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SUPPLY & DELIVERY CHALLENGES
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news
June 2020
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NCF survey – only 22% of care workers could access Covid – 19 tests in early May A survey of its members by the National Care Forum, which represents not-for-profit providers, suggests that in early May, less than a quarter (22%) of care workers who attempted to be tested for Covid-19 had been successful in doing so. The NCF survey represents the perspectives of a wide range of organisations who between them employ 31,262 staff. Of these 6,469 were identified as being a priority for testing (due to having symptoms) and attempts were made to get them tested. The NCF points out that, on 15 April, the Social Care Action Plan made an absolute commitment to testing for care workers: “We are rolling out testing of social care workers …. There is now capacity available for every social care worker who needs a test to have one, just as there is for NHS staff and their families.” “This promise is not being met,” said the NCF when it released the survey results. “Our survey shows that the employer portal is not working for social care employers. Using this
route, only 2% (138 out of 6469) of staff were able to receive a test at drive-through centres, with no home testing being available on the system via this route. There is a significant manual backlog in the system, which means that large numbers of providers seeking to access testing via this route are not yet even entered onto the system, and there is no prioritisation for social care employers. In the words of two of our members: ■ “I sent an email on Monday, 27 April to register onto the portal and sent it again on the 29 April.
prioritisation for care staff and therefore to obtain a test a care worker must compete against all other eligible key workers and members of the public. This means that employers are not able to plan a strategic approach to testing to align with the homes they most need testing in and employees are under no obligation to report their test results with their employer. Local testing systems seem to be the most successful, where they are in place. 715 members of staff have managed to access testing
VIC RAYNER: “The government’s promise to provide tests for all staff is exposed as pure words. Social care needs to be systematically prioritised in
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each and every testing system, in order for government to live up to its commitment.
After not hearing from them I phoned on 1 May to be told there was a backlog with registration onto the portal and I had to wait. The contact couldn't give me a timeframe and as of May), we have still not been contacted.” ■ “We have not had any success with the employer portal. Despite several e-mails being sent to register we have not heard anything back at all. Therefore, none of our staff have been able to be tested through this process.” The self-referral portal was more successful with 583 staff managing to get a test via this route. Out of this number, 546 attended drive-through appointments but only 37 received home testing kits. This route, whilst proving more successful, only enabled 9% of the staff who needed testing to obtain a test. The NCF points to a number of significant issues with the self-referral route: again, there is no
through local systems. However, this is only 11% of the total number of staff who need testing (715 out of 6469). Local testing systems remained hugely variable and inconsistent across localities – where they work well, testing is effective and efficient and responsive. “However, it is a postcode lottery,” said NCF executive director Vic Rayner. “The government’s promise to provide tests for all staff is exposed as pure words. Social care needs to be systematically prioritised in each and every testing system, in order for government to live up to its commitment. “We are calling for the prioritisation of social care employers through the Getting Tested Portal to ensure they have a strategic and targeted prioritisation of all their employees – regardless of symptoms, as previously promised by the government and for social care workers to be given priority status on the self-referral portal.”
C O M PA N Y I N D E X Barchester Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 30 Black Swan Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Bluebird Care Stroud . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Brendoncare Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Borough Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Centrum Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 Cinnamon Care Collection . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . 8 Colten Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Hallmark Care Homes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 HC-One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Inspired Villages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37 Loveday & Co . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 26 MHA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 New Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30, 34 Sanctuary Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
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news
June 2020
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Call for a ‘ring of steel’ around care homes as residents’ deaths continue to escalate Towards the end of April, the Government belatedly opted to include care home mortality figures in its daily publishing of the Covid-19 pandemic death toll for the UK. The first composite figures published on 29 April totalled 26,097. Only those people who had died, and who had tested positive for Covid-19 were included. Data gathered by the Care Quality Commission (CQC), published for the first time on 28 April by the Office for National Statistics showed that from 10-24 April care homes reported 4,343 deaths from Covid-19. Half of them came in the last five days, indicating an accelerating death toll. CQC reports suggest care homes are now seeing around 400 Covid-19 deaths each day, on average – a number on par with hospitals in England. Local authority social care directors have said the death toll in care and community settings is likely to rise higher than that in NHS hospitals. The number of deaths in care homes where Covid-19 had been included on the death certificate rose sharply from two in the week ending 20 March, to 22, 217, 1,043 and 3,093 in the following four weeks to 17 April, and Sir David Spiegelhalter, a University of Cambridge statistician, says more people may be dying of Covid-19 in care homes than in hospitals already.
By Caring Times editor GEOFF HODGSON There has been growing frustration among care home operators, staff and relatives that the Government has underestimated the gravity of the impact of the virus in social care. Sam Monaghan, the chief executive of MHA, the largest charitable operator of care homes, at which 294 residents have died from confirmed or suspected Covid-19, said the figures were starting to show “what we have known for some weeks now, that care homes are sadly the most affected area of society in terms of deaths from Covid-19”. At a recent Webinar organised by Caring Times’ sister publication HealthInvestor, Knight Frank’s head of healthcare Julian Evans said his discussions with major operators suggested that care home deaths had tripled in recent weeks and that the eventual toll was likely to exceed 40,000 (see Page 36). The National Care Forum (NCF), which represents not-for-profit care providers, said the initial published data confirmed what operators had known for some time – that deaths in care homes are continuing to rise significantly. NCF executive director Vic Rayner said the data
clearly showed the importance of tracking the impact of Covid-19 beyond hospitals. “It is essential we know what is happening in care homes and wider communities,” said Ms Raynor. “Data saves lives and having access to timely, accurate data about the impact of Covid19, both in terms of the devastating loss of life and the prevalence of Covid-19 outbreaks in care settings, means we have a much better prospect of targeting help and support to the frontline of care to defeat it. “It shows the very urgent need for a daily tracking of all Covid-19 deaths as a key priority for the Government. Every day we review the graphs on the daily briefings to understand the charting of the progress of Covid-19 in hospitals – we must now see the daily picture in care homes and communities. “The numbers revealed make it more important than ever that we build a ‘ring of steel’ around care homes. They need the right PPE equipment, medical monitoring devices, rapid and comprehensive testing, proper funding and intensive research to safeguard the people they care for. This virus is not going away – this data shows that the ‘whatever it takes’ mantra must be applied urgently to protect the most vulnerable in social care, as we have to the NHS. We need action and we need it now.”
Chai Patel sets out plan to reform and reward social care workforce
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Writing in The Times in early May, former HC-One chair Dr Chai Patel set out a five-point plan for the government and sector to reform social care and reward carers. For 35 years, Dr Patel has been an advocate for the vital contribution of the social care workforce, culminating in the launch of his Careforce initiative in 2017. Dr Patel’s new five-point plan comprises: ■ The government must publish a detailed and actionable social care workforce plan. ■ An independent representative body for social carers, run by social carers must be created. This should follow the model of the various nursing and medical Royal Colleges in being an apolitical, evidence-led champion for social carers. ■ The skills and qualification needed for the sector now, and in the future, must be defined, with clear, mandatory requirements at every career stage. ■ A clearly structured cross-sector career pathway must be created, that breaks down the barriers between the caring professions, interlinking social carers with nursing and social work. ■ The government must provide the long-term funding settlement needed to ensure social carers can have their pay and benefits improved to reflect the professionalisation of the role. Through the delivery of this plan it is hoped
CHAI PATEL: Social carers should benefit from higher salaries, improved terms and conditions, clearer career progression opportunities, and the knowledge that their peers are held to account through a transparent code of conduct and ethics. that those working within the care sector will have higher levels of job security, satisfaction, and remuneration, as well as a clearer purpose and vision within their careers. This will improve the experience of those receiving care and help evoke greater respect for care workers in our society more generally. “I have always been passionate about rewarding the vital contribution of the social care workforce, and this has been the motivation behind creating the ‘Careforce’ initiative several years ago,” said Dr Patel. “The Covid-19 pandemic has shown how important social carers are to not just the people they support, but to our NHS and our society. It is therefore high time this contribution is recognised, and the institutional and structural changes needed to professionalise the workforce
are undertaken. This includes clearer training, qualification and career pathways, as well as interlinking care work with nursing, social work, and broader NHS roles. “Social carers should then benefit from higher salaries, improved terms and conditions, clearer career progression opportunities, and the knowledge that their peers are held to account through a transparent code of conduct and ethics. “Our national Careforce has been left behind for too long. It is critically important that government urgently revises its approach to social care in the months and years ahead once this crisis is over. Social care has been a politically inconvenient topic for too long, and now must be the time to grasp the nettle and deliver the meaningful reform that has long been promised.”
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Case Study Inter-generational approach provides secret to happy Stirlingshire care home In partnership with Ontex Global
At Falls of Dochart care home in Stirlingshire, an inter-generational and fun approach to care has been a positive for the community. Previously a hotel, it became a care home in 1995 and a registered charity in 2002. On Friday 1st November 2019, the Falls of Dochart Care Home ran one of its regular Community Tea Parties to bring together GLÎ?HUHQW FRPPXQLW\ JURXSV LQFOXGLQJ WKH village nursery, the school and Connect DQ RUJDQLVDWLRQ VXSSRUWLQJ SHRSOH LQ WKH community with issues such as mental health and isolation).
Care Home Manager Mandy Hay, comments, â&#x20AC;&#x153;Our residents come from the local area and DUH OLNHO\ WR NQRZ WKH VWDÎ? ZKLFK KHOSV WR FUHDWH D UHDO IDPLO\ DWPRVSKHUH Our residents are also very active in the local FRPPXQLW\ IRU H[DPSOH JRLQJ RQ ZDONV visiting the nursery and attending exercise classes in the local hotel. We often have visitors from the local school coming to the care home and vice versa, for
H[DPSOH ZH UHFHQWO\ KHOG D :RUOG :DU GD\ DQG WKLV LQWHU JHQHUDWLRQDO DSSURDFK UHDOO\ works. The home is run by 10 volunteers on a Board of Directors and it really is a case of being run by the community, for the community.
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Ontex nurse advisor commented, â&#x20AC;&#x153;We started working with The Falls of Dochart Nursing Home 3 years ago when we took on the 1+6 FRQWUDFW IRU VXSSO\LQJ FRQWLQHQFH FDUH SURGXFWV WR 1XUVLQJ +RPHV DFURVV 6FRWODQG This is an extremely well-run Care Home, with ORYHO\ VWDÎ? ZKR UHDOO\ PDNH D GLÎ?HUHQFH WR the lives of their residents.â&#x20AC;?
For more information or images, please contact Louise Pinchin Call 07815 307592 or email louise@whiterosepr.co.uk
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news DIGEST SKILLS FOR CARE LAUNCHES ADVICE LINE FOR MANAGERS In response to the Covid-19 pandemic Skills for Care has launched an advice line to support the sector’s 20,000 registered managers and other frontline managers who are managing CQC regulated adult social care services. Advisors will help managers access the latest information, resources, funding, online learning and other opportunities provided by Skills for Care. They will also direct managers to the latest guidance and advice produced by other agencies. The advice line is just one of a wide range of support options Skills for Care has developed for managers, including a series of 30minute recorded webinars on a range of topics to support managers in adult social care during the pandemic. Subjects covered in the webinars include essential training, human resources supported by ACAS, attracting workers, using digital technology and motivating staff. The advice line is open between 9am and 5pm Monday to Friday on 0113 241 1260, and managers can find out more at: www.skillsforcare.org.uk/adviceline
June 2020
www.careinfo.org
BOROUGH CARE RESIDENTS FIND WAYS TO KEEP IN TOUCH Borough Care, a not-for-profit provider of care for older people in Stockport, is just one of hundreds of providers helping residents and their families stay in touch, as the country continues in lock-down due to Covid-19. Besides connecting via telephone and video call, residents and their families are also sharing messages with their families via social media, with Borough Care putting photos of residents with their messages on Facebook, Twitter and Instagram. Some family members have visited to wave through the window to their loved one, while others have sent cards, flowers and gifts to show they care.
Borough Care chief executive Dr Mark Ward said providers were aware how hard it is for families to be separated from their loved ones during this difficult time. “Staff at all our homes are making sure there are lots of opportunities for residents and their families to see and hear each other remotely,” said Dr Ward. “Our staff are working tirelessly to ensure residents are supported, both emotionally and physically, while families are unable to visit during the Covid-19 pandemic. We have received some lovely messages from families, who appreciate being able to keep in contact with their loved ones during this difficult time.”
CMA BEGINS PROCEEDINGS OVER BARCHESTER’S ADMINISTRATION FEES The Competition and Markets Authority (CMA) has begun proceedings against major provider Barchester Healthcare after what the CMA alleges to be that company’s failure to compensate residents’ families for administration fees charged following a resident’s death. In July 2019 the CMA issued a letter before action to Barchester, saying the CMA believed Barchester was breaking consumer protection law by requiring a substantial non-refundable upfront
administration fee from residents for which they received no services or products in return. The letter said the CMA believed the company’s description of the charge, and what it was for, was misleading and that residents were told about the fee too late in the admission process. With regards to fees charged following a resident’s death, the CMA says it believes that Barchester was breaking consumer protection law by charging the fee for a period longer than outlined in
OUTSTANDING Congratulations to the following care homes and services which have been recently rated as ‘Outstanding’ by the Care Quality Commission:
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■ Kingfishers, a 60-bed care home with nursing in New Milton, Hampshire, has retained its ‘Outstanding’ rating. Operated by Colten Care. Manager: Beata Brzozowska. ■ Churchfields, a 35-bed care home with nursing in Cassington, Oxfordshire, and Rosebank, a 28bed care home in Bampton, Opxfordshire. Both homes are owned and run by Jane and Gerry Roberts. Managers: Steph Eley and Lynn Hughes, respectively. This is Rosebank’s second consecutive ‘Outstanding’ rating. ■ Admiral Court, a 60-bed care home with nursing in Leigh-on-Sea, Essex. Operated by Hallmark Care Homes. General manager: Susan Cruse.
