Caring Times February 2021 by investorpublishing

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Staff / recruitment... Property marketplace... Innovation... Expert analysis...

CQC’s new strategy – what it means for you Carers and artists – raising quality of life together February 2021

A star is born – the history of The Royal Star and Garter in pictures Boardroom secrets – effective leadership in the care sector

Social care business management

GREEN SHOOTS PROFESSOR MARTIN GREEN OF CARE ENGLAND ON THE STATE OF CARE IN 2021

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Regulation

What the CQC’s new strategy means for you

The care champion

Martin Green of Care England on his hopes and fears for the sector

Full board

How senior management can deliver excellent care

Your best asset

Why nurturing staff pays dividends

Getting creative

How working with artists and musicians reaps benefits

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Promotional feature

Introducing the Mobile Shower Change Trolley from Pressalit ressalit, the leading Scandinavian designer of accessible bathroom solutions, has introduced a new height adjustable Shower Change Trolley, suitable for both adult and child environments in Changing Places facilities, schools or institutions. Providing safety and comfort for both changing and assisted showering, the new Pressalit Shower Change Trolley introduces a range of innovative features helping users and their carers, including foldable safety rails on all four sides and a vertical tilt mechanism. The shower and changing trolley has been created by Pressalit’s award-winning designers to combine a height adjustable changing table, with the option to use as a waterproof shower trolley. This flexibility is a valuable addition to any accessible or Changing Places bathroom, in wet or dry environments. Introducing foldable safety rails at the head and foot of the table, as well as on both sides, improves access for two or more carers to assist a user at the same time. The easy-tofold rails not only provide security for the patient and help prevent falls, they can promote a greater sense of ease and calm by providing a real visible definition of space. The contoured laminate rails feature black

trim edges to aid the visual definition, with integrated grab handles. Waterproof, non-slip, and quick drying, the durable mattress which is produced from high quality, PVS coated fabric, provides a comfortable lying surface, and has gable ends acting as further security. With flexipipe and drainage, the shower water runs off and away quickly and efficiently. The Pressalit Shower Change Trolley is free-standing and will fit neatly into the bathroom. It can be moved into position next to the shower when needed, its large diameter wheels ensuring easy manoeuvrability while the user is lying on the bed. The non-slip press-down foot pedals provide a secure central locking system across all four wheels. Its metal frame is lifted off the floor so that the wheels and lower frame of a mobile hoist can fit underneath if required. As with all Pressalit products, hygiene is always a priority. Smooth surfaces and round edges ensure the table is easy to clean and keep safe. There is also a basket underneath the table for convenient storage of accessories. With a height range of 550mm – 950mm, carers can adjust the table to suit their personal work preferences, including wheelchair transfer and minimising

inappropriate lifts. It features a gentle vertical tilt, with two secure, telescopic legs. As well as user comfort, the tilt allows for efficient water egress. The height adjustable table is powered by an easy to reach battery with an intuitive hand control. Andrew Lowndes, UK and Ireland Sales Manager for Pressalit, says, “Great care has been put into the design of the new Shower Change Trolley to ensure it not only provides a safe and secure changing and showering trolley, but with its flexibility allows users and their carers to adapt easily to individual situations. “This is an excellent addition to the Pressalit range. Not just another blue trolley, its bespoke design has a flexible approach to care from start to finish.” The Pressalit Shower Change Trolley has a maximum weight of 200kg. n

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Unpaid carers asked for feedback

The Care Quality Commission (CQC) and the charity Healthwatch are calling for feedback from unpaid carers. Unpaid carers have played a greater role than ever before in supporting people with their care needs, an incredible contribution in the fight against Covid. Kate Terroni, Chief Inspector of Adult Social Care at CQC, said: “There are 6.5 million unpaid carers in England and their voices are extremely powerful. We are incredibly grateful that many carers have already shared their experiences of what care is like when delivered in their own home, in care homes, hospitals and GPs – good and bad – this is vital intelligence to CQC and really does make a difference. By the end of December we carried out over 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

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 March issue: Display advertising copy space booking: February 5 Display advertising copy: February 10 Product news copy: February 5 Editorial copy: February 5 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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1900 risk-based inspections using vital intelligence, including from carers and members of the public. I’d like to make a plea that carers continue to talk to us about what care is like as they are our eyes and ears on the ground.“ Research undertaken by CQC and Healthwatch as part of their Because We All Care campaign has shown that unpaid carers are already more likely than the general population to provide feedback on health and social care experiences on behalf of loved ones, with 67% reporting they give positive feedback on care. In addition, 58% of carers also said they will be more likely to provide positive feedback on care after the coronavirus

pandemic. The research also found that unpaid carers are significantly more likely to have taken action to improve health and social care (71%) than the rest of the population (44%). Sir Robert Francis, CEO of Healthwatch England, said: “Unpaid carers are the backbone of our health and social care systems and their commitment and compassion have never been more vital. The COVID-19 pandemic has had a big impact on both them and those they care for whilst prompting a huge rise in the number of people taking on caring roles, ranging from shopping for food and collecting medicine to providing emotional support.

Call for drastic overhaul of “fragile and exposed” UK care system

The government urgently needs to deliver on its manifesto commitment to fix the failing social care sector, say UK care and health leaders. Launching its new report, Let’s do this: The promise of fixing social care, the Health for Care coalition says the COVID19 pandemic has thrown into stark relief the failings and underlying weaknesses of the social care system, which have left health and social care services struggling to cope. Health for Care – a coalition of 15 national health organisations, led by the NHS Confederation – hs come up with proposals for a better funding model and a restructured social care system and highlight the ongoing repercussions of the failure to plan properly for vital services and the dramatic falls in spending on social care in England, with figures showing a 12|% decrease per person over the decade to 2018/19. They also warn of very high staff vacancy numbers, with 112,000 social care posts left empty, and very low pay, status and career opportunities. Danny Mortimer, chair of the coalition and chief executive of the NHS Confederation, said: “The NHS and social care are sister services and have been supporting one another and working closely together throughout the pandemic. However, when one service does not work, the other suffers, and the

past few months have brutally exposed how fragile and under-resourced England’s social care system has become. “The Government must now deliver legislative proposals to fix social care, once and for all. A well-funded and good quality social care sector is fundamental to a healthy nation and a well-performing NHS. Without social care reform, with a clear and transparent timetable for delivery, backed up by a long-term funding settlement, not only will the NHS and social care continue to run at near breaking point through the pandemic, but they will struggle to address the longterm health and social care issues the crisis leaves in its wake.” Rachel Power, chief executive of the Patients Association, said that the social care system is "simply not set up to meet people’s needs today." “More people are living for longer with conditions that can’t be treated by the NHS, and they rightly expect care and support to allow them to continue to live well and play an active role in society. The current system creates an enormous disparity between people with some health conditions who are treated for free on the NHS, and others who struggle to access care at all and are charged when they do. A clear, equitable offer that people can count on to provide care and support when they are in need is absolutely imperative,” she said.

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Covid has led to greater team working

Managers of a group of care homes have said that responding to the demands of the Covid-19 pandemic has led to greater team working. A survey of home managers and clinical leads at Colten Care found that the impact of the coronavirus has made staff work ‘even better as a team’. They said they had been able to offer support and reassurance to residents at the same time as ensuring staff have the help they need too and were confident their homes would remain resilient should there be future waves of the virus. Among the home managers who took part in the survey, 100% feel proud of how they have coped with Covid in their homes and agree they have been able to offer great support and reassurance to their residents. Lucy Yao, Regional Support Manager at Outstanding-rated Ferndown home Amberwood House, said: “The survey gave us a good opportunity to reflect on what we have needed and ensure the right support is in place.”

Elaine Farrer, Colten Care Operations Director, said: “We will continue to develop resources to increase the resilience of our managers in responding to the challenges of Covid, reassuring our residents and supporting staff.” As well as Covid, the survey covered areas such as job demands, wellbeing, work-life balance, roles and responsibilities, career development, systems and processes, and communications. On career development, all respondents praised Colten Care for providing good opportunities to progress for its Nurses, Senior Care Leads, Trainee Nursing Associates, Senior Companionship Team Members and Senior Administrators. Among other insights, 100% of Home Managers believe Colten Care encourages them to exceed residents’ expectations, all feel they have support from their line manager to do their job well and all agree Colten Care is a great place to work. All respondents feel the company is good at identifying and developing

talented people and rate it as an ‘employer of choice’. More than 85% of Home Managers expect to still be working for the company in three years’ time, a higher proportion than a previous survey showed in 2016. Colten Care owns and operates 21 care homes in Hampshire, Dorset, Wiltshire and West Sussex. All are registered for nursing care and four are dedicated dementia care homes. Amberwood House is one of seven Colten Care homes rated Outstanding by care sector regulator the Care Quality Commission. The company has a 9.9 out of ten group score on the independent review site Carehome.co.uk. This is the highest rating of any care home group in the country with ten or more homes.

Cash for care home staff testing “welcome news”

Vic Rayner

Care leaders have welcomed ring-fenced government funding of extended Covid staff testing in care homes Vic Rayner, executive director at the National Care Forum said the £149 million cash injection was “welcome news” as requirements for testing had significantly increased, placing greater burdens on operators. “All staff in care homes will now need to have 2 rapid tests via lateral flow devices each week alongside the current weekly PCR testing – this is a tripling of the current staff testing regime which care homes are being asked to put into practice immediately with no notice. These additional commitments sit alongside major additional testing requirements around visiting, and the expectation that testing will be majorly ramped up during outbreaks,” said Rayner.

“The £149m extra funding from government is definitely welcome news. This is urgently needed to support the extra testing and comes after several months of intense discussion about the very practical difficulties of the exponential expansion of on-site testing in care homes and the very significant additional resource this requires.” Rayner said that ministers must now move swiftly to ensure the care sector have the tests they need. “The government must now ensure that all care homes have their LFD tests in place as a matter of urgency, if care homes are to make the additional testing happen. At this moment, despite national roll out, we know that a number of care homes have yet to receive their LFD tests and this must be resolved immediately,” she said.

