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Staff / recruitment... Property marketplace... Innovation... Expert analysis...
What the tech? We’ve seen the future and it works Lessons learnt – what has the pandemic taught us? January 2021
The 2020 Care Awards – recognising a year of resilience Regulation issues – how to deal with a ‘letter of intent’
Social care business management
OUR BEST SHOT – WHAT VACCINATION MEANS FOR THE CARE SECTOR
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January 2021
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What’s in the post?
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How to deal with a ‘letter of intent’ from the CQC
The 22nd National Care Awards 2020
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Meet the winners!
Technology and care
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How managers and staff are using the best of tech to deliver the best of care
Light at the end of the tunnel?
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Will mass vaccination solve the care sector’s Covid woes?
Learning the lessons
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Practical steps to better infection control
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Banning care worker movement “short-sighted and self-defeating”
Care leaders have hit out at government plans to limit the movement of care workers as “disproportionate and unjustified”. A consultation has been launched to seek the views of the adult social care sector in relation to the introduction of regulations that create a requirement on residential and nursing care home providers in England to restrict the movement of staff providing personal care or nursing care in their services. Professor Martin Green, chief executive of Care England, said: “We are at a loss to Editorial & advertising: Investor Publishing Ltd, 1st Floor, Greener House, 66-68 Haymarket, London, SW1Y 4RF Tel: 020 7104 2000 • Fax: 020 7451 7051 Website: careinfo.org Subscription rate, zero-rated for VAT: £70.00 if paying by credit card or invoice £63.00 if paying by Direct Debit (UK only). Add £20.00 mailing charge for Europe Add £30.00 mailing charge for Worldwide Subscription enquiries to: Email: subscriptions@investorpublishing.co.uk Tel: 020 7104 2000 Post: Investor Publishing Ltd 1st floor Greener House, 66-68 Haymarket, London SW1Y 4RF Editor: Rob Munro – 033 0052 6193 rob.munro@investorpublishing.co.uk Art editor: Rob Wheele Editor-in-chief: Dr Richard Hawkins Subeditor: Charles Wheeldon Managing director: Vernon Baxter
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Caring Times is published eleven times a year by Investor Publishing Ltd. ISSN 0953-4873 Average net circulation of 9,032 (July 2018 – June 2019) © HAV 2018 Ltd 2021 Deadlines for February issue: Display advert. space booking: January 8 Display advertising copy: January 14 Product news copy: January 8 Editorial copy: January 8 The views expressed in Caring Times are not necessarily those of the editor or publishers. Caring Times™ and the CT® logo are registered trademarks of HAV 2018 Limited
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understand why if these measures are to be introduced across adult social care settings, the movement of NHS staff between NHS settings is not being subjected to the same regulation. The difference in the treatment of the adult social care sector and the NHS seems to be disproportionate and unjustified.” Care England’s response to the consultation makes the following points:
The implementation of the regulation is likely to create specific risks in specialised services, for example those supporting individuals with learning disabilities and/or autism. n There will be a significant impact on low-paid staff. n There will likely be a consequence on staff mental health and levels of fatigue. n A greater degree of clarity is required around what role CQC will play in this policy. A consistent and proportionate approach is necessary. Professor Martin Green, chief executive of Care England n It is worrying that these regulations will converge proposal “short-sighted and selfwith the UK’s departure from the defeating”. European Union. The failure of the “Banning the movement of care home Immigration Act to appropriately workers targets individuals who have support the adult social care sector will little power of influence caused by zeroadversely affect the sector. n The Infection Control Fund [ICF] is hours contracts and a low income. We simply not enough to cover believe the enforcement of this policy will compensating both staff and other mean affected care home workers stand to employers when a member of staff is lose a substantial portion of their income. asked only to work for one employer. Care home residents will be impacted by this policy too. A departure of care home staff will leave residents without quality Others have raised concern that care care. Residents have persevered during workers will be financially worse off the pandemic and a departure of care staff under the proposals. who have remained constant in their lives An open letter to ministers drafted by will be of detriment to their health and the Care Workers’ Charity and signed by wellbeing,” says the letter. a group of industry leaders called the n
Keeping Everyone Smiling NO MATTER WHAT LIFE THROWS AT US Offering the best in residential and dementia care in beautiful surroundings, our approach is to nurture an atmosphere of care and community, all delivered in a quality lifestyle. Your well-being is our primary concern, and we will ensure you have the best support for your mind, body and soul, tailored to you.
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HC-One homes to pilot DHSC visiting scheme Three of HC-One’s care homes are taking part in the Department of Health and Social Care’s pilot to give Residents’ loved one's access to regular testing. This will enable more meaningful visits, with Residents and their loved ones being able to hug each other after such a long time. Roseland Court Care Home in Truro, Gittisham, Hill House Care Home in Honiton and Bereweeke Court Care Home in Winchester are three of around twenty residential care homes across England to be included in the visitor testing trial across three English counties - Hampshire, Cornwall and Devon. Through the pilot a designated visitor is given regular access to testing. The
testing of visitors, alongside other infection control measures in place, including wearing personal protective equipment will enable, where possible and safe to do so, indoor visits without a screen to take place between residents and their loved ones, as well as physical contact. There are currently two different types of visitor testing being trialled across the care homes participating in the pilot: the Lateral Flow Test (LFT) and the PCR Test. Roseland Court Care Home and Gittisham Hill House Care Home are trialling the LFTs, which provides a result within a swift 30-minute timeframe.
Bereweeke Court Care Home is piloting the PCR Tests, which is a test where the visitor takes a swab sample before visiting the care home and receives their test result back within a few days. Once the visitor receives confirmation of a negative result, they can visit their loved one in the care home. Liz Whyte, director of standards and Covid-19 lead at HC-One, said: “We are delighted to be involved in the Department of Health and Social Care’s pilot for testing care home visitors. This is an exciting and very welcome step. We have seen first-hand how much of a difference that testing Residents and Colleagues made to our response to Covid-19, and we are very pleased that testing is now being extended to care home visitors through this pilot.”
Frogmore raises funding for second London luxury dementia home
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Frogmore, the UK-focused real estate investment manager has borrowed £26.3 million to develop a 35-bedroom specialist dementia care home situated at 74-76 Prince's Square in the City of Westminster. It is the second in a portfolio of four specialist care homes that Frogmore is developing alongside specialist operator – Loveday. The first of the care homes, Chelsea Court Place, is open, fully operational, and currently at 100% capacity with a waitlist. Frogmore has two additional care homes in the pipeline – both in central London. As well as offering luxury facilities such as a cinema and library room, a spa and a private dining room, all the homes will have significantly more staff per member (resident) than is the norm in the industry. Commenting on the transaction, Andy Rogers, chief operating officer and group treasurer at Frogmore said: “Over the last 15 years, the percentage of people diagnosed with dementia in Westminster has increased by 32%, yet despite this, the borough has the second lowest number of registered beds for dementia, with
only three beds for every 100 patients.” Damien Hughes, senior property finance director at OakNorth bank that provided the capital, said: “We’ve now worked with the team at Frogmore on several projects and despite care homes being a new area for the business, it has already proven with its first site in
Chelsea Court Place, that it has a clear understanding of what members and their families are looking for. Frogmore’s chosen partner for this portfolio, Loveday, has enviable experience in this area, and together, they’re building a strong portfolio offering invaluable support to those they care for.”
Charity care home bond offer oversubscribed The charity bond offer for Greensleeves Homes Trust has closed early and oversubscribed despite the particularly challenging period for the care home sector. The offer of 5% bonds due 2030, from special purpose issuer Retail Charity Bonds PLC, was launched on 23 November 2020 and closed early at 12 noon on 3 December 2020. £15 million of the bonds have been sold to investors, while a further £10 million will be retained and may be sold at a later date to raise additional funding for the Charity as required. This will be the tenth successful issue of bonds through the Retail Charity Bonds platform since it was launched in 2014, taking the total issued through the platform to date to over £300 million. Allia C&C was the lead manager for the bond issue. Commenting on the success of the offer, Paul Newman, chief executive of Greensleeves Homes Trust, said: "This a great result for Greensleeves Care and strong recognition by the investor community in our business case which is based around providing the best quality of care we can to our many residents across the country. The funds raised will support us in delivering on our strategic ambitions of further expanding and modernising the care and support we offer for the benefit of all our stakeholders, but most importantly our residents, their families and our staff.”
Together, our amazing teams, residents, friends and families deliver the award winning care that Care UK is known for. Every one of us in the Care UK community makes a difference by supporting residents and each other through the challenges of the moment. Our combined passion and understanding brings meaning and fulfilment to thousands of lives every day; it’s at the heart of everything we do. Experts in award winning care. Trusted by over 6,500 families.