Vincent Hankey, a res let’s his famil
■ Newstone House, a 59-bed
■ The Beeches, a 44-bed care home in East Harling, Norfolk. Operated by Black Swan Care Group. Manager: Kayleigh Scarff.
care home with nursing in Sturminster Newton, Dorset. Operated by Colten Care. Manager: April King. Seven of
■ Chelsea Court PLace, a 15bed care home with nursing in Chelsea, London. Operated by Loveday & Co. General manager: Gabby Zackova.
Colten Care’s 21 nursing homes are now rated ‘Outstanding’. ■ Anisha Grange, a 74-bed care home with nursing in Billericay,
■ Netley Court, a 70-bed care home in Southampton, Hampshire. Operated by Cinnamon Care Collection. Senior general manager: Mark Shockledge.
Essex. Operated by Hallmark Care Homes. General manager: Daniel Rowark. Anisha Grange is the third Hallmark care home to receive an ‘Outstanding’ rating.
Rated
‘Outstanding’? let us help spread the word, email: editor@caringtimes.plus.com
the CMA’s guidance. Although Barchester stopped charging an administration fee in January 2019, the CMA says the company has not provided the CMA with satisfactory undertakings, including provision for financial redress for consumers in relation to the administration fee. In early April, the CMA said it now intends to issue a claim against Barchester seeking enhanced consumer measures including financial redress for consumers from 1 October 2015. In a statement, Barchester told Caring Times the company was “deeply disappointed” that the CMA had chosen to issue court proceedings at this difficult time. “The care sector is on the frontline, working shoulder to shoulder with the NHS, in the battle against Covid-19 – fighting to protect the vulnerable from this terrible disease,” said Barchester’s statement. “The timing of their decision underlines our belief that they do not fully understand the care sector. We have been working with the CMA for months now, and despite fundamentally disagreeing with their proposals, we have compromised and amended our fees to align with the industry, whilst trying to hold firm on what we believe is right for our customers and the service we deliver. “We strongly believe that our approach is customer-focused and have asked the CMA on many occasions for evidence to the contrary. No evidence has been forthcoming.”
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news DIGEST
June 2020
www.careinfo.org
SANCTUARY CARE INTRODUCES PAID WELLBEING ASSISTANT ROLES
key, a resident at Lisburne Court in Offerton, his family know he’s doing just fine!
Sanctuary Care has launched a call for wellbeing assistants to help enrich the lives of residents who are missing loved ones. The care provider began a recruitment drive last month for the paid role, which does not need prior experience, to ensure that residents are able to take part in group activities and social interaction during the current Covid-19 pandemic. The assistants will also handle light domestic duties from making beds and tidying rooms to putting the kettle on, serving meals and helping with laundry.
PANDEMIC COULD FORCE CLOSURE OF HALF THE CARE HOMES IN WALES, SAYS KREFT Care Forum Wales chair Mario Kreft has warned that half the care homes in Wales could be compelled to close unless urgent action is taken. Many care homes were already having to take out loans and consider imminent closure because of spiralling costs and falling income. Mr Kreft said the sector was already fragile before the Covid-19 crisis began and the pandemic threatened to put many providers out of business. The scale of the problem, he said, was illustrated by the fact that Wales’ 650 care homes provided 20,000 beds which was 8,000 more that the number of beds in hospitals. He feared that mass care home closures would lead to the NHS being completely overwhelmed. "We have members who are increasing their staffing costs and they're increasing other costs like buying their own PPE,” said Mr Kreft. “And of course we're seeing falling occupancy as people pass and as other homes choose not to admit people, because they're terrified that it's going to introduce the virus into those homes and obviously affect the residents they have.” Mr Kreft said most care homes needed to have 90% occupancy to be viable and anything below 85% was not sustainable – but some homes were down 25 to 30% occupancy. "We have got people that are seriously talking to their banks,
seriously talking within their organisation, whether the best thing and the safest thing for everybody is simply to close the doors,” he said. "We’ve never, ever encountered anything quite like this in the history of the care sector in Wales, and the UK. Unless urgent support is forthcoming we will be seeing care home closures week on week over the summer months.” Among those who is under severe pressure Glyn Williams, who runs the 28-bed Gwyddfor care home in Bodedern on Anglesey. In desperation Mr Williams has launched an online appeal to raise £33,000 towards the costs, fearing he would have to shut by the end of May. “The simple truth is we are in dire straits as things stand,” said Mr Williams. “The welfare of our residents is vitally important; they are like our extended family, but we just can’t survive as we are so underfunded.”
No care is provided through the role, though the assistance they provide to residents will be delivered in line with each resident’s individual care and support plans. With the doors closed to nonessential visitors at Sanctuary’s 102 homes across England and Scotland, the roles are helping ensure residents continue to receive the highest quality of care along with social interaction. Sanctuary Care’s group director Sarah Clarke-Kuehn said the response had been so large that recruitment for the roles had been temporarily suspended while more
than 3,000 applications were processed. Forty assistants will be due to take up the role imminently, with more than 100 expected to be recruited in total. “The social distancing measures that we all must follow limit our opportunities to socialise and this is never more important than in the case of older people,” said Ms Clarke-Kuehn. “The creation of these roles will make such a difference in helping our residents and staff through these difficult times, while providing new employment opportunities for local people in the areas where we have homes.”
ANXIOUS FAMILIES SEEK TO MOVE LOVED ONES The incidence of Covid-19 in care homes has led a small but growing number of families to seek legal advice about bringing their relatives home. In early May, the Relatives and Residents Association told the Guardian newspaper that their advice line had received at least 10 calls over four days and Emma Jones, a solicitor specialising in human rights at Leigh Day, said she had been receiving at least 10 calls a week from families struggling to persuade local authority social workers to let them remove residents from care homes. Relatives and Residents’
Association director Helen Wildbore said that, for those residents who lacked mental capacity, it was not always as easy to bring loved ones home as some families might initially think. “We have been supporting family members to explore the practical considerations, such as their relative’s care needs, including their medical and mobility requirements,” said Ms Wildbore. “Then they have to consider any risk associated with moving the person out of the care home. Many of our callers have come to the difficult conclusion that moving their relative is not a viable option.”
CARE WORKERS FEAR COLLEAGUES WILL QUIT Four in five of care workers expect colleagues to quit – with low pay being one of many factors amid the Covid-19 danger, according to a poll in late April commissioned by the GMB union. In the survey, conducted by Survation on behalf of GMB for ITV News, 99% of frontline care workers said they still hadn’t been
tested for Covid-19 and that 79% of respondents thought it was likely the care sector would see staff shortages as people were unwilling to work at current levels of pay amid the increased risk posed by Covid-19. One in five care home workers surveyed said they had considered quitting over the lack of PPE in their workplace.
REMOVAL OF VAT ON PERSONAL PROTECTIVE EQUIPMENT WELCOMED Care providers have welcomed the announcement at the end of April that VAT is to be removed from the purchase of Personal Protective Equipment (PPE) for care providers for the next three months as they fight the Covid-19 pandemic. The Independent Care Group (ICG) said it was refreshing to see that the government had listened to social care providers who were struggling financially because of
the fight against Covid-19. “We are pleased that the Chancellor has listened and taken this step to save some money for social care providers,” said ICG chair Mike Padgham. “It is a good start and we hope that it is followed by further measures, like efforts to ensure that more funding is given to local authorities so that they can help social care providers and that this
help gets to the front line. “We would also like the government to help providers to support social care workers who are off sick because they have diagnosed Covid-19 or have symptoms. In the longer term we want a complete review of social care." The ICG has warned that care providers are being hampered in their fight against Covid-19 through a lack of PPE and insufficient testing.
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news
June 2020
www.careinfo.org
First Minister of Wales announces £500 extra payment for care staff The Welsh Government will fund a £500 extra payment for all social care workers in Wales, the First Minister Mark Drakeford announced in early May. Mr Drakeford said the payment provided further recognition for an often “under-valued and overlooked” workforce. The payment will be available to some 64,600 care home workers and home care workers throughout Wales. It comes after the Welsh Government has provided an initial £40 million extra funding for adult social care services to help meet the extra costs associated with responding to the Covid-19 pandemic. “Tens of thousands of people work in social care in Wales, looking after some of the most vulnerable people in our communities and are doing so with great dedication in often challenging circumstances,” said Mr Drakeford. “They are undertaking tasks, which involve a high level of intimate personal care, often accepting a greater degree of risk and responsibility. Many of our social care workers are juggling their own personal caring responsibilities with their professional ones. The Welsh Government is working with local authorities, who commission social care services in Wales, and with trade unions and Care Forum Wales, to finalise details about the extra payment. The First Minister has called on the UK Government not to tax the extra payment, enabling social care workers to keep the full amount. The Welsh Government is also working with the Department for Work and Pensions to make sure it does not impact on people’s benefit entitlements. “We are urging the UK Government and the HMRC to make an exception in these truly exceptional circumstances,” said Mr Drakeford. Campaigners in England have now called on the government in Westminster to match a the Welsh bonus.
First Minister Mark Drakeford announces the £500 bonus for social care staff in Wales.
“We very much hope that the English government will follow suit and provide a bonus for all the social care staff facing the same risks and doing an amazing job here in England,” said Mike Padgham, chair of the Independent Care Group. The ICG has also called on the government to provide better financial support for care providers amidst concerns that the £3.2 billion pledged for local authorities to help them support social care is not getting to the front line.
Kilgour: Scottish care homes are in the ‘last chance saloon’
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Care home owner Robert Kilgour has appealed for extra Scottish Government and local authority funding for the independent care home sector as it bears the brunt of being on the frontline of the Covid-19 crisis. Mr Kilgour, who has campaigned incessantly for the improved supply of PPE and dramatically increased Covid-19 testing in Scotland’s care homes, said the sector was “on the critical list”. “The Scottish Government is rightly giving special financial support to Scottish businesses that are currently closed – it is both the right and the sensible action for them to take to ensure the swiftest recovery of the Scottish economy when the lock-down is lifted,” said Mr Kilgour. “Scottish care homes are not closed – they are on the frontline, and our residents and staff are enduring an absolutely torrid time. “Our brave staff are fighting 24/7 against the Covid-19 onslaught, with many working enormous shifts to care for those they consider to be their second families, but unless we get desperately needed funding to the frontline of this battle, thousands more elderly people in care homes will die across the UK. That is the grim reality facing the care home sector and the Scottish Government and local authorities need to act now. “With a few honourable exceptions such as
ROBERT KILGOUR: Our residents and staff are enduring an absolutely torrid time. Fife and Dumfries & Galloway Councils, Scottish local authorities are refusing to fund their independent care homes to the same level as their own local authority facilities. It’s a national scandal and is putting vulnerable people’s lives at grave risk.” Mr Kilgour is asking three questions: 1) Why are the Scottish Government and the vast majority of Scottish local authorities still refusing to give any meaningful extra financial support to the care home sector to help it cope with the huge extra Covid-19 costs that it is currently facing – especially when social care is doing such an important and crucial job at this incredibly difficult time for society? 2) Why are the Scottish Government and many Scottish local authorities continuing to support their own care home residents to a greater financial level than they are supporting the local
authority clients they have placed in independent sector care homes? 3) Why is the Scottish social care sector, for far too long a 'Cinderella' service, being abandoned in this way by the Scottish Government and most Scottish local authorities, with dedicated care home workers and vulnerable care home residents continuing to being treated as second class citizens? “We really are in the 'last chance saloon' if we want to save our social care sector,” said Mr Kilgour. “If our social care collapses with its 1,000 care homes, 35,000 residents and 50,000 staff – what happens to our NHS? “Without proper and fair financial support from the Scottish Government, I fear that many Scottish care homes will close, and we will face bed-blocking within Scottish hospitals at an unprecedented level. “After this Covid-19 crisis is over, we must devise and implement a new social contract. We need to look after the key workers who will have saved this country during this crisis so much better than we currently do. We owe them nothing less.”
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promotion
June 2020
www.careinfo.org
How smart technology can help in challenging times The care home landscape is facing some of the most challenging times due to the current situation. While the main focus of media attention has been on the NHS and its associated workers, care home workers are now rightly being recognised for the heroes that they are. Many care workers have put themselves at the forefront to care for and protect elderly and vulnerable people. We have even seen care homes with makeshift campsites in the gardens ensure that the residents are looked after without increasing the risk of bringing in infection. Incredible dedication that emphasises the strength of resolve of these key workers. The lack of PPE and hand sanitiser became apparent very quickly and some unscrupulous providers of equipment raising their prices at this unprecedented time of need became media stories. And rightly so. Other news from the care home sector indicate a worrying level of infections and deaths from the virus, so anything that can help reduce cross infection must be considered if this sad situation is to be curtailed.