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Sickness rates running at over 15% One on five managers across the social care and health sectors are reporting staff absence rates of over 15% . A snapshot survey by the Institute of Healthcare Management revealed the scale of sickness absence across the UK. The online, snapshot survey was completed by 82 IHM members. It found 32% felt sickness absence was ‘same as we would expect at this time of year’ but 37% thought it was ‘worse’ and 25% thought it was ‘much worse’. Asked to estimate how many staff were off sick, 30% said ‘up to 5%’, and 26% said 5-7%, 8-10%, or 10-12%. However, 12% said absence was running at 12-15% and 20% said it was ‘more han 15%’. One in ten respondents reported sickness levels of 12-15% and one in five reported absences of more than 15%. Despite this, a majority said they were ‘managing well’ or finding things ‘tough, but we are coping.’ IHM chief executive, Jon Wilks said

this was a tribute to the planning that had gone into preparing the NHS to cope with the Covid-19 pandemic this winter, and a demonstration of the resourcefulness that health and care services have shown as the second wave has accelerated. However, he said politicians and policy makers needed to be transparent about the situation, so the public could form realistic expectations about the NHS’ ability to open up new services and follow guidance intended to halt the spread of the disease. “At the moment, politicians and policy makers are talking about opening additional services, such as Nightingale Hospitals and Nightingale vaccination centres,” Wilks said. “Although the picture varies across the country, our members are saying that the scale of sickness absence in the NHS right now makes that fanciful. “Current services are managing, under enormous pressure, but without staff the

idea of opening additional beds and services is a non-starter. “We need openness and honesty about the position so workers and staff, patients and families have realistic expectations about the treatment available for Covid19 and other conditions, and don’t lose faith in the service because the reality fails to match the headlines they are seeing.” Wilks pointed out that these figures exacerbated long-term shortages of staff. The NHS went into the Covid-19 crisis with 100,000 vacancies unfilled and short of more than 40,000 nurses. Asked ‘to what extent staff absence is currently affecting your organisation’s ability to deliver services’, more than 22% of respondents said they were ‘managing well’ and 39% said it was ‘tough, but we are managing ok.’ However, 29% said ‘services are being affected, although we are not in crisis’ and 10% said ‘services are being seriously affected and we are in crisis.’

Bluebird launches national TV ad campaign Bluebird Care has launched its first ever national TV campaign. The advert highlights the care packages on offer from Bluebird Care, these range from companionship to 24 hour a day livein care and shows a customer who requires assistance with some day-to-day tasks, this includes using technology to contact his family members. Bluebird Care want to alert as many people who are in need of care and support, or those who may be considering care, to the care services that Bluebird Care provide. The TV adverts will be seen across many channels in the coming months. Hannah Banfield, marketing and communications director at Bluebird Care, said: “We are really proud of our first ever TV ad, and we hope all our Care Assistants and all our team members at Bluebird Care feel a sense of pride when they see it on the TV. We are hoping this will be the first of many TV campaigns we will be able to launch!”

All aboard!

The property owners at Castle View, the new retirement village in Windsor have a new hobby to see them through the next

level of lockdown – a model railway. And with travelling and holidays on hold for a bit longer, they can at least get away virtually, thanks to the arrival of their new model railway club.

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Yorkshire care home to be ‘yarn-bombed’ Staff and residents at The Hall Residential Care Home, in Thornton-le-Dale, are undertaking a project to yarn bomb the outside of the home as part of the village’s North Yorkshire Britain in Bloom entry. For the competition, staff and residents at The Hall want to make sure that their home is as decorative and colourful as possible. To bring the Thornton-le-Dale community together, the home is inviting local people to get involved while the country is in lockdown. Yarn bombing is a form of temporary street art that uses crocheted or knitted yarn to decorate buildings, benches, lampposts and fences. The care home is planning to make use of the form of street

art to decorate the outside of their building with wool flowers and pollinators in time for Easter weekend this April. Christina Stone, resident at The Hall, said “I’m very excited to be a part of the Britain in Bloom competition entry, I love gardening and find knitting very relaxing and can’t wait to see what the yarn bombing will look like.” Nicky Beach, manager at The Hall, said: “We wanted to do something fun and creative to keep our residents and the local community connected, and this yarn bombing is the perfect opportunity.

“Yarn bombing the outside of The Hall with wool flowers and knitted images will hopefully bring the community together and we are excited to see the yarn art that members of our community produce. “Whether you knit flowers, create wool pictures, French knit, or make rug mats, anything to help decorate would be appreciated!”

Leading the way!

John Godden MBE

Emrys Owen BEM

Dr Natalie-Jane Macdonald MBE

Care sector recognised in New Year’s Honours list

Among the care sector professionals recognised for honours were: Salutem Care and Education’s chief executive John Godden was awarded an MBE. John said: “This honour is for every single person within the Salutem family that have proven to be exceptional in the most difficult and challenging of circumstances.” Emrys Owen, a healthcare assistant at the Royal Star and Garter Surbiton Home, has been acknowledged with a British Empire Medal The charity says Emrys has been with them for 38 years and always given his

utmost to support residents. Sunrise Senior Living UK and Gracewell Healthcare’s CEO Dr NatalieJane Macdonald was awarded MBE She was honoured in recognition of her successful 30-year career and for effectively leading Sunrise and Gracewell’s 46 care homes during the COVID-19 pandemic. CareTech Foundation CEO Jonathan Freeman was awarded an MBE for services to charity. CareTech Foundation the first corporate foundation in the social care sector, which supports and champions care workers, those living in care and the care sector as a whole.

Senior carer Heather Burgess of The Rowans care home in Macclesfield getting her first dose of the PfizerBioNTech Covid-19 vaccine.

Resident Gladys Leaf receiving her first dose of the Oxford-AstraZeneca Covid-19 vaccine at The Manor House care home in Little Weighton

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Care operators retain investors’ confidence

Although the third national lockdown is creating challenges for care home operators, property experts anticipate a steady recovery in trading performance coupled with a notable increase in transactional volumes and a continued level of strong development activity. Specialist business property adviser, Christie & Co, was positive in its outlook as it published its annual Business Outlook report, ‘Business Outlook 2021: Review. Realign. Recover,’ which reflects on the themes, activity and challenges of 2020 and forecasts what 2021 might bring across the industries in which the company works, including the care sector. During the first wave of the pandemic, Christie & Co says the sector was hit with a number of resident deaths which reduced average occupancy levels by around 20% and resulted in “numerous financial and operational challenges, including the sourcing of PPE and managing staff absences due to sickness or self-isolation”. As more support has become available, the situation has certainly improved and, during the second wave, homes were much better prepared in terms of having the equipment, resource, and the support needed. Following increased testing and other innovations such as dedicated Covid-19 secure visitor areas and most recently the vaccine roll-out, Christie & Co anticipates a gradual recovery in occupancy as admission levels increase during Q2. Christie & Co also surveyed a pool of care business operators to hear their views on sentiment in the market, and how they felt about business operations in 2021. Over 95% per cent of care operators said they feet their business has been impacted by Covid-19 with almost half of respondents saying they expect it will take between one and three years for the sector to recover. However, 37.7 per cent were more optimistic, and thought that recovery will be seen within the year. Just over 35% of respondents said they are planning on selling their business or some assets in 2021 and 29% said they are planning on acquiring which indicates an active transactional market this year.

Christie & Co make the following market predictions for the year ahead:

An increase in activity as major portfolio processes paused in 2020 move forward and new opportunities are placed on the market. Increased activity with investment transactions as funds that were gated, or otherwise paused new deal activity in 2020, return actively to the market. Occupancy levels are likely to re-build in 2021, and referrals will increase as the vaccination and testing programmes are rolled out during Q1. Interest in the UK care sector from overseas capital is likely to increase further and we may see European consolidators become increasingly active in the UK market. Development activity is likely to continue at pace, both for care homes and extra care/ housing with care schemes. The development of new facilities is essential to keep up with demographic demand and the structural undersupply of future-proof care beds in the UK.

Richard Lunn, managing director at Christie & Co, said the positive approach

taken by operators was bolstering investor confidence. “Operators have shown their resilience and fortitude during this pandemic, and that confidence has been echoed by investors who continue to seek out the sector in growing numbers. Despite the challenges, we believe the focus on care over the last year will highlight the demand and opportunities for quality operators and businesses going forward,” he said The report includes Christie & Co’s Price Index, which, for the first time since 2009, shows a negative price index movement. This is attributed largely to a reduction in trading performance and is not related to the demand for care businesses which remains strong – particularly as a result of the sector’s profile during the pandemic. As part of its sentiment survey, the company also asked respondents to share their views on pricing movement in 2021 and found that 43% think it will stay the same, 20% think we will see an increase, and 37% think we will see a decrease.

Strictly for the birds! Two companies are helping nursing home residents participate in the largest wildlife survey in the world, Family-run Nursing Home operator, Morris Care and Upton Magna based CJ Wildlife, one of the UKs leading specialist suppliers of garden bird and wildlife products, have set up feeding stations and identification boards for residents across the family of Morris Care Homes. Residents have been enticing birds into their gardens with the new feeders and specialist bird food, as well as making homemade feeders ahead of the RSPB Big Garden Birdwatch which runs from the January 29 to 31. Morris Care Chief Executive Lucy Holl said: “We are very proud of the beautiful gardens and green spaces our Homes enjoy and know that for many residents, birds in these gardens provide an important connection to the wider world and bring a great amount of joy. “CJ Wildlife have been both generous and supportive, helping us to entice even more and providing information boards so residents can recognise them too. The Big Garden Birdwatch gives our residents the chance to give something back, because nature needs us too.” Almost half-a-million people join in the RSPB’s Big Garden Birdwatch every year. This year’s event takes place on January 29, 30 and 31. The public is asked to spend just one hour watching and recording the birds in their garden, balcony or local park, then send their results to the RSPB.

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promotion

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espite so much openness about health and wellbeing, incontinence is still a taboo subject. Many people simply don’t want to talk about incontinence, yet it is estimated that in the in the UK alone there are between three and six million people living with it. Ontex Healthcare is committed to encouraging people to talk about incontinence at every stage in life. In the wake of Covid-19 pandemic there is a much greater focus on self-care at home and this applies to all ages, but is particularly important for those who live alone in our communities. In the UK 3.8million individuals over the age of 65 live alone, 58% of whom are over 75, around 2.2million individuals. It is also a fact that older adults who live are:

n n

More likely to visit A&E More likely to visit a GP with around a fifth of persons aged 65+ who live alone visiting their GP once a month, compared to 14% of older persons who live with others More likely to have a mental health condition

Caring in every home If you’re caring for someone who is struggling with incontinence, these top five tips may help:

1. Ensure the person needing care leads a healthy lifestyle – healthy eating, drinking plenty of fluids and cutting back on caffeine are just some of the things that will help someone who is managing incontinence every day.

