard

Subeditor

Charles Wheeldon

Advertising & event sales director

Caroline Bowern 0797 4643292

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Business development director

Mike Griffin

Business development executive

Kirsty Parks

Event manager

Conor Diggin

Marketing content manager

Sophie Davies

Publisher Harry Hyman

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No-comment Commission

I know it’s somewhat in vogue to criticise the Care Quality Commission right now, and I don’t have half as much reason to complain as most Caring Times readers, but I’ve got a bone to pick with the regulator.

I emailed the CQC press team recently to ask for more details on the handbook it is developing for providers. The only news I could find was a rare interview with interim chief executive Kate Terroni. It also happened to be behind a paywall.

So, I politely ask for “more information and quotes”, a typical journalist’s request.

“What is it you’d like to know?” comes the response. This is when I get a sudden wave of déjà vu – I’ve had this conversation with the CQC press team before, months ago, about a different story. And they responded in exactly the same way.

So, I suggest, again politely, that a full press release announcing the plans for the handbook would be helpful. The response, similar to the last time: they “don’t have a press release” and I am “welcome to use anything from the [online interview] piece”.

Now getting slightly frustrated, I reply that the thousands of other companies, organisations and government bodies I’ve dealt with as a journalist all tend to announce news such as this in press releases and send it to journalists, and that the CQC might think about doing the same. I was not surprised when the conversation ended there.

Looking back over my interactions with the inspectorate over the last couple of years, they have all been like this. I’ve offered interviews and on-stage panel sessions on a number of occasions, to no avail. I’m pretty certain I can say, without exaggeration, that the CQC is among the top three least cooperative and communicative organisations I have ever worked with. It could easily be number one.

Browsing cqc.org.uk, it does have a ‘press releases’ section; that page is full of nothing but press releases with titles like ‘CQC rates Sheffield care home

Inadequate’, which it publishes with great frequency. Look a little further and its ‘news’ page is where it publishes announcements about the Commission itself. At the time of writing, the most recent post, from the beginning of August, is titled ‘CQC statement on riots’.

So, the regulator can find the time to comment on current events that have very little to do with it; it can find the time to shout about its ratings, good or bad, of providers; but it cannot find the time to interact with journalists covering the sector, or even churn out a 300-word press release on important changes it is making.

For a body that receives a fair amount of criticism for its poor communication with the providers it aims to serve, working with the press would – as I said in my last, ignored email to the CQC – go a long way to keeping providers informed and up to date. If the CQC is happy being a ‘closed culture’, as its inspection reports often accuse health and care services of being, then I suppose it should keep going, business as usual. If it truly wants to make amends for the past several years, then transparency will be a key part of that.

Sam Lewis, Editor-in-chief Caring Times

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News in brief

POLICY & POLITICS

Scottish health secretary Neil Gray has denied trying to buy Oasis tickets during a dementia panel at the Scottish National Party conference. Gray chaired a discussion on Alzheimer’s disease, during which the Sunday Mail said he looked up from his mobile phone and said: “I’m in the queue to buy Oasis tickets… on multiple devices.” The paper also claimed he made a joke about being “Half the World Away” from buying the tickets. Via social media he called the accusation “total nonsense”.

The number of Health and Care Worker visas granted by the UK government has seen an 81% drop. This is indicative of the changes made by Rishi Sunak’s government in March, which banned health and social care workers from bringing dependants to the UK. Data shows 89,095 visas were granted in the year ending June 2024, a 26% decrease over the previous year. The figure for the last quarter of that 12-month period, however, was

81% lower than April-June 2023. Care England’s chief executive Martin Green called the situation “untenable”.

English local authorities spent around £1.5 billion more on adult social care in 2023-24 than in the year before. Government data also showed that spending on children’s social

care was up £821 million in the same period, an increase of 6% for a total annual spend of £14.5 billion. Adult care spend was up 7% year-on-year, for a total of £23.3 billion. Overall, local authorities’ total net current service expenditure was £123.4 billion in 2023-24, £2.8 billion (2.4%) higher than in 2022-23.

HOME CARE

The Homecare Association has revealed “critical failures” in the Care Quality Commission’s regulation of home care services in England. This, it claimed, is putting home care recipients at risk and harming providers. It identified issues allegedly undermining CQC performance, including: resource constraints, a dysfunctional funding model, ineffective IT systems, misalignment with local authorities, and poor leadership at the CQC. The association also claimed that “the CQC is prioritising care homes over home care”.

LEGAL & REGULATORY

Westminster will make sprinklers mandatory in English care homes beginning in March next year. This comes “in response to the Grenfell Tower Inquiry’s phase one recommendations”, as revealed by building safety and homelessness minister Rushanara Ali. She confirmed in a written statement to Parliament:

Neil Gray

“Sprinklers enhance fire protection where residents may be reliant on others for help and assistance, especially if a building evacuation is needed. Care home owners and developers will benefit from a sixmonth transition period until the guidance comes into effect, and will then have a further six months to enable work on current development projects that are under way, or about to start, to continue.”

Care Quality Commission prosecutions are at their highest level

since the regulator’s introduction 15 years ago. The CQC’s prosecution rate of health and care providers is up 700% according to law firm Shakespeare Martineau. When comparing 20092013 with 2019-2023, prosecutions surged 700%, from 11 cases to 88. They also more than trebled compared to 2014-2018. Total fines have also seen a dramatic rise. Between 2009 and 2013, prosecuted providers were fined a total of £650,973. In the five years to 2023, the figure reached more than £10.6 million.

FUNDRAISING & EVENTS

The event formerly known as the Care Managers Show announced its new name: the Care Management Show . This comes as part of a broader commitment to reflect the evolving nature of the sector and the pivotal role of care management professionals. The change signifies a renewed focus on collaboration, innovation and comprehensive patient-management strategies. The event takes place 29 and 30 November at ExCeL London, with tickets available now.

SUPPLIER NEWS

Investment manager Octopus Investments has entered the European market for the first time. Octopus Investments Spain opened an office in Madrid’s financial district, its first permanent location in mainland Europe, as it looks to build a more global footprint. Ed Clough, managing director of Octopus Real Estate, has temporarily relocated to Madrid to support the growth.

Property news

The Welsh Government has awarded Pembrokeshire County Council a further £6.5 million towards building a new integrated health and social care hub. The grant was awarded through the social care integration and rebalancing capital fund for the works under way at the Pembroke Hwb regeneration project at the South Quay site next to Pembroke Castle. The Hwb will be a modern, accessible, social care, health and community hub to support the region’s aim to build active, resourceful, connected, sustainable and creative communities.

Healthcare real estate investment trust Aedifica has acquired four care homes with a total capacity of 264 residents for £61.5 million. The homes are located in Sayers Common, Sussex; Broadstairs, Kent; Southampton, and Midsomer Norton near Bath. Three properties have been recently completed, while the property in Midsomer Norton is expected to be completed by the end of the year. All homes are operated by Oyster Care Homes, controlled by the LNT Group.

Care homes, plots of land and a swimming pool owned by Bradford Council are being auctioned to avoid the council’s bankruptcy, The Telegraph & Argus has reported. The council also requested “exceptional financial support” from the government to balance its budget. Assets for sale include the former Valley View House care home, which was recently closed by the council, and has a guide price of £950,000. If all properties up for auction meet their guide price, the council will raise £2.66 million.

Family-owned care provider CHD Living has begun building its latest development in Elstead, Surrey, a 60-bed care home opening in autumn next year. It is CHD Living’s third development this year and will provide long-term nursing care, post-operative care and reablement services. The development will occupy part of a larger residential site which completed last year, comprising 69 houses and apartments. The approved planning permission covers a 3,000 square metre area for the home, set in one acre of grounds.

real estate & development

Property developer Zephyr X has secured £20 million in loans from Puma Property Finance for two new-build care homes in Southeast England: an 80-bed, all-electric care home in Reigate, Surrey, on the site of a former independent hospital; and a 45-bed care home in Whitchurch-on-Thames, Berkshire.

Mysa Care, backed by investment manager Downing, has completed three acquisitions. In Greater Manchester, Mysa acquired EAM Group, a residential care business with three specialist care units for adults with learning disabilities and complex needs. In South Wales, it acquired two residential properties, Parc Farm and Britannia House, which it will convert into supported-living services providing a home for people with learning disabilities, autism and complex needs.

A joint venture between property developer Barcroft Estates and an unnamed investment company has purchased a 70-bed care home scheme in West Malling, Kent, for an undisclosed sum, from investor and developer Barwood Capital, and Perseus Land & Developments. The scheme has been prelet to a not-for-profit care provider which supports older people through care homes. The facility is intended to offer residential care and dementia-specific care.

Adult social care provider National Care Group has expanded its supported living services in Wiltshire with three new developments opening in the past six months. The newly refurbished houses are home to 11 people with learning disabilities. The new specialist services have created 20 new jobs.

Kennedy Sabapathy, who owns four care homes, has acquired a fifth, Glendale Court care home in Teignmouth, Devon, from vendors Glenn and Gloria Taylor. The home occupies two interlinked period properties that have been extended and modified over the years to provide accommodation for up to 37 residents across 34 en suite bedrooms. The Taylors extended the building by acquiring a neighbouring property. Sabapathy owns three care homes in neighbouring Dorset – The Hyde in Bridport, Fairfield House in Weymouth and the Ferndown Nursing Home in Ferndown – and one in Shropshire.

Muller Property Group has acquired a 1.35 acre site in South Normanton, Derbyshire. The proposal for the site is a care home development (Class C2), featuring approximately 75 en suite bedrooms spread over two and a half storeys. Each room will be equipped with modern wetroom facilities. Additionally, the development will offer car parking and landscaped external areas.

Care Home wanted

Fully funded existing operator looking to purchase a profitable, compliant care home from someone looking to retire or sell.

• Up to 30 beds

• Located in the South East, South West (as far West as Dorset), Midlands (South of Birmingham) or London

• Price range of £1m- £3m

• Scope to extend desirable but not essential

If you are interested in an initial confidential conversation, please contact Joseph Joyce on 07816 168150 or joseph.joyce@hotmail.co.uk

People moves

Vic Rayner chief executive of not-for-profit social care association the National Care Forum has been appointed chair of Care Provider Alliance, a coalition of adult social care providers in England. The role rotates annually across each of the 10 associations. Rayner follows Jane Townson, chief executive of the Homecare Association. Rayner’s many roles include her more than eight years at the helm of the National Care Forum.

Worthing social care charity Guild Care has promoted Warren Fabes to chief executive, following the departure of Alex Brooks-Johnson who is taking up a new challenge in the charity sector. Fabes has worked for Guild Care as chief financial officer and deputy chief executive for the past eight years. He graduated from Cambridge University with a degree in electronics engineering before becoming a chartered accountant with KPMG. He spent more than 20 years working in large

in association with

national and international organisations as a finance director before joining Guild Care.

New Care has made a trio of senior appointments at Adel Manor Care Centre in Leeds, a 74-bed care facility. Marsha Tuffin has been appointed as home manager. She has more than 30 years’ experience in the health sector, starting work in residential care at 18 years old. Keegan Hutchinson has been appointed as deputy manager. His responsibilities include fulfilling staff training, completing audits, monitoring the quality and effectiveness of procedures, as well as maintaining relationships with stakeholders, residents and their families. Finally, former care assistant Matthew Bee becomes head of care.

Florence, the London-based tech start-up that connects vacant care home shifts to local nurses and carers, has appointed Roberto Taracido Ruiz as chief revenue. Taracido Ruiz

Vic Rayner

New Care's new Adel Manor senior team

Roberto Taracido Ruiz

Warren Fabes

started his career in environmental chemistry and pivoted to business and management consulting. Later he was appointed as managing director of e-commerce marketplace Groupon Spain and vice-president of sales for Groupon UK. Taracido Ruiz also worked at troubled office space company WeWork where his role “required navigating complex business landscapes and fostering collaboration across diverse teams and cultures”. In addition, he worked at beauty treatment booking firm Treatwell.