Many care homes have come to rely on a variety of smart technologies to enhance the smooth running of these facilities. These technologies include electronic care planning and medication management, smart nurse call systems or acoustic monitoring. In the media there hasn't been quite the same focus on these areas and how they can create safer working practices in care homes. Reducing physical interactions, touch points and visits to homes to carry out management activities or system maintenance if vital equipment fails, can all help when a care home is in a lockdown situation. But this kind of activity relies on deploying the right kind of technology. Many solution providers are equipped to deal with problems and queries remotely using various techniques. This might be with a simple phone call (95% of all support requests to Courtney Thorne are resolved on the same day â&#x20AC;&#x201C; via the telephone) or in some cases, via remote access using internet and mobile connectivity. Should a physical piece of equipment
fail, typically a replacement can be pre-configured at source then dispatched in a very short space of time with simple deployment instructions â&#x20AC;&#x201C; maintaining a safe care home environment. During these most challenging times availability of components and the logistics in getting hardware to the right place at the right time has emphasised the virtues of using companies with manufacturing based in the UK. Purchasing from a UK company, one which relies on its own trained staff located throughout the country provides further reassurance that solutions will be manufactured, delivered, installed and maintained to a level that preserves the safety and security of all residents, staff and management in care homes Whatever the challenge you face - get in contact with your technology supplier. They should appreciate and understand your situation and move heaven and earth to ensure that solutions can be offered and issues resolved, giving you added reassurance through these times. www.c-t.co.uk
STAY SAFE WITH SMART WIRELESS NURSE CALL Safer, more efficient care
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WANT TO TRY? Call 0800 086 2496
Find out more www.c-t.co.uk
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legal landscape
June 2020
www.careinfo.org
Does the care sector need a liability scheme? Ridouts Professional Services solicitor MADDI GAUNT asks if those involved in social care should be afforded the same legal protections as their colleagues in the healthcare space. 0207 317 0343
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are providers are undoubtedly facing incredible pressures in their attempts to function during the continuing Covid-19 pandemic. Over the past few months, providers will have had to make difficult decisions very quickly. Those decisions have had to be taken in the context of woeful shortages of PPE and access to testing, and where providers are facing unprecedented increases in costs and staffing shortages. Often, decisions which might have significant legal repercussions have been taken in response to – or despite – fluctuating guidance, or pressure from the government, or regulators. Take admissions; early government advice was that providers should take admissions to help relieve pressure on the NHS, even when the Covid-19 status of a service user was unknown. Whilst this guidance has since changed, some providers will have accepted admissions which may have been the source of an outbreak in their service. Another example is restrictions on visitors. We saw many providers seeking to take a proactive approach to social distancing and isolation and take the difficult decision to stop visitors early on. However, this approach was not initially supported by the CQC and some providers felt forced to re-allow visitors, at least until government guidance was finally published which supported restrictions being put back in place. Sadly, both may have caused an increase in outbreaks of the virus within services. It is entirely foreseeable that mistakes will have be made, and that some decisions taken by providers or their staff over the care of individuals, may not – with the benefit of hindsight - have been the best ones. This is not to say that providers should be criticised for their response and many criticisms, or claims, or regulatory action which might arise may lack merit, at least
www.ridout-law.com in the context of the pandemic. However, providers and care staff may well have to defend themselves. Where they cannot do so successfully, they may face significant financial liabilities. Providers are, of course, required to have insurance in place and may well have cover which indemnifies them for certain liabilities which could arise out of their Covid-19 response but insurance rarely provides blanket cover, where liabilities arise because of a worldwide pandemic. We have a health and social care system in the UK and, despite the differences in the way the two parts operate and are funded, they do not, and cannot, operate in isolation from each other. Both are facing similar challenges, and having to make similarly difficult decisions on a daily basis often at short notice, with many unknown variables at play, and with regard to guidance which is changing on a daily basis. Is it not then reasonable to expect both sides to have similar protection from certain liabilities which may arise as a result? Clinical NHS staff working in NHS hospitals, or under contract to the NHS, have the comfort of indemnity via the Clinical Negligence Scheme for Trusts. This offers their members broad protection against certain liabilities arising “out of or in connection with any breach of a duty of care owed by that body to any person in connection with the diagnosis of any illness, or the care or treatment of any patient, in consequence of any act or omission to act on the part of a person employed or engaged by a member in connection with any relevant function of that member”. A similar scheme operates for NHS-contracted GPs. The scheme is not limited to the Covid19 response, although changes were made to it to ensure that cover extended to all
NHS work required to respond to the pandemic. Further, the Coronavirus Act 2020 plugged the gap for any NHS clinical staff who would not, for whatever reason, benefit from the existing scheme, or otherwise have cover under insurance or other membership(s). Clearly, therefore, at least in the context of clinical negligence actions, this indemnity was deemed important to enable the NHS to mount the best and quickest possible response to the pandemic without being hampered by concerns about being sued for clinical negligence after the fact. Is it, perhaps, time to consider an indemnity scheme for care providers similar to that for the NHS? Aside from the practicalities of setting up, operating, and funding such a scheme (which, admittedly, may pose significant challenges), it would theoretically be possible to have a similar scheme for care providers, at the very least to cover the Covid-19 response period. Unfortunately, at this time of crisis it is unlikely that anyone will be able to give this proposal the time and attention it may deserve. When the dust has settled, however, it may be the time for serious conversations about whether a scheme should be introduced, and whether it might be able to operate retrospectively. At the very least, having a conversation about such a scheme would send a signal to the care sector that they are as valued in their efforts as their counterparts in the NHS.
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promotion
June 2020
www.careinfo.org
Donâ&#x20AC;&#x2122;t let complaints get you down The trials of running any type of business is a serious commitment, especially when your customers entrust you with their lives. This is certainly the case with care homes, and the current crisis has brought into stark relief the extent to which care homes fulfil a vital function in our society, safeguarding the elderly and vulnerable even under the most difficult of circumstances. It is inevitable that in such an environment things will sometimes be missed, or things will occur that could have been handled differently. Dealing with complaints from residents and their representatives is one of the less pleasant aspects of operating a care home, but it is important that managers and staff are aware of the correct procedures to follow in order to ensure the best outcome for all parties involved. This is why the Chartered Trading Standards Institute (CTSI) has published, in partnership with the Department for Business, Energy and Industrial Strategy (BEIS), a handy free information resource for those working in the care homes sector which sets out the best ways of dealing with complaints. Care home complaints covers the procedures that should be adhered to at every stage of the complaints process â&#x20AC;&#x201C; from the point at which the complaint is initially made through to its resolution â&#x20AC;&#x201C; in plain English and with real-world examples of what should be done in certain situations. The guidance gives an overview of the ideal complaints handling procedure (CHP) for care home owners and managers and explains the relevant aspects of consumer law with which care home staff should be familiar. Instilling confidence that if and when something does go wrong, the best efforts have been made to ensure that it can be addressed and rectified quickly and effectively, and with the minimum of disruption to residents. There is also a free downloadable guidance booklet which provides further details about
At a time like this, as the Covid-19 crisis continues to hit care homes particularly hard, it is difficult for those working in the care homes sector to feel like they are in control.
consumer law and guidance on staff training, as well as flow charts that can be used as a quick reference point to the steps that should be followed with some of the more common types of complaint.
To access the Care home complaints hub and to download the free guidance booklet visit businesscompanion.info/ carehomecomplaints
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legal landscape
June 2020
www.careinfo.org
Can staff refuse to work due to safety concerns? TOYAH MARSHALL, principal employment law adviser and solicitor at Ellis Whittam, outlines what care providers need to consider when staff are reluctant to come in to work. elliswhittam.com
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ntil recently, the impact of COVID-19 on the UK’s care sector was barely acknowledged. Only in the last few weeks has the government started to include the deaths occurring in care homes when reporting on the country’s fatalities, and those figures are alarming. In addition to concerns about the high levels of infections in care homes, the care sector as a whole is beset by a lack of personal protective equipment (PPE) and the testing promised for service users and care staff is still not readily available, meaning that staff are facing daily concerns about contracting the virus. As a result, employers and employees alike are under immense stress, worrying not only about their own health but that of their families by attending work each day. More and more employees are therefore unwilling to come into work, adding to an already pressured situation. Although other industries may be able to manage, the care sector is in a situation where every member of staff is valuable and needed. Assuming an employee is not classed as vulnerable due to their age, health or pregnancy (or living with someone who is) and they have not been ordered to shield, there should be no reason for them to refuse to come to work, especially if a care home has not had any suspected cases of Covid-19. If they are concerned about the risk of exposure by leaving home at all, then their employer can take one of two approaches; if the employer is in a position to manage
serious and imminent”, the employee has left work, refused to work in certain areas or refused to attend at all. However, can a fear of imminent and serious danger be reasonable in circumstances where all government guidance, including provision of the correct PPE, is being followed by the employer? It’s hard to say as, in this situation, we will likely have an employee whose refusal is reasonable and an employer whose instruction is equally reasonable, which leaves employers in a difficult position. Practically speaking, although disciplinary action could be taken – and there are circumstances where it may well be permissible to – disciplining or dismissing employees is not necessarily going to solve the problem of staffing levels within the home. Additionally, most managers will not have the time to follow through with any formal action either, with attentions focused elsewhere. With this in mind, and in an effort to maintain employee relations at a time when it is needed most, employers should consider alternative options, such as agreeing unpaid leave, redeploying to another department or annual leave. If, however, formal action is still the desired approach, advice should be taken. These are trying times, especially for the care sector; however, by working with their employees,employers will not only be able to minimise risk and absence levels but will also be able continue to provide quality care to service users at a time when they may need it most. ■ Ellis Whittam has created a Coronavirus Advice Hub, containing free guides, checklists, sample letters and risk assessment templates, to help care sector leaders manage the employment and safety implications of Covid-19.
without them, they could agree that the staff member can take a period of unpaid leave. If that isn’t suitable, the employee can be instructed to attend work, and if they fail to do so, treat their absence as unauthorised and deal with it as a disciplinary matter. Even when a care home has had cases of Covid-19, unless employees fall into the vulnerable category, live with someone who does or have been told to shield, it will still be unreasonable for them to refuse to come to work. However, caution may need to be exercised if the reason they are refusing to come to work, or even refusing to undertake certain duties, is because of a concern about health and safety matters, such as a lack of PPE or failing to isolate potentially infected service users. Refusals based on these reasons could constitute a protected disclosure (albeit it is worth bearing in mind that not all complaints of this nature constitute whistleblowing). Under the Employment Rights Act 1996, employees have the right not to be Ellis Whittam has created a Coronavirus Advice Hub, subjected to any detriment containing free guides, checklists, sample letters and risk where, “in circumstances of assessment templates, to help care sector leaders manage danger which the employee the employment and safety implications of Covid-19. reasonably believed to be
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THE BEATING HEART OF CARE: SUPPORTING CARE WORKERS BETTER
The Care Workersâ&#x20AC;&#x2122; Charity is a registered charity 1132286 (England and Wales) & SC048051 (Scotland)
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legal landscape
June 2020
www.careinfo.org
Legal obligations remain, despite CQC’s acknowledgment of pandemic pressures LAURA GUNTRIP, head of healthcare at Lester Aldridge, says that while the Care Quality Commission says it will make allowances for the challenges now being experienced by care providers, decisions made now are likely to be scrutinised in the future.
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are homes have been a media target for the last few years but they have usually been in the spotlight as the media has sought to expose poor care and other failings. However, we now find care homes taking centre stage in the current political storm that caused by the Covid-19 pandemic and care homes are a key talking point at all of the regular daily government press briefings. The focus now is on the lack of support provided by the Government to care homes, including supplies of PPE, testing and various other matters. It is refreshing to finally see the media supporting our care home ‘heroes’ and celebrating the amazing work by social care providers and staff across the country on a daily basis, rather than care homes being vilified en masse for the failings of a mere few. We can only hope this will set the tone in respect of the public perception of care homes in the future.
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Laura.Guntrip@LA-law.com 01202 786161
matters. Given the extreme pressure that care providers are facing, it would be wholly surprising if there were no safeguarding issues along the way and very surprising if care providers were able to maintain full and complete documentation as they normally would. It is entirely conceivable that the updating of some risk assessments or monthly care plan reviews may, on occasion, slip through the net at the current time, especially if homes are facing severe staff shortages as a result of staff self-isolating or shielding. Unfortunately, all of the legal obligations on care providers have remained unchanged. This includes all of the requirements in the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to safe care We hope that CQC will take a sensible and and treatment, consent, dignity and respect and pragmatic approach, given the wholly all of the other requirements. unprecedented situation that social care We have had some providers are currently facing, but it is perhaps apparently helpful comments from CQC, including: “We unhelpful that the legal obligations on care encourage everyone to act in the best interests of providers have not been relaxed. the health of the people they serve, with the top priority being protection of life. We However, it remains to be seen how the encourage you to use your discretion and Care Quality Commission will respond to act in the best way you see fit’. the current challenges faced by providers. CQC has also acknowledged that it may We represent care providers around the not be possible for providers to complete country and are regularly providing the full range of pre-recruitment checks advice in respect of inadequate supplies of before a member of staff starts work if PPE, difficulties obtaining testing, lack of staff are needed urgently to respond to the funding from local authorities, staffing pandemic. CQC has indicated that as long pressures, resident deaths and many other
as providers take reasonable steps to ensure that new staff are adequately supported, and sufficiently supervised to ensure people are safe, then it will not take a punitive approach. It is unclear what CQC will be expecting to see but it is only to be expected that the regulator will ask questions in due course and providers will need to account for some of the decisions they have taken along the way. If those decisions are not fully documented or if appropriate risk assessments are not in place, then it is unclear what approach CQC will take. We hope that CQC will take a sensible and pragmatic approach, given the wholly unprecedented situation that social care providers are currently facing, but it is perhaps unhelpful that the legal obligations on care providers have not been relaxed. Only time will tell but we certainly recommend that providers and managers document as much as possible and try to ensure that audits and checks take place wherever possible. In particular, if care homes start to reuse medicines, that is, giving medicine prescribed for one resident to another, it is vital that the correct process if followed and the correct documentation is in place. If necessary, providers should seek legal advice.
ed iv ce re uly e 7J tb 1 us y m rida es F tri by En
#CareAwards
ENTRY FORM 27 November 2020 London category sponsors
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THE 22ND NATIONAL CARE AWARDS| ENTRY FORM Carer
Care Home Manager
This award recognises the vital role of the care assistant in providing quality care. Evidence of dedication, sensitive handling of matters of importance to residents, and career progress through training will all be taken into account.
This award will be made to an exceptional care home manager (or deputy). They will be expected to demonstrate a high level of expertise in managing the services of the home to the benefit of residents, staff and their local community.
