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24-25 November 2023 ExCeL London
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Real change or more of the same? With the general election campaign well under way Sam Monaghan, chief executive of MHA, and Jonathan Gardner, chief executive of Bluebird Care UK and Ireland, give their take on this year's party political conferences AL SO IN THIS IS SU E
Leader’s spotlight Johann van Zyl calls for a specialist care sector classification
Surveys & data CQC State of care highlights ‘two-tier’ system
Healthcare Summit We round-up this year’s flagship event
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7 OPINION Care leaders assess this year's party conferences
9 LEADER'S SPOTLIGHT
13 POLITICS & POLICY
24 HEALTHCARE SUMMIT
Johann van Zyl says specialist care deserves its own classification
Anna Marshall-Day of MHA and AnneMarie Perry of CareMatch talk recruitment
We look back on this year's Healthcare Summit
business | welcome Chief executive officer Alex Dampier Chief operating officer Sarah Hyman Chief marketing officer Julia Payne Editor-in-chief Lee Peart Features editor Charlotte Goddard Subeditor Charles Wheeldon Advertising & event sales director Caroline Bowern 0797 4643292 caroline.bowern@nexusgroup.co.uk Business development director Mike Griffin Sales manager Luke Crist Business development executive Kirsty Parks Business development researcher Robert Drummond Delegate relationship manager Sharifa Marshall Event manager Conor Diggin Senior conference producer Teresa Zargouni Head of digital content Alice Jones Marketing design manager Craig Williams Marketing content manager Sophie Davies Marketing campaign manager Sean Sutton Publisher Harry Hyman Investor Publishing Ltd, 5th Floor, Greener House, 66-68 Haymarket, London, SW1Y 4RF Tel: 020 7104 2000 Website: caring-times.co.uk
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Real change or more of the same? Opposition parties pledged major reform during this year’s conference season but decades of broken promises mean the jury remains out on whether meaningful change will actually be delivered. While Labour pledged a National Care Service and new deal for care workers and the Lib Dems offered £5 billion in annual funding for free personal care, Prime Minister Rishi Sunak was silent on the sector which was relegated to the fringes of the Tory conference. While pledging modernisation for healthcare, shadow health secretary Wes Streeting said there was “no solution to the crisis in the NHS that doesn’t include a plan for social care”. Streeting promised to “grip the immediate crisis in social care” with a focus on the workforce with a plan addressing recruitment and retention, professional status for care workers and the first ever Fair Pay Agreement. Earlier at the conference Streeting issued an ominous warning to crack down on “exploitative” private equity owners of care groups. Leader Ed Davey promised the Lib Dems would put health and social care at the centre of its manifesto by offering “better social care” with more and “better paid” care professionals, while acknowledging the
crisis in the NHS was “inextricably linked to the crisis in care”. The Lib Dems also committed to a Royal College for Social Care. By stark contrast, major reform announcements were sadly lacking at the Conservative party conference with debate predictably focused on immigration. Immigration minister Robert Jenrick voiced concern about “very high” visa levels ringing alarm bells for care home providers forced to rely on overseas staff in the absence of a plan to recruit more UK workers. Fears of further recruitment challenges were further compounded by the subsequent announcement of a planned 15% rise in health and care visa application fees. The ambitious reform pledges from the opposition and lack of new ideas from the Tory government present a stark choice for voters. A weary social care sector could be forgiven for not holding its breath, however, on whether any party will ever really deliver the change the sector badly needs. Lee Peart, Editor-in-chief Caring Times
business contents 5 NEWS IN BRIEF
We round-up last month's big stories
7 OPINION EXCLUSIVES
Sam Monaghan, chief executive of MHA, and Jonathan Gardener, chief executive of Bluebird Care UK & Ireland discuss this year's political party conferences
9 LEADER’S SPOTLIGHT
Johann van Zhyl says specialist care needs its own classification
13 POLITICS & POLICY
Anna Marshall-Day of MHA and Anne-Marie Perry of CareMatch talk recruitment
15 SURVEYS & DATA
Skills for Care to develop a long-term workforce strategy and CQC exposes 'two-tier' care system
18 PEOPLE MOVES
The latest big people moves
20 PROPERTY & DEVELOPMENT
The latest property deals and developments
22 SUSTAINABILITY MATTERS
Jonathan Freeman and Aaron White on social care's green agenda
24 HEALTHCARE SUMMIT
We round-up this year's show highlights
28 LEGAL & REGULATORY
Mills & Reeve on CQC's powers of cancellation
4 | NOVEMBER 2023
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news | business
News in brief POLICY & POLITICS
Former financial secretary to the Treasury Victoria Atkins was appointed health and social care secretary in a major reshuffle of Prime Minister Rishi Sunak’s cabinet. Atkins, who replaced Steve Barclay who was moved to environment secretary, had been with the Treasury since the prime minister took office in October 2022.
coming to the UK were condemned by the Royal College of Nursing. In a letter to the home secretary, Suella Braverman, RCN general secretary, Pat Cullen, raised concerns about the effect of the 15% rise in health and care visa application fees and 35% increase in overseas student fees on the UK’s ability to attract and retain nursing staff. The next phase of a social care recruitment campaign was announced by care secretary Helen Whately. Made with Care encourages people with the right qualities to begin a career in adult social care and aims to reach millions of people via video on demand, radio and digital channels.
PROVIDER NEWS
Victoria Atkins
HC-One acquired Ideal Carehomes from Warwick Capital Partners and LNT Group. The acquisition includes 36 care homes in England with a further service due to open in Cheltenham in September next year.
An industry leading social care research project designed to reduce infection and improve lives has secured UKHSA funding. The mission of Vivaldi Social Care, which was originally established as a response to Covid, is to improve the quality of life for people living, visiting and working in care homes, while reducing the risk of infections and avoiding hospital admissions.
HC-One
Chief nurse Deborah Sturdy
STAFFING
Planned increases in costs for overseas health workers and nursing students
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Newcastle upon Tyne-based property, care and leisure company Malhotra Group has purchased three Four Seasons Health Care homes located in Howdon, Morpeth and Blyth. The homes have all been renamed, with the former Howdon Care Centre now named Eastside Gardens, East Riding Care Home as Bluebell Manor and Chasedale Care Home as Blythgate Manor. Kingsley Healthcare Group acquired Catchpole Court Nursing Home and St Mary’s Care Home in East Anglia from Four Seasons Health Care. The
acquisitions bring the total of Kingsley homes to 36 and add approximately 100 beds to its portfolio with "extensive" land opportunities on both sites, enabling the company to look at schemes to upgrade, reconfigure or rebuild "as appropriate," Kingsley said in a press release. Barchester Healthcare topped a ‘social media power list’ of the UK’s leading large care home groups published by adult social care PR consultancy, Townsend Communications, which ranked each group and their respective care homes according to their social media following on the five most widely used platforms in the sector: Facebook, LinkedIn, Instagram, Twitter and TikTok. A BBC investigation revealed 46 allegations of sexual abuse, neglect and assault made over four years against five care homes that are being closed by HCOne in Cambridgeshire. The complaints included an allegation of rape at The Gables in Whittlesey in 2020 which was one of three homes embargoed by Cambridgeshire County Council before HC-One announced they would be closed in August this year. HC-One and Cambridgeshire County Council highlighted the documented complaints were allegations and not proven crimes, adding none of them were acted on by police. A 63-year-old care home resident who went on a rampage with a bow and arrow has been sentenced to six months in prison. Former opera singer, Mark Holland, caused almost £3,000 worth of damage at Belmar Nursing Home in Lytham St Annes, Lancashire on 2 October after being told he could not go out shopping, Blackpool Magistrates Court heard. >
NOVEMBER 2023 | 5
business | cover story
News in brief > PROVIDER NEWS CONTINUED
Athena Care Homes said a “robust action plan” was in place to address areas of concern after its Amberley Care Home in Kings Lynn dropped from Good to Inadequate. The care home, which provides nursing and residential care for up to 106 people, dropped from Good to Inadequate overall and from Good to Inadequate in Safe and Well-led. Team members and residents at Hallmark Care Homes’ Kew House celebrated after receiving an Outstanding rating from the Care Quality Commission. Inspectors awarded the Wimbledon-based home Outstanding in the categories of Effective, Caring and Responsive. The home was rated as Good across the Safety and Well-led categories.
Staff celebrate at Kew House
LEGAL & REGULATORY
From 21 November the Care Quality Commission will start using its new single assessment framework in the South. Between 21 November and 4 December the regulator will undertake a small number of planned assessments with early adopter providers, while continuing to respond to risk. it will then expand its new assessment approach to all providers based on a risk-informed schedule.
Target Healthcare’s Roden Hall
Society and The Care Workers’ Charity benefitting from the proceeds.
TECHNOLOGY & INNOVATION
Four new projects have received more than £3 million from the government’s Adult Social Care Technology Fund to transform the use of digital technology in adult social care. The funding, which will help identify care-focused technology solutions that have the potential for wider rollout within the sector, is being provided to projects led by the National Care Group, Shropshire Council, Reading Borough Council and NHS Greater Manchester. A second phase has been launched of a national pilot to provide pain support for care home residents in Scotland. The move, which follows the Care Inspectorate’s publication of its Quality Improvement Plan for 2023/4, will see the trialling of PainChek at 15 care homes to assess its effect on medication usage and quality of life for care home residents, as well as its adoptability and
6 | NOVEMBER 2023
Signature chief executive, Kay Cox
FINANCE & INVESTMENT
FUNDRAISING
The fourth annual Care Sector Fundraising Ball, which took place on Saturday 30 September, raised £426,852 for its charities – breaking previous fundraising records, with the Alzheimer’s
longer-term sustainability. Over seven in ten (71%) people favour making CCTV mandatory in care homes, a poll commissioned by Signature Senior Lifestyle has found. The poll, which was commissioned by Signature at Reigate Grange via Savanta, shows 51% of the public want cameras in resident bedrooms and 69% would be more likely to choose a care home with CCTV in communal areas.
PainChek
Target Healthcare REIT, which invests in modern, purpose-built UK care homes, reported its annual results for the year ending 30 June 2023, with a pre-tax loss of £6.6 million compared with a profit of £49.1 million, driven by a swing to loss on the valuation of investment properties. Contractual rent increased by 2% to £56.6 million per annum (2022: £55.5 million), including a like-for-like increase of 3.8% predominantly driven by rent reviews.
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opinion exclusive | business
My party conference takeaways Now the conference season has come to an end, Sam Monaghan, chief executive of Methodist Homes (MHA) reflects on the conversations taking place around social care, across the political spectrum
C
onference season is always an opportunity to gauge the extent to which social care is being prioritised by the leading political parties. It was particularly relevant this year as the UK edges closer towards a general election. MHA attended the conferences of all three major parties – both hosting our own fringe events and collaborating with our partners. To me, it’s crucial that we’re present as it gives us a platform to voice our concerns about the future of social care and to understand where it sits on the political agenda. Overall, I think it’s fair to say there was a sliding scale in terms of how much social care was being prioritised by parties this year. The Conservative Party conference in Manchester, for example, was relatively light on content and detail around the sector, although it is clear they have a grasp on the issues we face, particularly our workforce challenges. In our conversations with ministers there was encouraging support for our concept of a Social Care Council, which we are
“The Conservative Party conference in Manchester, was relatively light on content and detail around the sector, although it is clear they have a grasp on the issues we face, particularly our workforce challenges.”