Later-living developer-operator Untold Living has appointed Henry Sumner as chief financial officer. Sumner joined Untold Living in January as interim chief financial officer, before being appointed to the permanent role. He was previously the operational finance director at Battersea Power Station, where he worked across multiple phases of the mixed-use redevelopment project. Sumner specialised in real estate

and operational finance in his prior roles at Lothbury IM, as property fund controller, and at AXA, overseeing a residential fund. He initially trained as an accountant with EY in the City of London.

Healthcare Homes Group has appointed experienced healthcare professional Sarah Collins as the new manager of Barking Hall Care Home in Barking, Ipswich. The home, nestled in vast gardens, is a 49-bedroom facility offering a range of services including nursing care, residential care, respite care and specialised dementia care. It is rated Good by the Care Quality Commission.

New Care has appointed Darren Molyneux as registered home manager at Wilmslow Manor, its luxury 63-bed care facility in Wilmslow, Cheshire. Molyneux joined New Care in 2018 as team leader and has since taken on the roles of head of care and deputy home manger, as well as achieving a diploma in Level 5 leadership and management in adult social care with distinction.

Oldbury Grange, a 69-bed nursing home in Bridgnorth, Shropshire, which provides residential, dementia, nursing, respite and palliative care, has appointed Jodie Haines as its new care home manager after she worked as its interim manager. Haines is a registered nurse who has worked in a number of complex care settings within care homes. Experienced as both agency and permanent staff, Haines worked her way up to become a care home unit manager, a clinical project lead, and then a deputy care home manager for a number of homes. She was also a compliance officer responsible for overseeing 12 care homes across the UK.

Henry Sumner

Sarah Collins

Jodie Haines

Reform the watchdog

William Walter, managing director of Bridgehead Communications, sits down with care leaders to discuss the biggest areas of concern the sector has with the discredited Care Quality Commission what it must do to rebuild trust with providers

During the general election campaign, which already feels like an eternity ago, Ian Trenholm announced he was stepping down from his role as the head of the Care Quality Commission. While a shocking move, it did little to prepare us for what followed: the publication of a report into the operational effectiveness of the CQC, which proved nothing short of scathing.

The findings of this review led current health secretary Wes Streeting to declare that “the CQC is not fit for purpose” – a stunning statement, but not without reason. The review found that one in five services, including new care providers, had never received a rating; providers hadn’t been reinspected regularly – with the latest care assessment for one care provider in 2015; and some inspectors were found to have had no previous experience in dealing with dementia patients.

In fact, the scale of failings uncovered at the CQC continues to grow. The Homecare Association has found in a report of its own that poor leadership, failing IT systems, and insufficient resources have all compounded the regulator’s lacklustre outcomes, leading to almost two-thirds of home care providers being either unrated or not having been rated in over four years.

CQC failures

Those with first-hand experience in the sector echo these failures, most

“The findings of this review led current health secretary Wes Streeting to declare that “the CQC is not fit for purpose.”

particularly inspection failures.

Karolina Gerlich, chief executive of The Care Workers Charity, notes: “The main concerns I’ve heard about include inconsistency in inspection standards, often due to inspectors’ varied backgrounds and personal biases.”

Care providers have felt this point is especially damaging. James Tugendhat, chief executive of HC-One, says that “the time between inspections is too long”, which means that often “a home’s CQC rating may not reflect the home’s current performance”. For Tugendhat, this has ramifications for not just care groups, but also for staff.

He says: “[Infrequent inspections] can be misleading for current and prospective users... and can impact confidence in care homes. It misses an opportunity to value and recognise teams that have improved their care, which can be frustrating and impact morale amongst the home’s team.”

Although inspections are also noted as a chief cause for concern by Anchor chief executive Sarah Jones, she expands on the role that a greater reliance on technology has had. “We have seen the consequences of moving to the digitalised system without adequate testing and ensuring that the system was fit for purpose”, she notes, adding that

“What’s needed is “more clarity on what matters most to the CQC” and “clear definitions of what outstanding care looks like.”

the move to remote assessments has been made without “assurance on the tools necessary for its implementation”.

This is something that Gerlich also felt relevant to the problems with the CQC and its poor reputation in the care sector, saying: “The CQC’s response during Covid-19 and its struggles with technology have further eroded trust.”

Lessons for the future

Given the current state of the CQC, an essential question is how the organisation can rebuild trust and become fit for purpose once more. Tugendhat sees the immediate priority as fixing the problems that have arisen in the Single Assessment Framework

William Walter

Karolina Gerlich

“Nonetheless, a fundamental, detailed review of the CQC appears paramount in signaling the intent to change.”

(SAF) since its introduction. He notes: “[The framework] represents an opportunity to further demonstrate the kind of care we provide.” Still, he stresses, what’s needed is “more clarity on what matters most to the CQC” and “clear definitions of what outstanding care looks like”.

Jones is more critical of the CQC, arguing that the public body needs to change its image fundamentally and build bridges with the sector once more. She says: “We need a regulator that supports transparency and a drive

to improve safety and quality across health and social care, and timely ratings prepared on a consistent basis are key to that.”

Central to this is the matter of trust, she believes, adding that “it is in everyone’s interest to improve public trust and confidence” in the care system, which requires regulators to ensure “that ratings are an accurate and up-to-date reflection” of the care being provided.

Building a new relationship to further trust between the regulator and providers resonates with Gerlich, too, who finds it “crucial to focus on clear communication and working together to improve care standards, rather than just imposing penalties”.

Part of this means that the CQC “should be more supportive”, which can best be done by “offering [more] guidance and education on compliance and best practices [as well as] shifting from a punitive approach to one that fosters improvement”.

Is a new regulator required?

Having discussed the scale of dissatisfaction with the CQC, we ended our conversation by asking whether the CQC’s reputation had fallen sufficiently that a fundamental change, such as a new regulator, was needed in the sector to restore confidence.

Most were skeptical of the idea. Gerlich believes that the “significant issues” that have “eroded trust in the CQC” are not grounds for such a change in the regulatory landscape, a view both Tugendhat and Jones share. Nonetheless, a fundamental, detailed review of the CQC appears paramount

in signaling the intent to change.

“A thorough review and a substantial transformation of the CQC are needed,” remarks Gerlich. She says that the CQC must become “more transparent and [engage] better with care providers and workers”. This is repeated by Jones, who asserts that the review must be “thorough” and “consult widely [while] looking closely at the failures within social care regulation as closely as health”.

The specifics of how to move forward are known, but it remains uncertain how well these can be achieved. As Tugendhat said, delivering a more effective SAF is essential, while fixing the technology problems, as Gerlich implored, remains paramount as well.

It’s clear that the CQC must rebuild trust by addressing these issues and prioritising clear communication and consistent inspections. Only by demonstrating that commitment to improvement can it restore its reputation and deliver the oversight that the care sector urgently needs.

James Tugendhat

Sarah Jones

Social media battle

Bridgehead Communications’ managing director Will Walter reveals the results of the firm’s analysis of care groups that are dominating the social media landscape

Care PR consultancy Bridgehead Communications has unveiled the second report in the 2024 edition of its social media power list, ranking the UK’s mid-size care home groups and individual homes based on social media following.

The consultancy launched its now annual survey last year with the publication of three reports ranking the UK’s top 20 small, mid-size and large care home groups respectively by social media following.

Using carehome.co.uk’s list of the top 20 mid-size care groups, the report, titled: ‘Social Media Power List 2024 – Top 20 Mid-size Care Home Groups’, ranks each group and their respective care homes according to their social media following on the five most widely used platforms in the sector: Facebook, LinkedIn, Instagram, X (Twitter), and TikTok. The report was compiled using follower data recorded in July this year.

As with last year’s report, the study also investigated the applications of social media in the adult social care sector. It explores the most effective social media platforms to use depending on the care group’s digital marketing objectives. It also highlights the importance of considering multiple factors in social media to boost engagement, and that striking a balance between group and individual home accounts is the most effective way of reaching a target digital audience.

Care groups and homes combined

In terms of the combined social media followings of each of the care groups and their individual homes, Carebase topped the charts, with 41,460 followers spread across Facebook, X, LinkedIn and Instagram. Its X following accounted for half of this total and was the highest of all groups, in fact constituting nearly two-thirds of the combined total of the top 20 on the platform. Despite this, it appears that Carebase no longer uses its accounts on the platform.

Carebase’s social media following was around 10,000 followers higher than the second-ranked care home group, Berkley Care.

As with last year’s report, Facebook accounted for the largest proportion of followers (56%, or 153,902) among the care groups and their homes. LinkedIn accounted for 20% (54,985), an eightpercentage-point increase compared to its proportion of followers among care homes in Bridgehead’s investigation last year. X accounted for 13%, Instagram for 10%, and TikTok for less than 1%.

Compared to its peers, Berkley Care Group had the most significant Facebook following, which came from a combination of group and individual home accounts.

Commenting on the findings of the report, Berkley Care Group’s sales and marketing director, Kat Clayton, said that Facebook has proven a “great tool for highlighting the unique, luxury experience we offer to our residents”. The platform, she continued, also offers an

opportunity to “share moments of joy and celebration” in homes, as well as “sharing the stories and celebrating the achievements of our fantastic staff team”.

On LinkedIn, it was Signature Senior Lifestyle which boasted the highest following (9,410), which came exclusively from its group account. On

Will Walter

Instagram, Future Care Group dominated with 16,670 followers, providing more than half of the total of all the top 20 groups combined.

Individual care homes

The analysis also compared the social media following of the individual homes belonging to the top 20 groups.

Cumnor Hill House, part of the Berkley Care Group, topped the charts for the second year in a row, with its total following (more than 7,000) coming exclusively from Facebook. Following behind on 4,300 followers came Carewise Homes’ Dryclough Manor, whose following also came exclusively from Facebook.

Bridge House Care Home, part of the Carebase group, ranked in fourth place with 3,230 followers. It reflected a more diverse use of social media platforms compared with those in first, second and third – its following divided across three platforms: Facebook, X and Instagram.

Facebook accounted for approximately 80% of the combined following of all individual care home groups within the analysis.

Care groups

Lastly, the report ranked each care group by its own social media following, excluding those of individual homes.

On group-specific accounts, LinkedIn proved the most-used platform, with

William Walter said: “It is a pleasure to launch the second report in this year’s series of social media power list insights. Launched last year, the power lists proved incredibly popular across the sector, offering marketing teams insights with which to inform their digital marketing strategy.

“These investigations offer fascinating insight into how care groups are using these platforms to grow their industry and public presence, with knock-on effects on occupancy rates, reputation, and staff recruitment and retention.

“Our report also considers the advantages and drawbacks of groupspecific social media accounts versus accounts for individual homes and explores how your group can strike the right balance.

“Given the larger presence of mid-sized groups on social media versus the smaller groups assessed in our previous report, the findings also offer an interesting demonstration of how social media use in social care is changing over time. The growing prominence of LinkedIn, for example, is an intriguing development. It will be interesting to see how these figures have changed when we turn to our third and final report, which covers the top 20 large care home groups.

“We’d encourage anyone to get in touch if they’d like to discuss the findings in more detail. We’d also be happy to offer a complementary virtual or in-person teachin to discuss how care groups can optimise their social media outreach.”

its tally (52,712) providing nearly half of the combined total of the groups (116,120). Facebook (22,223), X (29,951) and Instagram (11,230) also proved popular.

As a result of its significant X following, Carebase topped the groupspecific account leaderboards with 17,150 followers. In close second, though, came Oakland Care, with its 15,450 followers coming from a more diverse range of platforms. Its LinkedIn following (9,365) proved most prominent, though both Instagram (4,136) and Facebook (1,300) followings provided a relatively significant part of their total.