Criteria • Give a full description of the nominee’s role and responsibilities (up to 250 words) • Explain what positive effect the individual has had on the residents and staff within their workplace since being in their role (up to 250 words) • Provide examples of how the individual has provided high quality support to the residents, including any relevant information about activities, going beyond standard duties, dedication and commitment to understanding what is important to residents and families (up to 250 words) • 30 word biography of nominee
Criteria • Give a full description of the individual’s role and day to day management (up to 250 words) • Provide examples of where the individual has demonstrated (up to 500 words) • leadership skills and the ability to support, develop and motivate staff • confidence working with relatives and residents • creating a caring, stimulating and person-centred environment that is home-like and with good connections to the local community • Explain what positive effect the individual has had on their residents, staff and local community within the home since being in their role (up to 250 words) • 30 word biography of nominee
Supporting evidence • Provide 1-5 testimonials from staff, relatives or residents • Provide details of training, qualifications or accreditations the individual has received (if applicable)
Care Registered Nurse This award will be made to a registered nurse who has made long term care their area of professional specialisation. In addition to maintaining training and demonstrating outstanding clinical and managerial qualities, the winner will have demonstrated a high level of dedication to, and advocacy for, the people they support. Criteria • Give a full description of the nominee’s role and responsibilities (up to 250 words) • Explain what positive effect the individual has had on the residents and staff within their workplace since being in their role (up to 250 words) • Provide examples of how the individual has provided outstanding dedication to, and advocacy for, the people they support (up to 250 words) • 30 word biography of nominee Supporting evidence • Provide 1-5 testimonials from staff, relatives or residents • Provide details of training, qualification or accreditations the individual has received
Care Team This award will be made to a staff team who have developed and maintained an outstanding standard of care and team ethos within any care setting. Criteria • Give a full description of the service the team is based within (up to 500 words) • Explain why this team is a worthy winner of the award, including the development of any innovative projects to improve the quality of life for the residents or users of the service (up to 250 words) • Explain how the team has the skills, knowledge and enthusiasm to empower and enable residents to either regain or maintain a level of independence and meaningful lives (up to 250 words) • 30 word profile of the team Supporting evidence • Include the most recent inspection report from the home/service where the team is based • Provide 1-5 testimonials from management, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)
Entries must be received by Friday 17 July
Supporting evidence • Include the most recent inspection report for the home the individual manages • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received
Dementia Care Manager This award will be made to an outstanding manager (or deputy) of a care service where more than 50 per cent of the residents live with dementia. They will be expected to demonstrate a high level of expertise in managing the service to the benefit of residents with dementia as well as staff. Criteria • Give a full description of the individual’s role and responsibilities and why you consider them to be outstanding in their role (up to 500 words) • Provide examples of where the individual has demonstrated (up to 250 words) • leadership skills and the ability to support, develop and motivate staff • confidence working with relatives and promoting positive inclusive relationships with residents • creating a person-centred, supportive and stimulating environment with good connections to the community • Explain what positive effect the individual has had on the service and staff since being in their role (up to 250 words) • 30 word biography of nominee Supporting evidence • Include the most recent inspection report for the service the individual manages • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received
FOR ALL ENTRIES Please submit ALL the requested criteria and supporting evidence (any entries which do not submit the requirements will be disregarded)
Care Operations / Area Manager The winner of this award will have demonstrated exceptional vision, leadership and be at the forefront of new management techniques. They will have inspired their colleagues to provide exceptional care throughout the homes for which they are responsible. Criteria • Give a full description of the individual’s role and day to day leadership (up to 500 words) • Provide examples of where the individual has promoted the highest standards of quality care and service (up to 250 words) • Explain what positive effect the individual has had on the residents and staff within the setting since being in their role (up to 250 words) • 30 word biography of the nominee Supporting evidence • Include a recent summary of the most recent inspection reports for all settings (e.g. 5 Outstanding, 4 Good) • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received
Care Activities Co-ordinator/Facilitator This award will be made to a person within a care home or day care service who has made an exceptional contribution to the quality of life, health and happiness of all the people they support through the activities they provide. Criteria • Give a full description of the activities or lifestyle opportunities the individual has implemented, developed or maintained since being in their role (up to 500 words) • Explain how the individual works in a person-centred way, including how they inspire and encourage participation, motivation and understanding in residents (up to 250 words) • Demonstrate what positive effect the individual has had on the service since being in their role and why they should win this award (up to 250 words) • 30 word biography of nominee Supporting evidence • Include the most recent inspection report for the home or service • Supply 1-5 photographs of activities • Provide 1-5 testimonials from staff, residents/attendees and relatives • Provide details of training, qualification or accreditations the individual has received (if applicable)
Care Housekeeper Running the housekeeping services of a care home is vital for the well-being of residents and staff. This award will be made to an outstanding housekeeper who can demonstrate the passion and commitment needed to make a real difference. Criteria • Give a full description of the individual’s role and day to day duties and why they should win this award (up to 500 words) • Explain how the individual demonstrates a high level of dedication and innovation alongside a person-centred approach to provide the highest quality of service and environment for residents and staff (up to 250 words) • Provide examples showing where the individual has been a proactive and helpful member of the team, contributing ideas and making the home an enjoyable place to be (up to 250 words) • 30 word biography of nominee Supporting evidence • Include the most inspection report for the home or homes the individual is responsible for • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received (if applicable)
• Care Chef
This award will be made to a chef in a long term care setting who shows exceptional ability in providing well-balanced, nutritious and delicious food. Criteria • Outline the reasons why the nominee shows exceptional ability in providing well-balanced, nutritious and delicious food that takes into account individual needs of the residents (up to 500 words) • 30 biography of the nominee Supporting evidence • Provide a copy of a monthly menu served within the last 3 months • Provide a copy of the three-course menu (taken from the monthly menu) that the nominee will cook at the ‘Cook Off’ if chosen to be a finalist • Provide the cost per resident of the ‘Cook Off’ menu
Entries must be received by Friday 17 July Care Home of the Year This award will be made to a care home with 15 or more residents which can demonstrate exceptional quality care across all the services it offers. Criteria • Give a full description of the care home including how residents and staff live and work together successfully and how the home is part of the local community (up to 500 words) • Give a brief description of the sort of activities the residents take part in and how they are designed to promote well-being and social interaction (up to 250 words) • Explain how the care home is homelike for the residents and how the residents actively participate in this (up to 250 words) • Describe how the care home provides exceptional care and support to people enabling them to live fulfilled and meaningful lives with a focus on maintaining skills and independence and contact with the local community (up to 250 words) • 30 word profile of care home Supporting evidence • Include the most recent inspection report • Supply 1-5 photographs • Provide 1-5 testimonials from staff, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)
The Dignity & Respect Care Home of the Year This award will be made to an exceptional care home which can convincingly demonstrate that it has put dignity and respect for its residents and staff at the very heart of all it does, and that this emphasis has resulted in tangible benefits for residents, relatives and staff alike. Criteria • Give a full description of how the care home provides an environment for residents where they are treated with dignity and respect (up to 500 words) • Explain how you support the people who live in your home to make choices about the way they live and the support they receive (for example: independence, lifestyle opportunities, cultural and religious beliefs, privacy, eating and nutritional care, pain management, personal hygiene) (up to 250 words) • 30 word profile of the home being nominated Supporting evidence • Include the most recent inspection report • Supply 1-5 photographs • Provide 1-5 testimonials from staff, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)
Care Newcomer NEW AWARD FOR 2020 This award will be made to a person working in care, who is new to the sector over the past 18 months, and who is already delivering the very best standard of care. The judges will be looking for an individual who excels in their personal and team roles, and exhibits enthusiasm, professionalism, confidence and a shining commitment to their on-going career development. Criteria • Give a full description of the nominee’s role and responsibilities (up to 250 words) • Explain what positive effect the individual has had on the residents and staff within their workplace since being in their role (up to 250 words) • 30 word biography of the nominee Supporting evidence • Provide 1- 5 testimonials from residents, relatives of residents and colleagues • Provide details of training, qualification or accreditations the individual has received
Care Champion This award will go to an exceptional person, whether they are a member of staff, a relative, resident or a volunteer who has gone above and beyond and made a real difference. It could be a charitable achievement or making life better for residents and relatives, or simply someone who has done great things but may not have had the recognition they deserve. Criteria • Please explain why this person is so important, and why they are a worthy winner of this award (up to 500 words) • 30 word biography of nominee Supporting evidence • Provide 1-5 testimonials from staff, relatives or residents
Outstanding Care in a Crisis NEW AWARD FOR 2020 This award will be made to a care home that has demonstrated an outstanding level of care and compassion to their residents during the Covid-19 pandemic. Criteria • Give a full description of how the care home responded to Covid-19 pandemic, including (up to 500 words); • how exceptional care and support was given to residents, relatives and staff • how the home continued to promote well-being and social interaction in unprecedented circumstances • 30 word profile of care home Supporting evidence • Provide 1-5 testimonials from staff, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)
THE 22ND NATIONAL CARE AWARDS| ENTRY FORM Care Leadership This award will be made to an outstanding individual, in any care setting, small or large, whose leadership has resulted in an exceptional outcome for clients, team members and the organisation they work for. Criteria • Give a full description of the individual’s role and responsibilities and why they should win this award (up to 500 words) • Show examples of where the individual has demonstrated (up to 250 words) • leadership skills and the ability to support, develop and motivate staff • confidence working with relatives and promoting positive inclusive relationships • promoting well-being by monitoring the re-evaluation of care needs in partnership with the resident, their key-workers and relatives • Explain what positive effect the individual has had on people using their service and staff members (up to 250 words) • 30 word biography of nominee Supporting evidence • Include the most recent inspection report for the service for which the individual is a care leader • Provide 1-5 testimonials from staff, residents and relatives • Provide details of training, qualification or accreditations the individual has received
Care Home Group This award will go to an outstanding care group with more than three care homes which is able to evidence exceptional client care combined with excellent staff development and impressive financial results. Criteria • Give a full description of the care home group including the settings, residents and members of staff (up to 250 words) • Describe how the care home group provides exceptional care and support to residents enabling them to live fulfilled and meaningful lives with a focus on maintaining skills and independence (up to 250 words) • Describe the corporate identity, values and focus, the group’s strengths/ USP, training systems and approaches as well as the group’s success in delivering high quality care and plans for the future (up to 250 words) • Summarise the group’s financial performance over the last five years (up to 100 words) Supporting evidence • Include a recent summary of the most recent inspection reports for all settings (e.g. 5 Outstanding, 4 Good) • Supply 1-5 photographs showing some of the Groups settings • Provide 1-5 testimonials from staff, residents and relatives • Provide details of any recognition or accreditation from any recognised bodies (if applicable)
FOR ALL ENTRIES Please submit ALL the requested criteria and supporting evidence (any entries which do not submit the requirements will be disregarded)
Lifetime Achievement in Care This award will be made to an exceptional person who has committed a significant portion of their life to working in a care home, or in social care, in the community or in sheltered housing, and has made a substantial difference to the quality of life of the people they have worked with. Criteria • Describe and provide evidence of how the individual’s dedication and commitment throughout their care career has impacted the people they have supported (up to 500 words) • Evidence how the individual has influenced or inspired those they have worked with (up to 250 words) • 30 word biography of nominee Supporting evidence • Provide 1-5 testimonials from residents, relatives of residents and colleagues • Provide details of training, qualification or accreditations the individual has received
Care Personality
#CareAwards
An independent panel will select 5 finalists who they feel have made a big contribution to the care home sector within the past 12 months. The people chosen will be contacted before the awards ceremony and notified of the finalist position. This award does not require an entry from individuals, however if you would like to nominate someone for the panel to consider please do so along with 500 words to support your nomination.
27 November 2020 London
#CareAwards HOW TO ENTER
CATEGORY (please tick)
• Choose the category you wish to enter • If you choose more than one category, a separate entry form must be completed for each separate entry • Read the judging criteria provided carefully • Complete and supply ALL of the required information, criteria and supporting evidence • Enter online at careinfo.org/awards • Alternatively, complete this form and email to: events@investorpublishing.co.uk, remembering to attach all your supporting documents • Please make sure that the name of the nominee and the award category is included on all separate attachments and supporting information • If you wish to enter by post please contact the events team on events@investorpublishing.co.uk for the postal address.
RULES • The competition is open to all staff working in long-term care and hospital settings • Entries are treated in the strictest confidence • Finalists will be required to attend the Judging Day in London in October 2020 – date TBC • The Care Chef Judging will take place separately in October 2020 – date TBC • Entries will not be returned • One copy of the submission is required • Use one entry form per entry, photocopies are acceptable • Employees of the Caring Times and their families are not entitled to enter • Entries will be judged by a panel of eminent and impartial adjudicators appointed by Caring Times • The winners will be announced at the National Care Awards Gala Night on 27 November 2020 • There will be four or five finalists in each category • Award winners and finalists may state in advertising or other promotional material that they are or have been winners or finalists. The year that the Award was won must be included in the same typeface and size as the statement of the Award
CHECKLIST (please tick)
□ This entry form completed by you □ Required judging criteria □ Required supporting evidence □ Full contact details for the nominee and nominator All entries must be received by FRIDAY 17 JULY 2020 For sponsorship opportunities contact caroline.bowern@investorpublishing.co.uk
□ Carer □ Care Registered Nurse □ Care Team □ Care Home Manager □ Dementia Care Manager □ Care Operations / Area Manager □ Care Activities Co-ordinator / Facilitator □ Care Housekeeper □ Care Chef □ Care Home of the Year □ The Dignity & Respect Care Home of the Year □ Care Newcomer □ Care Champion □ Outstanding Care in a Crisis □ Care Leadership □ Care Home Group □ Lifetime Achievement in Care □ Care Personality DETAILS Name of person being nominated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Job title _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Organisation _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Website address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Organisation address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ____________________________________ ____________________________________ Postcode _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Telephone _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Email address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Name of person making nomination _ _ _ _ _ _ _ _ _ _ _ _ _ Nominator contact number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Who should we contact if successful? (please tick) Nominator Nominee
□ □
SUBMIT
Enter online: careinfo.org/awards Email to: events@investorpublishing.co.uk
ANY QUESTIONS? Contact The Events Team: events@investorpublishing.co.uk or 0207 720 2109
Enter online at careinfo.org/awards Best of luck from everyone at Caring Times
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staff sacrifices
June 2020
www.careinfo.org
Staff move into care homes to help protect residents during pandemic Nine staff at the White House, a 22-bed care home, in Teignmouth, part of Centrum Group, have temporarily moved into the home to protect the home’s 17 residents from the Covid-19 virus. When care workers and domestic staff at the home realised that they could not guarantee social distancing as the residents all have dementia, they decided to move into the home to minimise the risk to the residents. They have now been living at the home for a month. Registered manager Demelza Lamport Coles said it was the care assistants who fronted the idea of moving into the care home, “A lot of the staff came to me and said this is something we should consider,” said Demelza. The staff have converted the offices and one of the residents’ flats into makeshift bedrooms with camping gear. They also have a caravan on site which was donated for the period of the lockdown in by a local person in case anyone wants quiet time. The team are quite multi-disciplinary taking on various roles being a small specialist home. The registered care manager has joined the team leader and five care staff, doing night shifts twice a week, the domestic and maintenance co-ordinator is the cleaner and cook for the home. Staff have developed a rota so that they have two days off and share the work load. The initiative has meant the nine staff members are unable to go home and see their own families. Many of them have had to make arrangements for other family members to take care of their children in order to do this. Katie Smith, who has started working as a care assistant at the home only recently, said she was nervous about the lockdown, but she is remaining very positive. “It’s hard because I had been doing shopping for my Nan and Grandad,” said Katie. “I can’t do that now, or even see them though the window.” “The positive thing about us all being here is the residents all seem a lot calmer. Seeing the same faces each day has made a massive difference. “The thing that keeps me going is the staff and the residents, because it’s just like one big family living together.” Sorelle Martin, domestic and maintenance co-ordinator at the White House, echoed this. “We all try and keep each other’s morale up- the residents have fun with us as well. They seem very calm – most of them are eating better.” The team at the White House have organised video calls to connect residents with their families. The care assistants are still working their regular shifts to ensure they all have well-deserved breaks from work. Centrum Group director Tushar Shah said it was heart-warming to see staff put the needs of residents ahead of their own and move into the care home to self-isolate. “The crisis is a challenge for all of us, however those living with dementia will not be able to understand the concept of social distancing and selfisolation,” said Mr Shah.