2. Look after yourself – As a carer it’s also important to look after yourself as well as those you are looking after. Dealing with incontinence care can be embarrassing and frustrating so it’s important to make sure you have some quality time planned to de-stress. 3. Maintain good hygiene practices – Wear gloves when dealing with used hygiene products and thoroughly wash your hands afterwards. Make sure that you dispose of the hygiene products and gloves appropriately (never down the toilet).

4. Incontinence care is challenging: try to stay relaxed – Some people may be resistant to receiving help for their incontinence issues as they feel embarrassed or like they lack independence. Humour can also be a powerful tool for lightening a situation and creating trust between you and your loved one, which in turn may alleviate some of their embarrassment or resistance. 5. Use the right incontinence products – It can be completely overwhelming when there is so much product choice, which is why iD is here to try and provide products for all levels of incontinence from light to severe. Ontex has recently relaunched its iD Expert Slip and iD Expert Form brands, designed to support for those with moderate to heavy levels of incontinence.

The iD Expert Slip range has been designed for those who no longer feel they have control of their bladder and when urine leakage is heavy and cannot be controlled in any manner. These all-in-one products will help to manage moderate to heavy incontinence and have anti-leak cuffs and waist elastication to ensure a snug fit with a high level of absorption. The iD Expert Form range has been designed for heavy urine leakage that cannot be controlled. The pads feature an odour control system that locks in any odours to keep you feeling fresh.

For more information visit id-stockist.com or call us on 01536 269744

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legal landscape

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Is it time for smarter regulation? Anna-Maria Lemmer, associate solicitor, Ridouts, asks what the regulator’s five year strategy means for the care sector. n 7 January 2021, CQC published a formal consultation paper on its new draft strategy that it aims to implement over the next five years. CQC acknowledged that the pandemic has forced the health and social care sector to think differently and stated that the purpose of the draft strategy is to enable more effective regulation for the future. CQC’s draft strategy focuses on four themes:

1. People and communities 2. Smarter regulation 3. Safety through learning 4. Accelerating improvement

This article will focus on the second theme of CQC’s draft strategy which is ‘smarter regulation’. CQC apparently wants its assessments to be more flexible and dynamic and said that it will update ratings more often so that everyone has an up-to-date view of quality. It stated that being smarter with data means its visits will be more targeted with a sharper focus on what it needs to look at. This raises a number of issues which will be explored in this article. CQC’s previous strategy for 2016 to 2021 also set out four priorities that it would focus on and one of those priorities was to “deliver an intelligence-driven approach to regulation”. Caroline Barker, COO of Ridouts Professional Services Plc first considered the issue of whether technology can make CQC more intelligent in a 2018 Ridout Report and it is clear that not much has changed

CQC’s previous strategy

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legal landscape between then and now. The relevant considerations remain the same. CQC's consultation paper states, "We now have IT systems that can handle large amounts of data, which will enable us to use artificial intelligence and innovative analysis methods. This replaces more manual handling of data and will ensure we interpret data in a more consistent way." In its previous strategy, CQC hoped that by being more intelligence-driven, it would become a more effective and efficient regulator. However, many providers in the sector would say that they have not seen any evidence of CQC being an effective and efficient regulator over the last five years so it is hard to see what will be different this time around.

How successful will CQC’s new strategy be?

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The success of CQC’s new strategy all depends on its IT systems’ ability to analyse and interpret data. The questions that arose in 2018 still arise now, will CQC look at quantitative information and/or qualitative information? if CQC is determining inspections on risk, there is a chance that providers will only get “noticed” if they are considered to be a risk. This could mean that CQC inspectors show bias towards finding poor practice and this could impact on a corresponding rating. CQC’s rating of a service is often based on the subjectivity of individual inspectors and members of the public rely on ratings provided by CQC. If CQC’s IT systems misinterpret data this could lead to various consequences such as inaccurate CQC inspection reports and subsequent ratings. It could also lead to warning notices and often criticisms in an inspection report can form the basis of escalating enforcement action. Enforcement action could be Notices of Proposal, section 31 letters of intent or Notices of Decision which can have serious consequences for a business. It is very important for providers to challenge misleading or inaccurate CQC draft inspection reports through the factual accuracy comments process as this is a provider’s only opportunity to challenge the factual content of a report. Sometimes providers decide not to challenge reports because they either do not think that it will make any difference or they do not want to damage an existing relationship with their inspector. However, the consequences of not challenging an inaccurate report can be very serious. If an inspection report goes unchallenged and it is subsequently published, there is a presumption that the report is accurate and the content of the report becomes the truth. If providers challenge any inaccuracies found by CQC at the outset, this can help to minimise the effects of further enforcement action later down the line. The facts are one aspect, but another is how they are applied with reference to a provider’s regulatory obligations. This is where legal input can be additionally

beneficial as it will look at what the legislation requires. As we all know, computer systems can be flawed. Therefore, it is important that the data and information gathered by CQC through its IT systems is verified before it is allowed to impact on CQC’s assessment of risk within a service. This is particularly important where CQC is relying on information provided by third parties, as often third party information can be subjective. If CQC inspectors become more reliant on data gathered through IT systems, it is possible that good care being provided by a service on the ground may be overlooked by CQC. This could lead to information being skewed and increased enforcement action by CQC as a result. It is therefore important for CQC inspectors to triangulate the data gathered with ‘real life’ facts from the ground and important that they ask providers for their comments in order to corroborate their findings.

The success of CQC’s new strategy all depends on its IT systems’ ability to analyse and interpret data. The questions that arose in 2018 still arise now, will CQC look at quantitative information and/or qualitative information? For example, is it the number of statutory notifications a provider has submitted to CQC that will flag up a risky provider? Or, is it the type of issue within a singular notification that highlights potential concern? Are we looking at long term or Caution short-term trends? CQC should exercise caution in the way As with any information that is that data gathered is relied on to predict gathered and prompts an inspection, that potential failures and potential breaches information merely highlights a potential of regulations. CQC's consultation paper area of concern which must be tested and states, “We’ll use our regulatory powers corroborated by CQC inspectors. in a smarter, more proportionate way so Artificial intelligence could be reliant on we take the right action at the right time. potentially skewed facts depending on Based on the best information available, the algorithms and rules that are used. and enabled by technology, we’ll be Analysed information itself, must be proactive in using innovative analysis, continually analysed, tested and, if including data science techniques, to required, the base line changed. support robust and proportionate CQC's consultation paper states, “We’ll decision-making. Combined with the change our assessments to be more experience, knowledge, and professional dynamic, and update ratings more often, judgement of our inspectors, this means so that everybody will have an up-towe’ll be alert and ready to act quickly in a date view of quality.” The significance of more targeted way and tailor our CQC updating ratings more often might regulation to individual services and be a good thing for providers which have circumstances.” However, technology can been rated as ‘Requires Improvement’ or only do so much and any system is only ‘Inadequate’ because they have more as good as the data that is inputted. opportunity to get re-rated but for providers rated as ‘Good’ or ‘Outstanding’, they might want their If you require assistance or advice in relation to challenging CQC draft inspection reports or rating to remain in place until CQC challenging other CQC enforcement action, our specialist solicitors can help. Please contact Ridouts carries out another inspection. There Professional Services Plc using the email address info@ridout-law.com or by calling 0207 317 0340. is another potential issue and that is,

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voluntary sector

Royal Star & Garter, a charity which provides care to veterans and their partners living with disability or dementia, is celebrating its 105th birthday.

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1916 Residents first moved into the old Royal Star & Garter Hotel on Richmond Hill, but it soon became apparent that the building was not fit for purpose. Residents were moved out to Enbrook House in Sandgate, Kent, while a new Home was built, before returning in 1924. Nearly a century later, it became clear the iconic Home on the Hill was no longer suited to meet the needs of today’s veterans. The charity invested in three state-of-the-art Homes in Solihull, Surbiton and High Wycombe, and residents left the Richmond Home for the last time in 2013.

Royal Star & Garter marks 105th birthday he charity was established on 14 January 1916 to care for the severely injured young men returning from the battlegrounds of the First World War. It followed concern expressed by Queen Mary, who charged the British Red Cross Society with the task of finding a ‘permanent haven’ for severely disabled young men returning from the trenches in Europe. In previous years, the special day has been marked with music, food and parties. This year, there will be low-key celebrations in the Homes, and it will not be possible to mark the anniversary in the usual way due to Covid restrictions. For 105 years, the charity has evolved its loving, compassionate care to meet the needs of each generation’s veterans. Here are some of the memorable dates and individuals in the charity’s history.

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1916: Residents first moved into the old Royal Star & Garter Hotel on Richmond Hill, but it soon became apparent that the building was not fit for purpose. ➤

1924

King George V, with Queen Mary, opening the new Richmond Home on July 10

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1948 Residents competing at archery

➤ Residents were moved out to Enbrook House in Sandgate, Kent, while a new Home was built, before returning in 1924. Nearly a century later, it became clear the iconic Home on the Hill was no longer suited to meet the needs of today’s veterans. The charity invested in three state-of-the-art Homes in Solihull, Surbiton and High Wycombe, and residents left the Richmond Home for the last time in 2013.

1948 Archery competition: A nurse helping out at the competition which would become a forerunner to the Paralympic Games

1950 The rooms provided training in productive skills as part of residents’ rehabilitation

1948: In the late 1940s, a paraplegic ward was established by Dr Ludwig Guttmann, founder of Stoke Mandeville Hospital. Dr Guttmann used pioneering techniques to get residents playing sport. Believing that sport was vital to their physical and mental well-being, he

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1964

1964 Anniversary Day: Residents raise a glass to Royal Star & Garter on 14 January 1964

HRH Princess Alexandra became the charity’s President in 1964

introduced archery, which could be played from a wheelchair. In 1948 and 1949, Guttmann held the Stoke Mandeville Games with an archery competition between Stoke Mandeville and the Star & Garter team, which the latter won twice. This was the forerunner to the Paralympic Games. Today, residents are still encouraged to take part in physical activities which promote positive mental and physical health, and the charity’s Homes are all equipped with in-house specialist physiotherapy rooms, which help with mobility issues and overall well-being.

1950: In 1950 the Nuffield Workshops, funded by a gift from Lord Nuffield, opened at the Richmond Home. It provided training in productive skills, such as clock-making or shoe repair, as part of the residents’ rehabilitation. Today, we keep residents busy and active with a range of activities, ranging from arts, gardening, entertainment, games and music. These play a key part in the holistic care provided at Royal Star & Garter. This has always been the case.