Comply with the law

Sam Lindsay, principal associate at law firm Mills & Reeve, provides an overview of general health and safety duties for providers looking to avoid prosecution

Healthcare regulations are so often at the forefront of regulatory compliance discussions in the sector, but care home operators and care providers also need to be aware of their statutory health and safety duties.

Why it’s important

Effective health and safety arrangements keep people safe and prevent avoidable harm.

If that isn’t reason enough, providers that breach their duties commit an offence, regardless of whether any harm results from the breach. Where harm does result, or where a breach is particularly egregious, then a provider may be prosecuted. Upon conviction, a provider faces an unlimited fine based on turnover, and individuals guilty of offences may face prison time.

In July last year, providers operating an inpatient hospital were fined a combined £400,000 for failing to keep staff safe from violence.

What are the health and safety duties?

General duties in the Health and Safety at Work Act 1974 require employers to take steps to, so far as is reasonably practicable, ensure:

• The health, safety and welfare of their employees while at work, and

• The safety of others affected by their undertaking.

The Act also requires those in control of premises to ensure, so far as reasonably practicable, that those premises are safe.

A provider is therefore responsible for the health and safety of not just its workforce and the people it supports but also visiting third party staff, family members and other persons who may be affected by its activity, or who come onto premises under its control.

Who regulates health and safety?

The Care Quality Commission is the

English enforcing body for health and safety where it concerns the provision of regulated activity by a registered provider, but the Health and Safety Executive or relevant local authority are responsible for enforcement otherwise. Following a fatal accident the police will investigate suspected homicide offences.

What about fire safety?

Fire is a particularly high-risk area for care providers, particularly residential services.

The Regulatory Reform (Fire Safety) Order 2005 is the main piece of legislation concerning fire safety for premises.

The order requires persons in control of commercial premises to arrange for a competent person to complete a fire risk assessment and ensure premises conform to relevant standards.

Guidance on fire safety for premises, including residential care premises, is published online at gov.uk.

You’ll also need to assess and control the risk from fire for individual people you support and in connection with activities too.

Fire safety enforcement is typically the responsibility of the local fire authority.

What does compliance look like?

Providers need to take all reasonably practicable steps to ensure people’s health and safety in an organised and sustainable way. This means:

• Having an overarching health and safety policy.

• Establishing an effective system for health and safety governance and oversight.

• Staying up to date on health and safety developments.

• Completing suitable and sufficient risk assessments to identify hazards, quantify risk of harm and identify the control measures necessary to mitigate the risk so far as reasonably practicable.

• Implementing safe working arrangements based on the risk assessments, and

• Documenting the arrangements and keeping them under review. Your workforce will need to know about the arrangements relevant to their role, so consideration needs to be given to how information will be disseminated. Staff will also need rolespecific training and refresher training to maintain competence.

Sam Lindsay

Find your supplier

Bridgehead Communications’ latest care tech map has landed, an infographic detailing suppliers providing software and digital solutions dedicated to transforming the social care sector

The care sector is served by dozens of different software suppliers, offering products that cover a range of functions – from recruitment and staff rostering to medicationsmanagement and the handling of medical records.

While this breadth of options is undoubtedly a good thing, the care tech landscape can be a confusing one, even for experienced care home managers. What’s more, with the government now strongly encouraging care providers to go paperless, it has never been more important to know your Birdies from your Nourishes.

To help choose the most appropriate offers from the sector’s suppliers, Bridgehead Communications has unveiled Version 2.0 of its comprehensive care tech map, featuring more than 50 providers. It has compiled an infographic detailing the activities of key players providing software and other digital solutions dedicated to transforming the social care sector.

The initiative aims to highlight a wide range of innovative solutions that enhance the consumer experience for residents, their families and friends,

optimise care management for providers, and support efficiency and productivity across the sector.

The sector map includes 51 companies, representing a broad spectrum of technological advancements in social care. Around half of the solutions covered (49%) provide digital tools for better

Will Walter

management of home care and supported living, while around two-fifths (43%) support management in care and nursing homes in the UK.

The inclusion of seven non-UK companies underscores how innovation in the field of technology targeted at the care sector is a global initiative, with

Commenting on the infographic, William Walter, managing director of Bridgehead Communications, said: “I am excited to introduce version 2.0 of our in-depth map of the care technology sector, which categorises 51 prominent players in the field. At Bridgehead Communications, we are striving to establish ourselves as the go-to partner for PR, marketing and thought leadership for social care.

“The adult social care sector is set to become increasingly crucial in the UK and across the developed world, with the demand for care services on the rise. It is essential that we adopt solutions that not only enhance care outcomes but also boost efficiency.

“Our map showcases the wide array of technologies available and by offering a detailed snapshot of the leading companies and their solutions, we hope to help care providers and policymakers in navigating this intricate ecosystem.”

representation from the US as well as parts of mainland Europe, ranging from the Netherlands to Norway.

Notably, the companies covered in the analysis varied significantly in size and the scope of their operations, ranging from the likes of CareBuilder, which has 21 employees, to Alcove, which has just under 100.

Lewis

One of the companies featured most extensively is Cera Care, which operates in the home care field. Its platform’s primary offering is its ability to match clients with carers and to facilitate easier and more direct communication between care workers, clients and family members. Another is the service Found by Lottie, a cloud-based customer relationship

management software designed specifically for the care industry. Found by Lottie offers modular solutions for managing enquiries, customer relationships, occupancy, finance and billing. It also partners with close to 1,000 care services, including Care Concern and the Orders of St John Care Trust.

Adding his insight, Caring Times editor Sam Lewis commented: “Bridgehead’s care tech map is an invaluable asset for care providers across the UK, both in domiciliary and residential care.

“I have been writing about social care for more than two years and have developed relationships with many of the companies included in this map. Nevertheless, it can still be difficult to keep track of the exact remit of each player, and how they distinguish themselves from their competitors, due to the sheer volume of companies in the sector and the many different functions they can have.

“Even the most seasoned care executive could no doubt use the map to find a new partner to help them navigate the at times choppy waters of running an adult social care business.

“Caring Times extends its thanks to Will and the team at Bridgehead for distilling this information into such a digestible guide.”

Sam

A life in care

Caring Times editor Sam Lewis sits down with Hayden Knight, chief executive of Orchard Care Homes, to discuss his five years at the helm of the dementia specialist care provider, his 28 years in care, and his new appointment to the Care England policy board

Passionately good-willed, laidback and open are not always phrases that can be applied to chief executives, especially when you put them in a room with a journalist. It comes as a very welcome relief, then, to find Orchard Care Homes boss Hayden Knight mercifully devoid of the usual forced formality and corporatespeak one might associate with most business executives. Not to say he isn’t professional or effective at his job –quite the contrary – but in many ways he seems to be the anti-chief executive: relaxed, personable, opinionated and, above all else, human. You could say that speaking with him, compared to most business leaders, is like Knight and day. 2024 has been something of a milestone year for him. Knight joined Care England’s policy board in August – Martin Green’s approval marking a greater testament to his character than I could ever give – and in September celebrated the fifth anniversary of his becoming chief executive at Orchard. When one takes a look at Knight’s CV, his self-assured nature begins to make sense. He entered the care sector on 1 October 1996, 28 years ago this month. The way he tells it, he had just finished an engineering degree and was working a “well-paid” but not particularly satisfactory job in that field when he decided to quit. Having worked part-time in a care home while studying, Knight knew where his heart really lay, and he quickly found a role with Priory Group, a company he would ultimately stay with for 23 years, rising from a humble support worker to managing director, a title he assumed in 2017.

“I think I was on about £3 an hour at first, but I loved the job.

“I went back to care because it was something I actually enjoyed,” he says. “I think I was on about £3 an hour at first, but I loved the job. That’s how my adventure started. From there, I took advantage of all the qualifications I was offered and I progressed through the ranks.”

Knight expresses his gratitude to Priory Group for his time with them, and for their willingness to “invest” in him, without which he might never have landed the Orchard role, first becoming chief operating officer in May 2019, and soon after chief executive in October of that year.

Talking to him, it’s easy to see why he was able to climb the ladder. His passion for all aspects of care and business shines through as he discusses Orchard’s current health as a business, and how he envisions its future trajectory.

“We’ve 23 homes currently,” he explains, “but obviously our endeavour is to be bigger.”

In describing Orchard’s current position in the market, he says: “We are a specialist dementia organisation,” adding that “about 95%” of its residents have some form of the condition.

On how it became known to the

public as ‘the dementia specialist’ in social care, he reveals the company’s twopronged approach. “One is our dementia promise,” he reveals. “It’s not just a dementia strategy that sits on a shelf. It’s all-encompassing. It changes values and behaviours, even in the way we articulate how we support residents.”

Secondly, he cites Orchard’s ‘Reconnect communities’, designed for those with more severe cases of dementia. The company’s website says the communities “allow for a more

Hayden Knight

Fun at Thornton Hall

“I’d love to be able to say all our homes are rated Outstanding. That’s my dream.”

tailored, personal approach to dementia care”, and “as the name suggests, help people reconnect with their lives”.

“Sadly, sometimes there’s just nowhere for people with high-acuity dementia needs to be supported,” Knight says. “Some of these people come to us from failed placements. These communities have really become the bedrock of our dementia support system, and the outcomes they are achieving are phenomenal. We’ve just recently opened our tenth Reconnect community, and we’ve got plans to open far, far more in the future.”

But expanding its dementia support is not Orchard’s only goal. Knight is keen to evolve into a business that caters for other kinds of specialist elderly care too. “If you look at the data,” he reveals, “there is a great requirement for elderly mental health provisions, for example, because there’s just a lack of them.” He goes on to mention that there is a

similar scarcity of services dealing in older adults with Down’s syndrome and learning difficulties. That passion shines through when he says: “I really want to move into that specialist space. There’s a lot of specialist support for younger adults, but not so much for the elderly.”

Sector struggles

It's not all looking to the future for Orchard, though. Unfortunately, the present is laden with the kind of challenges that face most companies in the sector.

“Obviously, people recruitment is a challenge,” says Knight, “but fortunately, when I say challenge, we’re actually making good headway on that front.”

He goes on: “I’ve worked in the sector for 28 years. In that time, recruiting and retaining good staff has always been a challenge. Always. Social care jobs are seen as hard work, long hours and low pay.” He laments: “It’s not recognised for the skilled job it is, nor for how much it gives back to the community.”

However difficult staffing has been in the past, the last few years have proved to be some of the worst ever for care providers, and now the concern is the lack of international staff coming to the UK, a demographic upon which the sector had heavily relied. In March, changes to the Health and Care Worker

visa system meant that migrant workers can no longer bring ‘dependants’ (family members who rely on the worker financially, such as children) to the country, cutting the number of visas given to health and care staff by more than 80% year-on-year in the first three months under this new stipulation.

“Yes, we have unfortunately seen quite a drop-off in those applicants from overseas,” says the chief executive. “That has reduced quite a lot in the last few months. We are still attracting them, but not in the quantities we were before.” Luckily, Knight says, Orchard doesn’t have high staff turnover, and it is managing to keep vacancy rates low.

The other thorn in his side has been the much-publicised turmoil at health and care regulator the Care Quality Commission, but this is an area he believes is improving slowly. “This morning we had another inspection report come in for one of our homes,” he reveals with a smile. “We had been quite concerned about how things would go under the new inspection framework – everybody was – but so far we’ve had three inspections come in and all of our homes remain Good-rated under the new regime. The group is 100% CQCcompliant, which is something we’re really, really proud of.” Without missing a beat, though, he goes on to add: “But

Art at Green Park

business | leader's spotlight

Good isn’t good enough, you know? Now we are embarking on the road to Outstanding. That’s our next endeavour. I’d love to be able to say all our homes are rated Outstanding. That’s my dream.