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“Bumper year” for senior housing investment and growth 2020 was a record year for investment into the UK’s senior housing sector – according to new research by global property consultancy Knight Frank. Using data from the firm’s in-house deal tracker, Knight Frank forecasts that a total £1.5 billion will have been invested into the senior housing sector by the end of the year. Tom Scaife, head of seniors housing at Knight Frank, said: “There is now a clear and extensive range of tenures and offerings available, providing a variety of services and amenities to suit a range of needs, demographics and price points. The investment case remains an extremely compelling one, with the market being driven by demographic changes, seniors’ property wealth, and a weight of capital seeking diversification. “With so much activity taking place in the senior housing sector this year, it’s no wonder we’ve witnessed a bumper year for investment.” Further research by Knight Frank has found that while ‘Retirement Housing’ pricing largely tracks average house prices for residential property in England and Wales, ‘Housing with Care’ is outperforming it. According to Knight
Frank, ‘Housing with Care’ property prices increased on average by 20% over the last five years. Michael Voges, executive director of ARCO, backed up the findings, saying its members “…have reported a sharp increase in demand for Retirement Communities – particularly in the midmarket. “This trend only accelerated during the coronavirus crisis as more older people have sought good quality housing, support, the security of access to care if they need it, and to be closer to community. We are seeing increasing interest in our sector across the board – politically, from new operators entering the market, from investors and from older people’s advocates. We are confident that if the Government implements much needed reforms we will see very significant increases in supply in the coming years.” Lauren Harwood, head of seniors housing research at Knight Frank, predicted the market would continue to heat up. “In the next five years, we expect to see a race to scale and brand building from some of the early movers to create
Tom Scaife, head of seniors housing at Knight Frank
management platforms with operational efficiencies. Accordingly, we expect the number of specialist seniors housing units across the UK to grow by approx. 10% over this time,” she said. In absolute terms, this will take the total number of seniors housing units in the UK to more than 800,000 by 2024, up from around 735,000 currently. Despite this growth, there remains a significant supply and demand imbalance – one which puts the UK far behind peer countries, says Knight Frank. Compared to the penetration rates in Australia (5%), New Zealand (5.5%) and the United States (6%), the UK’s penetration rate in the Housing with Market stands at just 0.82%. Knight Frank predicts that for the UK to catch up with its peers in delivering much needed seniors housing, at least, 400,000 additional Housing with Care units need to be delivered.
Charities launch campaign to celebrate care workers
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The Care Workers’ Charity (CWC) and three other charities are launching a joint campaign to shine a light on the inspirational people making up the UK’s two million care workers, looking after some of the most vulnerable people in our society. The CWC, Institute of Healthcare Management (IHM), the National Care Foundation (NCF) and Thank and Praise (TAP) are jointly backing the campaign to make the public more aware of the importance of care workers, and in doing so, improve workforce wellbeing across the social care sector. According to the CWC’s Wellbeing Report (2019), 51% of care workers have considered leaving their role in the past
three years because of the effect of the job on their mental health and 80% of care workers said that they have not had formal training on managing mental wellbeing at work and 68% of care workers said they were interested in such a service. The campaign is designed to demonstrate how critical care workers are to society, alongside their colleagues at the NHS, and encourage the public to show their appreciation by posting messages on TAP’s thanking platform, as well as gaining much needed donations for the CWC. “Care workers across the country have been going above and beyond to deliver the best support that they can give, even
Karolina Gerlich, CEO of CWC
with issues with PPE and testing, while making personal sacrifices,” agreed Karolina Gerlich, CEO of CWC. Vic Rayner, CEO of the, said: “Our incredible social care workers have been out there each and every minute of each and every day providing care and support in people’s own homes, in supported living settings, in extra care housing, in care homes and in day centres,” n
Campaign hashtag: #ThanksForCareWorkers
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Providers call for patience on care home visits
Care providers have asked the public to be patient over the reintroduction of visiting to care and nursing homes. The Independent Care Group (ICG) made its appeal after ministers announced arrangements for care and nursing home residents to resume having in-home visits and for younger residents to visit loved ones themselves over Christmas. The ICG warned that new systems would take time to introduce as the Government rolls out testing kits to thousands of homes across the country. ICG Chair Mike Padgham said: “Yesterday’s news was excellent for all those families who have been apart from their loved ones for too long and every care and nursing home across the country will do its utmost to meet the arrangements the Government has announced.
“But this is going to be a huge undertaking and we appeal to families to be patient with their loved ones’ homes as they try to resume visiting as soon as they can. “It is going to take time for the tests to reach all homes and then for staff to be trained up in the procedures needed to test relatives and then have them come into homes to see their family and friends. “The public have shown amazing patience so far and we just appeal to them now to show a little more whilst we prepare for these long-awaited visits.” Professor Martin Green, chief executive of Care England, called on the government “to recognise the intricate balance between well-being and
Kingsley Healthcare opens new £12m luxury care home
Kingsley Healthcare has opened a £12m care home that will generate more than 100 jobs in Brackley. The home, in Wellington Road, has 66 modern en-suite bedrooms, a cinema room, library, café, hairdressing salon, quiet lounges and conservatory; attractive outside spaces include a sensory garden. Its contemporary design is the work of award-winning Leamington Spa-based Rickett Architects. South Northamptonshire MP Andrea Leadsom and the Mayor of Brackley, Cllr Christopher Cartmell, were given VIP tours ahead of the first resident’s arrival – and both said how impressed they were with the home’s facilities and decor. Other guests of honour included Emma McGowan, alumni and community relations manager at Winchester House
school, who runs the Brackley Community Dementia Friendly Choir. The home’s dementia unit has been named the McGowan Suite, honouring her valuable community work through the choir. Pupils from the school have presented the home with a colourful piece of artwork which will take pride of place in the Maypole Café, a relaxed meeting place for families near the front entrance. Home manager Sheena Croston said: “I am thrilled by the positive feedback I have had from everyone who has visited the home. “Once Covid has gone away, we will be eager to build even stronger relationships with local groups and organisations and invite them into the home. It is important for us and our future residents that the home becomes a central part of the community.”
safeguarding” when it comes to allowing care home visits in conjunction with testing. “Although the new testing regime is extremely welcome we need to face facts that it will be a while until it is entrenched and also needs to operate as part of a raft of other infection control measures,” he said.
Exemplar to open Birmingham specialist care home Exemplar Health Care, a provider of specialist nursing care for adults living with complex needs, is investing £4.9 million to open its third care home in Birmingham, in May 2021. Blackmoor will be Exemplar Health Care’s third home in Birmingham and its fifth specialist care home for the West Midlands region. The home will support 30 adults who need specialist nursing care and are living with a complex physical disability or mental health condition. Charlotte Loyd, commissioning director at Exemplar Health Care, said: “It is extremely rewarding to be able to support 30 local people with complex health needs, and to provide over 100 stable and local jobs. As well as providing employment opportunities, there are plans in place to help Blackmoor become part of the local community. It’s our ambition for Blackmoor to be a place where we host community events, and where our residents can be part of the community, whether through work placements, local events or volunteering.”
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Vaccination programme will be “marathon, not sprint”
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Healthcare leaders have warned that implementation of a national vaccination programme will take considerable time and the UK is “not out of the woods yet”. Responding to the news that Pfizer’s Covid-19 vaccine has been approved by the MHRA for use in the UK, Danny Mortimer, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said: “This is the starting klaxon for people readying to deliver the vaccine. What’s ahead will be a marathon and not a sprint, with many months ahead to vaccinate everyone who needs it. This welcome news, however, does not mean that we are immediately out of the woods. Mortimer warned that more clarity was needed from the government on the details of how the programme will be rolled out. “Our already-stretched NHS faces a monumental effort now to roll-out the vaccine quickly and effectively. Our members across the NHS have already done a great deal of planning for this moment but there are still questions to be ironed out quickly and support needed to ensure the process works as well as we
need it to. We need to see effective coordination at national, regional and local levels and support with logistics and the appropriate technology to ensure we are recording who has been vaccinated in the correct way.
He added that it was vital that health and social care staff were among the first to receive the vaccine. “We now need to see more detail, including about the priority groups to receive the vaccine and it is important to see health and social care staff among them,” he said.
Call for care rewards Care leaders have appealed for a comprehensive strategy for rewarding adult social care workers in England. The move follows the Scottish government's recent announcement of a one-off payment of £500 for Scotland’s health and care staff. Whilst the Welsh Government previously pledged to pay care workers in July. In its letter to the Secretary of State for Health and Social Care, Care England outlined that it was both willing and able to work with the Government to craft such solutions in the coming weeks and months. Professor Martin Green OBE, chief executive of Care England, said: "The Prime Minister and others in the Government have frequently paid tribute to care workers, who have been at the front line of the UK's response to the COVID-19 pandemic. Therefore, this week, we wrote to the Secretary of State to urge him to engage with the important issue of rewarding the adult social care workforce. This is interlinked with the need for the Government to fund the recent increases in the National Living Wage. "The need to reward social care workers is accentuated when we consider the Chancellor's recent pledge to increase the pay of NHS nurses. A failure to reward the adult social care workforce will only further the perception that social care is the poor relation of the NHS. Whilst any such strategy should reward both care and auxiliary staff alike as both are fundamental to care services."
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Thinking out of the box
A Borders care home has created personalised hobby boxes for its residents, enabling them to continue to enjoy their favourite activities while adhering with social distancing measures. After residents of Mansfield Care’s Galahill House in Galashiels could no longer use communal areas following COVID-19 restrictions, staff had the creative idea to organise individual activity boxes for each resident to enjoy in their rooms. The care home’s staff have created personalised activity boxes for its 20 residents, filled with hobbies each resident enjoys, such as knitting needles, CD’s and DVD’s, crosswords and magazines. Tracy McGeown, Activities Coordinator at Galahill House, said: “After restrictions were introduced to keep our residents safe, we had to adapt
to new ways to ensure everyone is cared for and kept entertained and socialised. “We came up with the idea of a personalised activity box which are catered to everyone’s different interests. The boxes stay in our residents’ rooms so they can enjoy them whenever they want, and are updated regularly. “As well as being entertaining, we’ve included activities in the boxes for cognitive and sensory engagement. For example, one of our residents used to be a farmer and likes to read a particular farmer’s magazine which he gets from his friend, we ensure he receives every new edition of the magazine in his activity box. “Another of our residents adores playing dominoes, so our care staff regularly take time to play with him. This ensures he’s still playing the game he loves every day, but he’s also minimising contact with other residents.”