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proposing as part of our ‘Fix Care For All’ campaign. Our recommendation is that the Social Care Council would act as an independent body representing the 1.5 million people working in social care. As well as examining pay scales, accreditation and training, the council would also manage sectorwide recruitment drives and public perceptions around a career in care. Echoes of the Social Care Council could be heard in discussions around the idea of a National Care Service (NCS) at the Labour Party conference in Liverpool. There seemed to be more of a buzz around the issues facing social care in general and people seemed energised about the idea of the NCS. First raised by the Fabian Society, an NCS would tackle issues around pay and professionalisation, but it became clear during the conference that it means different things to different people. Without more clarity of messaging, it’s hard to form an opinion on whether it’s exactly what the sector needs. At the other end of the spectrum, social care appears to be a huge priority for the Liberal Democrats, and they have already pledged their backing to the concept of a Social Care Council. The Liberal Democrat leader, Sir Ed Davey, has put social care front and centre as part of his offering to voters – recognising that it is one of the biggest challenges facing the country today. The enthusiasm the party has shown, particularly around the social care workforce, is encouraging – and who knows what influence it may have, both on the doorstep and at the ballot box, when the time comes. Cautiously optimistic I’m cautiously optimistic about what I’ve heard, but we need to see more
Sam Monaghan
consistency on the ideas being presented – and until we can read the pledges, written in black and white in manifestos, we don’t know what it will really mean for the sector and its workforce postelection. In the meantime, we must continue to work together as a sector to ensure we are heard. In the same way that we need clarity from politicians, they also want clear messages from us. Seeing so many social care organisations come together at fringe events, to highlight the issues we face, was particularly encouraging across this year’s conferences. Our collective voice is hugely powerful. I also believe that not-for-profits in the sector can add real value to the conversations taking place within parties as they look to shape their social care policies. With more people relying on social care in later life and fewer people entering the profession, we are on the front line of workforce challenges and are happy to share our experiences. At MHA, we are committed to working with any party prepared to commit fully to protecting and investing in the sector and the people who work in it.
NOVEMBER 2023 | 7
business | opinion exclusive
Where’s the plan? Jonathan Gardner, chief executive of Bluebird Care UK and Ireland, asks what the political party conferences can tell us about the future of social care
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ith a General Election on the horizon, eyes were locked on this year’s annual party conferences to see what upcoming manifestos might promise for social care. Whoever forms our next government will need to act quickly to address some of the short-term crises our sector faces. From a demand and supply imbalance to a public funding shortfall, to recruitment and retention pressures, there is no shortage of issues to focus on – and that’s before considering the need for a long-term plan for sustainability and growth. There were some encouraging common themes across the Conservative, Labour and Liberal Democrat party conferences, including the need to reduce reliance on hospitals; the opportunities of digital innovation and AI; and the need for greater support for the workforce. At party conference fringe events, it was also encouraging to hear NHS voices making the case for investment in social care. Head of NHS Confederation Matthew Taylor, at a Labour Party fringe event, called it “the number one priority” and said that “every acute leader recognised that investment in social care is the long-term solution”. However, and despite its universal
“If people were expecting this year’s party conferences to be the moment political leaders stood up and made bold commitments about the tricky subject of reforming care funding, they would have been disappointed. ”
8 | NOVEMBER 2023
impact, social care has sadly never been a vote winner. If people were expecting this year’s party conferences to be the moment political leaders stood up and made bold commitments about the tricky subject of reforming care funding, they would have been disappointed. The Liberal Democrats gave the firmest funding commitment, pledging £5 billion per year to introduce free personal care in England, in line with the Scottish model. This level of detail is welcomed, but directing funds towards free personal care would be divisive – not least given the need to fund expanded access to care to the estimated 1.6 million people aged 65 and over with unmet care needs. Labour is clear on their commitment to the workforce and, like many providers, I welcome the notion of a fair pay deal that would allow premium employers to go above and beyond to attract top tier employees. However, Labour’s conference plans didn’t shed any further light on what might come next in their 10-year plan to form a National Care Service – which, it has been suggested in a conversation with a Labour shadow treasury minister, would be a second term parliamentary issue if progressed. Headlines from the Labour party conference questioned their likelihood to follow through on the plan at all. The scrapping of HS2 was the headline grabbing moment from the Conservative Party Conference, but this was not the only notable change of course in the past year. T-Levels, a technical-based qualification in England, will be phased out in only their second year of existence, including the promising health and social care qualification. Likewise, overseas visas, upheld as the pinnacle of solving the recruitment crisis, are becoming increasingly restricted and costly due to Home Office policy. These policy u-turns do little to boost reassurance and stability in our sector, which still awaits
Jonathan Gardner
an alternative funding plan for reform since the social care levy was reversed a year ago. The need to bolster community-based care is perhaps more urgent than I have known it in my 20 years of working in community healthcare – for the benefit of service users, carers, staff across the system, and ultimately cost savings. Each political party has (at times loosely) acknowledged this need, but none have truly demonstrated how they would work towards building the infrastructure and funding needed to support this shift. So, while positive headlines emerge in relation to the need to move away from reliance on hospitals, now that party conferences have wrapped it is clear that providers must continue to lead the way in driving innovation, integration, and quality across the sector. We can do this as individual providers, and we can do it well. But what we cannot do is implement the systematic, long-term consistency that will bring much needed stability and sustainability to our sector. That will require prospective governments to step up and risk politically tricky conversations to position social care as a major priority for the country now and in the near future.
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leader’s spotlight | business
We need a new classification Johann van Zyl, chief executive of Cornerstone Healthcare, says the specialist care sector needs a distinct classification to reflect the care it provides more accurately and allow for a more appropriate assessment by the Care Quality Commission
S
outh African born van Zyl, who is stepping down as chief executive on 8 January to become a nonexecutive director as a shareholder, joined specialist care provider PJ Care when he arrived in the UK in 2012. “I could see there were two units in the company serving people with progressive neurological conditions such as dementia and Huntingdon’s disease that were always full and I could see the demand because people were coming from all across the country,” van Zyl says. “I realized if they came from that far and wide, there must be a massive shortage in other parts of the country as well.” Following his research, van Zyl established there were around 15,000 people in England suffering from a specific neurological condition with a mental health diagnosis who were difficult to care for in residential or nursing care homes. “What happens a lot is they remain “Following his research, van Zyl established there were around 15,000 people in England suffering from a specific neurological condition with a mental health diagnosis who were difficult to care for in residential or nursing care homes.”
Johann van Zyl
sectioned in mental health or semisecure hospitals even when it’s time for them to be no longer sectioned when they are much better, but care homes don’t want to take them because of their mental health history,” van Zyl says. “That’s where I saw a massive shortage of beds.” Over half (55%) of Cornerstone’s residents come from placement breakdowns in care homes. With the remainder coming straight from hospital. “We sit between care home placement breakdown and discharges from NHS mental health wards,” van Zyl explains. “That’s why I describe our
services as ‘hybrid hospitals’.” Van Zyl established around 5,000 of these vulnerable people were being care for by specialist care providers leaving a current shortfall of around 10,000 beds. After a two-year period of research, van Zyl bought South Africa Lodge and Kitnocks House in Hampshire. The business acquired investment from its majority shareholders, London private equity fund Ignite Growth and Icelandic bank Kvika Securities, with van Zyl and fellow founder chief operating officer Dara Ni Ghadhra holding minority stakes. With Ignite Growth due to exit from its investment in the next two years, >
Neurological conditions covered by Cornerstone Healthcare Frontal temporal dementia (Picks) Alzheimer’s disease – moderate to severe stage Parkinson’s disease with dementia Vascular and mixed dementia
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Lewy bodies dementia Huntington’s disease Korsakoff ’s syndrome Progressive supranuclear palsy
Personality disorder Complex healthcare needs, for example, dementia with some complex physical health needs and/or challenging behaviour
NOVEMBER 2023 | 9
business | leader’s spotlight
Cornerstone's South Africa Lodge
> van Zyl says Cornerstone is on the look-out for a new buyer and is already holding conversations with potential partners. “The idea is we will achieve £10 million EBITDA and then we will go to market,” van Zyl says. The chief executive said he’s relaxed about a change of ownership. “I am not concerned if it happens because this such an established little niche sector,” van Zyl says. “Someone who takes us over must be really committed. It’s a natural investment cycle. You know they will exit at some stage and that was always part of the plan. There’s a couple of really interesting equity funds out there who I am sure would be interested.” NAPPI principle With many of Cornerstone’s residents exhibiting challenging behaviour, van Zyl says comprehensive staff training was key to its successful care model. “Our care is based on the principle of non-abusive psychological and physical intervention (NAPPI) principle,” he says. “We support them by positive behaviour support. Those are the principles we use to train our staff. Through planned persistence, tactful interruption and creating an expectation of cooperation we are able to deal with residents’ aggression. “We have four-day, class-based
10 | NOVEMBER 2023
inductions and then staff spend 14 days shadowing a mentor.” The care provider also has its own NAPPI-accredited training team as well as compulsory e-learning prescribed by the CQC. High staffing Van Zyl also highlighted high staffing ratios as being key to a successful care model. The care provider has a staffing ratio of one nurse to 12 residents compared with a typical care home ratio of one nurse per floor (20 to 30 residents). Typical carer ratios, excluding oneto-ones, are eight carers to 12 residents and the business also has a clinical manager for every two units of 12. “When we had to use agency staff during Covid we made sure we gave them the same training as our staff and made sure that we block booked,” van Zyl says. The chief executive says Cornerstone was in a very good position regarding staffing with a vacancy rate of only 3% at its three Hampshire services. “We always make sure we are in the highest ranking in our county for pay (see box),” van Zyl notes. “We are a member of Living Wage Foundation and pay above the Real Living Wage.” The chief executive says Cornerstone is able to pay its staff well because the
Leading the way in pay - Senior nurse: £39.15 an hour (plus annual bonus of 5%) - Nurse: £36.53 an hour (plus annual bonus of 5%) - Senior healthcare assistant: £19.50 an hour - Healthcare assistant: £18.60 an hour - Ancillary staff: £16.35 an hour
work is very challenging with higher fees charged to commissioners due to the high acuity levels of the care, with weekly fees beginning at around £2,500 up to £6,000 for one-to-one care. Competitive pay rates come at a significant cost for his business, van Zyl explains, with monthly costs for his 350 staff in excess of £1 million. Staff support is provided through bonuses and one-off rewards. Staff received £200 Asda food vouchers at the start of the cost of living crisis in October 2022. Workers also received twice-annual £450 bonuses for two years during Covid. Mental health support is provided for staff with colleagues eligible for six counselling sessions during periods of high stress.
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leader’s spotlight | business
Right environment Van Zyl also singles out providing the right environment as being key to offering the best care. “It was very difficult with our older established homes because we bought them already designed and operating,” van Zyl explains. We put a lot of cap ex into adapting the homes to make their line of sight better but still not have an institutionalised feeling and give our residents a feeling that they are in a home. We try to keep noise to a minimum, but still have very engaging activities.” Commissioning The shortage in supply to meet demand for specialist care delivers Cornerstone a strong hand with commissioners when it comes to negotiating fees, though van Zyl notes commissioners are reluctant to grant inflation increases due to the high base level fee provided. Funding is often split 50:50 between clinical commissioning groups and local authorities with a small minority of private payers remaining from the
government’s ‘discharge to assess’ programme during Covid. “Our care is very expensive,” van Zyl explains. “If someone has been in the system for such a long time then very seldom are families still responsible for payments. They very rarely come from someone’s house. “The hard work is for us to explain to funders why they can’t put us into a cookie-cutter category for prices,” van Zyl adds. “Each resident is assessed and we have to work out a figure to meet their specific needs.” The chief executive says the CQC and Hampshire County Council had made good progress in understanding the specialist care model. “It took a while but I am quite proud of the relationship we have built with the CQC,” van Zyl says. “We strive for zero placement breakdowns and we achieve it for the most part. The only breakdowns we have is when our consultant psychiatrist says this patient needs to go back to be sectioned in hospital and then comes back to us when they feel better.”