“Obviously that will take time,” he concedes, “but if we’ve hit Good across the board, I don’t see why every home can’t attain Outstanding. Quality and governance is very much the priority at Orchard.”

When asked how the company goes about not only maintaining but improving its inspection ratings, Knight says: “We have a very robust governance structure and framework. We’re fully digital, so we have access to numerous kinds of data and information which can prove very helpful. Perhaps most important of all, we have some incredible individuals in the business, not least the specialists in our quality team.”

QMOs (or quality monitoring officers), Knight explains, “go out to the homes and do our mock inspections” in a bid to prepare them for the real thing.

“For me, though,” he adds, “the silver bullet, the reason we’ve achieved such remarkably consistent ratings across the board, is because we have a culture of transparency, of trust and honesty.” Without that transparency in business, he claims, “you don’t always have visibility of what’s going on, and where improvements can be made.” Orchard’s managers, he says, “know to speak up when things aren’t quite right, and then we get in there and rectify the problem before it has a chance to escalate. It’s all about trust and being a learning organisation, because things do go wrong in business – that’s a given – but what’s important is how you act when these things happen. It’s about having the desire to admit your mistakes and

“We have 23 homes… in the next five years

I’d like to double that number.”

use them as a means to improve.”

On whether the CQC has been, at times, frustrating to work with, Knight admits: “Yes, towards the latter stages of the previous CEO’s tenure it was getting to be more and more challenging. When they brought the portal out it was disruptive to say the least. That particular issue is starting to ease now, but there’s a long way to go.”

Regarding the regulator he adds: “They are making a lot of promises. I suppose only time will tell if they can deliver on them.” He remains sceptical, however, adding that “if history tells us anything, it’s that the CQC hasn’t always been able to deliver on what they’ve promised”.

Of course, the disorganisation and

lack of communication from the inspectorate is often discussed in the health and care sectors. What isn’t so often talked about is the effect this has on providers. Knight explains: “We need to make sure that this regulator is futureproofed and fit for purpose, because at the moment it’s not delivering. This also hampers our growth. We have to respond to market demand, and right now we are seeing a lot of demand for nursing homes with clinical support. If we wish to move forward and support the community, we have to register a lot of our properties as nursing homes and we were getting pushed back and pushed back by delays on the CQC’s end. It was a completely fragmented process. Urgent registration should be taking

Professor Martin Green of Care England visits Middleton Lodge

Green Park intergenerational group

leader's spotlight | business

place in nine to 12 weeks; we were looking at nine to 12 months, which was horrendous.

“Fortunately, things are settling. The portal seems to be ticking along and

we are getting some responses back. However, it was not a good time, and it pulled us away from doing what we should be doing, which is to focus on outcomes for individuals.”

Care England

Fortunately, Knight is now in a position to wield some influence at a legislative level within the care sector thanks to his new “supportive role” on the Care England policy board. At the time of our conversation, he is still keen to get stuck into his work with the organisation, but mentions that the areas he wants to focus on in particular are “staffing, regulation and funding”. He adds: “The role is a privilege.”

As much as he relishes the work, he knows that it will be an uphill battle. No one knows better than Knight the glacial pace at which politics can move. Discussing the still relatively new Labour government, he says: “I’ve been in the sector, like I say, since 1996. I remember Tony Blair coming in and he made all

Music therapy at Lofthouse Grange

business | leader's spotlight

“I suppose in my work here I’ve been giving Orchard an identity.”

these promises about the care sector. That was 28 years ago. Since then, we’ve had seven prime ministers and we’re still in exactly the same position, so you’ll have to excuse me if I feel a little sceptical towards any new government.

“I think the only person who made some sort of strides, actually, was Boris [Johnson],” he goes on. “Not enough, but he did start to move things forward.”

Looking back to the current Labour administration, and justifying his scepticism, he continues: “The reforms were scrapped on day one. I knew that was going to happen. We all did. If you look at their policy around social care, for example the National Care Service, they’re making some big pledges but there are no numbers in there, there’s nothing to back it up. So everybody in the sector is right to be a little dubious and confused about exactly what Labour’s intent is.

“Politicians just don’t seem to take it seriously,” he adds. “It’s just wilful blindness at this point, isn’t it? They always want more for less. They want higher quality and better outcomes, like we all do, but they’re not giving us anything with which to achieve that.”

He also laments what he labels a “lack of consistency in approach” across the country, claiming that working with the many different local authorities and integrated care boards up and down England can be a challenge.

Knight also decries the recent scrapping of the Winter Fuel Payment. “That’s just going to drive up ill health and drive more people into care homes,” he says. “I understand that we have some wealthy pensioners, but it should be means-tested. It can’t just be a blanket approach. Many of these older people will get ill and will end up on a hospital ward or in a care home, and aside from anything, that won’t save the government money.”

Regarding what, in an ideal world, he

would like Labour to do about the sector, Knight believes that there’s not enough recognition for the role social care plays in the overall health and care system. He concludes: “Ultimately, I want equality. Yes, the NHS is important, but without our sector there is no NHS.”

Five years

When we discuss the fifth anniversary of Knight’s taking over as chief executive at Orchard, he looks wistful. “It’s gone very fast,” he says. “I’ve thoroughly enjoyed it.

“Obviously we had the pandemic a few months into my tenure, which really tested my mettle. I suppose it tested all of us – those that were new and those who had been at the company for years –but I’m very proud of what the company did during those years.”

He adds with conviction, “I’ve got no ambition or plans to move anywhere else for the foreseeable future,” something about which Orchard shareholders will no doubt be happy.

Shareholders certainly cannot accuse the chief executive of not dreaming big. Looking ahead to the next five years, he confirms: “It’s all about growth, and further diversification into other specialisms. Right now, we have 23 homes, but in the next five years I’d like to double that number, if not more.”

Certainly not resting on its laurels, Orchard has just opened its latest dementia-specialist Reconnect community at Langfield Care Home in Middleton, Greater Manchester. “That’s absolutely flying,” enthuses the chief executive.

When asked if he has any other news or announcements to share, Knight once again bucks the trend of most chief executives and corporate types. Rather than mentioning another home that Orchard has in the pipeline, or else some new ESG programme, he chooses a much more personal topic.

“There is some sad news for us,” he reveals with genuine emotion. “Cheryl Baird, our group director of quality, has been with us for some time, but unfortunately she will be leaving us towards the end of the year.”

On Baird, who joined Orchard at the outset of the pandemic, he goes on: “She’s been absolutely instrumental in the growth of Orchard and the stability and quality we have achieved today, as well as the specialism we deliver. It’s truly a very sad day for Orchard, and I wish her all the success in the world moving forwards. She leaves a real legacy behind.

“So, the search for her replacement is ongoing, but we’ve got a fantastic team I know I can rely on.” It is this sort of sentiment, said with genuine feeling behind it, that shows how Knight was able to rise up the ranks at Priory and later Orchard.

As we come to the conclusion of our conversation, the chief executive says: “I suppose in my work here I’ve been giving Orchard an identity. Now Orchard is known for being the specialist business in dementia. You asked about my biggest achievement in care, and I suppose you could say that, in my 28 years, Orchard itself is my biggest achievement.”

Eckington Court - Nurse Jasmine

How much is spent on care?

New government data has revealed a 7% year-on-year increase in adult social care spend by local authorities, a £1.5 billion rise

English local authorities spent around £1.5 billion more on adult social care in 2023-24 than in the previous 12 months.

This comes via new UK government data, which also showed that spend on children's social care was up £821 million in the same period, an increase of 6% for a total annual spend of £14.5 billion.

Adult social care spend was up 7% year on year, for a total of £23.3 billion.

Including adult social care, children's social care and housing services, local authorities’ total net current service expenditure was £123.4 billion in 202324. In real terms, this was £2.8 billion (2.4%) higher than in 2022-23, the government revealed.

It also noted that local government expenditure accounts for just under a fifth of all government spending.

With regard to adult social care, the government was able to reveal that the spend increase was "largely due to a realterms increase of £514 million (10.3%) in physical support for those aged 65 and over, and of £434 million (6.8%) in learning disability support for those aged 18–64".

Caring Times editor Sam Lewis commented: “How Keir Starmer's incoming autumn budget will affect this in 2024-25 remains to be seen, as the prime minister continues to hint that public spending may take a hit.

“Nevertheless, these rising figures do illustrate the difficult situation in which the government finds itself, as increasingly unrealistic sums of money are needed to fund public services every year.”

Sam Lewis, editor, Caring Times

Rising dementia costs

The Alzheimer's Society has shed light on the rising need for dementia treatment and resources in society

Aseries of reports commissioned by the Alzheimer’s Society has set out the economic and healthcare effects of dementia.

The first part of the research showed that the annual costs of dementia in the UK, which stand at £42 billion today, could rise to £90 billion by 2040.

The document also shows the role that early diagnosis and symptomatic treatment play in reducing system pressures and decreasing the likelihood of crisis for people living with dementia.

A post on the Alzheimer's Society’s website says: "Suboptimal diagnosis, treatment, care and support results in a worse experience for individuals and means that dementia has a disproportionate impact on the healthcare system, with its impact set to increase significantly as prevalence grows."

It goes on to explain that the rise of dementia means that, by 2040, there will 6.9 million additional primary care contacts associated with dementia, requiring an estimated 1.7 million more hours of primary care time.

People with undiagnosed dementia attend A&E on average 1.5 times a year, which is higher than attendances for diagnosed mild, moderate and severe dementia patients, and three times higher than attendances for patients without dementia.

Early diagnosis, treatment and support is essential to help people with dementia navigate the health system better. However, spending on diagnosis and treatment is equivalent to just 1.4% of total dementia healthcare costs. By contrast, unplanned hospital admissions make up almost a third of all dementia healthcare costs.

Meanwhile, almost one in six hospital beds today are occupied by someone living with dementia, with the number of bed days for dementia patients expected to increase over time, growing from 20,500 beds this year to 29,400 beds by 2040.

By 2040, 6.9 million additional primary care contacts, such as GP appointment, will be required each year, representing a 43% increase on current 2024 activity.

The report showed how, through early intervention and treatments such as cognitive stimulation therapy, AChE inhibitors and memantine, many people with dementia could lead more comfortable lives, and the health and social care system could save a significant amount of its annual dementia expenditure. billion The annual cost of dementia to the UK billion The projected annual cost of dementia to the UK in 2040 £90 £42

One in six

Number of hospital beds occupied by someone with dementia

20,500 - number of beds needed for dementia in 2024

29,400 - number of beds needed for dementia by 2040

Care must be more data-savvy

Claire Smout, Skills for Care’s head of digital skills, discusses the organisation’s ‘Workforce Strategy for Adult Social Care’ and how it is using data to support better learning and development outcomes

This month I will talk about how the ‘Workforce Strategy for Adult Social Care’, which launched in July, is using data to help us push for better learning and development outcomes across the adult social care sector.

Data is crucial to enabling us to understand and frame the challenges that our sector faces. One of those challenges is that we are living longer – the number of people aged over 65 is expected to grow by almost a third in the next decade. This means we may need 540,000 new social care posts by 2040. The number of people aged 18 to 64 with a learning disability, mental health need or a physical disability is also projected to increase over this period. In addition to this growing need for social care services, we also have difficulties attracting and retaining staff. In 2023-24, there were 131,000 vacancies on any given day, which is a vacancy rate of 8.3% – around three times the average for the economy. Over a quarter of people leave their jobs in care each year and around a third of them leave the sector altogether. The high attrition rate in many social care jobs greatly compounds the challenge of a growing demand for services.

What does this data mean for our learning and development requirements in the near future? Well, we know that people with a relevant social care qualification have a significantly lower

turnover rate (26.5% versus 37% for those holding no relevant qualifications), while those receiving regular training in their role also have a lower turnover rate (31.6%) than those who don’t (40.6%). This makes learning and development one of the key levers for driving the change we need to see in retention rates to address the forecasted increase in need for social care services.