1966 Golden Jubilee: Residents and staff mark the 50th anniversary of the charity on 14 January 1966

1953: Remarkably for a 105-year-old charity, Royal Star & Garter has only had two Patrons in its entire history. The first was Queen Mary, who was succeeded by her granddaughter Her Majesty Queen Elizabeth II in 1953.

1964: Princess Alexandra became the charity’s President – a role she still dutifully fulfils – following the death of Field Marshal the Viscount Alanbrooke of Brookeborough KG, GCB. ➤

1976 Diamond anniversary: Staff and residents celebrate 60 years of Royal Star & Garter

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1981 An RAF helicopter landed on the Home’s terrace

➤ 1981: The RAF brought a helicopter to the Home, landing it with great precision on the terrace. The charity has always maintained close military links to all of the Armed Forces. Having the opportunity to reminisce about their experiences with members of the Armed Forces has always been important to the residents. This is still the case, with reminiscence and recall especially important for people living with dementia.

2006: The charity celebrated its 90th anniversary in January, with a concert, including music hall numbers, followed by a celebratory tea and a piece of 90th birthday cake. Guest-of- honour was Her Royal Highness Princess Alexandra, escorted by Royal Star & Garter’s former Chairman of the Body of Governors, Vice Admiral Sir John Dunt KCB. Over 200 guests, residents, staff, supporters and volunteers also attended.

2016: A century after it was founded, residents and staff celebrated the charity’s centenary with tea parties amid balloons and flowers, and to the sound of military bands. It was the start of a year of memorable events, which included a fundraising centenary black-tie dinner at the Imperial War Museum. The charity also produced a centenary book, featuring stories of courage and determination over the previous 100 years.

Chief Executive Andy Cole said: “This charity was formed during a past national crisis, to care for severely injured soldiers and sailors, and since then we have had the ethos of care with courage at our heart. 105 years later, as we live through another national crisis, we are still able to provide the very best care to our veterans.”

2006 Princess Alexandra arriving at a dinner marking Royal Star & Garter’s 90th birthday

2016 Centenary dinner: Charity Chairman Major General Tim Tyler introduces his wife to Princess Alexandra while Chief Executive Andy Cole watches on

2018 The Princess takes part in a flower arranging activity during a visit to the Surbiton Home to mark the charity’s birthday in 2018

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hygiene and infection control

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Promotional Feature

Hygiene is key Professor Martin Green OBE is an Expert Advisory Council member for P&G Professional and the Chief Executive of Care England.

t’s true that cleanliness and hygiene have always been a priority in service sectors, yet the Covid-19 crisis has put infection control to the forefront of every conversation. In both the mind of the media and general public, hygiene remains a hot topic and will continue to be a priority for everyone this year. Communicating the details of your cleanliness protocols will be especially poignant and important within the care

home sector, where some of the most vulnerable people live. In many ways, care homes are well positioned to understand the importance of infection control because for many years, businesses have had to manage the challenge of the Norovirus and seasonal flu. These ongoing, annual challenges means hygiene maintenance procedures within the sector have always been rigorous.

One of the biggest challenges we face is that care homes needs to be ‘clinically clean’, and yet we also have to create an environment with the understanding that this is a person’s home. It is a careful balance that needs to be considered and reflected in the way in which we prepare cleaning regimes, and in the products we select to use. I do not think there are many people who cannot instantly recognise the smell of a hospital ward; we often hear people talking about how they dislike the smell of these environments as they can often smell ‘clinical’. The challenge for care homes is that we must be equally as focused on cleanliness and hygiene as any medical environment, but at the same time, we have to recognise that the services we provide are both care, and someone’s home. There is a need to balance cleanliness with homeliness, and one of the ways that this can be achieved is by using products that people are familiar with, but that also deliver effective results, time after time. Products preferred by professionals, such as those in the P&G Professional portfolio including Fairy, Ariel, and Flash, can help ensure a feeling of well-being in the minds of residents, their families and staff because they are familiar. Not only this, but Flash Professional Disinfecting Multi-Surface Cleaner and Flash Professional Disinfecting Degreaser have recently received test results indicating they kill SARS-CoV-21 , the virus that causes Covid-19, when used according to label directions. This is good news for the care sector, and it is my belief that these products will be vital in our fight against viruses, and an essential resource in protecting our most vulnerable citizens. P&G Professional products also require minimal training, as each is labelled with simple how-to-use instructions to help ensure the user understands how to work with them effectively. Hygiene and cleanliness are the cornerstones of good care, and care providers must understand the balance in hygiene coupled with creating a sense of familiarity for comfort- the P&G Professional product portfolio answers this need. To learn more about P&G Professional and its professional cleaning systems please visit https://pgpro.co.uk/ or call 0800 716 854 1Tested on SARS-CoV-2 and enveloped viruses

according to EN14476.

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Promotional Feature

FAQs – Keeping your laundry infection-free For the care sector, it’s more important than ever to follow best practice when it comes to managing an on-premise laundry (OPL) in order to maintain strict standards of hygiene and infection control. If you work in or run an OPL, here are some of the FAQs the team at WASHCO are often asked. Does thermal disinfection kill germs? Thermal disinfection, ie, hot temperatures, kills germs, but it is important to follow best practice, as stated by the Health Technical Memorandum. It recommends hot wash cycles of 65°C for a minimum of 10 minutes or 71°C for no less than 3 minutes. Our WASHCONNECT range of smart washers allow you to monitor which cycles are being used with real-time temperature validation in order to give you confidence that thermal disinfection is taking place.

your woollens where high temperatures are an issue but thermal disinfection might be your best solution for sheets, killing germs and removing stains and discolouration. Why does my equipment need regular servicing? As with most machines, servicing is absolutely key to ensuring everything is working properly; for example, checking the machine is holding the correct temperature. Regular maintenance also means fewer breakdowns and less hassle for your laundry.

Are clean and disinfected the same thing? In the world of laundry, the words clean and disinfected are not always interchangeable. In other words, you might have linens which have been washed and thoroughly removed of all germs but they still have stains or discolouration – so, disinfected but not clean. This is why it is important to make the right choice for each and every wash.

Does it matter if I overfill my machine? To put it simply, if you overfill your machine, it can’t do its job properly. As a result, you can’t have 100% confidence that your laundry is clean and infection free.

Does one solution fit all? As with many things in life, one solution doesn’t fit all when it comes to laundry. Ozone might be the perfect solution for

Can I dry on a high heat setting in my tumble dryer to kill bacteria? You can, but we definitely wouldn’t recommend it. You’ll need to set your

dryer at 60°C+ for at least 60 minutes in order to kill bacteria, but this will also destroy or damage most fabrics and linens. Who are WASHCO? WASHCO specialises in the supply, support and lifecycle maintenance of commercial laundry equipment across the UK. Working with industry-leading brands such as Miele, Speed Queen and Primus (Alliance), we deliver a complete solution to care homes via our highly trained technical team and network of field engineers. Our line-up of innovative solutions includes an industry-first range of smart laundry equipment – WASHCONNECT. Using the latest IoT technology, WASHCONNECT gives you 100% confidence in your infection control management. Our CQC compliant washers and dryers ensure linen is hygienically clean with full visibility and real-time temperature validation throughout the entire laundry process.

Care homes across the UK are choosing WASHCONNECT to transform their laundry. For more information and to explore the benefits for yourself, call us on 01635 263418 or email hello@washco.co.uk.

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hygiene and infection control

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Protecting care homes with clean air solutions from Axair

Advanced air and surface purification technology â&#x20AC;&#x201C; Wellisair helping care homes stay virus-free during the coronavirus pandemic. Care home residents often with weakened immune systems are more vulnerable than most to infection, making protecting residents a tough challenge. Even the most diligent cleaning and disinfection routines cannot completely remove microorganisms from the air and surfaces â&#x20AC;&#x201C; which are continually being replaced by coughing, sneezing and contaminated hands.

CASE StuDy Wardington House Nursing Home At Wardington House, Care Home-owner George Tuthill researched and investigated OH technology, which he had initially heard about on the US news: Using OH /

Hydroxyl generators in care homes has become common practice in the US. Having initially purchased 5 US manufactured OH / Hydroxyl Air Purifiers he explored the UK marketplace for an alternative product as the noise level was too high. George came across the Wellisair air purifier, initially purchasing three units from Axair Fans UK Ltd, then a further six units over the next two months. Wellisair is the perfect solution for keeping care home residents safe in communal areas, as well as protecting staff and visitors. Wellisair provides continuous, natural, powerful air and surface sanitisation 24/7 by producing and expanding Hydroxyl radical particles through the natural process of oxidisation. The OH (Hydroxyl) compound produces a cascade reaction of oxidisation on a molecular level, binding with the

Wardington House was built in 1785

Hydrogen in the structures of compounds that form viruses, bacteria and mould etc causing an irreversible breakdown rending them harmless. From installation to 99.9% room sanitisation in less than 2 hours. Wardington House care home has thankfully had no cases of coronavirus to date due to the investment and measures put in place by the owner, for the health, safety and wellbeing for both residents, staff and visitors alike. Contact Axair Fans at sales@axair-fans.co.uk or 01782 349 430 for more information.

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leadership

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The care champion Professor Martin Green, chief executive of Care England, talks to Kathy Oxtoby about how the pandemic has transformed the way care homes work, how staff have adapted to new ways of working, and the challenges the sector faces in 2021 hese are difficult times. But difficult times require, and allow, people to think differently.” Professor Martin Green, chief executive of Care England, the largest representative body for independent social care services in the UK, is reflecting on what have been, and continue to be, the most difficult of times for the care home sector. And yet despite facing extreme challenges – being in the frontline of care during a global pandemic, and dealing with the trauma of bereavement, while all the time being vulnerable to the virus – care home managers and staff have been able to “think differently”. They have adapted to change, to using new technology. They have continued to innovate, and come up with new ways to support residents and enable them to maintain some form of contact with families despite restrictions. Put simply, as Martin says, “they have been amazing during this time of emergency”. Throughout the pandemic Martin has been championing social care and older people’s care, just as he has done throughout his working life. [See box.] “My entire career has been in the voluntary sector, particularly in organisations for older people,” he says. Posts held include chief executive of three Age Concerns in London, trustee of Age Concern, England, and chief executive, Counsel and Care. “This experience of working in the voluntary sector most of my life, both in the UK and overseas was, I suppose, my stepping stone to being appointed to CEO of Care England,” he says.