New care classification The Cornerstone boss says a new care classification is required that better reflects the care that operators provide and ensures the CQC can better assess specialist care providers. As well as higher staffing ratios, van Zyl points out that Cornerstone inevitably has a higher number of safeguarding incidents because of the greater freedom given to challenging service users. Ticking timebomb With 10,000 people with neurological conditions still being cared for in NHS wards and care homes, as well as living in the community, van Zyl highlights the risks of vulnerable people being cared for in appropriate settings. The chief executive cites the example of one resident with Huntingdon’s diseases who set his own flat on fire. “It was only then that people realised that this is now serious,” he says. Cornerstone expects unmet demand for specialist care to grow by 3% each year under current projections due to undercapacity in the system. >
Cornerstone's Cale View development in Wincanton
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NOVEMBER 2023 | 11
business | leader’s spotlight
> “I know a lot of investors are increasingly interested in specialist care but the risk is big,” van Zyl notes. “In the beginning I couldn’t get any funding to start my business. A lot of people don’t want to put all of their eggs in one basket with us despite believing in what we do due to the high risk. I think it will always be an underserved sector.” M&A The chief executive predicts some of the larger sector players will acquire smaller specialist operators such as Cornerstone, adding there will only be a limited number of entrants to the market. Cornerstone will be doing its bit to meet extra pent-up demand with the supply of 150 beds through its Cale View care home in Somerset and The Burren due to complete at the end of this year which will almost double the company’s capacity to 360 beds. In addition, the care boss revealed to Caring Times he is currently in negotiation over the acquisition of a 74-bed service.
“We will be close to 500 beds within the next two years,” van Zyl says. Global leader Looking at the global picture in specialist care, van Zyl highlights Germany as being “quite advanced”. “They realised very early that complex care had to be kept separate,” he says. The care leader recently spoke at a care conference in Iceland to share how the private sector can be used to provide specialist care services. “They wanted to learn from us because they don’t do it,” he says. “They have complex care people among
residents within their care homes. That’s an indication that we are doing the right things here and people want to learn from us.” The care leader has also had discussions with multinationals in South Africa about investing in the sector. “I definitely think that we already are a beacon,” van Zyl says. “We had to find our way through the dark, but we are beginning to provide a light for others in how to do this the right way. We feel there’s a good future for the company going forward provided we can deal with all the other pressures that are out there.”
Care home portfolio Service
Location
Beds
CQC rating
South Africa Lodge Kitnocks House Marula Lodge Cale View
Waterlooville, Hampshire Curdridge, Hampshire Mytchett, Surrey Wincanton, Somerset (opening Nov 2023) Bristol (opening end 2023)
99 63 42
Good Good Good
74 80
n/a n/a
The Burren
Cornerstone's Kitnocks House
12 | NOVEMBER 2023
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politics & policy | business
Valuing the workforce Anna Marshall-Day, director of people and communications at MHA, discusses the need for greater recognition and fairer treatment of social care staff and the importance of ethical recruitment
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ecent reports from both the Migration Advisory Committee (MAC) and Skills for Care highlight the scale of the workforce crisis that exists in adult social care. Both organisations are clear in their analysis that recruiting staff from overseas is essential in helping to drive down vacancies. Following consultation with the social care sector, the MAC’s review of the government’s skilled worker Shortage Occupation List has recommended that social care workers remain on the list. Care positions accounted for half of all visas issued to skilled workers over the past year, but it is estimated that 150,000 vacancies remain across the sector – so this announcement was widely welcomed. The MAC report also called for the removal of the going rate discount, which we fully support. In an open letter to the Home Office, the MAC argues “low-wage employment is where the most serious exploitation of workers occurs”. It suggests that abolishing the going rate discount is a way to protect migrant workers from potential exploitation. “Proposed as part of our wider Fix Care for All campaign, a Social Care Council has the potential to transform the recognition and professionalisation of social care – by advocating for the people that care for and protect the most vulnerable in our society.”
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Recognise the value of care staff This ties into a wider issue – that greater recognition for social care staff is long overdue. We believe people should be rewarded appropriately for the value they deliver, both to those they care for and to the UK economy. Remunerating people below an acceptable rate does nothing to retain staff or to encourage others to join the sector. Ethical recruitment is key – whether we are employing people from within the UK or from overseas. At MHA, we guarantee an hourly rate for every recruit we sponsor from overseas that is above the minimum level set by the Home Office. We also remove fear and uncertainty around not being given sufficient hours by guaranteeing fulltime and permanent contractual hours – again above the minimum guidelines that have been set. But valuing people goes beyond this. That’s why we offer additional support through orientation services and guidance from international peers as new staff settle into their roles. For us, it’s important that employees can see a long-term career path and that their value is recognised. That’s simply not possible unless they are paid and treated fairly. The Social Care Council – a voice for social care Our call for the government to fund and enable the creation of a Social Care Council is one way of ensuring this happens long-term. The Council would act as an independent body representing the 1.5 million people working in social care – examining pay scales, accreditation, training and recruitment, and investing more into changing public perceptions around what it means to choose care as a profession. Proposed as part of our wider Fix Care for All campaign, a Social Care Council has the potential to transform the recognition and professionalisation
Anna Marshall-Day
“We believe people should be rewarded appropriately for the value they deliver, both to those they care for and to the UK economy.”
of social care – by advocating for the people that care for and protect the most vulnerable in our society. In the past year, MHA has recruited 90 nurses and carers from overseas and an additional 150 members of staff, from 24 countries, who are already settled in the UK. But the sector is on a constant recruitment drive. According to the Skills for Care report, 29% of people working in social care are aged 55 and over, and are likely to retire after the next 10 years. Confronted with an ageing workforce and an ageing population, we must build a strong pipeline of talent in the labour market, but that means a stronger commitment from government that it will do more for people working in or joining the sector – whether we are sourcing people from the UK or elsewhere.
NOVEMBER 2023 | 13
business | politics & policy
A global solution Townsend Communications’ managing director, William Walter, interviews Anne-Marie Perry, founder and chief executive of CareMatch, about the critical importance of global recruitment in the social care sector and its effect on addressing skills shortages
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ecent reports from both the Migration Advisory Committee (MAC) and Skills for Care highlight the scale of the workforce crisis that exists in adult social care. Both organisations are clear in their analysis that recruiting staff from overseas is essential in helping to drive down vacancies. I attended a conference the other day where we were prompted to consider a global approach to recruitment in social care. It’s crucial to be mindful of where we recruit from, as many more countries are currently grappling with significant shortages in their social care workforce. I operate a domiciliary care company with a sponsorship licence, and it has significantly improved our recruitment success. We now have an 80% success rate of recruits joining our team after they have undergone interviews, testing and training. This is in stark contrast to our recruitment efforts before acquiring “Overseas recruitment promotes a diverse workforce that tends to be more resilient and adaptable compared with only recruiting domestic hires.”
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the licence, during which we spent anywhere from £2,000 to £10,000 a month on staff recruitment with very poor results. Despite having a dedicated recruitment team to support candidates throughout the application process, we found our domestic recruitment had low success rates, resulting in both wasted time and money. Overseas recruitment promotes a diverse workforce that tends to be more resilient and adaptable compared with only recruiting domestic hires. We’ve found that overseas carers, when they share the right values, make very positive additions to our existing teams. They not only add depth to our teams but also increase their size, allowing our company to be more flexible with working hours and helping us achieve better work-life balances for our staff. This, in turn, helps mitigate burnout within our current workforce. Before care workers and home carers were added to the Shortage Occupation List, the government advocated for the development of a ‘homegrown workforce’. However, when one considers the statistics reflecting the increasing elderly population against the decreasing working-age population, it becomes apparent that this may not be a viable solution. While I firmly believe that we can do more to attract a domestic workforce and encourage more individuals to join the social care sector, the numbers simply don’t support this idea.
Anne-Marie Perry
For years, the NHS has relied on foreign recruitment to bolster its staffing levels. Given the current challenges the NHS is confronting and the call for enhanced community capacity to manage hospital flow, removing overseas recruitment from the Shortage Occupation List could, in my opinion, significantly strain our care services and the NHS. With that said, it’s crucial to understand that this is not seeking a cheaper workforce. All care providers have a duty to uphold fair labour practices, promoting cultural integration within legal and ethical guidelines. Foreign recruits are currently indispensable, and we should greatly value their contributions in supporting care across the UK.
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surveys & data | business
A 15-year strategy Skills for Care says it is developing a workforce strategy for social care as ‘green shoots’ begin to surface
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kills for Care has announced plans to develop a 15-year workforce strategy for adult social care. The announcement came as the strategic workforce development and planning body published its annual ‘State of the adult social care sector and workforce’ report, which revealed a 1% rise in the workforce between April 2022 and March 2023. Skills for Care said it will work with a wide range of organisations and people who have a stake in social care to identify the social care workforce needed over the next 15 years and set out a plan for ensuring the sector has enough of the right people with the right skills. Additionally, the strategy will help employers and commissioners with workforce planning, support the government’s reform agenda and complement the NHS Long Term Workforce Plan covering the same period, which was published earlier this year.
driven by an increase in international recruitment. Vacancies in the sector fell to 9.9% – around 152,000 vacancies on any given day – from 10.6% in the previous year. Turnover also fell slightly to 28.3% from 28.9% in the previous year, meaning 390,000 people left their jobs with around one-third leaving the sector altogether. In further positive news, the number of registered nurse filled posts increased by 2% in 2022/23 to 33,000 as an estimated 70,000 people arrived in the UK and started direct care-providing roles in the independent sector.
Green shoots The ‘State of the adult social care sector and workforce’ report revealed ‘green shoots’ in the workforce climate largely
Structural issues The report also laid bare the deep-rooted structural challenges besetting the sector with inadequate remuneration
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and career progression remaining major issues. Care workers with five or more years’ experience are paid just six pence (0.6%) more an hour than those with less than one year of experience. The report also revealed a mixed picture in terms of workforce demographics. While the proportion of men in the sector rose for the first time on record from 18% to 19%, only 8% of workers were aged under 25, compared with 12% of the economically active population. Projections show the UK will need 25% more posts (440,000) by 2035 to grow proportionally with the projected number of people aged 65 and over in the population. Five key factors The report identifies five factors that are key to retaining staff: being paid more than the minimum wage, not being on a zero-hours contract, being able to work full-time, being able to access training, and having a relevant qualification. Where none of these positive factors apply, care workers are more than twice as likely to leave their jobs than when all five factors are present – a 48.7% turnover rate compared with 20.6%. While welcoming the ‘green shoots’ identified in the report, Skills for Care chief executive, Oonagh Smyth, said challenges remained. “We can’t simply recruit our way out of our retention challenges. So, we need a comprehensive workforce strategy to ensure we can both attract and keep enough people with the right skills to support everyone who draws on care and support - and all of us who will draw on care and support in the future,” Smyth said.
NOVEMBER 2023 | 15
business | surveys & data
To have and have not The CQC has warned of the emergence an “unfair”, two-tier care system for the haves and have nots as cost pressures and low funding force an exodus from local authority funded provision.