The strategy has a huge amount to say in terms of what can be done to offer people the training opportunities they need to remain within the sector and provide us with the highest standard of care, with more than 20 recommendations made within its ‘train’ section.

However, the strategy recognises not only the crucial nature of data in helping us understand our needs for the future, but in the development of the sector

in general. Data skills are noted as an important area of growth for adult social care, with multiple recommendations highlighting that we need to bring more data and digital talent into our sector if we’re to deliver the best care possible. These include:

• The Association of Colleges and the Association of Employment and Learning Providers should support the higher education sector to offer programmes on the use of digital, data, technology and artificial intelligence in social care (plans should be developed early next year).

• Develop a strategy to improve continual professional development and supervision to grow the workforce through degrees, enhanced and advanced apprenticeships, and maximising the benefits and impact of assistive technology, data and AI through innovation, leadership and training.

The strategy leans heavily on data to illustrate how critical learning and development opportunities are if we’re to shape a positive future for our sector, in addition to recognising the importance of growing adult social care’s current data skillset. I’m excited to see the benefit that an increased use of data and development of data skills within adult social care will bring to those working in the sector and being supported by it.

34 REACTION

37 LEADER’S SPOTLIGHT

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The importance of monitoring temperatures in care settings

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Social care leaders react to Lord Darzi’s review of the healthcare system

Creative Caring

As always, carers have been demonstrating their creativity through fun and innovative events for their residents

Delightful donkeys

Residents of dementia care home

Camelot House and Lodge in Wellington, Somerset, were delighted to receive a visit from donkeys Charlie and Flora, accompanied by handler Kelly Baker of Kelly’s Donkeys. “Many of the ladies and gents who live with us have farming connections, and they were so happy to be able to be so close to Charlie and Flora, to stroke them and smell their lovely smell,” said Sam Paddon, head of care at Camelot House and Lodge. The donkeys wear specially designed nappies and are trained to use the lift or stairs.

Wall of sound

Ashlynn Grange Care Home in Peterborough has introduced a Musical Wall. Ashlynn Grange’s lifestyles team transformed an old wooden pallet, adorning it with a variety of instruments crafted from unconventional materials such as metal pans, bells and a washboard. Residents contributed by painting the pallet in bright, cheerful colours.

Beautiful game

Cardinals in the Community, the charitable arm of Woking Football Club, is delivering weekly exercise and team building sessions to residents at Friends of the Elderly’s Bernard Sunley care home in the town. Activities include skittles, bowling, throwing bean bags magnetic darts and of course football. The exercises and games are tailored to help with hand

and eye co-ordination, dexterity, balance and flexibility.

Global grub

Residents of The DurhamGate care home in Spennymoor, County Durham, and their families and friends have been ‘visiting’ different countries from the comfort of their home, by taking part in themed cuisine and cultural experiences from around the world. Head chef Karl Aylward’s dishes from across the globe have included French crêpes, Italian lasagna and tiramisu, Spanish tapas, and Greek beef stifado and spanakopita.

Peaceful painting

Residents of St George's Court Care Home in Cambridge enjoyed a multisensory painting session accompanied by soothing sounds of nature, floral scents from a diffuser, and drinks and snacks. The event, which started with a short breathing exercise and guided hand movements, was held during National Relaxation Day. A practice painting aimed to ensure everyone could test out the different brush types and techniques before starting on their larger canvas piece.

Dog days

HC-One’s Victoria Mews care home in Coventry celebrated International Dog Day by honouring year-old Shorkie (Shih Tzu and Yorkshire terrier) Geraldine, who frequently visits the home. Geraldine, who’s owned by manager Michael David, has a positive effect on the wellbeing of staff and residents alike. “When staff are feeling stressed or low, they will often take five minutes out with the dog, and this picks them back up,” said David.

Nailed it

Wendy Benson, wellbeing co-ordinator at HC-One’s Silverwood care home in Rotherham, has been learning how to do manicures, to the enjoyment of residents who love to try out her colours and designs. Those using the home’s hair and beauty salon also benefit from the skills of hairdresser Pam Hawksworth. A record player provides background music, with residents picking the songs they enjoy.

Classic cars

MHA Ty Gwyn in Penarth arranged a classic car show for residents, with four cars brought to the care home including a Morris 1000 Traveller (1967) and an

Austin 1300 (1972). Mary- Anne Rawle, activities coordinator, said: “Some of our residents are very knowledgeable when it comes to cars and they were very happy to see them. The cars would have been very popular when our residents were car owners.”

Volunteer vehicles

Haughgate House Care Home in Woodbridge, Suffolk, part of the Healthcare Homes Group, hosted a visit from Service by Emergency Rider Volunteers Motorbikes, a charity that transports blood, medical supplies, and equipment to hospitals. Residents had the chance to get up close to vehicles which play a crucial role in saving lives. A local police office also attended the event with his police motorbike.

Wedding bells

Daniela Danciulescu, manager of Hamberley Care Homes’ Brookwater House in Enfield, London, acted as officiant for team members Mihai and Lavinia Marcu, who ‘got married’ at the care home. The couple’s official wedding took place in Romania, but the care home celebration event included a cake prepared by the home chef, bridesmaids and residents lining up with flower hairbands.

Lodge

Care Homes group, invited members of the local community bring along their talented dogs to take part in a fun canine obstacle course. Residents cheered each dog through the tunnels and over obstacles, and made treats to reward them for their efforts. The dog show was part of a summer fete which included musical performances, stalls and fun activities.

Fun in the sun

Residents at Valentine House care home in Silver End, Essex enjoyed a sunny afternoon for their annual Garden Party and Fun Day. Residents and guests entered the large, secluded garden at the rear of the home through a balloon arch and enjoyed a barbecue, party games, entertainment and an opportunity to meet and chat with other families and friends of relatives plus the staff from the home.

Meditation in motion

Meadowbrook, a new Connaught Care luxury care home in Bishop’s Stortford, Hertfordshire, has launched a tai chi and mindfulness programme to boost the physical and mental wellbeing of residents. During weekly classes, participants learn workouts aimed at improving their balance, flexibility and resilience. In the first class, residents were taught basic exercises including neck rolls, shoulder shrugs, ankle rotations, leg stretches and other low-impact activities.

Food for thought

Kind-hearted residents at 21 care homes across the South helped gather food items to support families in need. All Colten Care homes took part in collections and other activities to mark National Food Bank Day on Friday 6 September. As he

helped sort through and pack items at Avon Cliff in Bournemouth, resident Derek Parker said: “I’m so pleased to be able to support a very worthy cause. I’m hoping all will go well and our contribution will make a difference.”

Firefighter

Milton Grange Care Home in Carluke, Lanarkshire, has a new fire warden, 90-year-old Jenny Wilson. Jenny, who moved into the Popular Care home last year, has quickly become an integral part of the community, bringing her warmth, cheerfulness, and a passion for knitting to the home. Home manager Alice Karran said: "Jenny's appointment as fire warden is a testament to our commitment to empowering our residents and making them feel valued and integral to our community.”

Alice in Wonderland

Residents at Butterfly Lodge Nursing Home in Plymouth enjoyed an Alice in Wonderland themed ‘dementia day’ put on by popular local pub The Anchorage. Sarah McCaffrey, deputy manager of the Camelot Care home, regularly brings a group of residents to the pub for drinks and lunch. She said: “We really appreciate being able to make a booking for our group and know that they will be able to relax and enjoy themselves, with their special needs being catered for in a friendly and caring fashion.”

Canine capers

Lofthouse Grange &

Care Home in West Yorkshire, part of the Orchard

10 questions with…

We speak with Alex Teixeira, home manager at Four Seasons Health Care’s Kingston Care Home in Surrey

Why did you join the social care sector?

Because of my mum. She inspired me to become a nurse and her kindness towards others made me the person I am today. In addition, I felt inspired to pursue management due to my dad. He has worked in management since his early career and his dedication, persistence and resilience when facing problems makes him one of my role models.

I joined Brighterkind, part of Four Seasons Health Care Group, in 2014 and worked in Scotland as a registered nurse. I later moved to London and started working at Kingston Care Home, as deputy manager and progressed to be the home manager in 2022.

What do you enjoy most about your job? Making a difference every day. My door is always open and what makes my day the best is when a relative visits and tells me that their loved one looks so well since they moved into our home, and that the team are doing a great job. I also love seeing the joy on our residents’ faces when they get involved in the activities we arrange as part of our

‘Magic Moments’ programme. Whether it’s an exercise session, a visit from our local school pupils, a trip out and about, or a good old-fashioned singalong on a wet afternoon, getting everyone together for fun and friendship always makes me happy.

Who is your social care hero and why?

I’ve got so many. When I joined Four Seasons, my manager was an inspiration and invested trust in me to develop and become my best. My regional support manager, who supported the blossoming of my management skills and my regional manager who always points me in the right direction. Everyone is a hero in this industry, and I wouldn’t be who I am without the support of everyone who I’ve had the pleasure to work with over the years.

What’s the one thing you would change about social care?

I would change the investment and importance placed on social care. It needs more funding so we can help everyone who needs our support and

ensure the ‘golden years’ of our elderly population are lived to the full. With the right levels of care and support in place, every day can be fulfilling.

What in your opinion makes a great care worker?

Someone that takes the time to really get to know their residents so they can deliver truly individual care. They are compassionate, professional, creative, enthusiastic, relish a challenge and are a ray of sunshine who brightens up everyone’s day. They are up to date with all the training provided and support other team members to deliver outstanding care.

What do you do when life all gets a bit too much?

I would enjoy some quality time with my family or go for a walk with my dog. If the weather is awful, we’d cuddle up on the sofa with a nice film and a fleece blanket.

What advice would you give your younger self?

Don’t overthink too much and enjoy the ride. Life can be hard at times, but you will remain resilient after every challenge.

Which three famous people would you have to dinner and why?

I would say Meryl Streep, Nicole Kidman and Jane Fonda. I adore their roles as actresses and we would have fun chatting over dinner.

What three items would you bring with you on a desert island?

A knife, a rope and a flashlight. This would put my survival skills to the test, for sure.

What is your secret talent?

I would say my ability of having conversations in my head in two different languages (I’m Portuguese). I also do my own French manicures, and I can mimic a kitten calling out.

Alex Teixeira

The clock is ticking

Stephanie Nimmo, communications and engagement lead for the Digitising Social Care programme, explains how to make the most of your digital care tech – and to make the switch while funding is still available

My favourite thing about my job is getting out and about and hearing from the amazing people who work in adult social care. We launched our ‘Clock is Ticking’ campaign in spring, highlighting the benefits of switching from paper to digital social care records (DSCRs) and the need to secure funding while it lasts. This month we’re on the road again at the Care Show in Birmingham, and we’ll be asking delegates two questions: have you made the switch, and are you making the most of it?

We weren’t all born into a world where we touched the screen of a digital device before we took our first step. When I got my first smartphone I was pressed for time, juggling work and family and, frankly, bamboozled. I didn’t have the time or energy to make the most of it. I used to liken it to having a Michelin-starred chef in my kitchen and asking for beans on toast. But eventually I started to explore the phone’s functions and uses and now, like most of us, go into minor panic when I can’t locate it within about 30 seconds.

Judging by the conversations I’ve had with many of the leaders and colleagues in adult social care, their experience with setting up digital social care records is not dissimilar. Once they have researched, selected and adopted a digital social care record solution, and then trained staff to get it up and running, they don’t always have the time or resource to explore each and every function available.

Of course, the majority of suppliers will guide providers through their solution and all that it can do. You can find the Digitising Social Care (DiSC) programme’s list of assured solutions on our website. But it can take time to explore how the additional functions can offer additional support to you, your team and, most importantly, the people in your care and their families.