All that jazz!
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Residents at a care home have been treated to an exclusive digital concert by one of Scotland’s most exciting jazz stars, Georgia Cécile. Georgia, with her boyfriend and jazz pianist Fraser Urquhart, prerecorded a 30 minute performance of her favourite songs specifically for customers of Blackwood’s Broom Court Fraser Urquhart and Georgia Cécile care home in Stirling. The 31-year-old, who was named best vocalist at the Scottish Jazz Awards last year, was eager to get involved with the project when she heard about it through the Edinburgh Jazz and Blues Festival. She said: “It’s been a crazy year for musicians and performers across the world. I really miss performing live so I was thrilled when the opportunity came up to perform virtually for a new audience at Broom Court. “Together, Fraser and I pulled together a set list of some of our favourite tunes and we self-recorded the event from our home. The Edinburgh Jazz and Blues Festival and Blackwood were amazing in working out all of the IT requirements to make sure residents at Broom Court could enjoy the concert.” The Edinburgh Jazz and Blues Festival worked with Georgia and Blackwood to record, create and stream the concert direct to Broom Court care home, which accommodates and cares for residents with a wide range of disabilities.
Ellen with her activity box
Hampshire care home opens botanical lounge A New Forest care home has ‘brought the outside in’ with the launch of a peaceful indoor oasis to support residents’ mental and physical wellbeing. The botanical lounge at Colten Care’s Belmore Lodge in Lymington features an abundance of lush plants in a bright, airy space that will evolve in line with the seasons and residents’ interests in gardening. A living wall and planters contain plant varieties known for being among the best at absorbing carbon dioxide and releasing oxygen into the air. They include dragon trees, spider plants, aspidistras and mother-in-law’s tongue, all helping to create a fresh, therapeutic ambience. Gardeners at the home have added some further seasonal cheer to the greenery through colourful cyclamens, orchids and poinsettias. Belmore Lodge home manager Julie House said: “It’s widely acknowledged that plants are good for you. Gardening and engaging with the natural world is a positive and therapeutic activity that improves both mental and physical wellbeing. This botanical room is a quiet, serene space well away from any screens or commotion, somewhere you can experience a fresh-air feeling all year round.”
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New Altro wood adhesive-free is homely and hassle free Solution for Gloucester nursing home ew Altro Wood™ adhesivefree is providing Coate Water Care’s Woodstock Nursing Home in Gloucester with homely flooring for bedrooms and en suites, was quick to fit and caused minimal disruption. Altro Wood adhesive-free is a safety wood-look floor with easy cleanability; perfect for decorative, homely or biophilic areas. The range has been created with design freedom in mind Altro Wood adhesive-free shares some designs with Altro Wood Comfort and Altro Wood, allowing you to coordinate floors with different performance criteria across different areas of the building. Nursing Home Manager, Trudy Glassonbury, says: “Our previous flooring was getting very tatty and needed replacing. We wanted to continue with a wood effect product, as it is stylish, homely, and warm looking. We needed something that would be quick to fit, so that it would cause minimum disruption to residents.
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“C&C Flooring, who we have worked floors to use Altro’s with for many years, recommended the innovative new Altro Wood adhesive-free product, underside emboss because it could go down on top of the structure, which existing flooring and would take a provides 14dB impact sound reduction fraction of the time to install compared and comfort underfoot. It has 12 woodwith an adhered product. look designs, enabling you to create “This was ideal for us, as we could fit it biophilic, stylish, or warm and homely in the five bedrooms and en suites we aesthetics together with the safety and were refurbishing without prolonged durability needed for medium to high disruption to residents. It took far less traffic areas. time than an adhered flooring would have With a 10-year guarantee and Altro’s taken. There was no need to remove the one in a million slip-resistance old flooring, or put down a screed, or reassurance, Altro Wood adhesive-free drying time. It was so professional and offers high levels of comfort underfoot fast. Plus of course there were no adhesive providing a safe, durable and decorative smells, which in a care home setting with solution for busy spaces. Robust enough vulnerable residents is a very important to withstand rigorous and frequent consideration.” cleaning, like all Altro floors, Altro Wood Using Altro’s award-winning adhesiveadhesive-free can be steam cleaned free installation method, you can halve thousands of times without damage. It is installation time compared with a ideal for public-facing areas, where it will traditional adhered installation. continue to make a great first impression and support the wellbeing of users for Depending on substrate condition, a the lifetime of the product. 200m2 corridor would be laid in two days Trudy says: “We are delighted with our compared with four days with an adhered new flooring; it looks lovely, has superb floor covering, with a significant cost safety credentials, is very easy to clean saving too. and the entire installation process was With no DPM and no adhesive required, completely hassle free.” floors can be welded and walked on the same day. Adhesive-free floors are ideal for busy public spaces Altro has been at the forefront of innovation for over where disruption needs to be 100 years. Today, working closely with architects, end minimal, plus there are no customers, engineers, designers and contractors associated adhesive odours. And around the world, our insight and expertise help them at the end of their life, they can transform everyday spaces into environments that can be re-used elsewhere or recycled. improve the wellbeing of everyone that uses them. The new Altro Wood www.altro.co.uk adhesive-free range was the first
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legal landscape
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he CQC’s Transitional Monitoring Approach has seen the CQC move away from timetabled inspections to inspection activity being carried out when there is perceived risk. Providers are coming to the CQC’s attention through a variety of ways and the CQC is using intelligence to determine what, if any action, is required. Services of potential concern will trigger the CQC to look further. One effect of this new approach is the increased use of the CQC issuing ‘Letters of Intent’. The letter is issued to a provider indicating that the CQC intends to take urgent enforcement action unless the provider can provide assurance that such action is not required. The CQC provides a very short window in which providers can provide an action plan describing the action they have taken, and will take, to mitigate the perceived risk.
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These Letters are a precursor to urgent action being taken. However, the CQC need not give the provider an opportunity to address any concerns. If it so choses, the CQC can take urgent action amending a provider’s registration. The CQC has several options it can take. It can cancel a provider’s registration. Where you are a single location provider, or the CQC wishes to cancel your overarching registration (where you have several locations on your registration) the CQC has to go to a magistrate’s court to do this on an urgent basis. If however, you have several locations on your registration and the CQC wishes to cancel one location’s registration then the CQC can vary your registration by removing a location. It can do this by simply serving a document on you. This is called a Notice of Decision and is served under section 31 of the Health and Social Care Act 2008 (and this is what is often referred to in the above mentioned Letters of Intent). The same process can be used to add conditions to your registration or suspend your registration (regardless of whether you are a single or multiple location registered provider.) A section 31 Notice of Decision is not subject to any outside scrutiny and the decision within the notice takes effect immediately. This, of course, can have devastating consequences. Where this is a cancellation this means that to carry on
Urgent action
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Postman’s knock Did you know the CQC can cancel your registration by issuing you with a piece of paper? Caroline Barker, chief operating officer at Ridouts, explains the impact of a ‘letter of intent’ from the regulator providing a regulated activity with no valid registration means that you are committing an offence which can be prosecuted by the CQC. It also means that service users will have to be removed. Where conditions are imposed, you must comply with them immediately and if you fail to do so, this also constitutes an offence which is prosecutable.