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he State of Care report reveals almost a third (29%) of social care providers are worried about their financial stability with over a quarter (26%) having considered leaving the sector in the past 12 months. Local authority budgets have failed to keep pace with rising costs and the increase in the number of people needing care, the report adds. The CQC’s chief executive Ian Trenholm said: “The combination of the cost of living crisis and workforce challenges risks leading to unfair care, with those who can afford to pay for treatment doing so, and those who can’t facing longer waits and reduced access.” The report warned: “As local authority-funded adult social care places are often less profitable, there is the risk that people who live in more deprived areas, and receive local authority-funded care, may not be able to get the care they need.” As the graph below demonstrates, with service users in the North of England far more reliant on statefunded care, the threat to continued local authority care provision is creating a north-south divide in the ability to
16 | NOVEMBER 2023
access care services. While more than 70% of care home residents are state funded in the Northeast this figure drops to just over 50% in the Southeast. The report reveals care home profitability at “historically low levels” in 2022/23 due to increases in non-staff costs, specifically gas and electricity price rises, as well as inflation in food and other costs.
EBITDARM in ‘specialist services’, which include supported living services and other residential and home care services for autistic people and people with a learning disability declined consistently between September 2021 and March 2023 (by 5.1 percentage points to a profit margin of 14.6%). Higher staff costs have been the key factor in this profit reduction for specialist services (increasing by 3.4 percentage points). This is further exacerbated in residential settings, which have a higher use of agency staff and are more affected by recent inflationary increases in non-staff costs, such as heating and food. Some providers said they may have to hand back unsustainable packages of care. The CQC said a national workforce strategy was needed to raise the status of the adult social care workforce and ensure that career progression, pay and rewards attract and retain the right professional staff in the right numbers. Ian Dilks, chair of the CQC, said integrated care systems presented the best opportunity to “ensure fair care for everyone” so that “people get the care they need, not just the care they can afford”.
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NOVEMBER 2023 | 17
business | personnel
People moves McCarthy Stone, a developer and manager of retirement communities, appointed Ciaran Aldridge as managing director for its Northern division, managing the division’s land and construction budget which will total around £250 million over the next three years. Aldridge was previously national property director at supermarket operator Aldi since 2016, responsible for coordinating Aldi’s property strategy and for expanding the business, which now has more than 1,150 stores throughout the UK and Ireland. He was at Aldi for a total of 16 years.
Ciaran Aldridge
Antonine House care home, part of care provider Meallmore, has appointed Shelley Watters as general manager. Watters has almost 20 years’ experience in the sector and started her career as a care assistant. She has nine years care home management experience, most recently as home manager of Meallmore’s Parklands Care Home in Alloa.
in association with
director of Championing Social Care at the CareTech Charitable Foundation, leading communications, fundraising, programme management, strategy and governance for the initiative.
Niharika Noakes
Wellbeing Care’s Meadow View care home in Irchester, Northamptonshire has appointed Dr Rahees Abdulla Chettintavida as care home manager. Chettintavida previously spent 12 years as a GP, practising medicine in India and the UAE. He then transitioned into hospital administration, gaining three years’ experience in the field before spending a year as an executive director of a home healthcare company.
has held various leadership positions at Kent County Council. She has worked with care homes, day services, and support programmes aiding people to maintain independence. She has led various teams supporting the adult social care sector and has direct experience of working with providers. She has managed and commissioned adult social care contracts over the years, and also worked closely with providers during the pandemic. She contributed to the Cost of Care government exercise last year.
Nicola McLeish
Untold Living appointed Ed Aldridge as land and planning director to manage the later-living developer-operator's pipeline of sites and assets. Aldridge is a qualified chartered surveyor with experience in whole-lifecycle development within the care and laterliving sectors. He spent nearly a decade at Castleoak Care Development.
Dr Rahees Abdulla Chettintavida
Orchard Care Homes appointed experienced HR professional Richard Waterhouse as group director of people and talent. Ed Aldridge
Superior Care appointed Faye Gailey as registered manager of Portway House Care Home in Oldbury in the West Midlands. Gailey has spent seven years in leadership roles within the care sector.
Shelley Watters
Adopt a Grandparent appointed Niharika Noakes as chief strategy and transformation officer, tasked with driving the charity’s growth and impact and taking its subscription app into care homes and specialist services across the UK. Noakes has more than 15 years’ experience of strategic communications and digital media, active citizenship projects, advocacy, and community development. She was previously
18 | NOVEMBER 2023
Richard Waterhouse
Surrey Care Association which represents more than 230 adult social care providers in Surrey, appointed Nicola McLeish as its chief executive, succeeding Bex Pritchard who has held the role since 2021. McLeish has more than 20 years’ social care experience and
Faye Gailey
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personnel | business
Parklands Care Home in Alloa, part of the Meallmore group, appointed Richard Catahan as care home manager. Catahan has more than 30 years’ managerial experience and spent the past 12 years in health and social care across England and Wales, managing nursing and residential facilities for young people and the elderly. Catahan started
Richard Catahan
his career in finance and marketing, before moving into the care industry, initially working with young people who were leaving the care system. He moved on to care for older people in 2013. He has managed nursing and residential facilities for people with various specialist needs, including those living with complex dementia and individuals with a range of functional mental health disorders. The National Association of Care Catering appointed Neel Radia as its national chair for the next two years. This is the fourth term Radia has assumed as national chair. He is a wellknown figure in the industry with more than 25 years’ experience working with
wholesalers and food manufacturers within hospitality and public sector catering, as well as leadership roles in the not-for-profit sector. Until this appointment, Radia was the lead for the NACC’s Meals on Wheels campaign, championing nutritional support for older and vulnerable people within the community.
Neel Radia
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NOVEMBER 2023 | 19
business | property & development
Property news Four Seasons Health Care entered into conditional sale and purchase agreements for the sale of 11 sites for £41.3 million. Costs relating to these agreements are estimated to be in the region of £2 million, including costs in relation to the unwind of negative working capital of £1.5 million, broker fees of £300.000 and certain legal costs of £200,000, joint administrators said in a statement. Completion of the transactions is expected to complete before the end of this year.
retirement community comprising 72 apartments for people over the age of 60. A care home comprising Tor Na Dee and Craig Court in Aberdeen was put up for sale for a guide price of £17,155,000, reflecting a net initial yield of 6%. The property is let to care operator Care UK. The lease has 18 years unexpired and has annual RPI rent reviews capped at 4%.
Nursing home provider Amica Care acquired Ernstell House, a nursing home in Plymouth with 64 luxury care suites offering 24-hour residential, nursing and dementia care. The home offers specialised care for individuals with neurological conditions, including Parkinson's disease, strokes and acquired brain injury. It also offers physiotherapy services tailored to each resident’s mobility and rehabilitation requirements. Ernstell House welcomes residents for respite from anywhere between one to six weeks depending on individual needs.
Tor Na Dee care home
Exemplar Health Care unveiled a £200 million expansion plan to create 40 specialist care homes and 4,000 jobs, adding to its existing portfolio of 42 services over the next five years, focusing on the Northwest, Northeast and Midlands. A number of development sites have already been identified and 10 homes are already in development.
Martin Vickerman, property and developments director at Exemplar Health Care
Adlington Retirement Living opened The Spindles, a West Yorkshire
Residents at two Bury care homes were shocked by news they have just 28 days to find a new home. The notice closure for the 14-bed Elizabeth House and 18-bed Moorfields care homes was announced by administrator Kroll which has been running the services since November.
Keren Wilkinson, chief executive of Amica Care and Sandra Tucker, home manager of Ernstell House
Rented retirement home provider Birchgrove purchased a £36 million development in Mill Hill, North London to transform the site of a former medical research facility into a 60-apartment community. Ayrton House will provide purpose-built, self-contained, one-, two- and threebed apartments for people in later life, with communal features including a restaurant, club room, licensed bar and wellness suite, as well as landscaped gardens.
Hartford Care opened the doors to its Cotswolds Rise luxury care home in Swindon, which offers residential, dementia and respite care across 66 en suite bedrooms. CGI of Birchgrove's North London development
Lord Mayor of Bradford, Councillor Gerry Barker opens The Spindles
20 | NOVEMBER 2023
Cotswolds Rise
Rented retirement home provider Birchgrove has purchased a 78-apartment development in Hampton Court, the eighth site in its portfolio in Southeast England. The £39 million deal to acquire the site CARING-TIMES.CO.UK
property & development | business
has been completed with Octagon Developments, which designs and builds homes throughout Southern England and will deliver the apartments on a turnkey basis by 2025.
CGI of Birchgrove's Hampton Court development
SpringCare acquired The Chace Care Home in Great Malvern, Worcestershire, a residential and dementia care home registered for up to 41 residents. The business has been owned by Anthony Reeley and his family for more than 40 years. SpringCare has a portfolio of 15 homes across the Midlands and North of England.
The Chace Care Home
Boutique Care Homes acquired Connors House in Canterbury in an off-market acquisition from Rapport Housing & Care, which owned the freehold of the site. Connors House will be redeveloped to offer 78 bedrooms across two storeys, a bistro, hobby room, interactive spaces and
landscaped gardens. The development will create more than 80 full-time jobs. Exemplar Health Care, a nursing care provider for adults living with complex and high acuity needs, has begun on-site construction for its new £6.9 million care home in Padiham, Burnley. Warrington-based contractor Triton Construction leads the development with Loughboroughbased Watson Batty Architects designing the home with input from Exemplar Health Care’s service user council, a group of residents living at its homes, who help ensure the plans meet the needs of future residents with a broad range of health conditions.
CGI of Exemplar Health Care's Burnley development
Nestlings Care has leased a 20-bedroom residential block building providing accommodation over two floors, which was built in 2008 offering lodging for the children from an adjacent former boys SEN school in Congleton, Cheshire. Nestlings Care is an independent group providing specialist therapeutic, residential placements for young people and young adults with mental health difficulties.
which has delivered the scheme, identified the site’s potential for elderly care and submitted a full planning application for the construction of the care home and nine affordable homes, which was consented to earlier this year. Construction of the care home should be completed in the second quarter of 2025.
CGI of Borough Care's Uttoxeter development
The mayor of Tunbridge Wells, Councillor Hugh Patterson, officially reopened a historic Greensleeves Care home. Mount Ephraim House, which has features dating back to the 17th century, was officially relaunched in an event attended by more than 50 professionals in health, care, and businesses,, alongside the home’s residents and their relatives.
Greensleeves relaunches Mount Ephraim House
Athena Care Homes completed the purchase of two care homes in Cambridge. The transfer of Alex Wood House and Langdon House from CHS Group brings the group’s portfolio to seven care homes. Nestlings Care's Congleton lease
A resident and staff member at Boutique Care Homes
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Not-for-profit provider Borough Care purchased a development site with consent for a 76-bedroom,home scheme on an approximately 2.8-acre care site situated close to Uttoxeter in Staffordshire. Mercian Developments,
Athena chief executive Mala Agarwal (far right) with her Cambridge management team
NOVEMBER 2023 | 21
business | sustainability matters
Make your policy green In our ongoing series, Aaron White, head of business services and sustainability at Oakland Care, outlines small but effective changes care homes can implement to promote sustainability, here focusing on producing a simple environmental policy
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y past six columns have looked at hands-on, practical actions that can be carried out more or less straight away, to get the momentum going. However, I know some organisations like to start with a clear plan set down on paper of how they are going to get from A to B. The end point of sustainable planning is the establishment of a full Environmental Management System (EMS), but this complex piece of work should definitely not be your starting point. An EMS sets out ways to work towards mitigating an organisation’s impact across all of its areas of business, including annual audits and a full programme of communication. At Oakland Care, we completed this last year, but that was after three years of making sustainable changes within the business. However, it is possible to create a simple environmental policy earlier on in your sustainability journey. Start out by establishing who will be responsible for green issues, and who is going to work with them. Then simply list your environmental impacts under five headings: local environmental impact (such as noise and odour pollution and impact on biodiversity), travel (including the team’s commute to work), waste and recycling, procurement, and utilities. For example, under utilities you might write “We are aware we have gas boilers in each home, and this results in emissions.” You don’t need to quantify your impact at that stage, you just need
to register that you know these things have an impact on the environment. Then you can start listing the actions you already have in place to mitigate some of the environmental risks that you spotted in the first section. For example, you might say “We realise that we pollute the environment by using our gas boilers so we have heating controls in each room to ensure the boilers are on as little as possible.” See my previous columns for ideas of changes that you can make. A few bullet points for each section will be a great starting point and is a good way to show that sustainability is going to be a serious focus for your business. You can then commit to reviewing the policy every year, building on the actions you are already taking. It doesn’t matter if you can’t get it all down on version one – we are on version five. It’s a case of starting with something simple that can be enhanced as you go along, rather than spending time trying to create a very thorough policy right at the start, time which
Aaron White
might be better spent making on-theground changes. Make some changes first, it makes writing the policy or EMS a lot easier down the line because you will have examples of actions you are already taking, and have a clearer picture of which areas you want to progress even further.