Using a ‘family portal’ function allows families to stay up to date on everything, from personal care and medical support, to daily mood and emotional wellbeing. Recent research has shown this is one of the biggest priorities for registered managers, staff and families. Keeping in touch with care delivery digitally, for example through a mobile app, means family members can check in at any time and from anywhere, to see how their loved one is doing.

Access to vital medical information through digital social care records has also been revolutionary for care teams. The GP Connect function allows appropriate staff in Care Quality Commission-registered care providers access to a restricted view of a person’s GP record, ensuring they have up-todate information to support the delivery of safe, person-centred care and includes real-time information about medication changes. It’s been nothing short of “amazing” according to one care home owner and registered nurse manager.

Staff have started using the voice-totext function in many digital social care

record solutions. This offers a double benefit: up-to-the-minute, on-the-spot record-keeping and care planning, as opposed to a pile of paperwork to deal with at the end of a shift, with extra time saved from not having to type in the information. This has also proved to be hugely valuable for care staff with neurodiversity, allowing them to dictate observations and plans directly into their mobile device instead of trying to structure a written update.

Introducing digital champions into your organisation can be a great way not only to support the wider team to work with new digital solutions, but to explore those tools to make sure you’re using them to their fullest potential. See DiSC’s guidance on digital champions on our website.

Wherever you are on your journey to digital, as well as making sure you’re getting the best out of the technology, make sure you’re getting the best out of funding and support. Funding won’t be around forever, so make the most of it while you can. Reach out to your local team to find out how the process works in your area.

Industry reacts to Darzi

In the wake of the Darzi report, or ‘The Independent Investigation of the National Health Service in England’, the health and social care sector has come out in full force to back many of the document’s findings

Martin Green, chief executive of Care England

“Ministers must recognise that investing in and reforming social care is not just a separate issue. it is integral to the survival and success of the NHS. Right now, 13% of NHS beds are occupied by patients awaiting social care support. These delays are not just numbers; they represent people who deserve timely care in the right setting. Until we address this backlog in social care, we will continue to see pressure mount on hospitals and the NHS.

“We are ready to engage with the government and offer solutions. The expertise exists within social care to contribute to reform for both the NHS and social care, and we are ready, able and willing to be part of the solution development and not just participate in a box-ticking consultation. Now is a critical moment for change.

“Instead of excessive oversight that has failed to deliver, the focus should be on front line care for individuals and communities. We need to streamline, remove barriers, and prioritise real solutions – not layers of ineffective bureaucratic regulation.

“With unprecedented transparency in the analysis provided in [the] report, the path forward is clearer than ever. If the government and its departments can work at this speed to produce such comprehensive data, they can certainly accelerate the changes we urgently need for social care. Now is the time for bold decisions and meaningful action.”

Vic Rayner, chief executive of the National Care Forum

“As Lord Darzi has highlighted, it will be impossible to fix the broken NHS without high-quality social care. He rightly points out that social care ‘is a vital service in its own right, helping people with disabilities, and all of us we age, to lead full and independent lives for as long as possible’, but this value has simply not been recognised, nor has it been invested in.

“Without high-quality adult social care, it will be impossible to sustain economic growth, tackle inequalities or deal with wider issues in public services – and ultimately, enable people to live their lives to the full.

“We now need to see positive action on adult social care. In the past few days we have heard some welcome statements from the government about the need to grapple with the immediate challenges as well as the long-term ones. There is time, political capital, and the expertise of a united social care sector to make this happen. We urge the government to chart a course with adult social care at its centre and we stand ready to help transform adult social care for the millions who work in it and most vitally, draw upon it.”

Jane Townson, chief executive of the Homecare Association

“Lord Darzi’s review starkly illustrates the challenges facing our healthcare system. The findings resonate deeply with what we in the home care sector have long observed and advocated for.

The shift towards community-based care is not just desirable; it’s essential for the sustainability of our health services and the wellbeing of our nation.

“Home care plays a key role in preventing hospital admissions and readmissions, and reducing delayed discharges. With 13% of hospital beds occupied by people waiting for social care, it’s clear that investing in our sector can contribute directly to reducing waiting lists for NHS treatment. Our report offers suggestions for improving the hospital discharge process, from the perspective of home care providers.

“We urge policymakers to pay attention to Lord Darzi’s recommendations and invest in community services, particularly home care. By doing so, we can help to reduce demand for costly NHS services, increase efficiency and improve outcomes.”

Sarah Woolnough, chief executive of The

King’s Fund

“This review is an authoritative and sobering articulation of what patients have been telling us for some time –services are stretched to breaking point and people are losing faith that support will be there when they need it.

“The review is more than just a gloomy assessment of how long it will take to recover services, it is a mandate for government to take bold, decisive action.

“The biggest improvements to health and care in this country will come from prioritising services outside of hospital. That means greater investment in the

primary and community services that support people before they end up needing hospital treatment. It means political focus on public health strategies that keep people healthy and prevent illness in the first place. And it means finally getting to grips with the muchneeded reform of adult social care.

“Lord Darzi’s review also underscores the need to move beyond past lazy criticism regarding the value of NHS managers and instead recognise that implementing major improvement to the health service requires investment in high-quality leaders.

“Ministers now face tough tradeoffs between tackling immediate NHS pressures or prioritising reform of the root causes of the crisis. [The] review makes clear that incremental improvement will not do – radical change is needed. The task is not simply to prop the NHS back up; it is to create a new approach to health and care in this country.”

Thea Stein, chief executive of the Nuffield Trust

“Lord Darzi’s damning report underlines the stark realities experienced across almost every corner of the health service. Wide-ranging problems have been growing in plain sight for years

and Darzi’s impressively comprehensive assessment will be familiar to anyone who has studied or experienced the slow deterioration of health care provision in England.

“While not surprising, the report’s findings are deeply troubling. As our research work has repeatedly shown, too often the NHS is not able to provide people with the timely care they need, despite steadfast public commitment to the core principles of the health service. The impacts of this are not felt equally: people in the poorest areas are particularly struggling to access healthcare.

“The big question now is what happens next.

“The government has an early opportunity to make good on longargued points on dysfunctional NHS funding in its first budget. The health service is staring down the barrel of a significant shortfall in funding this current year and the chancellor will need to set out clear plans to tackle this, ahead of a longer-term funding settlement.

“Rightly, the report repeatedly references the interrelated, compounding pressures of the desperate state of social care and cuts to public health provision. But by design it does not dig into those issues. In future, we hope to see serious work by the government to address those broader societal issues that determine population health and impact health care access.

“Ultimately, Lord Darzi’s diagnostic report sets out important aspirations to be delivered in the forthcoming 10-year plan to treat – and fix – the NHS. But the improvements we all hope for – and that patients desperately need – will take time, commitment and major financial, practical and system-wide support. There will be no quick fixes.”

Kathryn Smith, chief executive of the Social Care Institute for Excellence

“Although focused on the problems facing the NHS, the Darzi Review

strengthens the case for acting on social care reform sooner rather than later. The Review lays bare the critical and longstanding issues facing both the NHS and the social care system, from service fragmentation and underfunding to inefficiencies and an ageing population. To resolve the NHS’s long waiting times and improve healthcare outcomes, we need to consider patient pathways across health and social care systems as a whole.

“Lord Darzi’s analysis recognises that health and social care cannot function effectively in silos; they are interdependent. Enabling people of all ages, not just older people, to live independently, manage long-term conditions and relieve the pressure on finite NHS and emergency services are goals of both systems. Without a coordinated approach, people will continue to face under-met and unmet care needs, and family carers will remain overstretched.

“Waiting for government action and investment on social care may prove to be a false economy. Social care must be treated as an equal partner to the NHS, and we must leverage opportunities now for upstream prevention, new models of community care and digital innovation. The NHS 10-year plan has an important role to play in reimagining both our future national health system and social care.

“This is a vital moment for the future of care in the UK – one we cannot afford to miss. We look forward to working closely with government and health and care partners as future plans for the NHS and a National Care System take shape.”

Put the ‘social’ into social care

Rob Martin, managing director of care services at later-life care and housing provider Anchor, explains the benefits of digital social care planning

We can talk about change in terms of evolution and revolution, and digital technology has been a revolution for industries across the board – arguably, none more so than social care. When you dig deeper into this revolution, one of the key ways digital care planning is changing the face of social care is through its ability to bring the ‘personal’ back to care.

We know the incredible people that make up our industry are passionate about their jobs because they truly care. I’ve experienced this personally, having started my career in care as a registered manager after serving in the Royal Artillery for almost seven years. Rolling out a digital care planning programme enables carers to spend more time doing the part of the job they love the most – building relationships with residents and providing exceptional faceto-face support that helps them live life to the full.

Moving to a digital system and capturing information in real-time, as opposed to filling out paperwork after the event, not only unlocks more time for person-centric care, but also the ability to build a deeper understanding of residents, with this knowledge being readily available for all team members. We can instantly access and log their

likes, dislikes, wellbeing, what’s going well and what hasn’t been so successful, as well as the health-related details, so that we can create a stronger connection with our residents.

Having access to this vital information at the touch of a button makes social care seamless, eases the burden on colleagues, and ensures targeted care for those who need it. By implementing electronic administration systems, medical records can be updated, accessed and shared efficiently. In doing so, the risk of human error is minimised and the inefficiencies associated with paperbased systems are effectively reduced. Remote monitoring tools and wearable technology can also be used to detect noise levels, alert colleagues, and monitor a patient’s health data in real-time. Vital signs like heart rate, sleep patterns and mobility can be continuously monitored and flagged for any concerning changes. These technologies can even identify patterns and trends in a person’s health, which could help predict future requirements and allow carers to put in preventative measures, particularly when it comes to things like falls prevention, monitoring dementia symptoms and maintaining dignity with less intrusive care throughout the night.

Crucially, embracing technology in social care locations will strengthen relationships with hospitals and GPs, as well as with loved ones.

By being able to use tech with the resident’s consent, loved ones can access real-time information and stay informed about how they’re doing. The beauty of this is that face-toface visits then don’t need to include extensive time getting an update from a carer but can provide more quality time with their loved ones.

At Anchor, we’ve seen a transformational change by moving from an analogue

approach to digital – both for residents and colleagues. Our revolutionary digital care planning project enables colleagues to capture key information more quickly and efficiently on handheld devices at the time of delivering care to residents. This ensures much more detailed information on residents and their wellbeing is recorded to enhance the quality of care.

It also enables us to see trends in the organisation on a micro and macro level as we can capture a much richer level of data than ever before. We have a clearer oversight of what’s working on a broader scale across the organisation and can adapt accordingly.

Another benefit is that it’s more environmentally friendly as it significantly reduces the amount of physical paperwork.

We’re at the beginning of what will be truly possible with digital innovation in social care. As tech in care continues to evolve, the potential applications are boundless. By adopting the right technology, the sector can enhance accessibility, improve communication and offer personalised, data-driven care.

Digital technology is not simply a tool for improvement in the social care sector, it’s a pathway to transformation. I’m certainly excited to be part of that journey and to see where it takes us.

Rob Martin

A business built from scratch

Charlotte Goddard talks to Oakminster Healthcare founder and chief executive Sunita Poddar about the family business she now runs

Newly married to her structural engineer husband, Sunita Poddar arrived in the UK unable to speak English and with no qualifications. Today, she is the founder and chief executive of a group of five care homes in the Glasgow area, employing more than 350 staff and caring for more than 380 residents. She has achieved this, she says, while consistently being underestimated as a professional woman.

“I came to this county in 1977 as a very young bride,” she says. “It was challenging, as people would not take me seriously, as a young girl in a sari running a business.” Poddar learned English by working in a grocery which was owned by her brother and sisterin-law. Her entrepreneurial streak was evident from the start, as she moved on to lease a petrol station in 1981 which she ran until 1987, introducing profitmaking innovations including a couple of pressure washers and a video club.