Such action can have knock-on effects. These cases are often high-profile, generating media interest – after all, service users will have to be found new places to live and can often be taken away in ambulances given the urgency. Provider brands can suffer and where one location is removed, the CQC can start inspecting other locations to see whether the same issues occur at your
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legal landscape other services and whether it ought to be taking action elsewhere too. Without successful challenge you will have to declare the cancellation on any further applications to the CQC or tenders with commissioners. However, whilst the decision takes effect immediately this does not mean the end of the road for providers. With a further relatively small investment (in comparison to the loss to the value of a location without registration) the location/provider may be able to regain its registration; its value and future profitability. Providers may appeal to an independent Tribunal called the First Tier (Care Standards) Tribunal. You have 28 days from the date the Decision is served on you to lodge your appeal. Once the appeal is lodged the proceedings are fasttracked, the Tribunal recognising the commercial impact of the Decision, and a hearing should take place within about 10 working days of you submitting your appeal. This is a very short timeframe. It is important that you know and prepare your case thoroughly in the available time. Unlike a proposed cancellation or variation to your registration, which means there are usually between 6-9 months between the date of the proposal and the date of the hearing, you do not have the luxury of time to develop your position. From the date the Decision is served on you, you have a maximum of around 42 days until the appeal is heard. However it is also important to remember that despite the short timeframes involved, these cases are dynamic and can develop at fast pace with a need to respond and react to evidence being put forward. Both side are required to make legal submissions, and prepare and submit evidence, including witness statements. You may need to make applications to the judge, and will need to liaise with the CQC. The Tribunal must consider the position of the location/provider at the date it makes its decision – at the hearing date. You will need to demonstrate that whatever the CQC said was the position when it issued the Decision, that it is no longer the case. The CQC have to base their evidence on the legal requirements of the regulations. This means that your representations should do the same, linked to evidence that demonstrates
Regaining registration
either why the CQC’s position is wrong to start with or, why it is wrong now. If urgent action is taken via a magistrate, then a magistrate can only make a cancellation order if it appears to them that unless the order is made, there “will be a serious risk to a person’s life, health or well-being”. If the CQC takes urgent action by issuing a section 31 Decision then it must have reasonable cause to believe that unless it acts “any person will or may be exposed to the risk of harm”. The threshold of the test under section 31 seemingly a lower one which is concerning given the fact it is not subject to external independent oversight. Whilst the burden of proof remains with CQC to prove its case, steps will need to be taken by any provider in these circumstances to satisfy the Tribunal that the will be no risk or serious risk to service users should the appeal be allowed. You might ask whether this is possible when there are no service users residing at the location. Whilst this is, indeed, tougher to do it is not impossible. Ridouts successfully appealed a magistrates’ order cancelling a care home’s registration which had resulted in all the service users being moved out and the home being empty at the date of the final hearing. Sometimes urgent action can come out of the blue and on other occasions there has been a slow build-up over a number of weeks or months of regulatory breaches, poor inspection ratings and warning notices. Whatever the reasons why the Decision arrives, it is important that once that Decision is in your hands that you establish a clear plan. Whilst the initial unfolding hours will be consumed by service users moving, dealing with commissioners and families, and staff members who are concerned for their jobs, the next steps will be to understand what has happened and why it has happened. Establishing the facts first and then understanding the legal basis for the action taken can help inform you about the operational action that you
A clear plan
January 2021
www.careinfo.org
might need to take. Demonstrating that action, and how that addresses the alleged failures to comply with the legislation, will enable you to put forward your strongest position and give you the best possible chance of regaining your registration. Action taken under section 31 is some of the most draconian action that the CQC can take against a provider. We do not believe that it can have been the legislature’s intent to allow the CQC to cancel a location’s registration immediately without external scrutiny, which is the purpose of an application to a magistrate under section 30. However, it is a weapon in its arsenal that the CQC does use. However, it is possible to protect your business following such action. Ridouts successfully brought an appeal to the First-Tier Tribunal when CQC took such action against a provider which stripped it of its registration under section 31. Ridouts believes that this is the only successful appeal against action taken under this section of the legislation. Should you be on the receiving end of such urgent action it is important to take swift but carefully considered action. It can make the difference between keeping your business or not. Should you have any queries in relation to this article, please contact us on 0207 317 0340 or info@ridout-law.com.
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Thank you to our sponsors...
Main sponsor
Christie & Co has been delighted to be involved in the National Care Awards since their inception, 22 years ago. This year more than any, it’s so important to highlight, acknowledge and reward some of the most hard working, dedicated professional people delivering care on the frontline everyday. It is crucial to showcase all that is good in the sector and remind everyone of the commitment and sheer hard work by many people across the UK.
Category sponsors
Hallmark is a family-run care provider that has three ‘Outstanding’ homes. It provides residential, nursing and dementia care to 1,200 residents across 20 locations UK wide and has won 100 awards over the last 23 years.
Court Cavendish is Britain’s leading health and social care turnaround company. We are delighted to be the launch partner for the new Care Champion award, which will recognise the hidden heroes who are passionate about improving their area of specialism to revolutionise the delivery of highquality care. HC-One, the Kind Care Company, is the UK’s leading provider of residential, nursing and dementia care services. HC-One strives to be the first-choice care home in every community for those looking for the very best care, and for Colleagues seeking a long-term career delivering the kindest and highest quality care. Care UK is a leading national provider of residential care for over 6,000 older people. We deliver nursing, end of life and specialist dementia care as well as day and respite care. Our Fulfilling lives approach has seen us achieve some of the strongest regulator ratings in the sector.
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TLC Care provides luxury care and enhanced wellbeing in award-winning homes across North London, Hertfordshire, Surrey and Cambridge. Our expert teams offer personalised residential, nursing, dementia and respite care, designed to provide each resident with the support they need to live a fulfilling and active life. Compass Associates are a multi-award-winning recruitment business, with a market-leading track record in the elderly care sector. With Consultants aligned to cover the entire UK with dedicated geographical remits, the team have delivered more than 1,500 care home management placements since the business was established in 2009. Find out more by visiting www.compassltd.co.uk
carehome.co.uk is the UK’s most popular care home sector website with over 16 million visitors each year. Listing over 17,500 care homes and providing access to over 180,000 reviews it is a valuable resource for care seekers in helping them make an informed decision when selecting the perfect care home for loved ones. carehome.co.uk is committed to helping care homes face the challenge of COVID-19 by fast tracking new supportive functionality including virtual tours and real-time COVID-19 update announcements. Through their 24 years’ experience Lifetime Training have grown and developed to become the UK’s leading training provider for Care, helping over 5,000 learners a year to reach their career goals with the highest quality apprenticeship courses across the sector including in domiciliary, learning disability, dementia and residential care. Avery Healthcare provides high-quality residential, dementia, nursing, and respite care throughout its 57 care homes in England. Set in purpose-built, high quality communities, Avery differentiates by combining first class care with hotel-standard services, enhanced by a sector-leading Well-being programme that supports resident independence with an active fulfilling lifestyle. It is an employer of choice for the care sector, with an award-winning training and development division delivering proven career pathways for all staff. Established in 2009 Domus Recruitment are Social Care Recruitment Specialists focusing on Middle Management to Senior Board Level appointments. Our industry specific focus allows us to channel all of our energies into Care and we are proud of the transformational impact our work has on Care Providers that we partner. Our belief and dedication to quality and elevates our service above and beyond our client’s expectations and leads to long lasting relationships and results. We’re proud to sponsor the Care Awards for the third year running and what a testing year it has been. We express a heart felt thanks to the strength and resilience the sector’s people have demonstrating in these times. Barchester is one of the UK’s largest care providers supporting older people to live with dignity and respect. A leading care provider over the last 25 years, Barchester support almost 12,000 residents across 236 homes and 6 mental health hospitals for a variety of care needs for short breaks to long term stays. Barchester are proud to be the only care home provider to win the RoSPA Health and Safety Award in 2019 and 2020. Ontex is a leading global producer of disposable incontinence products. Due to our focus on quality, innovation and value-for-money, our products are distributed in more than 110 countries. In the UK, our iD & Lille healthcare incontinence products are used by over half a million people and supplied through medical shops, distributors and the NHS. Our core values of integrity and customer care, combined with the latest design and manufacturing technology, make us the smart choice for health institutions and consumers globally. Christie & Co is proud of our commitment to the care sector and have sponsored The National Care Awards since its inception. Christie & Co are specialist business property advisers to the entire spectrum of care related business properties, including specialist, elderly and medical care, and are recognised as market leaders in each of these important sectors.
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MAIN SPONSOR:
Meet the winners CATEGORY SPONSORS:
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Programme Sponsor:
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Meet the winners... Carer 2020
Award category sponsored by: Hallmark Care Homes
Dani Whitehouse Fernhill House Care Home, Majesticare
Although up against four incredibly strong nominees, the judges chose Dani for her willingness to take on huge responsibility, her focussed approach to training and mentoring members of staff, the positive impact she has on her colleagues, her calming influence and clear attachment to the individuals she cares for and, her meticulous attention to detail when it comes to the unique requirements of the residents of Fernhill House Care Home.
Care Registered Nurse 2020
Award category sponsored by: Care UK
Elizabeth Smith The Gables, Consensus
This was a hotly contested category, with very strong candidates. The judges chose Elizabeth because she demonstrated outstanding dedication and advocacy; she makes a real change to people’s lives, while making her staff feel ‘worth their weight in gold’.
Care Team 2020
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Award category sponsored by: Barchester Healthcare
Kew House Care Home Hallmark Care Homes
“I love the joy of waking up, getting up and seeing other people” said John, a 93 year ‘’young’’ resident of Kew House. This quote captures what their Lifestyles Team set out to achieve – they are passionate, innovative, energetic and devoted to their work and making such a positive difference to the lives of their residents.
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Meet the winners... Care Home Manager 2020 Samantha Evens Arcot House Care Home, Doveleigh Care
Samantha has shown inspirational leadership, achieving Outstanding across two homes, with all five domains rated as Outstanding in her most recent inspection. Residents, relatives and team members are empowered, enabled, involved and engaged with Samantha going over and above every day to make a difference to the lives of others.
Dementia Care Manager 2020 Gary Haynes
Hastings Court Care Home, Oakland Care The judges chose Gary because he demonstrated quiet determination in making a difference to the lives of people with dementia, leading by example and with a focus on developing relationships with residents, families and staff that are built on trust and mutual respect, underpinned by his ethos that ‘every day is a positive day’.
Care Operations / Area Manager 2020
Award category sponsored by: Compass Associates
Amy Burt
Doveleigh Care The judges felt that all the candidates were very high quality however Amy Burt was their clear winner. They chose Amy because it was evident that she exhibits authentic leadership in her 3 homes. Her testimonials from staff and relatives evidence her dedication to high quality care and team member wellbeing. All 3 of the homes have not only achieved Outstanding ratings, but have retained and improved their Outstanding ratings which is a phenomenal achievement.