CARE ASSISTANT KATIE SMITH: The positive thing about us all being here is the residents all seem a lot calmer. Seeing the same faces each day has made a massive difference. A similar example of the dedication of the staff at Victoria House care home on the Isle of Wight inspired social care commentator JEF SMITH to pay them homage in verse:
Great Victorians Victoria would be as proud of you As we, though not so royal, are. Always, care Makes grave demands on caring staff. It’s true That looking after folk calls us to share Large portions of ourselves, but what you’ve done In giving up your children, husbands, wives, Goes well beyond all that. It can’t be fun To know such huge disruption in your lives, Living and sleeping in a tent. It’s tough,
“The only way the staff could protect and care for our residents was to move in with them. What has been really positive is how the lock-in to the home has allowed the residents and carers to develop a stronger bond.
Not having your own space or bed or food.
“We always knew that care staff were superheroes, but this pandemic has brought the best out of all key workers in society. For this, our residents, their families and local community are really grateful for their sacrifice and dedication.”
Though some say ‘needs improvement’, or just ‘good’
The White House Care Home made a Youtube video on the whole experience, to watch visit https://www.youtube.com/watch?v=jlFV5WNoyU0&feature=youtu.be
■
Heroes are often made of lesser stuff.
- I do know how the CQC does banding For me Victoria House is quite Outstanding!
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legal landscape
June 2020
www.careinfo.org
There is an inherent flaw in CQC’s inspection report writing process in relation to adult social care services, says NEIL GRANT, solicitor and partner, at Gordons Partnership. The answer? Genuine transparency.
Less than full
disclosure C
22
QC’s draft inspection report writing and factual accuracy processes are flawed in relation to adult social care, given that a provider will only ever get to see part of the evidence obtained during their CQC inspection. Only what is deemed to be the “best evidence” will be included in an inspection report. There will be additional evidence contained in CQC’s inspection record, that the provider will know nothing about. As a lawyer, I find that most inspection reports – even the best ones – will contain errors. At least there is a process whereby a provider can point out those errors as part of factual accuracy and they will (hopefully) be corrected by the regulator. But what about the additional evidence that sits in the inspection record which has not been shared with the provider? It is relied upon in rating the service, and in judging whether or not a breach has occurred, even though the data may be inaccurate, in whole or in part. The provider won’t ever be able to comment on it. Even if the data is correct, why keep it hidden? It must be in the public interest for that information to be shared with a provider to further CQC’s duty to protect the public and promote improvement. It doesn’t have to be contained in the inspection report. The inspection record can be shared with the provider separately. Transparency CQC is obliged to operate in a transparent way, yet the shortened form of inspection report that was introduced in January 2019 has had the effect of making regulation more opaque than ever. This problem has
been compounded by CQC’s policy not to disclose the inspection record whenever a request is made for it by a provider or their lawyer. As CQC states on its website: “We will not release the inspector’s full notes from an inspection. We will consider requests for extracts of notes about a specific issue where this is reasonably necessary to enable you to understand the basis for a statement in the draft report that you believe is factually inaccurate (that is, if the basis of our statement is not clear from the draft report).” This is all well and good, but it doesn’t help a provider who wants to see all the evidence obtained during an inspection, positive and negative. You can’t know what you don’t know. A provider should be entitled to see the full inspection record for their service, not just a summary. Best practice in regulation Under section 4(1) of the Health and Social Care 2008 Act, in performing its functions, CQC must have regard to: (g) “…best practice among persons performing functions comparable to those of the Commission (including the principles under which regulatory action should be transparent, accountable and consistent)”. Best practice in regulation requires CQC to have regard to the Regulators’ Code issued under the Legislative and Regulatory Reform Act 2006 when “developing policies and operational procedures that guide their regulatory activities”. Transparency is one of the statutory principles of good regulation in the 2006 Act. Disclosure of the inspection record would promote transparency and demonstrate a commitment on CQC’s part
to best practice when regulating the sector. The regulator’s disclosure policy in relation to the inspector’s notes is unlawful given the bar on disclosure is expressed in absolute terms. At the very least, as a public regulator CQC should exercise a discretion when a request is made for the inspection record by a provider. Indeed, until about four or five years ago, CQC applied a presumption in favour of disclosure but then changed its position. It begs the question – why has it adopted a policy that is less transparent? I would go further; to ensure the factual accuracy process is meaningful and fair, CQC should issue the full inspection record to the provider (subject to the removal of any genuinely confidential content), along with the draft inspection report. These days most inspectors type their inspection notes on devices so they should be readily available for onward disclosure to a provider, and any handwritten records can easily be scanned in as well. It is not an onerous task. CQC is presumably aware that most providers do not have the resources to mount a public law challenge, which would be the only avenue open to them. One would hope and expect that a national regulator in such a vital sector would be prepared to acknowledge that its procedures lack transparency and to alter them without having to be compelled to by a judge.
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in association with
academic partner
stream partner
satellite symposium sponsor
WEDNESDAY 11TH – THURSDAY 12TH NOVEMBER 2020 BOURNEMOUTH BOOKINGS OPEN SOON: Early bird discount before 16th September Plenary speakers • Parallel sessions • Interactive workshops • Symposia • Posters • Early bird sessions • Special events
careinfo.org/event/uk-dementia-congress
WHY SHOULD YOU ATTEND?
PLENARY SPEAKERS
• •
Professor Linda Clare, University of Exeter
• • • • • • • • •
CPD certified two-day conference programme Plenary sessions, keynote speakers and a wide choice of parallel sessions, symposia and interactive workshops Over 40 parallel sessions to choose from covering the latest in dementia care, research, policy and innovation People with dementia and carers sharing their experiences Large and lively exhibition Themed and facilitated networking sessions Conference app Poster presentations Panel discussions and audience question time Opportunities to network and socialise with like-minded individuals Drinks reception and special events
Jackie Pool, Sunrise Senior Living & Gracewell Healthcare Minister for Health and Social Care (invited) Paola Barbarino, Alzheimer’s Disease International PLUS others to be confirmed.
Programme: theresa.ellmers@investorpublishing.co.uk Sponsorship opportunities: caroline.bowern@investorpublishing.co.uk Bookings: events@investorpublishing.co.uk organised by
JournalOfDementiaCare
@JDementiaCare
#UKDC2020
AWARD ENTRIES NOW OPEN THURSDAY 12TH NOVEMBER BOURNEMOUTH Note to entrants: We have tried to keep many of the awards categories as open as possible so that a variety of people, organisations and collaborations involved in the dementia care community are eligible to apply. This includes, but is not limited to, day care and community settings, home care providers, third sector organisations, hospitals, businesses, social enterprises, housing and extra care organisations. If you have a question, donâ&#x20AC;&#x2122;t hesitate to contact us.
Outstanding Dementia Care Resource This award will be made to an outstanding resource which can be shown to have transformed the lives of those living with dementia and/or their carers. Outstanding Dementia Care Innovation This award recognises the vital role of new and stimulating innovations in developing high quality services for people living with dementia. Best Dementia Carer This award recognises the vital role of the care assistant in providing quality care. Evidence of dedication, sensitive handling of matters of importance to residents, and career progress through training will all be taken into account. Best Activities Co-ordinator for People Living with Dementia This award will be made to a person within a care home or community setting with more than 50% of people living with dementia who has made an exceptional contribution to the quality of life, health and happiness of all the people they work with through the activities they facilitate. Best Dementia Care Practitioner â&#x20AC;˘ NEW FOR 2020 This award will be made to an outstanding dementia care practitioner (eg nurse, dementia lead or allied professional) who has demonstrated an expert level of skill, knowledge, management and leadership. They will have supported their colleagues in delivering high quality dementia care either in an acute, residential or community setting, facilitating staff training, developing person-centred care pathways and delivering improvements in dementia care practice. Best Dementia Care Manager This award will be made to an outstanding dementia manager (or deputy) in a dementia focused environment. They will be expected to show exceptional leadership, caring, training and management skills for the benefit of people with dementia and staff. Best Dementia Garden This award will be made to a dementia focused garden in any setting which has outstanding features that significantly enhance the quality of life of people with dementia and staff. Best Dementia Training Initiative This award recognises the vital role of effective training in dementia care. It will be made to an individual, organisation or collaboration that can demonstrate the value and impact of a training initiative which they have successfully implemented. Dementia Care Champion This award will go to an exceptional person, whether they are a member of staff, a relative, person with dementia or a volunteer who has gone above and beyond and made a real difference. It could be a charitable achievement or making life better for people with dementia and relatives, or simply someone who has done great things but may not have had the recognition they deserve.
AWARD ENTRIES NOW OPEN #DementiaCareAwards
Outstanding Arts and Creativity in Dementia Care This award will be made to an organisation, collaboration or person that has developed and delivered an outstanding creative arts project, in any setting, to improve the quality of lives of people living with dementia. Best Dementia Team This award will be made to a dementia-focused team which has developed and maintained an excellent standard of care within any care setting. Exceptional Contribution by an Informal/Family Carer â&#x20AC;˘ NEW FOR 2020 To recognise the valuable contribution of family or informal carers, this award is made by the Journal of Dementia Care to a person, or group of people, to acknowledge the difference they have made. This could be to a person with dementia, to a community or nationally. This award does not require an entry from individuals, however if you would like to nominate someone for the panel to consider please do so along with 500 words to support your nomination. Best Dementia Friendly Hospital This award will be made to an acute or community hospital which can demonstrate that it has developed outstanding and innovative services for people living with dementia admitted for treatment of medical/surgical conditions. Dementia Friendly Employer â&#x20AC;˘ NEW FOR 2020 This award will be made to an employer that can demonstrate they have developed an open and supportive working culture that values everyone and who flexibly support and enable staff affected by dementia. Exceptional Contribution by a Person/People Living with Dementia This award is made by the Journal of Dementia Care to a person, or group of people, living with dementia who live and work with incredible passion and commitment to improve the lives and wellbeing of others living with dementia, and who inspire so many within the dementia community. This award does not require an entry from individuals, however if you would like to nominate someone for the panel to consider please do so along with 500 words to support your nomination. Best Dementia Care Home This award will be made to a care home with more than 50% of residents living with dementia which provides an outstanding environment with exceptional standards of care and support for people with dementia as well as relatives and staff, and is a well-respected place in the local community.
Deadline for entries: Friday 17th July 2020
careinfo.org/awards
category sponsors
QUESTIONS OR QUERIES EVENTS@INVESTORPUBLISHING.CO.UK SPONSORSHIP OPPORTUNITIES CAROLINE.BOWERN@INVESTORPUBLISHING.CO.UK Categories subject to review
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interview
June 2020
www.careinfo.org
Dementia care at the Caring Times editor Geoff Hodgson talks to LAURENCE GELLER, founder, chairman and chief executive of Innovative Aged Care, which operates a luxury dementia care facility in central London under its ‘Loveday’ banner, and is building more in the capital.
26
highest end W
ith just 15 beds in Kings Road in the heart of Chelsea, with an overall staff ratio of around two staff-to-one resident, and a care worker/resident ratio of one-to-two, the dementia care provided by Loveday & Co, a subsidiary of Innovative Aged Care, is not cheap, with fees staring at more than £2,000 a week. But Laurence Geller, the company’s founder, believes this is the way care should be delivered, and something that the care sector as a whole should be working towards. “I think the care industry is not an industry,” said Laurence. “It’s primitive, it’s not even a cottage industry. Providers should be leading the way in education; there is a paucity of qualifications, accreditation and training schemes. A home carer course run by the Alzheimer’s Society is three days – I wouldn’t let my mum be looked after by someone with that amount of training.” Laurence, who has built-up a £6 billion public company based on luxury hotels, said he had given several million pounds to various institutions, particularly to the University of West London (of which he is chancellor) to start developing professional, accredited dementia care training courses. “We want to share this output,” he said. “If we can get care workers trained, the industry will get a better reputation, we’ll get more people in it, we’ll create a career path and we will develop an industry.” Along with his son Guy, a former chief executive of Sunrise Senior Living and
who now looks after some 6,000 beds in the United States for a private equity firm he runs, Laurence has been involved with elderly care since the early 1980s. “I was a run-away-from-home sort of kid,” he said. “I left school when I was 15 and went to Switzerland, got into the hotel business and became a chef and grew-up through the hotel business. “When Guy was at Sunrise, I had a number of hotels in Europe, with one in the UK and Guy would ask me ‘How do I get care homes in central London, because they’re on my back to get some?’ I said ‘you’re not going to do it because Sunrise is part of a homogenised group of companies, which means your room-rates, or your average weekly rates are going to be prescribed by compared competition, and you cannot compete at those rates where you are looking for a 100-odd rooms in central London with residential, offices and alternative uses so forget it and don’t drive me mad’. “Guy and I would talk a lot about care and he said ‘Why don’t we think about dementia; your parents died of it, why don’t you think about taking that on as a charity?’ “I thought I could do more in the UK than in the States, and because the Alzheimer’s Society here made me chairman of their national appeal, I decided to become involved in dementia here.” Laurence identified a “chronic need” for dementia beds, both in the UK generally and particularly in central London. “Guy and I discussed building a luxury dementia care home; would we break through the rate barrier? Guy thought we’d get some improved rate but that the key was to go from the one care worker for every seven or nine residents ratio that we have in all the typical UK and US homes, and try to do it on a one-to-two ratio. So we looked for a lease in a good residential location and where we could get permission to convert it into a dementia care home.