“Start out by establishing who will be responsible for green issues, and who is going to work with them."
22 | NOVEMBER 2023
Team members from Elsyng House Care Home helping with tree planting and park maintenance at a local park
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sustainability matters | business
Greener fundraising Jonathan Freeman, group sustainability director at CareTech, explains how this year’s Care Sector Fundraising Ball was the greenest yet
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rom numerous discussions over the past few months, it is evident that interest in sustainability in the social care sector is growing. Support for the new Social Care Sustainability Alliance that I chair, engagement in Autumna’s Go Green initiative and the growing number of conference discussions, podcasts and media articles on sustainability all point to a sea change in the sector’s approach to facing up to its responsibilities for the environment, our communities and our people. This is really positive news, which we can all celebrate. As vice-chair of Championing Social Care, I was part of the committee that oversaw the recent Care Sector Fundraising Ball. This annual Ball brings together more than 600 guests from across the sector to the Grosvenor House hotel in London’s famous Park Lane to raise funds for two amazing charities. This year’s event on 30 September raised a staggering £426,000 for The Care Workers’ Charity and the Alzheimer’s Society. And the event was a real showcase of all that is fantastic about the sector. However, bringing together that many guests from across the country (and from overseas) to a large event in London, with a three-course meal, entertainment, event materials and the like undoubtedly has an impact on the environment. By considering the entire life cycle of the Care Sector Fundraising Ball 2023 from planning and preparation to execution and post-event activities, we made this Ball our most sustainable event to date. Key aspects of our commitment to sustainability were the following: • Environmental stewardship. From minimising our carbon footprint to conserving resources, we sought to make responsible choices that would reduce our environmental impact. For example, we asked ourselves at all stages whether we needed physical materials at all and, if we did, then sought to ensure that we used refurbished, recycled and recyclable
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equipment and products whenever possible. We also ensured we recycled or reused all materials that we could after the event. • Ethical sourcing. We gave priority to suppliers that promote sustainability and/or that are social enterprises or small businesses. Our venue for the evening is Green Key certified and proud of its commitment to be a more sustainable business, sending zero waste to landfill, conserving water and energy and reducing the use of single use plastic. We also worked with our catering suppliers to ensure high sustainability and animal welfare standards, favouring lower carbon menu options. • Waste reduction. We were particularly conscious of food waste from such a large event. We worked with our catering suppliers to calculate the carbon footprint of all menu items, making this information available to guests. As well as enabling us to calculate the carbon impact of the food itself, making this information prominent to our guests helped them to make informed decisions and also to promote wider awareness of the impact of different foods. Unfortunately, it’s just not possible currently to work with food banks to distribute cooked foods. So, as well as working with our caterers to minimise overproduction of food, we agreed that any excess food would be available to their staff and hotel staff to take away after the event. • Transport. A key priority for us was to reduce the environmental impact of staff and event attendee travel by promoting sustainable transport use. We encouraged all guests to use the most sustainable mode of transport, promoting the use of Ecolibrium’s free carbon travel planner app. We also asked all contractors and guests to complete a short travel survey so that we can calculate the carbon impact of their travel options and we promoted local hotels with strong environmental credentials.
Jonathan Freeman
This year, we worked with two key organisations to aid our efforts: • Ecolibrium – Using Ecolibrium’s Travel Calculator, we were able to calculate and analyse the total carbon emissions of everyone travelling to the Ball with the aim of balancing the carbon produced. • Ecologi – This organisation provides individuals and businesses with a platform to take action against climate change by funding and supporting carbon reduction projects and initiatives. Working with Ecologi, we have planted trees and are supporting renewable energy/carbon avoidance/ nature-based projects on behalf of each attendee to balance our carbon emissions. Thanks to the support of these two organisations, we were able to calculate the carbon impact of all of the transport by contractors and guests – not assisted by a national train strike – and funded projects that will balance the 25 tonnes of carbon generated as a result of the Ball. While the scale of climate change can often feel overwhelming and we worry that we as individuals have little ability to make a difference, it really is the case that the collective effort of lots of small individual changes really can make a significant difference. NOVEMBER 2023 | 23
business | healthcare summit
Healthcare Summit 2023 – bigger and better This year’s Healthcare Summit was even bigger and better than last year’s, with more than 700 representatives from leading operators, investors, advisors and suppliers gathering to take part in content-led market overviews, thought-provoking panel discussions and tailored round table discussions at the Business Design Centre in late September. Here’s our round-up of some of the highlights
Shaping the care sector vision A distinguished panel of social care leaders discussed how social care can be put on a more sustainable footing. Opening the discussion, Vic Rayner, chief executive of the National Care Forum, said that with most highincome countries facing similar social care recruitment challenges, it was time to take a global perspective on sector reform. Rayner also highlighted changes to workforce policy on the horizon in the event of a Labour victory in next year’s general election with the party having vowed to outlaw zero hours contracts. “We need to look at how employment practice may change rapidly and how we can make that a positive experience for our workforce so that we end up stronger,” Rayner said. Jane Townson, chief executive of the Homecare Association, said it was all very well Labour pledging to ban zero hours contracts, but first they would have to get rid of zero hours commissioning. Ian Turner, co-chair of the National Care Association, warned of further
wage cost pressures on employers with the National Minimum Wage set to become two-thirds of national median income by next year. Mike Padgham, chair of the Independent Care Group and founder of St Cecilia’s Care Group, said that with no more money in the system it was time to shift money from the NHS into social care. The panel was split on the need for a national minimum care wage. Padgham and Rayner supported parity with the NHS, whereas Turner argued for flexibility to accommodate regional and service variations. Townsend highlighted the benefits of the system in New Zealand where people with care needs are split into four needs groups from less acute to acute, and four different minimum pay rates have been legislated to recognise the different skills levels for each group. Providers are then given a pot of money in each district related to their level of need, with each provider given a mix of different level care needs. “The minimum wage is all very well,
but every time it goes up Lidl and Aldi increase theirs further,” Townsend observed. “We have to do something different.” Assessing the political outlook, Rayner said only the Liberal Democrats had put health and social care at the centre of their manifesto. She highlighted the Lib Dems’ policy to introduce a Royal College for Social Care. Rayner added that Labour had said some “really clear things” about the workforce and had a “really clear focus” about what a National Care Service is and an ambition for a 10-year plan. “Those sound to me like things we can think about and work with,” she added. She contrasted this with social care not even featuring among Prime Minister Rishi Sunak’s 10-year priorities. Rayner argued social care must be a “first term issue and be addressed within the first two years of any government”. All the speakers were downbeat on the progress on social care reform and highlighted the urgent need for action because of the country’s ageing demographic.
L-r: Mike Padgam, chair of the Independent Care Group, Jane Townson, chief executive of the Homecare Association, Ian Turner, co-chair of the National Care Association, Vic Rayner, chief executive of the National Care Forum and Lee Peart, editor-in-chief of Caring Times
24 | NOVEMBER 2023
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healthcare summit | business
L-r: Andew Cannon, chief executive of Voyage Care, James Allen chief executive of the National Care Group, Johann van Zyl, chief executive of Cornerstone Healthcare, Ryan Brummitt, managing director of Optimocare and Lee Peart, editor-in-chief of Caring Times
What makes specialist care attractive to investors? The leaders of care providers set out the case for investment in specialist care and the challenges facing the niche sector. National Care Group’s chief executive James Allen said that offering small community-based services that supported people in their own home made specialist care “an agile sector” better able to respond to some of the challenges facing the sector. “We can work with commissioners to find solutions to their problems quite quickly, Allen said. “We provide small, bespoke services to meet local need. We get to market quicker and adapt services and we can spread capital cost by working in partnership with other agencies.” Voyage Care chief executive, Andrew Cannon, agreed: “We have an agility of response where we can provide council support if required and we have “We have an agility of response where we can provide council support if required and we have the stability and security of tenure of support.”
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the stability and security of tenure of support,” he said. Johann van Zyl, chief executive of residential specialist care provider, Cornerstone Healthcare, said some of his investors were initially wary of entering the sector because of its high risk but were glad to have invested. Highlighting the 2,000 people with learning disability and autism in secure hospital settings, Ryan Brummitt, managing director of Optimocare, said the onus was on specialist care providers to convince commissioners how to get people with complex needs safely back in their own homes in the community. “With that complexity comes a fee structure that will allow that person to be supported in the community,” Brummitt said. “I think that’s an untapped resource at present.” When discussing the particular commissioning and funding challenges faced by the sector, Cannon said that with care being entirely publicly funded, specialist providers did not have the ability to cross-subsidise from private pay to offset low fees. “Each package is bespoke and dependent on the assessment of people’s needs, but you are boxed-in, in terms of efficiencies and in terms of the units of serviced care,” Cannon noted. Cannon added that learning disabilities providers offer a ‘Cinderella service’ to elderly care and had to operate on 1.8% fee increases from integrated care systems.