“T

One of the challenges of older people’s care is that it is “quite neglected because there is a lot of ageism in the system”, he believes. “People who need care and support often have a difficult time because we’re an ageist society. What really drives me is older people’s care – it’s so important because it enables people to live the best life possible,” he says. Martin has been driving the strategic direction of Care England since 2005. He says the organisation’s long term aim is “to really make sure older people’s care is recognised as an important part of the health and care system, and that everything that is done enables and helps care providers to deliver the best care possible”. In the short term he says Care England has four key strategic areas of work. “First, is funding for quality care. We want a long term funding solution that enables care providers to invest and develop good quality care services.” Next, the organisation wants proportionate regulation. “We do believe in regulation - it has to be the cornerstone of public protection. We need a regulation system that’s fit for purpose, learns the challenges of the sector, and is not punitive and overly burdensome,” he says. He cites the airline system as having one of the best types of regulation, “which does critical forensic analysis of critical incidents, learns lessons and cascades them to the entire sector. That should be the model for social care regulation, which unfortunately I don’t think it is at the moment”.

Ageism in the system

Care England’s third priority is workforce. “What has come out during Covid is how amazing the social care workforce is. And yet there isn’t a strategy for workforce in social care.” What is needed, says Martin, is “a 10-year plan and a skills competencies framework”. “We need clear carer pathways and much better payment and salary scale levels for staff, who are dealing with the same issues as their counterparts in the NHS are dealing with,” he says. Innovation and development is the organisation’s final priority. “What we want to see is a sector innovating model. I’ve talked about things like developing care homes as hubs for supporting people with long term conditions in care homes. “There is also a great need for the care home sector to embrace new technology to make us more efficient and to use resources more effectively. And another real issue that is part of the innovation and development agenda is about getting better social care data,” he says. A key issue for 2020 was, and continues to be Covid-19. Martin says one of the main achievements for the care home sector during this Covid emergency is “how much commitment staff showed”, adding “that was particularly commendable at the start of the pandemic as care homes were abandoned – particularly by the NHS”. “I saw letters and emails from primary care saying ‘we are not going to come into a care home’ and ‘we are withdrawing district nurse services’”, Martin recalls. “And some letters were from GPs saying ‘we will not admit people to hospitals’.

Care homes “abandoned” by NHS

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leadership “There was clear evidence at the start of the pandemic that far from the notion that there was a ‘ring of support’ around care homes, they were abandoned by pretty much everybody – local authorities and the NHS,” he says. He suggests this “abandonment” was because “this is what happens when bureaucratic organisations focus on processes. Instead of responding they withdraw. They can’t say ‘where is the plan to deal with the crisis?’ because they are so bureaucratic and focused on processes they find it difficult to act nimbly,” Martin says.

Dealing with the trauma of losing residents

2020 challenges for care homes were not only about how they kept people safe but also having to “deal with the trauma of losing so many residents – sometimes ten residents within the space of 48 hours”. “This has had an enormous psychological impact on staff and residents because their families were not able to be with them and support them at the end of life. But the care sector did a fantastic job in making sure that this support happened where possible,” says Martin. He also believes that what hasn’t been acknowledged as challenging for the sector is the financial impact of Covid. “What we’ve seen in this pandemic is a great deal of reduced occupancy. The only way to sustain services is by having high occupancy levels - if you don’t there are severe financial implications.” He says some of the support from government was slow, initial support was directed through local authorities, and only about a third of it according to the Public Accounts Committee got to the front line of care. Another financial issue for the sector at the start of the pandemic, he says, “was that our PPE supply rocketed, because the NHS was prioritised by everybody, including government and suppliers”. He says that not only were care homes facing not having enough PPE, but supply lines were disrupted in order to give PPE to the NHS. “One corporate told me their normal PPE bill was £240,000 but that they had already signed off £2.7m – so that gives you some idea of the scale of cost pressures on the sector,” he says. Staffing was a major issue for the sector. “A lot of people were having to shield and self-isolate within their staff teams. But it was amazing the way staff supported not only residents, but also each other. We owe

a great debt of gratitude to staff who gave their commitment to supporting colleagues as well as residents,” Martin says. How to keep contact between families and residents during the pandemic when loved ones are unable to visit has been a significant issue for care homes. As well as adapting to using new technology, such as video conferencing, staff have devised new and innovative ways of for people to stay connected. “One care home organised a ‘drive through’ music event where residents could look out at the car park to see their families members and share music together – just one of many examples of creativity in this pandemic”, says Martin.

Pandemic has “transformed” the social care sector

The pandemic, he says, has transformed the social care sector in many ways, in particular, giving it “increased recognition, and probably for the very first time, real understanding of the fact that care services are dealing with the most vulnerable people, and this is being acknowledged by citizens and the media”. The impact of Covid-19 means the sector, in some areas, is now going to be “more fragile”, says Martin. “What we will see is that some people will leave the sector, mainly because financials are going to be difficult post Covid, and also because they’ve been through an emotionally draining time.” He points out that what people don’t realise about the sector is that it is predominantly made up of small providers – individual care home owners who provide a “significant amount of care”. “If they leave the sector they will leave a gap in provision,” he warns. People working in the sector have “really understood the benefits of technology” during the pandemic. “Technology has, for example, been seen as an interface between the NHS and care homes, which should make connections between the two easier in the future,” he says. And there have been other positives for the sector during Covid. When care homes were being “abandoned by the NHS”, this meant care staff were doing “a whole raft of things they were told they could never do, giving some much more confidence in their own ability,” Martin says. He explains where district nurses would typically come to care homes to dress

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www.careinfo.org ulcers or to give injections, suddenly staff were doing these procedures under supervision of nurses working in those homes. Such examples highlight how “care staff have really shone and shown what they can do, and also signal to the system that there is capacity for care homes to do much more – though this would have to be remunerated, and with proper training”, says Martin. With England now in its third lockdown, the pandemic will continue to impact on the sector in ways that are difficult to predict because, as Martin point out, “this is a fast moving situation and things change all the time”. And given the speed of change he believes that politicians should be “very careful about making definitive announcements”. “One thing that that has come through the pandemic are the times when politicians have announced something, but nobody has a delivery plan in place,” he says. What is also “completely ignored is the fact that the system is decentralised. So you have a range of public health directors giving contradictory advice. It’s difficult for care homes when central government is saying one message and local government another – things are not joined up,” he says. “What we need is clarification where the power between ‘local’ and ‘national’ lies. What we saw with all the tiers was confusion. It’s much more helpful having a national position with everybody knowing what it is,” he says.

Fast moving situation

Visiting policies: defined by care homes not government

Inevitably, he says the third lockdown is going to put care homes “back to a situation where connections between families and residents will be more difficult”. “Of course, this time the difference is we can look towards the horizon of a vaccine and that will help residents, families and staff to feel more positive than they did at this point last year”. But with care homes once again having to close their doors to visitors, he stresses, “we cannot underestimate the enormity of the challenges for relatives not being able to visit loved ones in care”, and also “the enormous impact on people’s mental health”. Set against that impact however, is the knowledge that thousands of care ➤

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leadership ➤ home residents have died in the pandemic. Given that there are tough choices to be made about people’s health, wellbeing and safety, Martin believes visiting policies “have to be defined by care homes, not government”. “Each care home community is very different. Care home providers should make decisions about protecting their residents based on the evidence on who is in their service, because they are in the best position to know how to manage visiting effectively.” Covid-19 testing was initially “quite problematic, but has got much better”, Martin believes, stressing that testing “has to be a cornerstone of the response to Covid”. But now, with vaccinations coming down the line “what we’ve got to do is to make sure the maximum number of staff as well as residents get vaccinated, and we what want to see commitment by government to vaccinate every care home resident by the end of January – I hope that target is met,” he says. On the issue of integrating health and care, Martin says that “government has not done nearly enough”. He calls for a “really clear culture change programme in government and the NHS, which understands organisations are less important than people”. “What we’ve seen throughout pandemic is the mantra ‘protect the NHS’. But the NHS is an organisation. It’s about the NHS protecting citizens and many of those citizens are in care, not in health services. “The government needs to start to understand that these are interdependent systems. It then needs to look at resources allocated across social care and apportion them more fairly across health and social care. “At the moment social care is a poor relation, a ‘Cinderella service’, and we’ve seen that in the way the government responded to the pandemic by saying the NHS has a ‘blank cheque’. They throw money at the NHS, but not social care. “I blame local government that the money allocated did not go to front line care services. And this has continued to be a problem throughout the pandemic.” The big issues for care services in 2021 include “how to restore occupancy levels, how we make sure enough money is in the system and that we get a long term solution to this” he says. “Every Prime

Integrating health and care

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Minister since Tony [Blair] has fudged this issue. Now, with the pandemic we must have a long term financial solution,” he says. Recruitment and retention present another challenge for the sector. “A lot of people are going to be worn out by the pressure of the pandemic, so we not only need to attract new people to the workforce, but we’ve also got to retain people – to nurture our colleagues. “That will be a challenge in the coming months because as the vaccination programme rolls out and we move away from being in crisis there’s a tendency to forget what people have been through.” His hopes for 2021 are that it will be a year of “absolutely seismic change”, and that government will come forward with “really clear long term funding proposals”. He would also like to see “a clear workforce strategy that recognises training and support needs, and also recognises that we have to pay people because they are doing a very skilled job”. The UK’s exit from the EU means staffing in general will be a challenge, he believes. “What the government seems to talk about is a ‘home grown workforce’, but we need to understand that it takes time to grow a workforce. “I want to see government coming forward with a very clear plan on how that’s going to be done, a plan on a transition point for the sector - which has relied to an extent on overseas staff - and a bridge time between leaving the EU and developing this home grown workforce.” 2021, he hopes, will also be the year “when we really start to see care homes embracing technology and data as an

A year of “seismic change”

CarE EnGLanD Working on behalf of small, medium and large providers, registered charity Care England speaks for both members and the whole care sector. its membership includes organisations of varying types and sizes, amongst them single care homes, small local groups, national providers and not-for-profit voluntary organisations and associations. Between them they provide a variety of services for older people and those with long term conditions, learning disabilities or mental health problems.

essential part of planning and developing care. For example, I want to see the introduction of electronic care planning where you can make sure you have capacity”. He says technology, such as the iPad that flashes up when a resident’s tablet is due, or the automatic sensor that lights a resident’s way to the bathroom. “can be used really effectively to enhance residents’ experience, and we need to build this technology into our future”. While care home staff have faced “a really testing time” during Covid, Martin says “one of the things they should hold on to is that the sector has come through it – showing its ability to deal with hard times. “Sometimes people don’t recognise just how amazing staff have been. I would say the sector needs to take a step back, to try and learn the lessons from how people did during the pandemic, and use those lessons to make a stronger service for the future.”