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interview “From the start we said it would be luxury provision with a much more intense, bespoke care package than had ever been done in the care industry, and we invested several million pounds. We didn’t want to take partners because we weren’t sure of our model. We thought we’d run it for a number of years and if we lost money, we’d look at it as a philanthropic research experiment. “Guy helped with the labour standards and put the operational systems together, I did the building, the luxury side of it. We were stunned by the speed at which we filled up, the reception we got from the right demographic targets, the ability to get better than our expected average weekly fees and all of that told us we had potentially a profitable business. Chelsea Court opened in November 2016 has now been operating for a full three years.” Laurence and Guy had expected it would take up to two years for Chelsea Court to achieve full occupancy, with an average weekly fee of just over £2,000 by the end of that two years. It filled up in six months and they exceeded that average weekly fee in the same period. “We have continued along that path,” said Laurence. “We’ve been full ever since, we have a waiting list and we are profitable. “We have not done this for money: I have been giving to dementia activities elsewhere and I have just founded a Masters Degree in Dementia Care at the University of West London. “An interesting thing we noticed in that first year was that, every time somebody would come in, and it was 80% women, it would be the same story; the doctors had given them three to six months to live and the family couldn’t cope with them at home. But neither Guy nor myself believe that psychotropic drugs are the answer, and because of my background in nutrition, we found that by providing as good food as you would get in any great London restaurant, and by stimulating our residents with bespoke and curated activities, physical and mental, and by giving them companionship, they continued living well beyond what had been predicted. Of those original residents, I think that more than half of them are still with us. “One early resident had been given three months at the outset of her stay with us, but at the end of that three months she was communicating, complaining – wonderfully so – she was
June 2020
www.careinfo.org
For the most part, the care industry seems to be continuing to do what everybody has done for 20 to 30 years; I don’t see bold innovations and I see it being run much more on a commercial basis, rather than going down the service route.
having wine and gin and tonic with her meals, she went to Royal Ascot that year. Those kind of results inflamed our passion and our desire to do more. So we have invested a lot of money into the business, buying land, or buildings or options, and also investing in training and specialist courses.” Loveday and Co is owned by Guy and Laurence, with a couple of junior employee partners. While Chelsea Court has only 15 beds three new properties, in Abbey Road, Notting Hill and Kensington Square, will add another 100 beds. “Our plan is to get a significant market share in central London as a core business with central synergies in training and purchasing, and we probably need somewhere between eight and 10 properties to do that,” said Laurence. “The problem is that you are buying very expensive real estate, and converting them takes 18 months to two years, so there’s £115 million going in to them. “We’ve made tons of mistakes but in the end we have three new projects ready to go, with a combined project cost of about £120 million, and we brought in a property company, so now the family owns 100% of Loveday, the operating company, and we have sold the properties to a private equity firm, Frogmore, with an option to buy them back. “Frogmore are fabulous partners; they have taken on the building side of it while we have these three projects under way, and we are now actively negotiating to buy more properties to expand further. Kensington Square I think is 42 rooms, Notting Hill is 34 and Abbey Road is 26. I would say our ‘sweet spot’ is 35 rooms; with very intense individualised and curated individual services, it is hard to do much more. I want growth to be organic, with the development of close relationships. I think I could make a lot more money but I don’t intend to.” I remarked that with an ageing population, there were going to be ever more people developing dementia who lacked the wherewithal to pay for the levels of care provided by Loveday & Co,
but Laurence insists that his is a model that can be worked towards. “We are proving that by taking a different approach, you can increase the amount of care without increasing the costs and so get better results, but drugging people and giving them crap food will not change anything,” he said. “By having different systems you can improve lives but it’s all about training. Everybody in a care home has to be empowered to give better results. “I have come to believe that, for the most part, the care industry seems to be continuing to do what everybody has done for 20 to 30 years; I don’t see bold innovations and I see it being run much more on a commercial basis, worrying about eking-out pennies and reducing costs rather than going down the service route. By charging more I am allowing other people to charge more, so they can build better and take lessons from what we have done. They can put more staff in and still make a profit. But what will happen is that some providers will put up their rates and give no extra services. “We have put our wage rates up some 40% since we started, we give training incentives and performance bonuses, and in four years we have had 20% staff turnover. I think that wages in the social care sector in general are appalling and when I hear people congratulating themselves on how long they holdingout, not paying the London living wage I think it’s unbelievable. There are billions of pounds invested in the elderly care sector and to chintz people over two or three pounds an hour is ridiculous, because staff will leave. “There are several big companies in this industry; these people are professionals, they know the world is changing and they will evolve. Their services will improve; they’ll copy from me, they’ll copy from others. Where change will be slowest is in the small groups of independent care homes. They will be the problem; they will not reinvest in their product, they will not invest in training, and they will be the ones who hold our industry back.”
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management
R
unning a safe, efficient and effective laundry is as critical as running a safe, efficient and effective kitchen in any care home, never more than in current circumstances. Every step of the process, from collection of dirty laundry from a bedroom to the return of clean , hygienic laundry to that bedroom should be organised and controlled. As the care industry copes with one of its most challenging periods yet, it is
June 2020
www.careinfo.org
Christeyns Professional Hygiene national sales manager MARKâ&#x20AC;&#x2C6; DRINKALL discusses best practice in a care home laundry. christeyns.com
Never a more critical time for the best practice in laundries crucial that best practice is consistently adhered to in all aspects of care home operation, every day with every process.
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Staff: Staff should change into uniforms at the site rather than travelling from home in them, and uniforms should be laundered to the appropriate standard in the controlled environment of the on-site laundry. It is, however, recognised that this may not be possible in all homes. All practical steps to ensure that staff uniforms are hygienic when in use and do not present a contamination risk inside or outside the home must be taken. All staff should wear appropriate personal protective equipment (PPE) when handling linen, particularly foul or infected linen, and when handling laundry chemicals. Follow the guidance provided by statutory bodies and on the packaging of the chemicals. A care homeâ&#x20AC;&#x2122;s machine and/or chemical supplier should be happy to provide training to ensure that staff are aware of how to get the best out of equipment, promote efficiency and ensure safety standards are met. Rooms: Ensure that all linen which is, or is suspected to be, foul or infected is placed into a soluble red bag and then sealed in a non-permeable bag before it leaves the bedroom. It should be transported directly to the laundry. Any solids should be removed from the laundry before it is placed in the soluble bag. Keep clean and dirty laundry separate to ensure there can be no transfer of infection from dirty to clean linen, washing hands and using clean PPE where appropriate.
Transport and storage: Have separate storage and transport arrangements for clean and used laundry, ensure these are cleaned regularly. Housekeeping in the laundry: Keep the machines, floors, trolleys and surfaces clean. If a water softener is in use, ensure that it is functioning correctly; hard water will cause results problems and damage the washers over time. Have separate containers or trolleys for soiled linen and clean linen. Do not open red bags before they go into the washer. Never store or leave laundry on the floor; it is unhygienic and will result in footprint stains which cannot be removed. Report any faults with machines immediately. Never leave hot linen unattended or overnight, it might cause a fire. Ensure that linen is below body temperature before leaving unattended. Handle and store clean linen hygienically. Dosing systems: Ensure that dosing pumps are working. Report any faults immediately. Is the light or screen on, do they operate during every process? Are there any leaks, are the drums going down, do they need replacing, is the correct drum on the correct tube? Check drums daily. Always wear gloves and eye protection when handling the chemicals. Never mix chemicals. Ensure that an appropriate stock of all the laundry chemicals is maintained to eliminate the risk that these will run out. Running out of even one chemical will negatively impact the washing results.
Washers: Do not significantly overload or underload the washers or dryers; this will cause results problems and may damage the machines. Make sure that the appropriate wash process and dosing program is selected, paying particular attention to making sure that foul and infected linen is processed on a disinfection program. Do not attempt to shorten a wash process by advancing the machine, it will impact upon results and may cause skin irritation for staff or customers. Use a prewash when required. Select a destainer process for any stained linen. Never use fabric conditioner on kylies or microfibres. Never put starch and conditioner in the same process. Dryers: Load to the rated capacity of the dryer where possible. Do not overload as it will decrease efficiency. Select a cool-down option where appropriate, particularly on polycottons. Do not leave dried laundry in the dryer at any time as it poses a fire hazard. When removing linen from the dryer, smoothing and folding it immediately and while still warm will result in a better finish and reduce the need for ironing. Clean the lint trap every day, otherwise it may become a fire hazard. Running an efficient and effective onpremise laundry can give care homes peace of mind. However, it must be well managed around strict guidelines and with staff who are kept up-to-date and knowledgeable about the important role they play in keeping everyone safe.
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moving around Appointments Home care provider Bluebird Care Stroud has appointed Tracy Morgan to the post of care manager. Having passed her registration in the first week of April, Tracy’s appointment is the latest in a career path which began when, after managing a physiotherapy clinic for 18 years, she started at Bluebird Care Stroud as a care assistant and then worked in various roles including supervisor, care co-ordinator and live-in care manager. Of the current situation in which home care workers find themselves as a result of the Covid-19 pandemic, Tracy said she had seen many examples of people pulling together to support one another. “This situation of social isolation combined with fear of becoming unwell is challenging and new for everyone,” said `Tracy. “But in our own community we have seen many examples of staff going above and beyond to help vulnerable individuals overcome the challenges they are meeting. “The creativity and resilience of people is really coming to the fore now, and despite this being a worrying time for everyone, there are many examples of selfless acts, and philanthropy abounds.” Many events and trips Bluebird Care Stroud had planned for 2020 are now uncertain. However, Tracy says she is looking forward to the time can spend time together again. “I am looking forward to bringing our staff and customers together to do some fun and interesting things,” said Tracy. “I think these will be all the more enjoyable because we will have had such a long period of restriction; we are reminded that our normal freedoms are so very precious.”
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Anne Mirasol and Tracy Johnston
Tracy Johnston and Anne Mirasol have been appointed by New Care as home manager and deputy manager respectively at Ruddington Manor Care Centre, in Wilford, Nottingham. The duo will work together, combining their knowledge and expertise, to run the 66 bed care facility, which offers residential and nursing care services. Tracy has worked in the health sector since she was 16 years old, starting off as a carer. She qualified as a nurse in 1999 and has worked for the NHS and privately. With many years of managerial experience, as deputy manager, home manager and regional director, Tracy is perfectly placed to lead the team at Ruddington Manor and ensure each and every resident receives exceptional care. Anne, who originates from the Philippines, has worked in the health sector since 2007. She moved to England in 2011 working as a Registered General Nurse n a care home before progressing to clinical lead in 2016. Anne is responsible for providing clinical, managerial and placement support to Tracy. A large part of her remit will include liaising, networking and communicating with outside agencies, organisations and commissioners of services, as well as families of all residents.
June 2020
www.careinfo.org
Barchester Healthcare’s Red Oaks care home in Mansfield, Nottinghamshire has welcomed former Business Woman of the Year, Lin Amos, as its general manager. With more than 30 years of experience in care, including dementia, palliative and clinical, Lin has spent the last 20 of these years in leadership and management roles. In previous posts Lin has managed Holmes House in Leicestershire, Edingley Lodge care home near Newark, part of Barchester Healthcare, and spent five years working as operations manager at Tynefield Court care home in Etwall, near Derby. “I couldn’t have wished for a warmer welcome from the staff and residents at Red Oaks,” said Lin. “Caring for people is a calling not a job. Managing a care home has many challenges, especially at times like this. I have always been drawn to helping people and I was lucky to have a wonderful, close relationship with my grandparents. It was seeing how they were treated as elderly citizens within the community and being totally dissatisfied with their end of life care, that spurred me on to create caring homes that would bring love, respect and dignity to every single resident, regardless of their situation when they come to needing residential care. “Here, I am part of a team that believes we are one big family – our staff, residents and their families – and Red Oaks is our home. “There’s always ways to improve the standard of care you can give and our team is committed to providing the very best person-centred care. Getting to know our residents from the moment they arrive, including their past life and experiences as well as understanding their personality and nuances enables us not only to get their care package right, but it allows us to really build a strong bond with them and their families. That is when you create a home-fro- home experience for all involved. “In the UK there is still so much fear and many taboos around end of life care. It’s a part of life that will come to us all and I feel so privileged to be able to help families as well as their loved ones during these times.” Lin said Red Oaks was fortunate not have had to deal with any Covid-19 issues but had still had to manage instances of staff isolations and cutting down on family visits. “I feel sad that it’s taken a pandemic to really shed a light on the many incredible carers in the UK devoting their lives to care for others, but at last we are getting recognition for the work we do,” she said. “We are able to continue visits for our palliative residents through scrupulous PPE and social distancing. We’ve been inundated with kind messages of support and thoughtful gifts from our residents friends and family and members of the community which really helps to keep our spirits up “There is no room for complacency in our sector– everyone living at Red Oaks deserves the very best quality of life and everyone at Red Oaks is 100% committed to ensuring this is what they get. My ambition is that we will be the care home of choice for the region and one of the best in the UK.” Marianne Wanstall has been appointed as the new chief executive of Hampshire-based charity The Brendoncare Foundation. She will take up her post on 1 July when the current chief executive, Carole Sawyers, retires. Marianne will lead the organisation as it develops its services for older people in care homes and the community across the South of England. Marianne joins Brendoncare from the travel industry and has previously worked with the National Trust. She is also a long-standing volunteer and trustee of the charity, Across, which organises pilgrimages and holidays for people with high levels of disability, lifelimiting and terminal illnesses. “I am really looking forward to the opportunities ahead for Brendoncare,” said Marianne. “I have had a growing desire to work for an organisation that shares my personal values and of making a positive difference to people’s lives, where people’s needs are central and their wishes paramount. “Brendoncare offers a great standard of care in its homes, and is having a vital impact in reducing loneliness and isolation through clubs in the community. I am thrilled to join the team and keep building on its success.”