Both Cannon and Allen agreed, however, that integrated care boards had the potential to address health inequalities more effectively in system terms and through more sophisticated outcome-based commissioning. Van Zyl said commissioners had struggled to understand the high staffing costs and care needs required for specialist care. “They don’t understand what I’m doing,” van Zyl said. “It’s very difficult for them to comprehend why I am more expensive than a nursing or dementia care home. They can’t understand why my admission fee is so much higher.” Van Zyl added he was facing having no inflation uplift due to the high base fees of his business, for the second time in five years. Panelists agreed however that recruitment challenges had eased in recent months, thanks to a combination of factors including greater access to overseas staff, staff recognition and support, and competitive wage rates. Cannon said specialist care had a very good story to tell about how it can change people’s lives and offer real career opportunities: “If you’re capable and have good support in terms of ability to progress in this sector, you can really rapidly progress in a very short space of time. “You can be running a large business where you have responsibility of millions of pounds of turnover and hundreds or thousands of people.” >
NOVEMBER 2023 | 25
business | healthcare summit
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Trends in the right direction Dan Madden, head of sales and marketing at Carterwood, said trends in key trading key performance indicators for care homes are encouraging. Madden shared the Q2 2023 snapshot into elderly care home trading performance from Carterwood’s Collab anonymised data covering occupancy, average weekly fees, funding mix and staffing costs. Highlighting positive trends across the board, Madden said: “We are going in the right direction, but we are not out of the woods yet.” Occupancy Madden revealed occupancy was up 3.9 percentage points year-on-year back to a pre-pandemic level of 87.3%. Madden said there had been a “really slow painful recovery from the early pandemic level of 78%” back to levels last seen in Q4 2019. Self-funding The proportion of self-funding beds in the data sample grew by 3.5 percentage points to 42.5%. Madden said: “We have seen a steady increase in the proportion of self-funded
Dan Madden
26 | NOVEMBER 2023
beds across our data set and that is an effect of operators leaning into the selffunding market when they can.” Agency/staffing costs At £270 per bed and below 10% of total staffing costs, agency costs stood at their lowest level since Q3 2021. Staff costs as a percentage of revenue also fell by 3.8 percentage points yearon-year to 61.4%. “Agency staff costs reached unprecedented levels during 2022,” Madden noted. “That is starting to come down, partly due to successful overseas recruitment initiatives. The vast majority of operators we speak to have had success with that, though it hasn’t been totally straightforward for everyone.” Madden also noted the introduction of innovative technology such as digital rostering systems had helped reduce costs. Average weekly fees Revealing 10% and 11.8% rises in selffunded nursing and personal weekly fees to an average of £1,463 and £1,099, respectively, Madden said “these are big numbers compared to historic averages,” while highlighting historic fee growth of
5% typically. Madden said we were living through “extraordinary times” in which operators had “put through quite sizable fee uplifts in response to inflationary cost pressures”. Fee premiums have been additionally gained for nursing and personal care of 8% and 13% for newest homes, compared with 10-year-old homes; 13% and 16% for Outstanding homes compared with Good; 23% and 14% for 90%-plus wetroom homes compared with en suite. In addition, Madden revealed baseline local authority fees had gone up by 13.9% for nursing care and 11.6% for personal care, compared with 7.4% and 6.9% in the previous year. “Self-funded fee increases have been consistent regionally and across asset type and age of home and Care Quality Commission rating,” Madden noted. “It’s not really about the quality of the home, or the size of it, or how new it is. Everyone is facing the same cost pressures.” Regarding local authority fee rises, he added: “The fair cost of care exercise has been implemented but the numbers still are not sufficient. You would have to have sizeable increases for many years to get to what is acknowledged as the fair cost of care.” Conclusion Madden said: “We are not out of the woods yet. There’s a still way to go but we are moving in the right direction. We have still inflationary cost pressures and occupancy challenges coming this winter.” He added that he expected occupancy to stabilise during the winter: “We’re not expecting fee increases to continue at the rate they have done for the last couple of years. This is an extraordinary period in the sector.” Madden said he expected fee rises to return to a more typical 6% year-on-year increase, adding there was “ground for optimism about the future”.
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healthcare summit | business
To register your interest and find out about commercial opportunities for Healthcare Summit 2024, visit: https://healthcare-summit.co.uk/contact
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NOVEMBER 2023 | 27
business | legal & regulatory
Understanding CQC’s powers to cancel your registration Healthcare regulatory lawyer, Emily Wilkinson, walks through the Care Quality Commission’s cancellation procedures and the circumstances in which the regulator might urgently cancel a provider’s registration The CQC’s role in registration As the regulatory body governing healthcare providers, the CQC oversees the registration of all providers and ensures those which are registered meet the standards required by law. The CQC’s duties and powers derive principally from the Health and Social Care Act 2008, which gives the CQC a wide range of powers to enable it to carry out its regulatory responsibilities, including those that relate to registration and cancellation of registration. Where providers fall short of the standards, the CQC has the power under the Act to cancel a provider’s registration and, depending on the nature and severity of the situation at hand, may choose to do this according to either the ‘standard’ procedure, set out at sections 17 and 26 to 32 of the Act, or to the urgent procedure set out at section 30 of the Act. The standard process for cancelling a registration The CQC can cancel a provider’s registration on any of the grounds set out in section 17 of the Act. These include failure to comply with the requirements of the Act; failure to comply with the law by a registered person, manager or other person; failure to comply with any conditions of registration; and obstruction of an inspector or assessor or failing to provide information when requested. If a cancellation is not progressed urgently, the CQC will first give registered persons a Notice of Proposal, which will state that the CQC proposes to cancel the provider’s registration and provides its reasons for doing this. The notice will also give relevant timescales; typically providers are given 28 days from service of the notice to appeal or make representations. If no representations are made within the timescale given, the 28 | NOVEMBER 2023
CQC will then serve a Notice of Decision which will cancel the registration. Providers may appeal to the First-tier Tribunal up to 28 days after service of the Notice of Decision. Effectively the standard process gives providers several weeks to respond to and act upon the CQC’s proposals, during which time they may continue to operate their service. The urgent process for cancelling a registration However, the CQC may consider urgent cancellation according to section 30 of the Act where a registered service or activity presents a serious risk to a person’s life, health or wellbeing. In this context harm may not yet have occurred and the CQC is able to act pre-emptively. The CQC is not required to serve any notice on registered persons where it decides to take urgent action (though in many cases it will inform the relevant persons so as to facilitate the transition process for affected service users). Instead, it will simply issue an application to a Justice of the Peace for an order cancelling the registration. The Justice of the Peace may make the order if it appears to him or her that there will be a serious risk to a person’s life, health or wellbeing if the order is not made. When made, such an order will have immediate effect and the registration will be cancelled straight away, with the effect that any service provision must cease immediately. If a service provider does not cease its regulated activities at that point, it will be acting illegally as an unregistered care provider. Can I appeal against an urgent cancellation? The registered persons can appeal against a section 30 order to the First-Tier tribunal within 28 days of receipt of the cancellation order. However, the practical implications of receiving such
Emily Wilkinson,
an order (that is, the immediate closure of the service) are such that it may be difficult for a business to fully recover after receiving an urgent cancellation notice, since any service users will have been transferred to another service. The business may also suffer reputational damage as a result of the urgent closure. Typically, section 30 notices are preceded by a history of multiple CQC inspections as was the case at Ashdale Care Home, and as such providers should keep on top of any issues raised in inspection reports and respond in a timely fashion to any concerns. If you are informed the CQC is taking action against your service, you should seek urgent legal advice in the event that issues can be addressed, and representations can be made before any section 30 order is made. It will be important to consider the risks to residents from the CQC’s urgent cancellation power being exercised. In addition to powers of cancellation, the CQC can also remove a single location from a provider’s registration. This can be done urgently under section 31 of the Act, which will have the effect of requiring a provider to close immediately. The CQC’s section 31 powers will be the subject of our next column on the CQC’s powers to remove locations. CARING-TIMES.CO.UK
care
45 DEMENTIA CARE Chief executive Hayden Knight discusses the transformative effects of Orchard Care Homes’ Dementia Promise
32 CT ON THE ROAD
40 10 QUESTIONS WITH
41 CARE FOR TOMORROW
Charlotte Goddard received a warm welcome at TLC’s care home Karuna Manor
Farai Hanyane, home manager of New Care’s Statham Manor Care Centre in Lymm, Cheshire, shares what she loves about working in care
James Rycroft, managing director of dementia care provider Vida Healthcare, discusses the role of technology in care homes
care | manager's guide to...
Supporting LGBTQ+ residents Care provider Anchor was awarded Gold status by Inclusive Employers earlier this year. Anchor’s diversity and inclusion officer Teagan Robinson-Bell shares tips on creating an inclusive care home for LGBTQ+ residents
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here are an estimated one million lesbian, gay and bisexual people aged 55 or over in the UK. Older LGBTQ+ people can feel they need to ‘go back into the closet’ when they go into care, due to earlier experiences of stigma and harassment in the healthcare sector. Care providers are increasingly recognising that they need to be more inclusive and welcoming to residents who identify as LGBTQ+. 1. Ensure the workplace culture encourages open and honest conversations. The best way you can do that is by making sure your team has a safe space to ask questions in a respectful manner. At Anchor we call this Safe Curiosity. 2. Look into providing training for staff about how to support LGBTQ+ residents. This might cover understanding a range of LGBTQ+ identities and the language used to describe these, for example. 3. Representation is key – as the famous saying goes “you can’t be what you can’t see.” So, for example, make sure if you have couples on your marketing materials, there are images of same-sex couples. Don’t make assumptions about the sex of a resident’s current or previous partners. 4. Avoid making residents feel they have to hide their identity. Some residents will have grown up before homosexuality was decriminalised in 1967, and will have lived through Section 28, the law that prohibited the “promotion of homosexuality” by local authorities in the 1980s. All that will have had a detrimental effect on the way people view the world. When we have managers and staff who can talk about issues in an open and honest way it can make people feel so much safer, so an older person who identifies as LGBTQ+ can think “this is a place I can be myself and I don’t have to self-edit.”
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5. Put on events and get involved in activities that recognise the LGBTQ+ community which sends a message to residents that they are welcome. There are two annual opportunities to celebrate, Pride in June and LGBTQ+ History Month in February, but targeted activities such as music or reminiscence evenings can happen at any time. 6. Support and celebrate team members who identify as LGBTQ+, and ask for their input, which will make residents more confident that this is a supportive environment. 7. There have been times when people in my team have spoken to residents or colleagues about their prejudices. It is important to have a zerotolerance stance on discrimination and abuse, but we have also found that it can be powerful to bring people together to share their experiences with each other. This has to be done carefully because you don’t want to put someone into a situation where they are talking about their experiences and they are met with hostility, but once you hear a firsthand account of the issues and
challenges LGBTQ+ people have faced it becomes more real. 8. Think about some of the issues which people from the LGBTQ+ community might face especially when they are older. Some of our residents, for example, are trans but also have dementia. You can imagine how difficult it must be if that person is in a position where they have forgotten they have gone through a massive transition process. 9. At Anchor we have LGBTQ+friendly schemes, where we have specific training for colleagues around how to support LGBTQ+ residents. We also have LGBTQ+ affirmative schemes which offer a more proactive approach to inclusion, for example we might make sure we are showing LGBTQ+ films in the cinema. 10. Think about setting up an LGBTQ+ residents group, which can offer peer-to-peer support and also feedback opportunities to improve the environment, or a dedicated LGBTQ+ representative or mentor that residents can approach with any concerns.