ProfEssor Martin GrEEn – chief executive Martin Green, is chief executive of Care England, the largest representative body for independent social care services in the UK. He is also chair of the international Longevity Centre and a trustee of the national aids trust. in 2013 he was appointed visiting professor of social care to Buckinghamshire new University. in 2012, in his role as Department of Health independent sector dementia champion, he led the development of the Dementia Care and support Compact for the Prime Minister's Challenge on dementia. He is also a member of the secretary of state for Health's stakeholder Board; a Dignity commissioner; a Lambeth transformation commissioner; a member of the nursing and Care Quality forum; a Board member of the national institute for Health research (school of social Care) and a founder trustee of the national skills academy for social Care. in 2008 he was named care personality of the year and was awarded an oBE for services to social Care in the 2012 Queen's Birthday Honours List.

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; itâ&#x20AC;&#x2122;s at the heart of everything we do. Experts in award winning care. Trusted by over 6,500 families.

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Leadership considerations post-Covid he adult social care sector will emerge from the Covid-19 pandemic battle worn and weary but still resilient, and care providers must consider how they will manage their business and achieve the positive outcomes desired after such a major event. In establishing the direction of travel, organisations should also assess whether their leadership team have the skills for the journey they are embarking on or whether supplemental skills are needed. The main purpose of any Board is to direct the company’s business to ensure its prosperity whilst meeting its legal and regulatory duties. Running a care business is about great care delivered by sufficient numbers of well-trained motivated staff and achieving or exceeding budget within the context of relevant regulations. This summary belies the complexity of issues within long term care provision where there have always been challenges, but this past year has seen the biggest challenge of all. It would be a mistake to consider that the pandemic has affected all care providers in the same way. Each and every person and each and every business will have experienced their own Covid

Anne Smith of Brilliant Care Solutions looks at how boards of social care companies have a vital role to play in ensuring resilience throughout the course of the pandemic. journey. It is unlikely that many will emerge unscathed and some will have experienced first-hand how Covid can ravage the body, heart and soul of both individuals and the organisation. In addition to the emotional and physical impact, there have been the commercial challenges of decreased revenue, a spent workforce, and continued uncertainty. The virus has affected care businesses in many ways adding layers of complexity. Senior leadership in each organisation will be identifying what these effects are in order to move forward. Covid is likely to have affected a number of areas such as revenues, costs, staffing, consumer confidence, dependency levels and individuals’ physical and mental health. A change in the Care Quality Commission’s regulatory focus is also expected as a result of their review, which will put a greater emphasis on whole health and care system integration for the benefit of the service user, with feedback and safety as central tenets.

Running a care business is about great care delivered by sufficient numbers of well-trained motivated staff and achieving or exceeding budget within the context of relevant regulations.

Organisational strategies may need revising in response to help increase profitability, nurture staff wellbeing and talent, and deliver compliance and a high standard of care. Greater emphasis on the company’s vision and values may also be helpful. Covid -19 has posed and continues to pose both ethical and operational challenges, which can be answered more easily if the values of the company are well defined and fully understood. A regular review of the Board and senior team’s capabilities is a helpful strategy in achieving a high standard of leadership and strategic management. With so many changes wrought by the effect of the pandemic, this may be the best time of any to carry out such a review to assess whether the sum of the individuals’ talents in the senior team provide the full skillset of competencies required, or whether additional experience and talents may be needed. Covid itself has highlighted the need to have clinicians at senior level who understand the complexity of care and its impact and who can ensure that the organisation as a whole can respond appropriately. The ability to predict future care needs following the ➤

Nurturing wellbeing and talent

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➤ coronavirus pandemic will be hugely important in setting strategic direction. Those now requiring care may have a myriad of additional care needs, demanding greater clinical abilities within the sector’s workforce. Infection prevention and control is unlikely to return to its former back seat of care priorities and as a result a whole new focus will be on care. Demand for care services may increase due to an accumulation of people needing support, clinical care and attention and the effects of long Covid will remain. However, the emotional response to this pandemic could hold the demand back as potential service users and their families grapple with weighing up their need for care against the perceived risks in seeking care provision even with the advent of vaccination. Trust can be quickly lost but far longer to rebuild. It is also likely social care funding will significantly diminish once the acuity of the pandemic has passed. Competition is likely to be intense as organisations look to similar solutions for their organisation’s recovery. Leadership therefore needs to be highly entrepreneurial on one hand but proficiently process driven on the other, in order to achieve business success through creativity and detailed attention to high standards of delivery. Confidence in recruitment has grown during the pandemic due in part to people from other sectors seeking more reliable employment in health and care. It is difficult to predict the future. Some people may indeed have found a vocation but others as a result of their Covid experience will be seeking the exit door. Leadership will need to know and understand its own workforce to support and inspire it appropriately. Human emotion is a key component of care, never more so than now as a result of the pandemic. In addition to the

A clear vision

A successful leadership team can set direction, build an inspiring vision, and create something special for the future but they must have the full skillset to do so.

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Covid itself has highlighted the need to have clinicians at senior level who understand the complexity of care and its impact and who can ensure that the organisation as a whole can respond appropriately. physical difficulties, Covid has had a significant psychological and emotional effect on everyone. Boards and senior teams with a clear vision of the way ahead and the right skills and knowledge are likely to achieve successful outcomes, particularly if they recognise the psychological impact and have the emotional intelligence to respond appropriately. After all who is more likely to be more successful: a leader who directs without the emotional awareness and without connection with their staff or one that understands the situation and relates well to others? Emotional intelligence is a combination of skills encompassing self-awareness, empathy, and social skill which are particularly relevant at a time when people need to be encouraged and appreciated more than ever. Responding to feelings has never been more important. An effective leader will understand their own and others’ emotions, intuitively leading the staff and the organisation to better times. Where a skills gap in the leadership team is identified, there are a number of options available including reorganisation, recruiting additional Board members and senior managers with the required skills, appointing NonExecutive Directors, or considering a temporary fill with an appropriately skilled consultant. The appetite for change at a senior level and the cost of it will be major considerations. The size of the organisation will also influence choice as will protecting stakeholder interest. SMEs may find recruiting a NonExecutive Director for example a financially astute answer to bringing in the high level of expertise and

independent challenge required at a fraction of the cost of a full-time person. However as with all the options available, careful execution is needed to maximise the leadership skillset and the effectiveness of its Board, whilst minimising the risk of role conflict and ambiguity. Clarity of responsibilities are key. For instance, executive and nonexecutive directors share the same legal responsibilities for the company’s successful operation, but their roles are quite different. The executive team are responsible for running the day-to-day operations whilst a non-executive director is not, instead they can provide creative and informed contribution, independent oversight, constructive challenge as well as useful connections, therefore raising the leadership performance. Their expertise can help facilitate best practice and provide mentorship to the executive and management team; this could be particularly helpful when there are specific situations such as incidence, inspection, or post Covid issues, therefore adding to the overall resilience of the organisation. A successful leadership team can set direction, build an inspiring vision, and create something special for the future but they must have the full skillset to do so. Effective leadership has a habit of finding good things even when there are difficulties, they see lessons learned as an opportunity for longer term improvement They can achieve goals which can enable pride and a feeling of progress especially after difficult times and they can help the wider team develop a quiet optimism.

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James Rycroft, managing director at specialist dementia care provider Vida Healthcare, discusses the impact of Covid-19 on the social care workforce, and a range of investments employers can make to support carers at work.

Investing in your best asset lthough it’s been acknowledged for years that the UK’s health and social care systems have been in crisis, Covid-19 has created a global emergency which has caused irreversible changes. The pandemic has led to some of the biggest challenges ever seen by the sector and the landscape is changing rapidly. While social care and its workforce has often been overlooked and neglected, over the past few months its crucial role in caring for our vulnerable population has been highlighted and brought to the forefront of the public’s consciousness. We must safeguard our services for the future, and ensure staff are prepared for future crises and rewarded for their hard work. Social care employers must develop a workplace which not only benefits current staff and harnesses their loyalty and commitment, but also attracts new talent to the sector.

Covid-19 has, without a doubt, led to unprecedented changes in the social care sector which have had both positive and negative effects. The pandemic has led to the public becoming more aware than ever before of the crucial role of social care workers. Thanks to initiatives like ‘clap for carers’, more people are becoming interested in understanding, and taking up roles in the sector. Recent research from Vida Healthcare, released in 2021, found that since the start of the pandemic, almost two thirds (64%) of the public are more aware of the care industry, and 70 percent of people now value social care staff on a par with the NHS workforce. As more people become aware of the rewarding nature of working in social care, it may be that the pandemic has a positive effect on the sector in the long term.

Prior to the pandemic an ageing population and funding challenges had placed the social care system under increasing pressure, with staffing shortages, lack of funding, and inefficiencies all leading to services not only finding it difficult to provide quality care, but employers struggling to support carers at work.

Employers must understand why providing opportunities for career development is so important, and encourage staff to consider social care as a career rather than just a job. This will also drive their passion when it comes to caring for society’s most vulnerable, and ensure people are committed to delivering best practice and learning new skills. Investment in career opportunities will inspire more people to become interested in a role within social care, and make current carers feel supported in their ambitions. Employers should show compassion and interest in the personal development of employees to create a positive workplace culture and working

The impact of Covid-19

The pandemic has led to the public becoming more aware than ever before of the crucial role of social care workers.

Career progression

environment which retains existing staff and attracts new talent. This has been particularly important during Covid-19, where increasing pressures have led to many carers feeling unable to cope. While investment in career development and opportunities is important, employers need to consider the mental health of their carers. Investment in mental health initiatives will ensure the health and wellbeing of staff is easier to maintain, ensure that staff have more time to interact with the people they care for on a personal level, and reduce pressures on services and staff. A mental health crisis within a care setting can lead to ineffective care delivery, high staff turnover, and a place of work which doesn’t attract new talent. Connectivity with residents and their family members is also crucial. Opportunities to develop personal relationships with residents is important to engender trust and reduce stress, while connectivity with family members enables carers to showcase the crucial work they’re doing. Connections with family members is also likely to drive positive testimonials which will provide carers with a sense of achievement and purpose in what they’re doing. Employers can also show their gratitude through initiatives such as awards where staff members are nominated, and events such as Christmas parties. This will highlight to carers that they’re valued, and also give them a chance to destress and socialise with their colleagues.