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Meet the winners... Care Activities Co-ordinator/Facilitator 2020
Award category sponsored by: Avery Healthcare
Emma Crompton
Bradshaw Manor Care Home, Barchester Healthcare Emma is a true inspiration to all young professionals in care and those thinking of entering the sector. The term ‘above and beyond’ can be overused but could not be more fitting on this occasion. Emma’s commitment to improving the wellbeing of residents is quite remarkable.
Care Housekeeper 2020 Julie Loscombe Defoe Court, HC-One
The judges chose Julie because as well as taking ownership of infection-control measures, working tirelessly to ensure staff and resident safety, she has also helped other departments and arranged a variety of lockdown entertainment.
Care Chef 2020
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Richard Pearshouse Parklands Manor, Signature Senior Lifestyle
The judges chose Richard as he stood out from the rest of the finalists for being resident centric, focused on developing his team and producing food that supported residents in “living their best lives”.
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Meet the winners... Care Home of the Year 2020
Award category sponsored by: Ontex Healthcare
The Close Care Home The judges felt the overall standard was very high and it was a difficult decision, but their winner, The Close Care Home, is a stand out service because of its journey from Inadequate to Outstanding in just five years. It embodies what a care organisation with inspirational leadership can achieve.
The Dignity & Respect Care Home of the Year 2020
Award category sponsored by: HC-One
Hassingham House Care Centre Forest Healthcare
‘Dignity and respect is foremost in everything we do’ says brilliant manager Caroline Newman of Hassingham House. They have a Dignity Champion, a Dignity Tree and Dignity Days promoting resident involvement with the local community. Satisfying cultural and spiritual needs, encouraging diversity, valuing choice, ensuring appropriate communication all contribute to a superb resident experience.
Care Newcomer 2020
Award category sponsored by: Lifetime Training
Elise Woolnough
Woodland Grove Care Home, Oakland Care Elise’s passion stood out to the judges; with her holistic approach and inclusion of all of her residents, she came across as a ray of light to Woodland Grove Care Home, its residents, staff and relatives. She went the extra mile to personalise her activities and in these tough, restrictive times her resourcefulness and use of technology had a very powerful impact on the resident’s experience. The judges feel she’ll go a long way in social care!
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Meet the winners... Care Champion 2020
Award category sponsored by: Court Cavendish
Karolina Gerlich
The Care Workers’ Charity Karolina has demonstrated real passion and committed in taking on the role in very difficult circumstances during Covid-19. In a short space of time, she has put in a considerable amount of effort and raised significant funds to support care workers during the pandemic. Karolina has been a champion in raising awareness of the sector and the importance of care workers.
Outstanding Care in a Crisis 2020 EachStep Blackley Community Integrated Care
The judges chose EachStep Blackley because they felt that they demonstrated outstanding transparency together with the ability to maintain the wellbeing of residents and staff as well as having a commitment to ensuring a safe and high quality of care.
Care Leadership 2020
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Award category sponsored by: Domus Recruitment
Lorna Badrick TLC Care
Lorna is engaging, people focused and an inspirational and innovative leader that the judges would love to work with in their respective teams. She really was impressive and the judges admired her approach and passion!
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Meet the winners... Care Home Group 2020
Award category sponsored by: Christie & Co
Home From Home Care
Home From Home Care showed their quality in spades, demonstrating multiple Outstanding CQC ratings, and true innovation. Developing their own leaders and engaging their service users, the company had a refreshing approach to sharing new solutions across social care.
Lifetime Achievement in Care 2020
Award category sponsored by: TLC Group
Graham Stokes HC-One
Graham’s contribution to our understanding of dementia and the importance of person-centred care cannot be overstated. His dedication and passion are an inspiration and his achievements truly represent a lifetime’s work.
Care Personality 2020 Mark Adams
Community Integrated Care The judges said, “One voice emerged during the Covid-19 crisis to capture public and political attention. With government statements and action jarring with social care’s lived experience and distress, Mark Adams spoke out knowledgeably, with passion and anger. He made politicians wince and the care sector cheer as his devastating critique of government neglect went viral.”
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Thank you to our judges.... Nadra Ahmed
Ruth French
Lorna Badrick
Ram Goyal
Hallmark Care Homes
Ontex Healthcare
Joanne Balmer
Laura Guntrip
Mike Parish
Vernon Baxter
Steven Harding
Jackie Pool
Andrew Bennett
Richard Hawkins
Robi Roccella
Thomas Brandrick
Zahid Khan
Anne Smith
Pete Calveley
Robert Kilgour
Tony Stein
Jon Chapman
Mel Knight
Mandy Thorn
Sanjay Dhrona
Richard Lunn
Catherine Valenti
Carole Edmond
Yvonne Manson
Ben Westcott
Theresa Ellmers
Beverley Manzar
Gemma Willis
National Care Association
TLC Care
Oakland Care
Investor Publishing
carehome.co.uk
Domus Recruitment
Barchester Healthcare
Pinders
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The Close Care Home
Glassmoon
Journal of Dementia Care
Stow Healthcare
Lester Aldridge
Caring Homes
Caring Times
Avery Healthcare
Renaissance Care
Consultant
Christie & Co
Abbotsford Care
Ebury Court Care Home
Beverley McLoughlin
Care UK
Dementia Pal
HC-One
Brilliant Care Solutions
Healthcare Management Solutions
Marches Care
Court Cavendish
Compass Associates
Lifetime Training
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technology in care
January 2021
www.careinfo.org
How technology is transforming care A care home is not a setting traditionally associated with new technology but in just a few months, Covid-19 has resulted in a digital transformation in residential care to the extent that families are communicating via video to stay in touch, health professionals are connecting with care homes virtually, and remote monitoring and visitor tracking systems have become part of day-to-day practice. Before Covid-19, “there was little digitisation in care homes,” says Daniel Casson, adviser on digital transformation to Care England. “There was a slow move towards digital care,” which is partly because many care homes are small operations and funding for these systems was an issue, he says. Pre-pandemic, other challenges social care providers were facing when it came to adopting technology enabled care services included the sector being “risk averse, and slow to adopt new technologies or ways of working”, says Zillah Moore, director at Tunstall Healthcare, which provides technology based solutions and services to health, housing and social care providers. Another challenge, she says, is that “some care professionals are also concerned about technology replacing human contact”.
But this year, in response to Covid-19, the gradual and growing interest in, and need for technology in care home settings accelerated. “This acceleration has partly been driven by the need to find ways to help people stay connected with their loved ones and for residents to feel like their families are still with them, virtually if not physically,” says Liz Jones, policy director, NCF. The rapid rise of technology in the sector has also been driven by the need for care homes to be able to safely access services from healthcare professionals such as GPs, and for staff to be able to
Accelerated need for technology
There has been a rapid rise in the use of technology in care homes since the pandemic. Kathy Oxtoby talks to those working in the sector about its benefits and challenges, and how it is changing practice. Before Covid-19, “there was little digitisation in care homes,” says Daniel Casson, adviser on digital transformation to Care England. “There was a slow move towards digital care”.
Daniel Casson, adviser on digital transformation to Care England
attend meetings and attend training sessions, while minimising the risk of infection. The role of virtual technology has been critical in achieving this. “We have had to find virtual ways of keeping that communication and support flowing from a workforce point of view,” says Liz. This July, a report published by Digital Social Care, NHSX and the Institute of Public Care at Oxford Brookes University, revealed the latest data and information on how social care providers have been using technology during the COVID-19 pandemic. The report, The Impact of Technology in Adult Social Care Provider Services, shows the use of technology for social care providers has changed rapidly with the Covid-19. To encourage tech take-up in the sector, information governance compliance requirements have been temporarily relaxed. And "thousands of care homes have really made use of tech during the pandemic, enabling their residents to see their GPs or their families remotely”, an NHSX spokesperson says. Supporting this use, in September NHSX distributed up to 11,000 iPads
Residents at a Barchester care home using their ‘magic table’
worth £7.5m to care homes across England, to help residents connect with family and help staff access healthcare information quickly. NHSX has worked with telecom providers and government to ensure care homes could access cheaper internet deals during the pandemic, and has produced guidance and resources for care homes during the pandemic. It is also working with NHS Digital to enable care homes to get quick, free access to NHSmail. The move is “the start of care homes being integrated into the health and social care system,” suggests Daniel. All care ➤
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technology in care ➤ homes have been asked to start using the Capacity Tracker as a priority. An established tool developed in partnership with NHS, local authorities, and care providers, the Capacity Tracker provides information that supports discharge planning processes and enables tracking of care home capacity and vacancies. Video conferencing is being widely used by all providers, with the three main drivers being virtual GP appointments, keeping families in touch, and internal communication between dispersed staff, according to The Impact of Technology report. “Since the pandemic we’ve seen a much faster adoption of video conferencing software and a big rise in people using Microsoft Teams and Skype,” says Katie Thorn, digital engagement manager, registered nursing home association, and project lead, Digital Social Care. Another major change in the use of tech in the sector during Covid-19 is around staff recruitment and training, with organisations “using video conferencing software to do train people remotely and interview new staff members”, says Katie.
Keeping families in touch
With so much happening in digital tech in the sector it is important to capture information on the latest innovations and share good practice. NCF’s ‘Hubble project’, funded by NHS Digital’s Social Care Digital Pathfinders grant, aims to “support and inspire the care sector to embrace digital technology in their care settings in order to improve people’s lives through the use of technology based, data-enabled care”.