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continuing professional development | care
Promoting diverse leadership Christine Wint, head of leadership development at Skills for Care, discusses the Moving Up and Creating an Inclusive Organisation programmes supporting leaders from diverse backgrounds to progress
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t Skills for Care, one of our key strategic aims is supporting culture and diversity to ensure the workforce is treated equally, feels included and valued, and is supported to stay well and pursue their careers in social care. This aim is weaved into our vision across all the work we do and is a particular focus in the learning and development programmes that we run to support the development of black, Asian and ethnic minority leaders in social care. This includes our popular and longrunning Moving Up programme and our newly redeveloped Creating an Inclusive Organisation programme. Our Moving Up programme will soon open for applications for our January 24 cohort. Keep an eye on our website for registration details. This programme is aimed at managers and aspiring managers from black, Asian and minority ethnic backgrounds. The focus of Moving Up is all about you. It covers topics including personal branding, self-belief and identifying your own strengths and weaknesses. These are key attributes in developing and progressing in your career. It also offers a really valuable opportunity to network with others and share your experiences with peers from a similar background to you, as the programme includes both virtual and in-person learning. Moving Up has been running for 12 years and we know from speaking with past participants that it’s had a really positive impact, both in terms of tangible career progression as well as confidence at work. We know from our data that the adult social care workforce is very diverse with a high proportion of the workforce being people from black, Asian and minority ethnic backgrounds. However, the racial diversity split we see across the wider workforce is not replicated with
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the same proportions at a more senior level. This is why it’s crucial to provide learning and development opportunities to support the progression of black, Asian and minority ethnic leaders – specifically addressing the particular barriers or obstacles which people from these backgrounds may face in their career development. Our Creating an Inclusive Organisation programme has been redeveloped for 2023/24. It’s an e-learning programme which aims to develop everyone’s confidence to improve equality, diversity and inclusion (EDI) across organisations. The programme is primarily aimed at people from a black, Asian and minority ethnic background and provides support and tools to help them tackle challenges they may have faced in the workplace. Over the two modules participants will cover topics that are designed to develop leadership skills and promote career progression. All topics covered in the modules form part of an action plan which can be used to improve personal learning and understanding and also to educate colleagues and improve EDI within an organisation. Some of the topics covered include: an overview of EDI, promoting EDI in your organisation, leadership and management, and personal branding and communication skills. We’re very excited to be delivering this updated offer for 2023/24 and
Christine Wint
continuing to develop the support we offer for current and aspiring social care managers from all backgrounds. We can also commission a bespoke programme for organisations. By commissioning a programme, we can focus on the specific needs of your organisation and your staff. We will work with you to weave in some of the challenges your organisation may be facing around engaging with colleagues from a minority ethic background, build on their confidence and develop their leadership skills and ability. This can be arranged by contacting business. development@skillsforcare.org.uk Find out more about Moving Up and Creating an Inclusive Organisation on our website at: skillsforcare.org.uk
NOVEMBER 2023 | 31
care | ct on the road
Family values Charlotte Goddard received a warm welcome at TLC’s care home Karuna Manor, and found out how it supports residents to remain close to their Indian heritage
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tepping over the threshold of TLC’s Karuna Manor in Harrow, north London, visitors immediately realise they are in no ordinary care home. The home, which opened eight years ago, embraces and celebrates Asian culture. From its magnificent golden temple, to the Bollywoodthemed cinema and traditional Indian artwork throughout the home, residents maintain strong connections with their heritage. The friendly team are keen to share their culture with visitors. I was greeted by the home’s Hindu priest with a beautiful ceremony including coloured powder applied to the forehead and a garland of flowers. The floors of the purpose-built home draw their names from Hindu tradition. The top floor, which cares for people with dementia, is named Girnar House, after a holy mountain, while other floors are named after a holy city and a temple. Colourful pictures lining the corridors tell the story of each floor. Karuna itself is named after one of TLC’s core values. “The company’s values are truth, love and compassion, and compassion in Gujarati is karuna,” explains home manager Payal Chhabra. My visit coincided with the festival of Navarati, or nine nights, which celebrates the victory of good over evil. The temple was filled with singing and dancing as the priest, team members and visiting family engaged residents – and me – in a traditional stick dance, called "The 60-bed home offers residential, nursing and dementia care over three floors. It is running at full occupancy and even has a waiting list.”
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Dandiyaa, with residents sitting down and team members moving between them. Everyone was very encouraging, despite my woeful sense of rhythm. Karuna Manor’s residents are not just drawn from the local community. “People come from further away as well,” says Chhabra, who worked in healthcare in India before moving to the UK in 2005 as a chartered physiotherapist and joining TLC in 2019. “We have had people from Hertfordshire, Essex, Leicester.” The 60-bed home offers residential, nursing and dementia care over three floors. It is running at full occupancy and even has a waiting list. Its popularity led TLC to open another ‘cultural home’ Kailash Manor, also in Harrow. ‘Kailash’ means ‘one who bestows peace’ and is the name of a Himalayan peak and abode of Lord Shiva. “I think because of the cultural aspect of it, people don’t mind travelling,” says Vikaila Vekaria, Karuna Manor’s business and development manager. “When they bring their loved ones, they know they are going to get the cultural food, the temple, and they don’t mind making the journey.” For older people who may have attended a temple every week, the fact they can continue to do so is a definite draw. In the past, care homes have not always been seen as an option for people of Asian heritage, due to a strong
tradition of looking after older relatives in the family home, says Vekaria. “When I speak to relatives it is always about reassuring them they have done the right thing,” she explains. “Just because their loved one is going into a care home doesn’t mean you won’t see them – you can come in 10 times a day; there’s no restriction on visiting.” Families are encouraged to take part in activities and celebrations alongside their relatives, and there’s always something going on. Four different activities take place every day, from gardening to Bollywood-themed karaoke, to chair yoga. The home is full of nooks and crannies to socialise in or to chill out alone, including a tranquil garden, four conservatories and a library stocked with Gujarati books. On the lower ground floor there’s a hairdresser, spa and cinema. There’s always plenty of coming and going, including children from a nearby Montessori school, local temple communities and groups coming in to offer activities such as arts and crafts. Karuna Manor uses wellbeing app Oomph! and has also provided the platform with information on a range of culturally specific activities to share with other homes. While the majority of residents are Hindu, the home is inclusive of all religions including Zoroastrian, Sikh, Islam and Christianity. A wide range of festivals are celebrated – around 55
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ct on the road | care
different cultural events every year says Chhabra – and the temple includes statues and pictures of important figures in other religions. I was invited to share a cultural meal served traditionally in a thali, a meal made up of many small dishes, which residents are offered every day. “Thali is a traditional dish, and we include about 15 different items,” says Chhabra. “We get feedback from the residents and we will adjust or add things accordingly”. Creating 15 dishes for one meal may sound a challenge, but the home’s chefs are up for anything – one upcoming festival will require them to create 108 different morsels and dishes. Menus are based on traditional Gujarati cooking, but if residents prefer they can have something else, such as a baked potato. The home is vegetarian, with no meat or eggs coming into the house – although if residents want to go out to eat meat, the team will help them to do so. All meals are analysed by a dietician to ensure they are wholesome and balanced. “Food creates a shared culture, it inspires laughter, talks and reminiscences,” adds Chhabra. “We call mealtimes ‘stop the clock’ as everyone will stop what they are doing and join the residents on each floor.” Not all staff at the home have Asian heritage, so their training includes background on the culture. “We introduce them to a few Gujarati basic phrases, and always have a lot of fun and laughter,” says Chhabra. Like all TLC homes, Karuna Manor is ‘zero agency’. This is made possible by overseas recruitment, which sees the company sponsoring staff from all over the world. The more diverse the staff, the more the company is able to draw on their
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contacts overseas and keep the ball rolling. “We have team apartments so when they do come over, we support them for the first three months,” says Chhabra, who has taken part in mental health first aid training to support her team. “Rather than having to think about paying bills, they can learn about England and about TLC, and how the home works.” Karuna Manor is keen to use new technology to benefit residents, including investment in a sensor system for residents with dementia, which alerts staff when a resident is moving. “It has really helped us reduce the number of falls, as well as understanding what is happening – is the medicine wearing off at that time? Are they hungry? Is it continence needs?” says Chhabra. Karuna was also one of three care homes in Harrow taking part in a trial of DiADeM (Diagnosing Advanced Dementia Mandate), a tool to support the diagnosis of dementia for people living in a care home setting.
The residents’ voices are very important, and they are central to everything that happens in the home. Residents are involved in recruitment, health and safety and training. “There is a real sense of ownership and belonging,” says Chhabra, who will consult with residents on everything, from how to celebrate grandparents day, to whether the team should continue wearing masks. “They have choice and voice and control over everything and anything they want us to do.” The residents asked for masks to continue over the winter, then held a mask removing ceremony in the spring. Every aspect of a resident’s experience, from the activities they take part in to any end of life care that is needed, is planned around their wants, needs, interests and culture. Front doors display a picture of the occupant with information on their interests, and the names of their two key workers – unless the resident prefers not to have this, which is their right. Visitors to Karuna Manor will come away with an impression of joy, vibrancy and belonging. “It is not ‘they are the residents and we are the management team’. We are one family,” says Vekaria. When I visited the home, Karuna Manor was awaiting the results of a CQC inspection. As Caring Times went to press the news came in…an Outstanding rating. “We are overjoyed, and so emotional,” Chhabra told us.
Charlotte, Payal and resident playing Dandiyaa
NOVEMBER 2023 | 33
24-25 NOVEMBER 2023 ExCeL LONDON HOSTED BY LORRAINE KELLY Following the landmark launch event at the NEC Birmingham, join Caring Times at ExCeL London for the largest show in the UK dedicated to care managers. Lorraine Kelly will be our host, with thousands of managers, care groups and sector specialists in attendance.
WHO SHOULD ATTEND?
• Care managers • Assistant care managers • Care group executives and owners • Care suppliers • Representatives of industry bodies and associations
WHAT’S ON OFFER AT THE SHOW? ENTERTAINMENT
In this central stream, our host Lorraine Kelly will celebrate key figures in the industry and interview guests with first-hand experience of care.
FREE CPD
Leading training providers will deliver a best-in-class programme of free CPD. Managers will also be able to access information on how further training can help their career, and to talk to care groups offering funded apprenticeships.
OPERATIONAL EXCELLENCE
Including workshops and panels, this stream will empower managers to ensure best practice. Leading industry figures will speak to key issues including HR, recruitment, staff morale, and managing risk.
HOME CARE
Managers will have the opportunity to further develop the specific skills needed for home care management, and to hear about some revolutionary and exciting ways the sector is driving forward.
NETWORKING
Connect with attendees, whether this is finding the best talent, speaking to industry experts and operators, or sourcing a key service.
GET YOUR FREE TICKETS TODAY caremanagersshow.co.uk
care | carers’ stories
My life in care Tina Benson, head of care at live-in provider, Promedica24, shares her lessons learnt over 40 years in the sector as she climbed the career ladder from volunteer to head of care
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hen I started volunteering at a community village centre at the age of 16, I didn’t think I would be in the social care sector 40 years later. I am now proud to be head of care at Promedica24, one of the leading live-in care providers in Europe and the UK. I know this line of work can sometimes be challenging, so I want to share some of the lessons that I have learnt over the years to help people starting their careers in this sector. Look after yourself and maintain your sense of humour My first volunteering and healthcare assistant role at the community village centre where I started my career involved working with people with learning difficulties, mental illness and challenging behaviours. I learnt early on that you have to take every day as it comes and maintain a good sense of humour. You need to understand that when people are unwell, they don’t always mean what they have said or done and they still need your help. Self-reflection goes a long way and at
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the end of each day, you need to be able to compartmentalise and take care of yourself and your own wellbeing. Be adaptable After this role, I moved on to a dementia care position at a hospital, where I learnt about the unique way this complex condition manifests in every person. There’s no ‘one box fits all’ for any dementia patient and as caregivers we must adapt our approach to each individual in our care based on how they are feeling. Never underestimate the power and importance of simply sitting next to someone and being there to make them feel comfortable and well cared for. Believe in your work The significance of believing in your work should never be underestimated. This thought often keeps me motivated in difficult times. While live-in care is not as prominent as home care or care homes, I truly believe that live-in care can be the best option for people who want to and are able to remain in their own homes. It is very fulfilling to see
Tina Benson
the positive impact our service has on people’s lives. For example, we recently supported a couple whose biggest wish was to remain together. If it was not for our live-in care service, they would have been separated, as one of them required significantly more support than the other. Being in a position to help people spend the end of their lives in the way they would like and with dignity is a privilege and a testament to how rewarding a career in care can be.