Mental health

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staffing Social care employers must also understand the role of the recruitment process in ensuring talented individuals are employed by the sector, and what they are looking for from a workplace so that they can be supported effectively. Employers must consider potential staff who perceive social care as a career, rather than just a job, and are passionate about caring for society’s vulnerable. We must also seek to understand why workers exhibit loyalty to their employer and the sector, and how we can build on this dedication and commitment by recruiting the right people. Recruiting the right people who are passionate and dedicated will develop a positive and supportive workplace culture and working environment which retains existing staff and gives them the support they need.

Recruitment and retention

Vida Healthcare has developed and launched technological initiatives to support staff at work, and provide opportunities for career development. The Team Talk app was developed to keep staff across the two homes connected, provide insight into

Supporting staff in action

Februar y 2021

www.careinfo.org developments at board level, and offer updates on A mental health crisis within a care setting the latest headlines can lead to ineffective care delivery, high relevant to social care and staff turnover, and a place of work which care homes in particular. We’ve also invested in doesn’t attract new talent. supporting career progression with the and working practices, including staff recent investment in the shortages, limited funding, and increased development of our demand placed on care workers. training platform, Vida Academy. More recently the pandemic has Launched in July 2020, the platform changed the sector forever, with some provides learning resources and career positive effects having been experienced. development tools for staff to deliver best Never before has the public been so practice and identify new skills. aware of the role of carers in supporting In addition, we offer our staff resilience our most vulnerable people, and more and mental health wellbeing sessions on people are considering a career within a range of different programmes, the sector. including staff inductions and our However, this has put pressure on Aspiring Leaders courses. We also offer employers to step up and support their follow up sessions, either in small groups staff at work. We must work together to or for individuals, on request to provide develop a culture of learning, and greater staff with a confidential and private understanding of different tactics that space to explore their experiences, and can be deployed to ensure staff are give them a voice if they feel they aren’t supported. being heard. We must take advantage of the Looking ahead progress we’ve made during the There are a range of issues which have pandemic, and ensure it doesn’t slow to always prevented employers in social reduce staff turnover and attract new care from developing workplace culture talent to the sector.

comment Light at the end of the tunnel? Robert Kilgour, executive chairman of Renaissance Care which operates 15 care homes throughout Scotland with around 1,150 staff, says there is cause for optimism in the sector

espite the latest figures on current Covid cases and Covid related deaths in Scottish care homes, I am optimistic that we have turned a corner now and that there is light at the end of the tunnel. The vaccinating roll out to all Scottish care home residents and staff is going pretty well albeit in some parts of the country such as Edinburgh are slower than others and for example, at Renaissance Care, about 1% of our staff have so far refused to be vaccinated which is their right and we respect that.

Care home staff have been true heroes throughout this last year and continue to be amazing looking after their 'second families'. In my 30 years of working in the sector, I have never been prouder of them all but care homes are not islands, they are each part of their local communities and if Covid is rife there then it follows, as night follows day, that they will likely be affected - that is sadly just fact. On testing, again, great improvements recently – all Renaissance Care staff currently have two LFD tests and one PCR test every week and daily LFD tests

if there is an outbreak in a home. On visitors and visiting – Renaissance Care are currently only allowing outdoor, window and indoor 'end of life' visits - all supervised with full PPE and only following a negative LFD test result for all involved including any emergency contractors and Care Inspectors. On resident admissions – all of our care home admissions have to have had a negative test result.

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pitalfields Music was established in 1976 and has decades of experience in bringing music into different settings across the East End of London. This part of town is home to many creative artists but is marked by inequality and poverty – “diverse” and “vibrant” are adjectives that are often used. It can be a great place to live, but there’s a sense that the different

PHOTOGRAPHY: JAMES BERRY

Art for care’s sake

communities here sometimes inhabit parallel worlds, failing to interact, until something like this comes along. “It began with an idea – what would an artist’s residency be like in a care home?” says Nicole Artingstall, Producer at Spitalfields Music, who helped develop the project alongside artist and musician Julian West and social gerontologist Hannah Zeilig. Following a promising pilot, funding was secured from a wide range of donors for activities over three years. A variety of care homes were involved, run by different providers: a large and well-established commercial set-up, a charitable foundation, as well as a newer and smaller company. An early enthusiast was Dr Chai Patel, Chairman of HC-One Care Homes (now retired), who was impressed by the way the work using artists began “unlocking new experiences…. and engagement between the residents, the staff and the relatives. We’re onto something really quite special here.”

Tim Cape was one of the musicians on the project. “Everyone is a player and everyone’s the audience, and everyone’s involved,” he explains. “We try to open up various lines of communications that are non-verbal, through sound, through simple body movements, all through a sort of playfulness.” Charlotte Hunt worked with many of the musicians and artists. “It’s quite incredible how special this project is for artists, in their own practices and their lives. This is so closely linked to their identities, and what music can be – they’ve had profound moments that they’ll never forget.”

“We were very ambitious,” admits Bea Hankey, who worked to make it happen with Spitalfields Music. An approach called ‘co-creativity’ was central – something that would probably feel familiar to most primary school music teachers but is too often avoided in settings with older people. There’s an emphasis on being in the moment together, as equal participants, in a spirit of spontaneity and fun.

Even before the virus, however, it wasn’t always an easy journey. As they started out, both artists and care workers found themselves thrown into unfamiliar and often uncomfortable new situations. Give and take were needed on both sides to find a way of working together. Some of the over-stretched care workers were unconvinced, to start with, by the arrival of a group of artists who seemed likely to get in the way, agitate the residents and

Very ambitious

Introducing live creative sessions into care homes can be transformative, both for the residents and for the different professionals involved. Sonia Lambert reports on an innovative project in East London.

Convincing the carers

“At the very end, D looked at me with her sparkly eyes, and turned her hand to show me that she had arranged some of the yellow and blue balls in her hand in a pattern that she liked. ‘I made it’ she said.” (Creative Encounters: Artist’s Notes)

disrupt their routines. “Maybe the care staff want to keep a lid on it,” Tim says, “they’ve seen where it can go. ‘That’s another balance. There’s a risk, and if you’re trying to manage a care home, you don’t always want to take risks.” Repeat visits began to make an impact, however, and soon they were met with smiles rather than shrugs. It helped when care home staff began feeling that “we were familiar faces, ‘oh hi, you’re back!’” says Nicole. “Then the staff were supporting us, clearing away the tea trays, saying ‘hey, great to have you here.’ Partnership working was crucial. We were becoming part of the fabric of the home, in a very small way, and they supported the residents to feel that we were familiar too.” “I thought it was brave of the care staff,” says Bea. “They really did go with it. And trust was built.” “I think staff were surprised by the sound of the instruments and the effect it had,” said one of the care managers at the time. Others appreciated a break in the routine. “Every day is the same here, you guys came, this was different, another kind of connection, new conversations.” Above all, many of the staff were delighted by the extent to which residents were able to interact with this approach, even those with advanced dementia who were normally unresponsive. “The sessions were good for me. I always want to do something for my residents – music

Delighted

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Tim. “There’s a real urgency to having that connection, you can do the simplest little thing and it can be really charged.” “I’m glad I met you on my death bed,” said one resident, half joking and half serious. This work felt important to the artists but was also emotionally draining and occasionally shocking or upsetting. is the most important thing for them – when they have an instrument in their hand they can touch and feel it even if they can’t play it. Even residents who didn’t take part, who were in the lounge, were excited,” said an activities coordinator from one of the homes. The most enthusiastic members of care staff became ambassadors for the project. The sessions were an opportunity for care staff and managers to deal with some of the stress of their roles. Even on a bad day, these encounters could lighten the load, and the “mood would change in a session.” A carer might come in with “a face like thunder” but end up “dancing around with something on her head… destressing, unlocking something, a bit of lightness, and the care she was giving the rest of the residents benefited, too.” There were physical constraints - lounges were the wrong shape and seats were difficult to move. “One place had this long narrow room with these massive wipe clean chairs, that hold people up, but aren’t very conducive to a chill out, let’s reset the space…” remembers Nicole. “It required the artists team to really adapt and relax their requirements. OK, we can’t have everyone in a circle. Let’s try and connect the room somehow, bring in material that we run down the middle, or have instruments at either end.” Sometimes, Nicole says “the life of a home gets in the way.” Staff leave or get called away. “There are a lot of competing pressures. An ambulance arrives and someone needs to go to hospital…” Working with residents with dementia can of course be challenging, as well as very rewarding. There’s “the energy of a resident who’s excited to come in and drum, every session. How can we use that within what we’re doing?” Nicole recalls one resident who introduced an anarchic often subversive - unpredictability to proceedings: “she’d try and lift your top up, or prod someone who was playing the

Physical constraints

cello, or want to bang someone on the head – we tried to find ways to kind of meet her with that and involve her and her playfulness in the session.” Sometimes it went better than others, but as the project went on, the artists found it worked best not to control or shape the activities too closely. With practice, they responded intuitively to developments, helping residents to find positive, creative outlets for their energy. “We don’t distinguish between instruments and props”, Tim says. “Things that you can throw around or pass from one to the other, things that cross the room.” This is especially helpful for people who find it hard to move around or are confined to a chair - “it means that if you can’t travel yourself, your scope of interaction isn’t so small.” It was important, Nicole agrees, to provide “different routes in” with objects to touch, as well as dancing and sound. “Someone is going to have a connection with the music – someone’s interested in the scarves – or dancing with some lemons.” “There’s something for everyone – we’re all different,” says one resident. Familiarity and repetition are important to the residents, too – a sense of having spent time and made something together, even when precise details of previous visits or interactions can’t be recalled. “There’s nobody here that I don’t know yet,” says a resident, suggesting he feels comfortable and confident with the mood of the room. “From nothing, look what came up! Don’t try to sophisticate it,” says another. After the group session in the lounge, artists moved around the home playing music and interacting in other spaces and, w, in corridors and, where appropriate and requested, in residents' rooms. Some of the residents were very weak, in their final days or even hours. “There’s an incredible power to people in that state, there’s an awareness of being at the end of life,” says

Familiarity and repitition

Covid-19 came as a terrible blow. “It was awful seeing it all play out,” says Bea, “hearing what’s in the news, imagining what’s happening in those homes.” Suddenly, everything stopped. Having developed close relationships with the homes, staff and residents, it was very difficult to break off in this way, and especially to hear news of a high number of deaths, when several homes were badly hit. All the project workers and artists could do was to send “digital offerings” messages of support and materials that the homes could use remotely – working to pull together musical recordings, short films and pictures. It felt inadequate. “We got a sense that this isn’t what they need right now,” says Charlotte. “They were getting through day to day.” The care staff felt the loss of the project too and one of the managers said that “We really miss them – they miss hearing the instruments in the corridors.” A thank you note was received from a care home “Please let everyone know we are also thinking of them.” The artists and care workers involved speak with passion about the project and would love to get it back up and running, when conditions allow. They are hoping to spread the word about this approach. “Nobody should own this type of work,” Tim is keen to emphasise. “We’re very good at it, but essentially you’re just using your humanity and bit of musical or performative skill, so ultimately there are a lot of people with this skill.”