Improving people’s lives
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Katie Thorn, of Digital Social Care
January 2021
www.careinfo.org
Both big and smaller providers are telling us about what a great difference these projects are making to the care of residents The Hubble Project allows social care providers to virtually visit ‘innovation hubs’ to learn how other care providers have introduced, used and evaluated digital technology to improve care. The hubs are based in three care settings in England and showcase a range of technologies which include, electronic care planning, circadian lighting, sensor technology and telecare. The project’s webinar sessions use a mixture of pre-recorded content and live Q&A, with managers and staff demonstrating the technology that they use and their digital journey. This includes how they came to adopt new technology, the challenges and the benefits of implementing and using it, and the use of data to improve the quality of care. “What’s been great about running this project is that people - both big and smaller providers - are telling us about what a great difference these projects are making to the care of residents, says Liz. “Tech is giving amazing data intelligence, such as a record of how a resident is feeling, what their favourite activities are, or whether they’ve had a reaction to medication. And having data about them gives us the potential to improve the way we do things,” says Liz. Technology has the potential to “transform lives and make a significant contribution towards the ultimate goal of preventative health and care” says Zillah. “Solutions not only give users greater choice in terms of the care they receive, but also prevent incidents (such as falls) and generate rapid responses, leading to a reduction in the requirement for more complex and costly care by mitigating consequences,” she says. Technology in care homes “creates
Tech benefits
“Since the pandemic we’ve seen a much faster adoption of video conferencing software and a big rise in people using Microsoft Teams and Skype”
Liz Jones, policy director at NCF
value for the person, for the carer, and for the care organisation”, says Daniel. “Value for the quality of life of the person being cared for, value for the carer that they can better manage their day and for the organisation as it makes it more efficient and it can market itself better”, says Daniel. Katie says that generally people working in the sector are positive about the growing use of technology in care, and that they recognise the time saving and quality benefits of digital record keeping, and the “incredible” value of residents and their families being able to keep in touch with video calls when face to face visits are not possible. And she says for residents, being able to do online activities such as quizzes, means “people can still do those activities that are so important to them. The benefits of technology come at a price. For smaller organisations cost can be “one of the biggest barriers” to adopting tech systems, says Katie. In the long run however, “they can end up saving staff time”. If cost is an obstacle, then companies could consider taking advantage of some of the free offerings and trials available to see the benefits for themselves, she advises. Liz suggests being a smaller company can actually make it more nimble when it comes to introducing new technology, in contrast to larger organisations who will need to roll out new systems across many sites. But ultimately, as Daniel points out, companies need to maintain a competitive edge, “so the question for people to ask is not ‘can I afford this digital technology?’, but ‘Can I afford not to have it?’. Using equipment can be a challenge for providers with many saying that it’s difficult to navigate the best options to
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technology in care respond to the needs of the people they support, themselves and other parties in the system, according to The Impact of Technology report. And lack of strategic technical guidance, data protection and cyber security were all identified by providers as barriers to their uptake of technology, the report finds. Some practitioners may be concerned about whether technology, in particular remote monitoring software, might affect the relationship between “the carer and cared for person”, says Daniel. Lack of confidence when using new technology is a common barrier. “Learning about new tech can be stressful and involve a steep learning curve,” says Katie. The Impact of Technology report contains several recommendations to ensure the sector continues to take up digital solutions and details how providers can be supported, including “a review to ascertain how to prepare the adult social care workforce to deliver the digital future”. Zillah would like government to “provide greater support to empower all health and care providers to become technologically enabled and achieve a minimum standard.” And she believes training must be included in all health and care professionals’ education, to ensure that digital solutions are deployed effectively.” In addition to training, a lack of staff confidence can be overcome by “good leadership and understanding the benefits of technology”, says Katie. “People are more willing to learn new skills if they can see the benefits,” she says. It also helps for providers to “have a vision” of what they want to do with new technology in their care homes, and to “share experiences with each other and the important lessons learned, such as how to buy systems that ‘talk’ to other systems”, says Liz.
Lack of confidence
As for the future of technology in care homes, the transformation that took place in the first few months of 2020 are here to stay, those working in the sector believe. “This is a permanent change and people won’t want to step back from
Here to stay
January 2021
www.careinfo.org
Solutions not only give users greater choice in terms of the care they receive, but also prevent incidents (such as falls) and a reduction in the requirement for more complex and costly care by mitigating consequences what we’ve got now,” says Liz. “Our appetite has been expanded for systems that make life simpler and easier and that join up the care around a person. We can’t go back to working with bits of paper,” she says. For Katie, the landscape of how services are delivered in residential care will continue to change. But while acknowledging the “great benefits” of technology to the sector, she believes there is room for improvement. “In the future I’d like to see more joined up systems working between care homes, GPs and hospitals,” she says. And while welcoming the massive uptake of technology in the sector, she cautions, “we should never adopt technology for the sake of it. We need to remember the person being cared for, and to think about what works for that individual.” Before the pandemic, The Manor House, in Barnard Castle, County Durham, , was a regular user of technology. This 70-bed care home, which is part of the Anchor Care Group, was the pilot home for the Health Call Digital Care Home scheme, which is designed to support electronic referrals. It also permits the creation and sharing of baseline observations to develop a record of what is ‘normal’ for each resident and also identify signs of deterioration. Run by Durham County Council and County Durham & Darlington NHS Foundation Trust, the system has since been rolled out to 93 care homes across the County. Care homes receive a pack with tablet and medical equipment to use for remote monitoring plus training and technical support. Lynn Cuthbertson, care home manager for The Manor House, says one of the benefits of the system is that electronic referrals reduce time spent waiting in phone queues to request, say, a district nurse home visit, freeing their capacity to deliver direct care.
Using technology in creative ways
Zillah Moore, director at Tunstall Healthcare
At the start of the pandemic, she says the Anchor Care Group equipped its homes with plug-in portals that amplify sound, helping hard of hearing residents better communicate with their relatives. The home also has three iPads - one for each unit – and regularly uses video calls for GP consultations. Lynn says: “Technology is never going to replace families being able to come to the home and give your mum a hug. But technology can help people to still feel connected to their communities.” Traditional community activities have been replaced with virtual events. “This summer we had a virtual country show, with families taking pictures and videos that we collated to show residents on our TV screens, including a dog with the waggiest tale competition! “We used technology in creative ways to get as close to the countryside as we could get for our residents. And they loved it,” says Lynn.
Working hard to support the residents with new technologies
Southampton City Council has a wellestablished programme of support for 60 care homes in the area, many of which are small providers. When the pandemic hit and local authorities were given infection control funds by central government, the council, in partnership with NHS Southampton City Clinical Commissioning Group (CCG), used £60K of that money to provide iPad Carts to every care home in Southampton to help keep residents in touch with loved ones and healthcare professionals. The city-wide roll out of 60 iPads on moveable carts comes after a successful pilot earlier this year at Holcroft House, a care home run by the council, which is registered to support residents with a ➤
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technology in care
January 2021
www.careinfo.org
Examples of care homes using their iPad carts include allowing residents to enjoy a virtual meal with their loved ones over video call whilst homes were in lockdown, use by residents to access dementia friendly games, and virtual ‘ward rounds’ with GP practices.
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➤ diagnosis of dementia. The roll out of these devices will enable care homes to conduct video consultations with health and social care professionals during the continued pandemic. Residents can also use the devices to use Skype and WhatsApp to keep in touch with family and friends while Covid-19 visiting restrictions are in place. Barclays Digital Eagles, as part of a partnership with NHS Hampshire and Isle of Wight Sustainability and Transformation Partnership, have supported care homes to set up their iPads and helped to build skills and confidence with their functionality as part of the digital skills training scheme for care homes across the Hampshire and Isle of Wight region. Examples of care homes using their iPad carts include allowing residents to enjoy a virtual meal with their loved ones over video call whilst homes were in lockdown, use by residents to access dementiafriendly games, and virtual ‘ward rounds’ with GP practices. Michelle Fellowes, manager of Holcroft House, says: “Staff have been working really hard to support the residents with new technologies and we have been delighted with how our residents have
responded with their family members online. They have found this fascinating to be able to see and speak to their loved ones live, almost as if they are in the room with them.” Councillor Lorna Fielker, cabinet member, health and adult care, says in addition to the iPad carts, she says the council has ensured every care home in the city has access to NHSmail, Microsoft teams, and technical support in the form of mobile device management software. Lorna says that even when life returns to ‘normal’, “digital technology will continue to provide benefits for care home settings”.