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REPUTATION
DISCRETION
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Redwoods Dowling Kerr
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Talk to us today to find out how we can help you with your sale or acquisition strategy
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PROJ E C T
A RI E S
Project Ochre Project Ochre - East Sussex
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Former Care Home - Liverpool
Chaffinch - Greater Manchester ^ŽůĚ Žī ĂŶ ĂƐŬŝŶŐ ƉƌŝĐĞ ŽĨ άϮϬϬŬ
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R DE ER N F U OF
Project Aries - Bristol
Domiciliary Care Provider
R DE ER N F U OF
Residential Home - Nottinghamshire
R DE ER N F U OF
Domiciliary Care Agency - Kent
ZĞƐŝĚĞŶƟĂů ĐĂƌĞ ŚŽŵĞ͕ ƌĞŐŝƐƚĞƌĞĚ ĨŽƌ ϭϳ ƌĞƐŝĚĞŶƚƐ
dƌĂĚŝƟŽŶĂů ĐĂƌĞ ŚŽŵĞ ďƵƐŝŶĞƐƐ
ůů ďĞĚƌŽŽŵƐ ŽīĞƌŝŶŐ ĞŶͲƐƵŝƚĞ ĨĂĐŝůŝƟĞƐ
/ŶĐŽŵĞ ŽĨ άϰϴϰŬ ;zͬ ϮϬϭϵͿ ĂĚũƵƐƚĞĚ EĞƚ WƌŽĮƚ ŽĨ άϵϬŬ
'ĞŶƵŝŶĞ ƉŽƚĞŶƟĂů ƚŽ ŝŶĐƌĞĂƐĞ ŝŶĐŽŵĞ ĂŶĚ ĞdžƉĂŶĚ
Immaculately appointed throughout
15 single and 2 twin bedrooms
džĐĞůůĞŶƚ ƌĞƉƵƚĂƟŽŶ ǁŝƚŚŝŶ ƚŚĞ ƌĞŐŝŽŶ
Impressive detached nursing home, with 56 bedrooms
BUSINESSES ON THE MARKET Residential Care Home, West Sussex Well established care home for the elderly & mild ĚĞŵĞŶƟĂ ĐĂƌĞ͕ ƌĞŐŝƐƚĞƌĞĚ ĨŽƌ ϮϬ ƌĞƐŝĚĞŶƚƐ Fee income of £811k (y/e 2019) with an EBITDA of £301k High bricks and mortar value
Freehold Ref No: 47810
£2,700,000
Residential Care Home, Cumbria ĞƚĂĐŚĞĚ ƌĞƐŝĚĞŶƟĂů ĐĂƌĞ Θ D/ ŚŽŵĞ ĨŽƌ ƌĞƐŝĚĞŶƚƐ over 65, registered for 32 Fee income of £620k (y/e 2019) with an EBITDA of £181k
Approaching 1.8 acres with separate 7 bed family ŚŽŵĞ Θ ĂĚĚŝƟŽŶĂů ĚǁĞůůŝŶŐƐ
Freehold Ref No: 46648
£1,199,999
Nursing Home, Greater Manchester Nursing home providing care for the elderly, registered for 43 residents & 39 bedrooms
Fee income of £1.4m (y/e 2019) with an EBITDA of £281k
Specialist Care Home, Kent Well respected specialist care home, registered for 10 service users
Detached property set within c. 1 acre of mature grounds
,ŝƐƚŽƌŝĐĂůůLJ ŚŝŐŚ ŽĐĐƵƉĂŶĐLJ ǁŝƚŚ ƉŽƚĞŶƟĂů ƚŽ ĞdžƉĂŶĚ
/ĚĞĂů ƉƵƌĐŚĂƐĞ ĨŽƌ ĂŶ ĞdžŝƐƟŶŐ ŐƌŽƵƉ ŽƉĞƌĂƚŽƌ
Freehold Ref No: 46395
Freehold Ref No: 47745
£1,599,950
Project Apollo, Somerset Well respected nursing home, specialising in provision care for the elderly, registered for 50 residents
£1,200,000
Former Care Home, Staffordshire Former care home, assisted living for vulnerable young adults & registered for 10 residents
Fee income of £2.2m (y/e 2012) with an EBITDA of £940k
Flexible lease terms available with 5 and 10 year ŽƉƟŽŶƐ
Freehold Ref No: 47715
Leasehold Ref No: 47808
Rated ‘Good’ by the Care Quality Commission
Offers Invited
ϵͲďĞĚƌŽŽŵ ĚĞƚĂĐŚĞĚ ƉƌŽƉĞƌƚLJ͕ ƐƉĂĐŝŽƵƐ ĂŶĚ ǀĞƌƐĂƟůĞ ĂĐĐŽŵŵŽĚĂƟŽŶ ƐĞƚ ŽǀĞƌ ƚǁŽ ŇŽŽƌƐ ǁŝƚŚ ĞĂƐLJ ĂĐĐĞƐƐ
TO BUY: 0844 7011 821 TO SELL: 0844 3877 498 buy@redwoodsdk.com sell@redwoodsdk.com
Offers Invited
POW ER ED BY .co.uk
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business & property
June 2020
www.careinfo.org
Buying a care home –
DUNCAN ASTILL, partner, and AMANDA NARKIEWICZ, principal associate, at national law firm Mills & Reeve outline some of the regulatory pitfalls of conveyancing in the care home sector. mills-reeve.com
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or those looking to generate a healthy return and create real social value, care homes can seem an attractive investment. That’s definitely true, but in a highly regulated sector to get it right one does need to take due diligence seriously. When considering an investment in this sector, it is essential to have a basic understanding of the regulatory landscape – it is a heavily regulated market place and, in recent years, regulators have become far more willing to flex their muscles, posing challenges to those looking to buy or sell.
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CQC’s role and powers: the basics The Care Quality Commission is the independent regulator of health and social care services in England. “Regulated Activities” are set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Details of each location from which a service provider carries out regulated activity must be provided to the CQC. Failing to comply with the regulatory framework around registration is a criminal offence. The CQC monitors service providers’ compliance with its “Fundamental Standards” by inspecting, reporting on and rating locations from ‘outstanding’ to ‘inadequate’.
Service provision for people with learning disability and autism Although the size and scope of a service is generally a matter for the operator, the CQC’s guidance, Registering the Right Support (RTRS) informs the CQC’s approach to the registration of any new service for people with a learning disability and/or autism. Such services can be attractive to investors because the specialist nature of the care can offer better returns on investment than other areas. A significant feature of the CQC’s approach to such services is that it includes a presumption that accommodation will be for six service users or fewer. A new application for registration will be subject to the strict application of criteria in RTRS. Transfer of ownership of existing services for people with learning disability and autism can take place (particularly with a share sale, where there is no change in registration) but it is important to be aware that the current guidance (which is under review) also poses a challenge to existing services, which are expected to adapt their existing premises, as far as it is possible to do so, to meet the guidance. CQC’s civil enforcement powers The CQC has a range of civil and criminal enforcement powers in its
toolkit and it appears to be increasingly willing to deploy them. The CQC’s civil enforcement powers are set out in the Health and Social Care Act 2008. Enforcement action includes: imposing, varying or removing conditions of registration; suspending registration; cancelling registration; and urgent cancellation of registration (which can lead to an almost immediate closure of a location) in cases where there is evidence that there is ‘serious risk to a person’s life, health or well-being’. Whether buying or selling, it is important to consider the potential impact of ongoing enforcement action and to be aware of the complexities – transferring assets subject to enforcement action can be trickier and may take some careful navigation. The right of appeal against more serious civil enforcement action is with the Firsttier Tribunal; such proceedings can be expensive and, in our experience, take between six and 24 months, so it is not always going to be practical to wait for proceedings to conclude. Criminal prosecutions following serious incidents and fatalities The CQC’s criminal enforcement powers enable it to take action against both companies and individuals, such as registered managers and directors, who
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business & property
June 2020
www.careinfo.org
don’t skip due diligence fail to comply with the “Fundamental Standards”. Some offences carry small fixed fines, however, for other more serious offences, such as ‘failing to provide safe care and treatment’, the fines are unlimited. CQC has increased the number of criminal prosecutions of health and care providers by more than 32% in a year according to its 2018/19 annual report. Here are samples of high profile fines. ■ Southern Health NHS Foundation Trust was fined £125,000 in 2017 after it admitted it had failed to provide safe care and treatment when a patient was injured after falling from a hospital roof. ■ Hillgreen Care Ltd was fined £300,000 and ordered to pay £141,000 towards the CQC’s legal costs in 2019 for failing to provide care and treatment in a safe way for service users and a failure to put in place, and operate effectively, systems and processes to prevent abuse to service users. The CQC has also taken over from the Health and Safety Executive to take the lead in enforcement of safety matters involving service users who are in receipt of a health or adult social care service from providers registered by the CQC. The HSE and/or local authority will still prosecute, in circumstances where it is not appropriate for the CQC to take the lead. The Embrace Group fell foul of HSE regulations when a resident of the care home died after falling down an unlit internal concrete fire escape – the group was fined £1.5 million and ordered to pay £200,000 towards the HSE’s costs. Criminal prosecution Following serious incidents involving fatalities, service providers can also be investigated by the police for offences such as corporate manslaughter. A company can be guilty of an offence of corporate manslaughter if the way in which its activities are ‘managed or organised causes a person’s death’ where that ‘amounts to a gross breach of a relevant duty of care owed by the organisation to the deceased’. We have seen service providers investigated by the police following the deaths of service users that had been suffering with pressure sores, in
circumstances where the police have suspected that the provider did not have adequate systems in place and the pressure sores caused or contributed to the death. The first care home to be convicted of corporate manslaughter was Sherwood Rise Ltd in 2016, following the death of a resident which was found to be contributed to by neglect. The company was fined £300,000 and ordered to pay prosecution costs. Financial impact of a prosecution The Sentencing Council has a definitive guideline that applies to prosecutions of health and safety offences and corporate manslaughter. Although not directly applicable to CQC prosecutions, if it considers it appropriate to do so, the court can have regard to it. Following this guideline, the fine to be applied will vary significantly, depending on a number of factors including: ■ Level of culpability; ■ Harm (likelihood and seriousness); and significantly; ■ Turnover of the defendant company. Fines are linked to a company’s turnover to ensure that they have a real economic impact – therefore the greater the turnover, the greater the fine will be. For example, applying the highest level of ‘culpability’ and ‘risk of harm’, a small company (turnover of £2- £10 million) could be at risk of a fine ranging from £300,000 to £1,600,000. This range decreases for a ‘micro’ company and increases for ‘medium’ and ‘large’ companies. Large care home groups could therefore face fines well over £10 million. It is important to know that although insurance policies may cover the legal fees incurred in defending an investigation by the police, HSE or CQC, some policies will not cover legal costs after a decision to prosecute has been made, and for public policy reasons no policy will cover the fine imposed by a criminal court, or the prosecution’s legal costs. For anyone undertaking a share purchase of a care home or group of homes, it can be financially devastating to inherit this kind of liability: due diligence is therefore essential.
Due diligence - what can be relied upon? The first thing that is often looked at when purchasing a care home or group of homes is the rating given to each “location” by the CQC. Ratings and inspection reports are important: a poor rating is likely to attract an increased regime of inspection and oversight from the CQC; have an impact on the number of public and privately funded service users it can attract; and face more difficulties in attracting and retaining staff. But just how reliable is a rating? Although in most cases ratings can be relied on, Whorlton Hall is a cautionary tale – it was rated as ‘good’ until it was re-inspected by the CQC, following concerns raised by Panorama in relation to alleged abuse. Even if a rating is reliable, it is only half the story. Accidents and failures leading to serious harm and death happen in the care sector, and although services may have been transformed, lessons learnt and ratings improved, investigations can lie dormant for years, and almost be forgotten before being resurrected by enforcing authorities. It is therefore essential to get under the bonnet: review policies; meet the senior team; collate information on historic incidents and civil enforcement action; and request information on investigations by the coroner; police; HSE and CQC. If you don’t know what you’re looking for, seek advice. If due diligence is carried out and a serious investigation by the police, or a regulator is discovered, all is not lost. If both parties are willing to be sensible, identified risks can usually be quantified and factored into agreements to allow business to progress. We’ve worked with clients who have either agreed to place a portion of sale proceeds into an escrow account or negotiate indemnities from the selling shareholders to cover-off unknown risks at the point of sale. The message is simple: the consequences can be huge so don’t skip the due diligence. For those that get it right, there are many opportunities in this marketplace to generate a healthy return and create real social value.