A terrible blow

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Daleside Nursing Home in Birkenhead and Riversdale Nursing Home in West Kirby

Daleside Nursing Home is located in Rock Ferry, between Bebington and Birkenhead, in a sought-after and mainly residential area. Riversdale Nursing Home sits in the affluent coastal destination of West Kirby. Both homes are close to local amenities and benefit from easy access to Liverpool, Manchester, and Southport. Both Daleside Nursing Home and Riversdale Nursing Home were previously owned by Mrs Kate Armstrong Shone, who decided to sell to spend more time with her family. She comments, “I'm so pleased to have finally completed on the sale of these homes, meaning I can now concentrate on spending more time with my family. Thank you to James at Christie & Co and Sheridan at Kuits for getting it over the line. I can’t recommend their services enough.” The two businesses have been purchased by an experienced local care home operator.

James Knight, Business Agent at Christie & Co, who handled the sale, comments, “I'm absolutely delighted to announce the sale of both homes on behalf of my client, Kate. It’s been a very tricky process throughout 2020, with plenty of ups and downs along the way, however, everyone involved battled through and showed incredible resilience and persistence during what was a long transaction. “I would like to send a special thank you to all involved for doing everything they could to get this over the line. I wish the Kate and the new buyer the very best going forwards. I must also mention the fantastic work of Sheridan Broude and her colleagues at Kuits in Manchester. Without them, we may not have got this deal completed.” The sale was supported by Kuits, a leading, UK200-listed commercial law firm based in Manchester city centre. Both businesses were sold at undisclosed prices.

St Johns Nursing Home in Droitwich, Worcestershire, to Spring View Care

St Johns is a well-established nursing home registered for 43 service users and sits in a two-storey former Victorian hospital which was converted into a care home in the early 1990s. It comprises 40 single rooms all with en suite facilities, and three one-bed flats, all of which are spread across two units; The Pines which has 26 dementia nursing bedrooms; The Limes which has 17 bedrooms for residents with enduring mental health needs. The home is located in Droitwich, Worcestershire, and lies in a residential area in a cul-de-sac which is just a short walk from the town centre. Droitwich is a growing town which lies alongside the River Salwarpe on the A38 close to the M5 and M42 Motorways in North East Worcestershire. Further expansion is continuing in the town with major residential developments to the south. The business was previously owned by Shaw healthcare. Speaking on behalf of the company, Commercial & Development Director, Mr Geraint Evans, comments,

“Thanks to Christie & Co for making the transition of ownership to Spring View Care as smooth as possible. We wish all the residents and employees the very best. The employees at St Johns will also be transitioning with the service, so the residents can be assured of a consistent level of care with familiar faces.” St Johns has been purchased by Spring View Care, an experienced, expanding local operator with two other homes in its portfolio. Speaking on behalf of the company, Director, Mr Kamal Khan, comments, "We are delighted to be taking ownership of St Johns. Paul Reilly at Christie & Co has been instrumental in finding a home that meets our criteria so well and in helping to make the transition so smooth in the current environment. We’re really looking forward to the challenge of making St Johns one of the top performing Nursing

Homes in Worcestershire.” Paul Reilly, Director at Christie & Co, who handled the sale, comments, “Following a period of marketing, we secured a sale to Spring View Care, a company well known to us and a provider of excellent care. This acquisition is part of Spring View’s expansion plans and brings their current portfolio to three homes. We wish them every success in the future.” St Johns Nursing Home was sold off an asking price of £2,000,000.

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Castleoak hands over latest end-to-end care development ahead of contract

Care development specialist, Castleoak has handed over its latest end-to-end care home development The 64-bed Bishop’s Cleeve Care Home in the north of Bishop's Cleeve, near Cheltenham, will be operated by Advinia Health Care and backed by Octopus Real Estate Castleoak purchased the site, developed the design and achieved full planning permission, then creating a partnership arrangement with funding from Octopus Real Estate and a 30-year leasehold deal with growing quality care operator, Advinia Health Care. Castleoak has also delivered the design and build, including the off-site manufacture of the timber frame, starting towards the end of 2019. Despite the challenges presented by Covid-19, the care home was handed over ahead of schedule. Lisa Gledhill, who recently joined as MD, Development, said the company’s comprehensive capabilities and expertise meant the project was delivered in an accelerated timescale. “Having the complete set of development, technical, design and construction capabilities means we can deliver seamlessly. Add in the speed, quality and efficiency of our colleagues in off-site manufacturing, and this is end-toend development delivery of muchneeded, high quality care accommodation that we can all be truly proud of,” she said. Mark Cash, chief executive officer for

Advinia Health Care, said the new stateof-the-art building would allow for the provision of the highest quality truly person-centred care. He said: “There is a real short-fall of high-quality care home beds in the local area and we are confident that this new Advinia Care Home will help meet the needs of local older people. “The building itself is of the very highest standard, both in terms of luxury and comfort, but also from a safety and wellbeing perspective. “We look forward to working with the local community in the months ahead to provide the highest quality of care for the people of Bishop’s Cleeve and the surrounding area.”

Castleoak and Octopus Real Estate have partnered on a series of care and assisted living developments since 2012. Stavros Criticos, Investment Surveyor, Octopus Real Estate commented: “We are pleased to be working again with Castleoak, a developer with specialist knowledge in the sector who consistently delivers quality. At Octopus Real Estate, we are committed to growing our portfolio of modern, purpose-built care homes to address the structural undersupply of quality care beds across the UK. The sector still requires significant further investment given the country’s ageing population, and we continue to work with our development and operating partners to bridge this gap.”

The Court Nursing and Residential Care Home in West Felton, Shropshire

The Court is a former nursing home comprising 34 single bedrooms in a detached three-storey building with a single-storey purpose-built extension. It is situated in the village of West Felton, Shropshire, approximately five miles from the market town of Oswestry and 14 miles from the county town of Shrewsbury. The property has been sold to local husband-and-wife team, Mr Steve and Mrs Kerry Johnson, who plan to convert the former care home back into a domestic house with an annexe for Kerry’s parents.

The required planning permissions were granted for change of use in December 2020. Paul Reilly, Director at Christie & Co, who handled the sale, comments, “The home attracted lots of interest over a long period of time from both existing care operators and speculative developers. We had a few abortive sales as it was a sensitive local village who, in the end, were in full support of its change of use back to a domestic dwelling.” The Court was sold off an asking price of £550,000.

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Kilgour acquires new care home Dow Investments Plc, a general investment company whose chief executive is Scottish entrepreneur Robert Kilgour, has acquired Ayrshire care home Malin Court in a deal worth £1.1m. The 32-bedroom care home with around 50 part and full time staff is currently owned by Malin Housing Association, an elderly care charity which has been chaired by Sir Boyd Tunnock for the last 40 years.

Malin Court, which is situated on a 11acre site adjacent to Turnberry Golf Course facing across the Firth of Clyde towards Arran, also comprises a small hotel (currently closed) on its first floor – but Kilgour said that there were no plans to reopen this. The care home will be operated by Renaissance Care, where Kilgour is executive chairman, becoming its 16th

care home and the fourth in the West of Scotland – the others being Whitecraigs in Glasgow and Rosepark and Croftbank in Uddingston. Renaissance Care currently employs some 1,150 full and part-time staff in the 15 care homes it operates throughout Scotland and at its Central Support Office in Musselburgh.

A Look at Retirement Villages Social care options have expanded dramatically over the years, with a greater focus now on private care. Retirement villages are, arguably, the culmination of this progression, but what exactly are they and what are their benefits?

What makes a retirement village? Fundamentally, a retirement village is a purpose-designed village community built around the needs of those who require later life care. It allows for a satisfying social life and individual freedom,

Promotional Feature while providing 24 hour support from on-site carers. It’s this hybrid mentality, combined with a wide range of facilities, which make retirement villages so appealing.

Facilities Some retirement villages specialise in dementia care, others do not, though most villages do have a range of facilities, activities and services on-site to replicate a natural village-like life for residents. Retirement villages expand the ideas of retirement homes to a larger scale. Facilities may include: n n n n n n n n

Restaurant and bar Local shop Reception and transport services Lounges Organised activities Swimming pool and gym Salon Games room

Retirement villages also come with expansive green spaces, public and private gardens, and many will also have an on-site care home.

Living Arrangements Most retirement villages are not gated - residents are free to leave the site, with access to 24 hour emergency calls. Dementia villages will restrict access; it’s all about creating the most comfortable and effective space for residents. Some villages allow rental, but leasehold properties are the standard. Homes are catered towards the changing needs of residents; they take the principles of care home design and integrate them into a wider community setting. Residents have a perfect balance between privacy and independence, and social, physical and medical support.

Designing a retirement village Designing a retirement village, while more challenging, does leave greater opportunity for freedom. Whether designing homes themselves, planning a layout, designing external and internal navigation or thinking about the overarching structure of a retirement village, an expert hand is invaluable. Those experienced in designing and refurbishing care homes are perfectly placed to attend to the design of retirement and care villages, ensuring the ongoing happiness, safety and satisfaction of older residents.

At Aedifice Partnership, we manage new care and retirement village construction projects throughout the UK. For further details on the services Aedifice Partnership offer, visit www.aedifice.co.uk or call 0800 151 0234.

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A selection of transactions by Christie & Co

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PRECISE LEGAL SUPPORT In the face of legal challenges, precision and efficiency is key – especially in the health and social care sector where vulnerable people rely on your care. When you need legal support for your business, you need it to be right for you, and that’s why our team of specialist solicitors will work alongside providers, ensuring that you receive support that is tailored to you and your precise situation. Ridouts offers legal, operational and strategic advice to health and social care providers. Our clients are at the heart of everything we do. We get results no matter how time sensitive the issue. Our team of experienced solicitors understand the sector inside and out, giving you truly specialist and tailored advice for your needs. • • • • • • • • • • • • •

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