A robust part of life which residents and family rely on
There has been a “massive shift” in how Barchester Healthcare operates since the pandemic hit. “We were very much a faceto-face business and we have had to change and evolve extremely quickly,” a Barchester Healthcare spokesperson says. The group has invested around £60K in new devices and digital subscriptions as a result of the pandemic. To help families keep in touch, the independent care provider, which runs over 200 care homes, shifted from visits to video calling “immediately, to ensure that we could
continue to keep people close when visiting was restricted”. Its homes have all been supplied with new tablets to help residents stay connected with their loved ones. For those looking for care the group switched to offering digital show-rounds using video technology. It also provides virtual tours of the home and sends digital brochures. As residents have been unable to go out of the homes, “our activities teams have had to bring life inside our homes through the use of technology and planning activities, such as ‘armchair travels’ and ‘virtual cruises’. Barchester Healthcare has developed an online visitor booking system “not only to support our residents to have visits in our new Covid-secure visiting suites but also to capture vital track and trace information and ensure we have space between visits for infection control processes and cleaning to take place,” the spokesperson says. For staff, the group has moved its customer experience training online. Some staff members “struggle” with new technology “but we have supported them with additional training to help them get to grips with the changes in working ways and new kit” the spokesperson says. Feedback from resident’s families about staff has been “fantastic”, including praise for staff for their efforts “to provide phonein facilities using the house phone, mobile phones, tablet contact with FaceTime and Skype calls”. Some of the positives of Covid-19 “should be embraced for the longer term”, the spokesperson says. For example, while before the pandemic use of Zoom meetings and video calling was sporadic, “now it is a robust part of life at our homes which families and residents rely on”.
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covid-19
he starting gun to develop an effective vaccine that would confer immunity to what was ultimately dubbed the SARSCoV-2 virus was fired pretty much as soon as the news emerged from Wuhan in China of a new and deadly respiratory disease. Nearly a year and almighty global effort later, 90-year-old Margaret Keenan (pictured) was the first person in the world to receive a vaccination against the virus at 06.45 on December 8th 2020 in Coventry. So can we all breathe easy now that the end of the Covid-19 nightmare is in sight? Is it time to resume our normal routines of busy commuter trains, crowded workplaces and packed Friday night pubs? And has the care sector seen the worst of the pandemic and can we now look forward to a return to business as usual? Well not quite.
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Shooting for the moon The government says the care sector is the number one priority for the UK’s coronavirus vaccination programme but how will the fiendish practicalities and significant public mistrust hamper the process? Rob Munro investigates. There remains a raft of concerns over the effectiveness of a long-term vaccination strategy, including how practical it will be to vaccinate the care home population quickly and growing public mistrust of the vaccine itself.
The first vaccine to be deployed in the UK was developed by Pfizer using mRNA techniques which potentially offer greater flexibility and quicker development timelines than traditional vaccines.
Logistics and the cold chain
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covid-19
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‘It is disappointing to have ended up in a situation where the people who are top of the list are not able to get it immediately. We need to get vaccines in care homes, as quickly as possible.
Vic Rayner
But the downside of the technology is that, to remain effective, the vaccine needs to be stored at minus 70 degrees centigrade up until a few days before it is used. Enormous logistics planning will be required for the 40m doses of the vaccine that have been ordered by the UK, due to the vaccine’s fragility and the overriding need to preserve its quality throughout the supply chain and therefore the health of the patients – from Pfizer’s manufacturing facilities to their destination point and finally to the patient’s arm. Vic Rayner of the National Care Forum, says the nature of the supply chain for the Pfizer vaccine means the social care sector may face unique challenges and the most vulnerable are in danger of missing out. “We are delighted to have the vaccine assured, it’s also good news that more are on the way. However, it is disappointing to have ended up in a situation where the people who are top of the list for vaccination are not able to get it immediately. Bottom line is that we need to get vaccines to the people who need it most, in care homes, as quickly as possible. “ Rayner points out that administering
vaccine shots in hospitals or elsewhere just will not work for frail care home residents. “The only viable solution for widescale vaccination of care home residents is to get vaccines over the threshold and have them delivered onsite in care homes. It is not tenable to suggest, or encourage very frail people to go to hospital, or even community-based hubs. Throughout the Covid-19 pandemic care providers have worked hard to limit the risk of virus transmission in order to keep people safe, it is not sensible to change that now during what still is a national pandemic. “Now is the time for the NHS to work very closely with GPs and pharmacies and care homes to help mobilise a local vaccination service – we know that taking the vaccine to the people who need it the most is the most effective way to boost uptake rates and protect our care home communities.” “It seems that the Scottish government have come to a different conclusion, and in fact intend to honour the prioritisation
outlined by the JCVI and deliver the vaccine directly to Scottish care homes. It is not at all clear at this moment why the English government are not pursuing this path. However, if it turns out that all avenues have been exhausted, and that there is no way for the Pfizer vaccine to be administered within care homes, then we need some urgent guarantees that the alternative vaccines will meet the criteria to be delivered on site and in care homes. The timescale for assurance of the alternative vaccines must be clearly laid out. It’s all very well to ask care homes to be ‘patient’, but having outlined just how life changing this could be, the patience of residents, relatives and providers shouldn’t be expected to stretch too far.” Vic Rayner is also concerned that staff working in the sector are prioritized. “Care home staff are also at the top of the priority list for getting vaccinated and of course a great way to strengthen the protection of residents is to vaccinate care staff. The practicalities of staff having to travel to sites for vaccination raises a raft of problems around travel, payment of staff while being vaccinated, distance of homes from sites and booking into sites. As we know, the existing allocation from the Infection Control Fund is already stretched to the limit in its commitments and so funding will need to be made available to make sure care homes are supported to making this a reality,” she says. Mike Padgham of The Independent Care Group agrees. ➤
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covid-19 ➤ “Credit to the Government, it is wonderful that people in the vulnerable category are getting the injections first – they cannot happen quickly enough, and we look forward to the moment where everyone we care for and everyone who works in social care and for the NHS has been protected. “In the meantime, however, we have to remain on high alert because Covid-19 hasn’t gone away and sadly people are still being taken from us.”
effectiveness of vaccines is having a farreaching impact. A survey by myGP , the UK’s largest NHS-accredited independent healthcare management app, last month asked 2,000 UK adults if, knowing that a vaccine is now approved, they are planning to have it. A frankly staggering 31% said no, with the five main objections being:
Another obstacle to the success of vaccination is the public’s lack of trust in the process. Along with the anti-mask movement and assorted confused libertarians, the anti-vaxxers were quick to pitch their tent right in the middle of the Covid-19 battlefield and their steady drip-feed of propaganda has entered public discourse to an unwarrranted extent. While much of the anti-vax campaign is clearly nonsense spouted social media by a tinfoil hat fringe intent on ascribing evil motives to Bill Gates and George Soros via a convoluted and baffling conspiracy theory, the very questioning of the safety and
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Speed to market Side effects Hearing that pregnant women and under-18s aren’t eligible Trust -not knowing enough, including ingredients Not necessary, with the survival rate being 99%
The study reveals that public confidence in the Covid-19 vaccine has fallen by 9 percent since the summer when it was hypothetical, but now it’s a reality, consumers are worried about its speed to market. William Budd, clinical research physician at Imperial College agrees that there are multiple factors stopping people in the UK from wanting the vaccine and
says the government needs to do more to reassure them. “It is more than understandable that the public are questioning a vaccine, which, to anyone outside of the ‘science set’, will appear to be rushed to market and untrustworthy,” he says. “Trust in science is required, and knowledge is power - and myGP’s study revealing that 31 percent of people in the UK are refusing the vaccine confirms that we need to give the general public more, clearer information. “The main five health-related reasons individuals have given for not wanting the vaccine, are: the speed at which the vaccine has reached the market, potential side effects, concerns around why pregnant women and under 18s won’t be eligible, trust in terms of the testing programmes, and ingredients, and the common belief that a 99 percent survival rate makes the vaccine unnecessary. There is a simple explanation for each concern, and the Government must prioritise the communication of these explanations as a matter of urgency, in the interest of public health.” Vic Rayner echoes the need for a credible communication strategy for care workers in particular.
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covid-19
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It is more than understandable that the public are questioning a vaccine, which, to anyone outside of the ‘science set’, will appear to be rushed to market and untrustworthy William Budd, Imperial College
“Our understanding is that people who work in care are positive about this, and want the vaccine. But information is key, and communicating in a positive and empowering way with those who are going to do this first will be vital. It is not mandatory, but it is our responsibility to ensure that people have all the facts to make an informed decision,” she says. While the focus has justifiably been on older people in social care, some point out that others in the sector are equally vulnerable and should be prioritised too. Kathy Roberts, chair of the Care Provider Alliance says the wider social care sector must be included in the early vaccination programme. “Current evidence strongly indicates that the single greatest risk of mortality from Covid-19 is increasing age, and the risks increases exponentially with age, and so it is right that the people with first priority to the vaccine are those at greatest risk – older people living in care homes,” she says. “However, we must not lose sight that there is good evidence that certain underlying health conditions increase the risk of morbidity and mortality from COVID-19 when compared to people without underlying health conditions. The wider adult social care sector continues to support daily many of the people in the high-risk category and who are also on the priority list for the vaccine. For example, people with learning disabilities or autism, whose death rates have been 30 times higher than those of comparable age without a disability, and the disparity in deaths of people from a Black, Asian or Minority Ethnic background. Our members will expect specific arrangements for vaccinations in all types of care settings. In addition, Roberts again stresses the importance of an integrated approach to
Inclusiveness across the sector
protecting the health and social care workforce.“ Our work with DHSC colleagues has never been more essential to ensuring that all parts of the adult social care sector is prioritised for the effective rollout of the vaccine. In particular, we want to see a coordinated approach used for the care workforce to make sure that care workers are supported to get the vaccine, so that in turn they can support people receiving care and support to be vaccinated.” With luck and a following wind, 2021 will see the care sector significantly reduce the risk posed by the coronavirus through a comprehensive vaccination strategy but anyone hoping for a return to ‘normal’ with everything reset to pre-Covid levels is both overly optimistic and sadly misguided. There are many unknowns. While the efficacy of the Pfizer product is high and
Beyond the horizon
others such as the Oxford vaccine hold similar promise, there is doubt as to how long immunity is conferred and, crucially, whether the virus will mutate in the same way as the flu requiring yearly jabs to deal with new strains as they arrive. Reluctance to trust the jab threatens to derail the ultimate goal of herd immunity which relies on a significant level of uptake to effectively remove the virus from general circulation rather than merely protecting individuals on a case by case basis. But whatever the success of vaccines in controlling the trajectory of the disease, it is vital that lessons are learnt and permanent changes made, particular at the intersection between health and social care. The era of the two sectors existing in blissful ignorance of each other is over. Out of the ashes of the Covid bonfire, the integrated care phoenix must surely now emerge and perhaps the vaccination programme will be part of that process.