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staffing
June 2020
www.careinfo.org
Flexibility and staff incentives
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hatever challenges the care sector has faced in filling roles and ensuring continuity of care are being exacerbated by the current global health emergency. Perceptions around low-pay, long hours and physically-demanding work have sadly overshadowed the rewarding aspects of working in care – to the extent that there are around 122,000 vacancies at any one time, while 440,000 leave their job each year. Due to Covid-19, chronic labour shortages could become critical if staff are ill, self-isolating or shielding themselves. Unsurprisingly, both private sector and local authority providers have stepped up their recruitment efforts recently, with many looking to those who have lost their jobs, or been furloughed, to plug the gap. As long as their contract allows, furloughed staff can still get paid work elsewhere and it is hoped most employers would look favourably on anyone willing to take on a key worker role in the care sector. There may also be student nurses and medics, not yet qualified to work on the frontline in hospitals but eager to deploy their skills and compassion in care settings. Whether providers are relying on existing staff or an army of new recruits, they are going to have to work harder than ever to hold on to them and help them to deliver the highest standard of care. This could mean a change in working practices in some cases – for example, using technology to build safe and effective rosters, and seamlessly matching unfilled shifts with available employees. Among the advantages of using
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ABHISHEK AGRAWAL, from social care technology specialist The Access Group, looks at what providers can do to widen their talent pool during the Covid-19 crisis and beyond. technology which can enable staff to spend more time on the higher value parts of their jobs, is the reduced amount of admin and office work required from carers. As well as allowing employees to spend more time offering the face-to-face care that most staff entered the sector to provide, technology also is proven to increase productivity in general – something that is crucial during this current crisis. It is important to remember that some workers will be experiencing upheaval in their own lives, perhaps due to school closures or their partner being furloughed, and therefore want to change their hours or take on additional shifts. The best incentive, along with the extra pay, is to make the process quick and easy for them to do via their mobile device. Flexible pay Choosing their shifts gives staff a level of flexibility rarely seen in other jobs. Another initiative gaining traction is enabling them to choose when and how they are paid, so they no longer have to wait until the end of the month to get money in their account. While flexible pay doesn’t add to employers’ wage bills, it is a powerful
incentive for staff, particularly in uncertain times. Access Group data shows that users of these apps take on around 20% more shifts than non-users, perhaps knowing they’re able to access their earnings sooner. Covid-19 has brought about many changes in the care sector and beyond, and its impact will be felt for many years to come. The weekly Clap for Carers has become a ritual for many communities, while both the Queen and government have recognised the vital role care workers have played during this time. There is a clear public appetite to help others – and we have seen how important technology such as the GoodSAM app can be in mobilising them quickly. A recent government report stated: “We must ensure that social care gets the recognition and parity of esteem that it deserves” though it remains to be seen whether this will be enough to inspire more people to join the profession. For those that do, even on a temporary basis while furloughed, providers must take a flexible approach and offer the right incentives to get trained staff on the ground. ■ For more information about the Access Group visit: theaccessgroup.com/hsc
Stockport NHS commissions New Care’s newly-built Bramhall facility Having recently completed build on a care home in Bramhall, Cheshire, care home operators New Care made it available to the NHS to free-up beds at Stepping Hill Hospital.The 71-bed facility was immediately commissioned in its entirety by the Council and NHS in Stockport. Stepping Hill Hospital has already started to transfer patients who are well enough to be discharged from hospital but need rehabilitation and further assessment to identify their ongoing care needs before returning home. Cath Fairhurst, chief operating officer at New Care said the Covid-19 pandemic had put massive immediate pressure on the NHS and the current situation had highlighted the ongoing
huge shortfall of beds in hospitals, many of which were in use by stable patients who had been medically discharged but required rehabilitation before returning home. “There is quite simply nowhere for these patients to go, so they remain in hospital blocking beds,” said Ms Fairhurst. “As a registered nurse and in all my years of experience working in the health sector, we are navigating our way through unprecedented times. A fresh approach to the provision of care facilities and beds is needed now more than ever before. “The contract with the NHS will not only assist with the current crisis, but when Covid-19 is under
control there will undoubtedly be a need for more care home beds to deal with the longer-term implications of the more vulnerable patients.” In Wilmslow, Cheshire, New Care has resubmiitted a previously ‘refused’ planning application for a 60-bed care facility. The application was refused planning permission in January despite having a strong recommendation for approval by Cheshire East Planning Authority. The application has been appealed but New Care has now asked the Council to reconsider and to grant consent at the earliest possible opportunity rather than waiting months for the appeal process. to run its course.
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analysis
June 2020
www.careinfo.org
MARKET ANALYSIS
Care sector keeps its resilience By SAM WRIGHT, senior director with the healthcare team at CBRE For elderly care the last few weeks have been bruising. A shortage of PPE, a lack of testing and an increase in the number of deaths from Covid-19. It may therefore seem slightly counter-intuitive that the sentiment among investors is reasonably positive towards the care sector at the moment. This is not because they have missed what’s been happening, or because the think there won’t be further pain; it is because the sector has fared so much better than many others like retail, pubs and hotels that they also usually invest in. In part this is because care homes have been able to continue trading. While lower occupancy rates an increased staff and PPE costs may be impacting on profitability, they are at least being able to cover some, if not all of their fixed costs. This is in sharp contrast to most pubs, shops and hotels which are still having to pay a whole host of costs including rent, mortgages, utilities and business rates even though they can’t open. For many of these business though, this is potentially only the start of the troubles. With social distancing seemingly set to remain in place for the next six months at least, this raises bigger questions about their future viability. For example, if you own a restaurant that used to be able to seat 100 people but now can only seat 50, is it going to be financially viable to open? And that is before you have considered whether people will want to eat out, or whether people will want to eat in a restaurant where the waiting staff are wearing PPE. Thankfully these are not the questions that care home operators are having to think about. If anything, on one level this crisis has proved the resilience, and from an investor perspective, defencibility of the sector. We will see what happens over the next few weeks and months, and whether there is a second wave of Covid-19 cases. But one thing is sure; care provision is this country is a predominately need rather than choice-driven service; and this means that whatever happens, there will still be people who need to be cared for.
For the latest news in social care, go to: www.careinfo.org Caring Times’ official website
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analysis
June 2020
www.careinfo.org
Speaking at a webinar organised by Caring Times’ sister publication HealthInvestor in late April, Knight Frank’s head of healthcare JULIAN EVANS gave his analysis of how the Covid-19 pandemic had impacted care homes in the UK.
Care home deaths could exceed 40,000
K
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night Frank’s head of healthcare Julian Evans prefaced his presentation by pointing out that the current Covid-19 pandemic was not a ‘black swan’, that is, epidemiologists had been expecting something like it, and had been warning governments about it. “Neither was this a surprise to the NHS,” he said. “But the UK has only about six critical care beds per 100,000 people, compared to the rest of Europe – Poland, Spain, France, are all ahead of us ; Italy has 12 – this just highlights the fragility and the lack of investment by successive governments into an NHS that is no longer fit for purpose.” Mr Evans said how healthcare in the UK is funded needs a radical overhaul. “The problem is that the NHS has always been a political football, with health ministers rarely staying in post for much longer than 12 or 18 months. We need to be brave enough to tackle this,” he said. “We have experienced bed-blocking issues for the past 10 years or so, with more than 50% being elderly people waiting for care home placement or home care packages. This is another stark reminder that there is a significant lack of bed capacity in the UK’s NHS system. Added to this we have a structural undercapacity in the social care sector.” While not optimistic about the likelihood of health and social care integration in the wake of the pandemic, Mr Evans said praised the developing cooperation between the two sectors as the emergency continues. “We’d all like integration to happen but sadly I don’t think it will,” he said. “The social care sector has always been considered to be the Cinderella of UK healthcare, but if it had not been for the social care sector shoring-up the overspill
and the under-capacity of bed provision in the NHS, we would be in all sorts of trouble. I think the integration during this crisis period has been pretty amazing.” PPE and testing Mr Evans was less sanguine, however, about the Government’s consideration of social care in the first weeks of the pandemic. “There has been an absolute shambles in testing in the social care sector,” he said. “There is almost a growing sense of suspicion of propaganda, on the part of the government, not to allow testing in the private/social care sector in order to suppress mortality rates, as in the recording of them. Now, an operator’s first duty of care is to their existing clients, but also to their workforce, who are most exposed to the virus, and to compound that further is the very poor availability of PPE, the supply chains have been woeful – the Government had a two-week lead time on this and did nothing to begin assembling and ordering enough PPE. Guidelines on procedures are changing almost daily. So recorded care home mortality figures probably fall well short of the reality, because there’s no testing, and the anecdotal feedback is that a significant number of residents are dying of Covid-19, and these deaths are not being properly recorded. “It is really difficult to say definitively which deaths are Covid-19-related. There is a tranche of providers in the UK that operate between 3,000 - 5,000 beds, and many of those experienced up to 40 to 45 deaths per day in late April. A year-onyear comparison from 2019, when many were experiencing12 to 15 deaths a day shows the death rate to have tripled. Our estimate is that the Covid-19 pandemic could see anything between 40,000 to 50,000 deaths in care facilities. And these
operators are exceptionally good at infection control and clinical governance; they have been doing this a long time.” Mr Evans said that, while it appeared the rapid development of pandemic had caught many operators by surprise, they had nonetheless been quick to take their own initiatives, but that the bigger operators were better able to cope than many smaller providers. “There have been numerous issues around PPE; for example a care worker may be doing a 12-hour shift (and we were seeing an absenteeism of around 25% around the peak); now I understand the guidelines are that every three hours, masks need to be changed, so the carer would need to use four masks over the course of that shift. If the mask gets moist, then it will need to be changed, so a lot of PPE is needed. So if supplies are limited, those who are buying at scale, such as major providers, will be supplied before smaller businesses, so small providers are disadvantaged. So it is our view that sub25-bed care homes are highly vulnerable; they don’t have the economies of scale and I have a sense that because of the limited working capital they have, closures may be expedited over the next 12-months to two years, and that is going to further compound the national bed crisis we have got in the UK. “Around 11% of the UK population is over 65; by 2040 it will be almost 25%, because of the 1950s baby-boomers that are coming through. For lots of different reasons we have a structural underprovision of beds. By 2040 we’ll have a shortfall of some 300,000 beds, and that’s before you even look at the existing built environment today which is not of market-standard. That’s quite poignant because new facilities with 100% ➤ Continued on next page
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business & property
June 2020
www.careinfo.org
Legal & General announces £260m investment in two retirement villages Investment company Legal & General has received approval from Reigate and Banstead Borough Council for its later living business, Inspired Villages, to deliver one of the UK’s biggest retirement communities on the site of its former head office, Legal & General House in Kingswood, Surrey. It has also acquired a 12-acre site in Caddington, Bedfordshire, with outline planning permission to develop 200 specialist ageappropriate homes, delivering much needed housing stock to meet local demand and is expected to have a gross development value of £120 million on completion.
The Kingswood scheme will see over £170 million invested into the local economy at a time of heightened need. Works are due to start later this year and the site is expected to have a gross development value of more than £215 million when complete, making it one of the UK’s biggest retirement communities by value. Inspired Villages will be transforming the vacant and dilapidated site into a vibrant later living community with 270 specialist age-appropriate apartments, while preserving the long-term future of the Grade II* listed building.
➤ From previous page
governor of the Bank of England – the banks are far better capitalised as a consequence. “When you look at previous pandemics; a recession follows. But because the banks are well-capitalised, because there is a broad church of different investors into the market, we are well-placed for recovery. Many of us saw the fashion house Oasis go into administration recently, retail is on its knees, the hotel arena, unfortunately as an asset-backed sector, has been heavily exposed. The care sector needs inward investment and there is likely to be a ‘flight to quality’. Of course at the moment there’s a pause while investors wait to see how well care providers weather the Covid-19 storm, but I already sense they will come through it in a very robust fashion.”
wetrooms are finding it much easier to isolate residents. Converted properties make isolation very difficult.” Banks and investment Mr Evans said the current financial pressures facing care businesses were very different to those they faced in the 2007 financial crisis. “At that time we saw lenders and investors looking to default customers when they breached covenants,” he said. “Now lenders are looking to offer solutions so when operators begin to breach covenants, and it will happen, I think the banks will stand shoulder-toshoulder this time. Fair credit to Mark Carney adhering to Basel II when he was
Plans also include up to 10 respite units, allowing Inspired Villages to work with local GP practices and hospitals to help reduce pressure on the NHS and local care services. The Caddington site acquisition brings Inspired Villages’ development pipeline to 2,500 homes across the UK in the next six years. Together, these schemes will create around 1,000 construction jobs per annum, and up to 640 permanent jobs once the retirement communities are complete and operational. When complete, the Caddington scheme will include a restaurant, café, wellness centre (comprising a swimming pool, fitness studio and gym), library and cinema room. In keeping with Inspired Villages’ ethos of creating communities in and around its villages, many of these facilities will be available to both residents and the local community. Speaking of the Caddington project, chief executive of later living at Legal & General Phil Bayliss described it as an opportunity to deliver homes and support a lifestyle that would change the way people aged in the UK. “Our focus is not solely about how to extend lifespan and more about how we can extend our health span, improving the quality of life we already have,” said Mr Bayliss. “This acquisition follows Inspired Villages planning consent to develop one of the UK’s largest retirement communities in Surrey. As Inspired Villages continues to expand, it will play a key role in providing high quality later living housing to the UK through which we can address the social and economic issues linked to the UK’s ageing population.”
PROPERTIES AND BUSINESSES RECENTLY SOLD IN THE CARE SECTOR Bethany House & Bethany Lodge Location Registration Buyer
The Montreux Healthcare Fund, to be operated by Active Care Group
Seller
Mr Paul Mills
Agent Tel
Queens Lodge Nursing Home Location Registration
Accrington, Lancashire 40 elderly
Buyer
Constantia Healthcare
Seller
Fleur & Elizabeth Wilkins
Asking price Agent Tel
£2,850,000 Christie & Co 07764 241 328
Dymchurch, Kent
37
24 and 15 beds, residential & physical disabilities.
DC Care 01937 849 268
■ Information appearing in “Care Businesses Sold” is published in good faith that the information is accurate and cleared for publication. The onus for accuracy is on the property agent. Caring Times will not publish, in a subsequent issue, corrections or alterations to information supplied. Agents, please note that items cannot be withdrawn once the copy deadline has passed. We advise readers to confirm any details with the property agent concerned.
Abbotsfield Location Registration
Barrow in Furness, Cumbria 26 elderly
Buyer
Phil & Kim Rogerson
Seller
Jayendra & Lata Patel
Asking price Agent Tel
£995,000 Christie & Co 07764 241 328
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