In 1984, Poddar took her first steps into the care sector when her fatherin-law, a GP, suggested this would be a better fit with family life. She purchased a 12.5% share in a 23-bed care home in Prestwick, Ayrshire. The property was bought and converted in partnership with existing care home owners, friends of her father-in-law.

The next few years saw Poddar immersing herself in the business from the bottom up. “I followed everybody around making sure I understood what

“Once Poddar felt comfortable that she understood the business, it was time to strike out on her own and launch what was to become Oakminster Healthcare.”

happens,” she says. “When you are looking after vulnerable people, you want to make sure you understand their needs and requirements, so instead of being the boss I was a handyman, going to the cash and carry, making sure the laundry is running fine, making sure the kitchen is running fine, just learning the ropes.”

Once Poddar felt comfortable that she understood the business, it was time to strike out on her own and launch what was to become Oakminster Healthcare.

“In 1986 my husband and I saw a building run by the Department for Work and Pensions in Kinning Park, and I said I think we should get that and open another care home in Glasgow,” she says. “Our partners looked at the building and said you are mad, you can’t convert this building into a care home, but I believed in it, and we took a risk.”

Paying for the investment with a 100% bank loan, Poddar opened Kinning Park

Care Home, a 30-bed home offering nursing, residential, dementia, palliative, end of life, respite and intermediate care. It has its own luxury Italian café, as well as a cinema.

While people are more open-minded than they were back in the 1980s and 1990s, Poddar still finds that she is underestimated. “When you go to big corporate events and meetings, they see you in a sari, they look at you and say ‘what does she know, why is she here?’,” she says. “In the past I had to prove myself every step of the way. There is a better understanding now, in the 80s and 90s there were not that many Indian women in business, but there are people still out there who will judge you.”

Poddar aims to use her position and experience to support other women to succeed in the sector and in business in general. While the care sector workforce is predominantly female, men are disproportionately highly

Sunita Poddar

“Develop your emotional intelligence, understand your sector and people’s mindsets, how to work with them. It is about clear communication –lead with purpose.”

represented in senior management roles (31% of senior management roles are occupied by men, compared with 19% of the workforce in general in England, according to Skills for Care). “I am thankful that I am able to inspire other girls and women,” she says. “I feel that every empowered woman should

empower 10 other women, then they have lived their lives. I tell women it’s up to you, you have the power within you, all you need is someone to tell you that you can do it.”

What advice would Poddar give to a young woman starting out today, who aspires to follow in her footsteps and open a care home, or group of homes?

“The biggest thing is self-belief,” she states. “If I could do it then, you can do it now. You need to have a career vision and think about what you want to do. If you fail first time don’t give up, keep doing it until you get there. Not being successful the first time doesn’t mean it is failure, it just means you have more experience to do it better the next time.”

Being a leader in the care sector means advocating for yourself and others, she says. “Develop your emotional intelligence, understand your sector and people’s mindsets, how to work with

them. It is about clear communication –lead with purpose.”

Oakminster is currently in a stage of consolidation, with no immediate plans to expand further. “We are fortunate with an excellent team that works tirelessly to ensure the wellbeing of our residents and staff remains our priority,” says Poddar. “The care sector is under immense pressure to do ‘more for less’ and our immediate plans are to maintain the status quo.”

Oakminster has recently drastically reduced its use of agency workers, although recruitment and retention remain a challenge for the sector – and for business in general, following Brexit and Covid, says Poddar. “Retention is a high priority for us and we are investing a lot of money in staff training,” she says. “We were using a lot of agency staff as after Covid we lost a lot of team members; people left because they didn’t want to work in the care sector any more. But 90% of our staff are now employed by the company, and that helps to provide the standards of care that we want to deliver. We try to ensure the staff team understands we value them and they feel they have ownership – when that happens 99% of your problems go away.”

Having run care homes since the 1980s, Poddar has seen a lot of changes. One of the biggest is the increase in residents with more complex needs. “In the past people over 65 would just come in and admit themselves because they could no longer live alone; there were not that many assessments,” she says. “Now we are assessing people’s physical and mental needs, and they are coming into care much frailer, it is not just about basic nursing anymore.”

Because of this, the government needs to look at increasing funding for social care and primary care to reduce pressure on the NHS, she believes. “Basic nursing is fine but if people are coming with complex needs the funding needs to come with that. At the moment the government is demanding a five-star service for two-star money, and in fact we are trying to provide seven-star care for two-star money.”

“Basic nursing is fine but if people are coming with complex needs the funding needs to come with that. At the moment the government is demanding a fivestar service for two-star money, and in fact we are trying to provide seven-star care for twostar money.”

Another change Poddar would like to see is a more productive relationship between home care and care homes.

“In my opinion there is huge potential for care homes and care at home to collaborate to meet the needs of people in our communities. I firmly believe this would reduce and prevent hospital admissions,” she says. “However, bureaucracy and regulations prevent us from exploring opportunities, not to mention funding.”

Oakminster Healthcare has two intermediate care units that support patients who are discharged from rehabilitation before they go back to their own home, or have a period of assessment before being transferred to more suitable accommodation such as sheltered housing.

But is the government listening to the care sector? “I am a member of Scottish Care, and Scottish Care has become a voice to talk to the government, but so far I haven’t seen any changes, so I don’t know whether they are listening or not,” says Poddar. “It’s important that people who are working in care homes, in social care, are listened to and their views taken on board, hopefully we can bring positive changes to the sector.”

“I never had a dream to be a big businesswoman, the chief executive of a company employing so many people and providing care to so many people,” she concludes. “It wasn’t a plan, it is just my work that has put me here. I still feel that I haven’t done enough, there is so much more I can do. The journey is still ongoing so let’s see where it takes me.”

Outstanding leadership

Beverley Manzar, registered manager at Ebury Court Care Home in Romford, East London, and the National Care Awards ‘Care home manager of the year’ in 2023, shares her experience of what it takes to deliver Outstanding care

Since the Care Quality Commission introduced the top rating of ‘Outstanding’, there have been multiple attempts to define exactly what this looks like in practice. The focus has always been on principles involved in delivering Outstanding care with little consideration of how these translate into practice. It would be fantastic to have an exact definition of Outstanding. However, as there is no blueprint, these are my thoughts based on my experience. Recruitment, training, supporting and retaining staff, ensuring equality and transparency are hugely important but I feel the most important factor is establishing the culture and ethos which sets the tone of the organisation and embodies its values. It is essential that the owner shares these values as they are set from the top, cascade down and resonate throughout. Everyone is an equal part of the team but with different sets of responsibilities.

As registered manager, my job is full of challenges, rewards, angst, frustrations, joy, fun and happiness, but it is also deeply rewarding. I know I can make a difference to residents’ lives, ensuring they are happy and fulfilled, to families, who see their loved one happy and nurtured, to staff who spend a majority of their waking hours at work, as if they are happy and engaged, this will have a positive effect on their family life.

“As

registered manager, my job is full of challenges, rewards, angst, frustrations, joy, fun and happiness, but it is also deeply rewarding."

Staff are our tools to create the service that we want. The example you set matters. When you are around the home, in meetings or conducting supervision, the way in which you treat people will be noticed and emulated, sometimes directly and sometimes by osmosis as it seeps into staff practice. Your way of speaking, your way of behaving, the way you conduct yourself with your staff has a massive effect on staff behaviour, their attitude and performance. So, how do you get the right staff in place and retain them?

You need to assess candidate’s values, experience and their aspirations and the interviewing process should be constructed to get a good feel of them as a person because they will be working in the care home and these values will be pervasive and must accord with the organisation’s values. You could include questions like:

• What are your core values and how do they influence your decision-making?

• How do you define success and how does it align with your values?

• Tell me about a time when you went the extra mile for someone? And why?

• What would a perfect day look like and what values are represented in this choice?

It’s important to have a good understanding of a candidate’s values and feelings about working in care. How staff feel affects every aspect of their behaviour and while difficult to assess, it’s critical because their feelings have a tangible effect on residents and if they

do not share the organisations values, they will be unhappy and unfulfilled. An unhappy member of staff will be disengaged, demoralised and produce an unhappy environment, staff turnover increases, standards drop, and residents are unhappy.

Having selected the right candidate, how to retain them? Always prepare for new staff – they should be welcomed, their uniform ready, and the team should know of their arrival, so the new staff member feels valued and part of a worthwhile team. Ongoing support such as training and supervision is critical – I supervise all my staff monthly as I believe this

Ebury Court

huge investment of time and energy is absolutely worthwhile. I know every member of staff really well and I am best placed to understand them as an individual, plan their development and support them in this process.

How do I construct supervision? At each session, I ask two questions:

Question 1: Give me a sentence about how you feel at this moment? Staff could say they are happy and contented, or not happy. In this way, I know exactly how each member of staff feels and it can reveal things they are unhappy about. It also provides me with a monthly snapshot of how every member of staff feels. Negative staff feelings translate into negative action.

Question 2: Culture and ethos. What is it about the culture and ethos of Ebury Court that makes you want to continue to work here? Staff say we feel listened to, valued, supported, important, and can make a worthwhile contribution and enjoy the continued learning and development.

At the end of supervision, I also ask them to rate themselves on my satisfaction scale of 1 to 10. 1 = I am

very unhappy and 10 = I am very happy. After a short time, new members of staff often rate themselves ‘10’ because this question is not about knowledge and training, it is about how they feel at this particular moment.

Training is of critical importance. If you retain staff, once they have completed basic training, you can then train them at a higher level with no revolving door where you are continually repeating basic training which is demoralising and means your service probably always remain at the same level.

I am a practice teacher and enjoy training my staff. It is really effective as I can use the challenges that current residents present to illustrate how to deal with a variety of situations. I don’t use overheads but include case studies where members of staff role play challenging situations. This has been particularly affective for end-of-life care, for example, breaking bad news. Staff can practise their skills in a safe environment and get constructive feedback. At the end, I present a role play scenario as an example of best practice which enables staff to see the optimum way to manage these challenging situations. My training also enables me to reinforce the organisation’s values and demonstrate

how to deliver high-quality care in an Outstanding home.

Working in partnership with the owner of the business is critical. You must have a shared vision to deliver the highest quality of care. The owner must support new ideas and innovations thus improving the service. I introduced two innovations at Ebury Court which would be impossible without the full commitment of the owner.

Namaste Care for residents with end stage dementia. This programme runs from 10-12pm, 2-4pm, 365 days a year. Audit outcomes evidenced decreased or eradication of urinary tract infections, pain, use of anti-psychotic medication, improved quality of life and improved staff and relatives experience. My paper was published in American Journal of Alzheimer’s Disease & Other Dementias (October 2015).

The Lavender Club, for those with no or mild-to-moderate dementia, fun, meaningful activities in the form of a club, 10-12pm, 2-4pm and 7-9pm. The results are extremely successful –residents are engaged, reduction in falls, sleep patterns improved as residents are engaged and quality of life for attendees has measurably improved.

Working with the owner, we have a shared vision and are committed to retaining our Outstanding rating. If you care, staff care, which means the residents receive the very best of care which, after all, is what we are all here to do. You must really want to be the best and provide the best.

Beverley Manzar is speaking at the Care Management Show, which takes place on 29-30 November at London’s Excel. Use the QR code to find out more.

Managers guide to… temperature control

Care homes must maintain compliant temperatures as part of safety compliance. Kirstie Jones, head of client services and environmental health expert at Navitas Safety, shares advice on effective temperature monitoring

Acritical aspect of safety compliance in care homes is maintaining temperatures, whether in relation to rooms, baths and basins, medicine storage or food. Failures can lead to illness or, even worse, can be fatal in the elderly or people who are immunocompromised, which is why the Care Quality Commission places significant importance on temperature control during its inspections.