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What have we learnt from 2020’s pandemic and how can those lessons be implemented across the sector? Clinical epidemiologist and public health consultant Paul Nelson has some ideas.
Lessons learnt
he pandemic has demonstrated the vulnerability of older people, particularly in environments such as care homes, where the most frail of our society are gathered in enclosed proximity. We have learnt through bitter experience, as well as thoughtful design, that it is difficult but not impossible to protect care homes from contagion. This can be achieved through the implementation of systematised, highquality mitigations with training, assessment against standard operating procedures and the collection of data and its evaluation in a regular audit. Key measures that have proven, in combination, to be successful include:
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Bubbling staff (ensuring that staff and contractors do not visit multiple care homes). Advise and train staff to minimise their own exposure outside of working hours. Minimising entry and exit to essential visits from staff contractors. Protecting any person-to-person interactions with barriers to respiratory spread such as screens, PPE and monitored good ventilation of shared spaces. Enquiring about symptoms. Where possible, by objectively screening for signs of disease and visitors (such as temperature). Where possible, undertaking objective diagnostic testing (PCR) with necessary swift results turn around. This has been limited to weekly and report of results taking up to 4 or 5 days have limited the value of this powerful mitigation. And through limiting interactions with residents and zoning within the care home.
Limiting interaction with residents is the most difficult, psychologically and socially, as it can be so damaging to human wellbeing, particularly when the person, isolated, too often cannot
understand why, and can become extremely distressed. Loneliness and confinement are terrible – used in penal and torture regimes to break people – often, we hear later, when those torture victims return and tell their tale. The elderly and frail who live in care homes are by their situation the most vulnerable, and often have little or no voice to express their experience, complain or demand changes and improvements. It is terrible to imagine the intensity and widespread nature of personal torture and tragedy where the elderly often confused people are denied physical contact to ensure their safety. Now proven effective vaccines are on the way, it is tempting to think that the worst has happened. Yet, for the next 6 months to a year at least, the same tragic painful situation will persist. We will not be anything like back to normal for a long while, and many questions remain as to whether Covid-19 will become endemic and reappear year on year with the necessity to re-vaccinate with risks during that vaccination campaign period. We cannot afford to coast our way to the vaccine -we must not stop to breathe and sit out and tolerate the ongoing harm in the belief that it will all soon be over while the tragedy of care home covidmitigation imposed loneliness persists. So how can the sector best deal with managing the Covid crisis and, at the
same time, ensuring that the devastating effects of isolation for residents from families, particularly dementia sufferers can be minimised? We must do everything, use every available mitigation to minimise the isolation and confinement of elderly, vulnerable and often confused care home residents. Weekly PCR testing of staff is now widespread but delays in the return of test results reduce its effectiveness in protecting care homes. Trials of on the spot testing with lateral flow technology are underway, but relatively low sensitivity (up to 30% false negative) limits the confidence that a negative test gives. In this context, daily temperature assessment has now been mandated at least by the Scottish Government as part of enhanced measures for care providers. A focus on ensuring widespread good ventilation in shared spaces, as well as the usual PPE/cleanliness-based mitigations, can vastly reduce the risk of infections. If these measures are implemented fully and well in a systematised, verifiable and audited manner they can give care home management confidence. If these measures are not in place and implemented well, they may expose care home operators to liability for failing in their duty of care towards residents.
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business & property
January 2021
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PROPERTIES AND BUSINESSES RECENTLY SOLD IN THE CARE SECTOR
Waverley Care Centre Location:
Cedars Place
Penarth, Glamorgan, South Wales
Registration:
129, elderly
Purchaser:
Holmhurst Care Home Location:
Southampton
Registration:
16, mental health
Agent: Contact:
Contact:
Charles Phillips, 01962 833804
Location:
Agent:
Caerphilly, South Wales
Registration:
41, nursing
Asking price:
£900,000
Agent:
Christie & Co Oliver McCarthy, 0117 946 8500
Contact:
Worcester Lodge
Contact:
38 residential care Christie & Co Oliver McCarthy, 0117 946 8500
Purchaser: Vendor: Asking price:
20 elderly Christie & Co Charles Phillips, 01962 833804
Stow Healthcare Mr A Patel Undisclosed
Agent: DC Care Specialist Healthcare Business Agents Contact:
Chichester, West Sussex
Essex, Halstead 63, residential and dementia
Andy Sandel, 01937 849 268
Hartley House Location: Registration: Agent:
Cranbrook, Kent 57, residential and dementia Christie & Co John Harrison, 01622 656000
Caerleon House Nursing Home Location: Purchaser:
Clevedon, North Somerset
Registration:
Contact:
Registration:
Agent:
Rob Kinsman, 07717 335 367
Cornelius House Registration:
Registration:
Christie & Co
Christie & Co Location:
Location:
George & Anne Moore
Agent:
Bargoed Nursing Home
Contact:
Jacob & Beena George
Vendor:
Location:
Vendor: Asking price: Agent: Contact:
Caerleon, Gwent, South Wales 54, elderly Bal & Bindu Brainch Quantuma LLP £2.55m Christie & Co Oliver McCarthy, 0117 946 8500
■ Information appearing in “Care Businesses Sold” is published in good faith that the information is accurate and cleared for publication. The onus for accuracy is on the property agent. Caring Times will not publish, in a subsequent issue, corrections or alterations to information supplied. Agents, please note that items cannot be withdrawn once the copy deadline has passed. We advise readers to confirm any details with the property agent concerned.
Introducing IT Engine to Buyacarehome - IT Solutions for Care Homes With more and more care homes now using electronic care plans and electronic medication management systems, there is an even greater need to ensure Wi-Fi and electronic devices are working efficiently and 24/7. They are offering a very generous discount to Buyacarehome clients on their network and security review between now and 31st January which can be booked in any time between now and the end of March 2021. They usually charge £750 for this service but for this period they are offering it for just £99. The areas they cover are Sussex, Surrey, Kent and London.
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For more information – follow this link: https://www.buyacarehome.com/news/news/introducing-it-engine-to-buyacarehome---it-solutions-for-care-homes
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promotion
January 2021
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Why carry out a construction feasibility study?
There are a number of different phases that a construction project must go through before building can begin, one of these is a construction feasibility study carried out by a reputable construction management firm. In this article, we will be taking a look at exactly what a construction feasibility study is, and why they’re so important to the construction process as a whole. What is a construction feasibility study? Essentially, a construction feasibility study aims to find out whether the construction company in question can feasibly take on the project that they’re intending to. This means that the company’s financial situation will undergo evaluation, particular areas of strength and weakness will be notified (such as managerial experience or workforce size) and external factors will also be acknowledged, such as the COVID-19 pandemic and economic instability. After assessing the company itself, the study will then weigh this information against what they know is required for the project, for example, the materials, labour and time required to make sure that the project is completed before the deadline.
Once this analysis has been completed, a decision can be made as to whether taking on such a project would be financially viable for the company or not. To better understand the working components of a feasibility study, let’s break it down with TELOS, a handy acronym which stands for: technology, economic viability, legal considerations, operational feasibility and schedule. n
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Technology: This is asking whether the company has the necessary technology and systems in place to be able to carry out the project efficiently and whether the workforce has a sufficient understanding of those systems.
Economic viability: This stage is essentially a cost/benefit analysis. That is, are the financial risks of the project worth the potential reward? Legal considerations: Are there any planning restrictions that might act as a stumbling block for the project? What other legal requirements need to be met?
Operational feasibility: This phase of the study looks at whether the company will be able to manage and execute all of the complexities of the construction project.
Scheduling: This step looks at the various time constraints that have been set for the project, and whether they will have an impact on how easily the project can be completed.
What are the key benefits of a construction feasibility study? n
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A feasibility study could end up saving your company huge sums of money by avoiding a project that wasn’t financially or operationally viable.
For projects that are within scope, a feasibility study can help you work out how best organise your finances in order to structure and plan the project.
A feasibility study can also result in recommendations for further studies that could be of use, for example, ecology surveys, drainage surveys and arboricultural surveys.
A feasibility study can help a company better understand where their strengths and weaknesses are, and how they can be exploited or fixed in order to overcome the challenges presented by the upcoming project. Need some help with your next construction project? Aedifice Partnership are experts in a huge range of property development services, including construction feasibility studies. For more information, please contact our friendly, professional team today and we’ll be happy to help. Tel: 01582 766 663 www.aedifice.co.uk
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