Unfortunately, a number of care homes have come under fire for unsafe working practices in this area. Earlier this year, a Huddersfield care home was forced to take action after inspectors discovered high-risk food, including dairy, stored above 8°C, and meat with ‘freezer burn’.

In addition, fridge temperature records indicated that fridges had been running above the legal temperature for at least three months, with “no records to show that any corrective action had been taken”.

1. The Food Standards Agency has clear guidance on temperature management, stating that fridges should be kept at 5°C or below. Specifically, for food business operators in England, Wales and Northern Ireland, it is a legal requirement to store cold foods below 8°C. A freezer should operate at -18°C or below. The same rules apply to Scotland.

2. In care homes, there should be daily temperature monitoring for freezers and fridges that store either food or certain medicines. This should be completed at least twice a day using a calibrated digital thermometer with clear records of when this has been done, and by which member of staff.

3. High-risk foods must be cooked to above 75°C or held hot above 63°C. Cooked foods should be cooled to room temperature within 90 minutes

before being put into the fridge to continue cooling. Ideally, a blast chiller should be used as this cools food rapidly to below 5°C within 90 minutes under a more controlled environment. It’s also recommended not to overfill fridges as this stops adequate airflow, which can affect operating temperatures.

4. In the event that a fridge is accidentally left open or switched off, it’s important to check the temperature of the food affected and to know how long ago the issue occurred. If the temperature is below 8°C, food can be retained. The rule of thumb is that anything held above 8°C for more than two hours should be disposed of. If it has been less than two hours you could relocate it to another fridge.

While this may seem strict, bacterial growth can increase rapidly outside the safe range – so it’s always best to err on the side of caution to avoid any foodborne illnesses.

Regardless of the findings and the actions taken, it’s important to note that corrective actions must be taken immediately and everything must be recorded as evidence.

5. Check whether residents’ medicines need to be stored in a fridge, or whether they can be kept at room temperature. If medicines are being stored at room temperature, it must be below 25°C.

6. Smart sensors in fridges and freezers can remove the need for manual checks.

7. Temperature control is also relevant in bedrooms and common areas. Hypothermia is a serious issue which can develop in older people, even if they aren’t exposed to cold weather for long. The risk of hypothermia led to national headlines for a Shropshire-

based care home (now closed), where care home residents were ‘knowingly’ left without heating for 72 hours.

8. In a care setting, water temperature is also important to prevent colds, but also possibly scalding if not managed correctly. While the stored water tank temperature should be above 60°C, for a bath to be considered safe for elderly residents, it should be less than 44°C at the outlet. Showers and wash basins should ideally be no more than 40°C.

9. Temperature control should be included within monthly spot checks and twice-yearly internal audits. By doing so, care homes can ensure they are inspection-ready by picking up on issues as soon as they arise. Don't be afraid to write problems down –it shows you are aware of them and demonstrates that you understand corrective actions are required.

10. A number of settings have been in the news for a lack of incident management. Staff shouldn’t just be reporting accidents that result in harm. Near misses are as important, but often swept aside due to their less serious nature (as they don’t result in any physical injury or harm).

Kirstie Jones

Employee of the month

Maks Parulov, Renaissance Care’s peripatetic chef for the North of Scotland, shares his experience of providing a great dining experience for residents

Tell us about your background in catering?

I began my culinary career at HRC Culinary Academy in my home country of Bulgaria, before I travelled around the world, working in various hospitality and foodservice settings. I worked in Italy, France and the United States, alongside some of the best chefs in the world. Looking for a new challenge, I moved to Scotland in 2020 and joined Renaissance Care as head chef at Cowdray Club Care Home in Aberdeen. This year I was promoted to peripatetic chef for the north of Scotland, where I support the catering departments across eight different homes to deliver high-quality catering and dining service through advanced training and a range of development sessions.

What’s special about working at Renaissance Care?

Before working for Renaissance Care, I – like many people – thought care home catering would be quite limited and there wouldn’t be much scope for creativity or trying new things. I couldn’t have been more wrong. I have the opportunity to use my creativity every day and inspire the catering teams across the North to experiment with new flavours and cuisines, much to our residents’ delight. Receiving positive feedback from the residents on new dishes or menus we create is undoubtedly my favourite thing about the job.

How do you vary your menu to provide choice for residents?

At Renaissance Care we create four menu cycles a year, according to the season and the produce that is readily available at that time. We love to engage with the residents, and regularly organise tasting sessions within the homes, so they have a chance to try new dishes and we can gather their feedback before we put them on the menu. It’s really important that the dishes on the menu feature foods they love to eat, increasing the likelihood that they’ll eat what we

prepare and in turn, benefit from the nutritional value.

How do you meet residents’ nutritional and health needs?

Creating and providing seasonal, nutritionally balanced meals is key to resident wellbeing and is an area of expertise at Renaissance Care. It’s vital that our menus are of nutritional value but also appealing and will satisfy individual needs. We can cater any meal to suit dietary requirements and health conditions, as well as cultural and religious beliefs.

How do you care for residents with dementia?

We understand that many residents with dementia often have issues with eating and drinking. Memory loss means they can struggle to recognise food, while also suffering from a decreased sense of smell and taste. This can really diminish the enjoyment of food, which plays such a significant role in our lives. We make a conscious effort to create dishes that stimulate as many senses as possible, with food that looks, smells and sounds appealing. It’s equally as important that we focus on food that our residents want and can easily eat. Taking all of this into account, we also create ‘show plates’ to show residents what their food will look like in advance, and to tempt them into eating.

What’s your most popular dish?

One of our most popular dishes is definitely the Balmoral chicken. A delicious traditional Scottish dish, named after Balmoral Castle in Aberdeenshire, the chicken is stuffed with haggis and served with lashings of creamy whisky sauce.

What’s your favourite dish?

As a chef, I spend most of my day in the kitchen preparing meals for the residents before I go home and do the same for my family. There are so many dishes that I love to cook, but one of my favourites has to be a roasted leg of lamb, with baby potatoes, honey roasted root vegetables, and salsa verde.

How do you make the dining experience special for residents and their families?

I love using my skills and knowledge from the hospitality industry to add some excitement to our residents’ dining experiences. Mealtimes are a really important part of their daily routine, as for those who don’t see their family often, it’s a chance to socialise with other residents. This interaction is crucial for building a sense of community in the homes, and encouraging residents to fully enjoy their meals, increasing their nutritional intake and overall wellbeing.

Maks Parulov

The Ontex Care Hero is…

Charlie Keane takes home the second of the runner-up certificates for this year’s Ontex Care Heroes Award, along with a £250 Love2Shop voucher

There are thousands of people working in UK care homes who make a real difference, whether it’s behind the scenes in the laundry room, preparing meals in the kitchen or providing direct personal care for the residents. The Ontex Care Heroes Award seeks out and recognises those who go beyond the job description.

Whether it’s the gardener who brings residents their favourite biscuits or a housekeeper who helps residents to rediscover their hobbies, the award is designed to shine a spotlight on those who bring a little bit of extra joy into the care world.

“We’re excited to again sponsor Care Heroes,” said Ontex marketing manager Nicole Fenton. “It was tricky selecting the winners due to the many worthy nominations submitted. Our winners really have gone above and beyond in the workplace, so it’s lovely that they are recognised by their colleagues, residents or family members who have nominated them.”

For this year’s Care Heroes Award, Caring Times invited three runners-up and the overall winner on stage at the Care Managers Show at the National Exhibition Centre in Birmingham at the end of June to receive their certificates and prizes.

The winner and runners-up were selected after what was the most competitive Care Heroes nominations process yet.

“His passion for the residents is obvious and he is always looking at new ways and activities to not only engage our residents but to make them smile and laugh."

As well as receiving their certificates, each of this year’s Care Heroes was awarded a Love2Shop voucher – £250 for runners-up and £500 for the overall winner.

Over the coming months, we will be spotlighting each of the runners-up and, lastly, the winner with a page in the magazine.

Our second runner-up is Charlie Keane, therapy assistant at Oakleaf Care. Here’s what his colleague had to say about his admirable dedication to his role: “Charlie works at Oakleaf as a therapy assistant after progressing into this role from a support worker. His passion for the residents is obvious and he is always looking at new ways and activities to not only engage our residents but to make them smile and laugh.

“Off the back of resident feedback that they would like to see pictures of the local area hung up in the communal areas, he took it upon himself to set up a photography session using his own professional camera. This involved him taking the residents out into our grounds and surrounding areas and assisting them in taking photographs

of their choosing, which were later printed out to be hung up on the unit. Not only was this a wonderful and meaningful activity to those residents, but the photos were so great that it allowed us the opportunity to use them in the redesign of our welcome packs.

“Charlie has also been able to build a strong relationship with one of our residents who doesn’t really engage with other staff by tapping into that resident’s sense of humour. After witnessing one of their encounters together, it is obvious to see how much the resident enjoys the banter they both have together, and it’s wonderful to see that Charlie has been able to take the time to really understand the resident and what is important to him. I have no doubt that he does this with all the residents in our care.”

Congratulations to Charlie Keane, as well as the winner and other runners-up in this year’s Care Heroes Awards, in partnership with Ontex.

Charlie Keane

Nine words

Regular columnist Norrms McNamara reflects on what it’s like to live with dementia

So, what are you going to do about it?”

Nine words, that’s all, but they can mean so much to some, and not to others. My passion for helping those with dementia came from those very nine words, and here’s why.

When I was first diagnosed, the only thing my consultant said to me was to “use it or lose it”. We were given no paperwork or forward appointment date, and walked out totally bemused. As luck would have it, if you can call it that, my wife was a full-time carer and knew what to do next, but so many out there don’t.

What we did was enquire, ring around, and look on the internet to find out what help was available and in what form. Sadly, there was very little at the time, over 10 years ago, so the next step was to look for an upcoming meeting regarding dementia and attend it, just to test the water.

I have to say, I was horrified at what I found and heard. I will not name the conference, nor the organiser, but it was without doubt the most depressing thing I had ever attended – so very sad in so many ways. All we heard about were parts of the system that weren’t working, what treatments hadn’t worked and horrific stories about those with dementia and their carers.

The speakers were very good at explaining what dementia was and how it worked, and there were lots of stats

and slides – or ‘death by slides’ as we later coined it – but the thing that most concerned me was there was nothing positive coming from this, and no mention of future plans. So, me being me, I bided my time until they asked for questions and my hand shot up. When it was my turn, I politely repeated some of what we had heard – how this doesn’t work or that doesn’t work – then I asked the ‘expert panel’ those nine words: “So, what are you going to do about it?”

You could have heard a pin drop. There were audible gasps from the audience, and admittedly a couple of sniggers, but more amazingly it made people physically sit up and wait for and answer.

First of all, the panel was very quiet. They each had puzzled looks on their faces that said: Who the hell is this person and how dare he ask such a question? When I explained I was a person living with dementia, just

recently diagnosed, they also had a look that said: What’s he doing here? In those days people with dementia were not invited to attend or speak at dementia conferences.

The panel spluttered responses about lack of funding or how much the government had allegedly spent on helping and we came away totally frustrated and felt so very let down.

So, what did we do about it? I say ‘we’ and not ‘I’ because so many people came together to help. We created a local group called the Torbay Dementia Action Alliance from my bedroom, which turned into the Purple Angel Dementia Campaign, now a global movement recognised in over 60 countries, with an annual World Rocks Against Dementia event every September. Now in its 11th year, we have advised on TV programmes regarding dementia, opened the very first memory café in Nigeria, been covered by CNN, helped open one of the first memory cafés in the US, had lunch in Downing Street with a certain prime minister, met him three times since, and asked him those very same nine words and so much more.

So, the next time you go to a conference or hear about how bad things are, please feel free to ask: “So, what are you going to do about it?” You never know what might happen.

Till next time…

Norrms is diagnosed with Lewy bodies dementia.

Norrms McNamara