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advertorial | care
Congratulations to our third runner-up Activities coordinator Joy Clark was chosen as one of this year’s runners-up in recognition of her extraordinary commitment and contribution to the wellbeing of residents at Kingsley Healthcare
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arcia is an amazing activities coordinator like no other. She has a drive and enthusiasm that is positive and infectious. Her ability to encourage and motivate even the most difficult resident is a credit to her and for this reason residents, their families and her work colleagues respond warmly towards her with support and respect. She uses Facebook and local community pages to showcase the home which are shared by local dignitaries such as the mayor, councillors and the local MP. She has involved a lot of local people within the community using gift incentives to encourage connections, such as organising gift bags which local schoolchildren and the local church helped deliver to people, and she has held open events such as a summer and Alzheimer’s fete and Macmillan coffee mornings which are always successful and well attended. We are regularly mentioned in the local newspapers and involve local schools, childminders and church groups all helping to promote the home via word of mouth – this is all down to Marcia and the relationships she has forged to keep the home involved within the community. She is passionate that no resident should feel isolated behind the walls of the care home and should still be a valid member of society and she works extremely hard to ensure this happens. Marcia has created and implemented a very varied and successful activities programme which is well engaged – all of the activities are themed around the seasons and broken down so ‘Gardening’, for example, could be painting a plant-based picture or planting seeds, using mint sauce where paint is not
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2023
appropriate due to dementia and she has been known take the soil and pots into the bedroom if a resident is nursed in bed. Pets go all around the home and make visits in bed as well. By breaking the activities down, Marcia ensures everyone has an interaction even if they are not able to attend a group. She understands that not everyone wants to be part of a communal activity and might just prefer music or to sit down with a quiz in their room. Adapting the activity to a one-toone session means they are not excluded. She has encouraged residents through a Wishing Tree to find new zests for life, such as a lonely war veteran receiving 18,400 Christmas cards and gifts, and another initiative to raise money for
Ukraine by organising not one, but two, fundraising challenges raising more than £750, and also fulfilling a resident’s longing to be baptised. Marcia ensures activities are broken down into manageable time by all staff, so quality one-to-one time can be spent during personal care, chatting over lunchtime assistance, or staff taking turns in a group activity. By doing this she demonstrates it is not just the activities coordinator who is the face of activities, but that all staff are seen as part of the fun and not just there to provide care. Marcia sends monthly newsletters and activities planners to all the families ensuring they know what’s going on and to see if they wish to attend anything. She is a credit to the home.
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care | norrms’ blog
The shadow man Our columnist Norrms McNamara reflects on what it’s like to live with dementia
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ome mornings your loved one with dementia may well be a lot quieter than usual, after a night of night terrors. It’s so hard to explain these as a person living with this awful disease because of how horrific they are, but, sadly, what’s even worse is when they seem to go on and on and whatever shocking scenes you are watching, try as you might, you cannot wake up from them, and last night was unfortunately my turn. What you are about to read is not for the faint-hearted, and as they say on the telly, please look away now if you choose too… As we approached the seafront in the car it soon became clear it was flooded and there was no way through, fastforward and we were in a hotel looking out over the beach and saw blackened bodies, hundreds of them, children and adults lying on the beach, dead, dying and some trying to get up, blackened. Why? No idea, but in the night terror the scene was straight out of a horror film. We ran out, hearing the screams and cries form hundreds of people, some were quite clearly dead and the worst thing was watching people give CPR to those on the ground. I bent down and held a child in my hands, I screamed in a pitch I could not possibly reach when conscious, shaking my head trying to snap out of what I was seeing, but to no avail, as the sight of people in front of me in distress seemed to go on forever, and then?
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Norrms McNamara
Then I woke in my bed, safe and never feeling as relieved as I have before, knowing it was a night terror, but it doesn’t stop there. The heaviness in my mind of the scenes I had just witnessed stays with me for hours, sometimes days; the screams, the noises and the unnamed faces of the others in such pain follows me around for so long sometimes, flashbacks appear out of nowhere making me jump and sometimes scream all over again. Whoever said dementia was just about forgetfulness was lying! This disease is not just about forgetfulness but encapsulates many
other things that people don’t even realise; they never tell you about these things when you are diagnosed. In fact, they don’t tell you that much really. The only advice I was given by a qualified consultant was to ‘Use it or lose it’. I kid you not! And before you think ‘Oh well that was years ago’, it was only yesterday when I read that a family man aged 44 was given a diagnosis with no advice whatsoever! Was that because, like me, he was so young when diagnosed? Things really do need to change. I heard someone say the other day that his wife had a ‘touch of dementia’ – must be the same as being a ‘touch, pregnant’, eh? I’m not saying sit there for hours and share all the awful things connected with dementia, but for goodness sake give us a bit of a heads up please. My own advice would be to write down every question you can think of when you get diagnosed and ask the doctor. Also, while you are there, please make a follow-up appointment as I will guarantee you will come away and think ‘Oh how I wish I had asked that’. As to my own dementia decline, I do worry about the future and still hope things change for the better. Till next time…
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catering | care
Chef of the month Helen Styles works as head chef at Vida Hall, an Outstanding-rated care home operated by specialist dementia care provider Vida Healthcare maintain their independence. For example, at breakfast time they have a choice between a full English or alternatives, such as yoghurt. How do you cater for residents living with dementia? It’s difficult to plan in advance when it comes to cooking for people living with dementia due to the specialist requirements. At Vida, we cater for our residents by providing a lot of choice so that everyone is eating well. For example, varied snack choices are consistently available for residents as their unique preferences often mean they prefer eating at different times.
Helen Styles
Tell us about your background in care Moving into my first job in the catering sector, I wasn’t aware there were culinary roles in social care. I, therefore, continued to progress across a range of traditional jobs, including as a waitress and head chef at a local pub, before taking on a role as front-of-house in the care sector. Once I’d been introduced to the culinary world within care, I was hooked.
so that our residents are encouraged and excited to eat.
What is special about working in care? Working in care brings a real sense of fulfilment and connection. Every day I know that I’m making a difference to the lives of our residents. Working at Vida in particular also feels like being part of a family – it’s a lovely place to work.
What does your typical menu look like? As we provide bespoke care for people living with dementia who have specific requirements, we don’t have a typical menu. We prioritise familiarity and recognisable meals with a particular focus on including green and coloured vegetables to make sure that everyone is receiving the exact nutrition they need to stay happy and healthy. My background is in good-quality, traditional food which is a big hit with our residents, many of whom are elderly. We do, however, like to include individual favourites in our offering, such as curry and Chinese cuisine.
How do you vary your menu to provide choices for residents? We implement a four-week rolling rota of menus to minimise repetition and provide choices for our residents. We generally find that traditional foods keep them engaged at mealtimes and can evoke memories. This is very important for people living with dementia. Dietary requirements, including physical needs such as dysphagia, are incorporated into each menu to ensure that everyone can eat what they want. Making our food visually engaging is also very important
How do you meet the nutritional and health needs of your residents? Meeting residents’ nutritional needs is a priority and achieved through carefully curated menus, including a diverse selection of vegetables and seasonal fruits, so that each resident has a balanced diet. Ultimately, we can only meet the nutritional and health needs of our residents if they want to eat the food that we’re producing. For people living with dementia it’s also very important to give them choices so that they can
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What is your most popular dish? Favourite meals for our residents are fish and chip Fridays and a classic Sunday dinner. What is your favourite dish? As a baker, my preference is crafting desserts. Indulgent puddings always put a smile on the faces of our residents. How do you make the dining experience special for residents and their families? For many people, mealtimes are a social occasion and this is no different for our residents. It gives them opportunities to socialise with each other, our staff and their family members. Making sure we create food that looks engaging and is easy to eat is particularly critical when cooking for people living with dementia so that their experience is special. "As we provide bespoke care for people living with dementia who have specific requirements, we don’t have a typical menu."
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care | registered managers
10 questions with… Farai Hanyane, home manager of New Care’s Statham Manor Care Centre in Lymm, Cheshire, shares what she loves about working in care What one thing would you change about social care? Our link with health and the NHS. We sometimes have to jump through hoops to receive basic support, for example, dental care for elderly care is very limited. What makes a great care worker? Someone kind, reliable, patient, respectful and willing to learn. A great carer goes above and beyond and is always willing to help. What do you do when life gets a bit too much? During working hours I speak to the residents as they always have a lot of stories to share and outside of work I put my headphones on and hit the gym. What advice would you give your younger self ? Stop caring about what people think and travel more. Farai Hanyane
Why did you join the social care sector? It was an accidental beautiful coincidence. My intentions were to join the NHS; little did I know ageing Britain was my calling for a satisfying profession. After three months of being in the job. I knew I was not going to leave the social care sector. I fell in love with my job, knowing that I was making a difference in someone’s life when they are making that transition from home into social care. It’s a very difficult time for both residents and families and I love showing them this is not the end, but the beginning of a new life with new friends and family. What do you enjoy most about your job? The variety of the job. No day is ever the same. I enjoy spending time with
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residents who always have a lot of stories to share. I love empowering and coaching the team and seeing them develop and progress in their career. Who is your social care hero and why? All care home workers are heroes. We are expected to have a broad knowledge of the social and health needs our residents. We are looking after one of the most vulnerable groups of people in our society. We are the physiotherapist, dietician, speech and language therapist, and tissue viability nurse while we are waiting for any referral to come through. When our residents are down, we also play the role of counsellors and therapists. Most importantly, we are like one big family and we all celebrate special occasions together.
Which three famous people would you like to have dinner with and why? Nelson Mandela. I would like to know where he got the strength to serve 27 years in prison for standing up for what he believed and what kept him going. Ultramarathon runner David Goggins – his nickname is the ‘toughest man alive’. And Maya Angelou. She said: “People forget the things you say but never forget how you make them feel.” This applies to my role as a manager. It’s very important I make residents, relatives, staff and other professionals feel welcome and appreciated. What three items would you take to a desert island? A water bottle, kettle bell and fluffy pillow. What is your secret talent? The ability to cook without a recipe after sampling the meal for the first time.
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care for tomorrow | care
Get connected James Rycroft, managing director of dementia care provider Vida Healthcare, discusses the role of technology in enabling connectivity in care homes, reducing loneliness of residents and other positive outcomes
T
he Good Care Group recently reported that more than one million older people report feeling lonely all the time. Even in a care home setting where there are more opportunities for people to have social interactions with staff and other residents, isolation and loneliness can still occur. When an older person moves from familiar surroundings into a care home, it can cause feelings of stress as they have to adjust to a new home, new routine and different people around them. This adjustment to an unfamiliar environment can often lead to feelings of isolation. At this transitional time in an older person’s life it’s crucial for them to stay connected, whether this be with existing friends and family or by forming new connections with residents and staff members. Connect through technology Digital solutions can help residents remain connected to their loved ones and the outside world, reducing social isolation and loneliness. Technology solutions may be utilised by care home operators to keep residents connected to the people important to them. These online interactions with loved ones can make a significant difference and have a positive effect on a resident’s mental
health and wellbeing. Care home staff also play a significant role in easing feelings of loneliness, particularly when family and friends live further away and may have less time to visit. Technology can free up staff time so that they have more opportunities to socialise with residents and spend valuable time with them. Though smartphones and devices may seem daunting at first, building a positive experience with new technology is crucial for staff and residents who are nervous about, or new to, smart devices. Technology can help residents maintain social connections, which in turn can support them in maintaining their independence and improving their wellbeing. Technology in practice Connectivity within care homes is crucial to both residents and staff members. At Vida, we recognise the importance of embedding communication channels in our care provision that keep staff and family members informed and up to date. That's why we have developed and launched an app to maintain connectivity between staff, residents and family members across Vida’s three homes. Team Talk is user-friendly and gives families instant access to catch up
James Rycroft
on the health and wellbeing of their loved one through posts and updates, including videos and images. This creates a sense of community, even when family and residents may be physically apart and enables connectivity with their loved ones to reduce feelings of loneliness and social isolation. Team Talk is currently being adapted to suit the wider care market and will soon be available to other care providers to improve communication and connectivity. For more information, please visit: vidahealthcare.co.uk
Vida's Team Talk app CARING-TIMES.CO.UK
NOVEMBER 2023 | 41
care | care for tomorrow
Half-way there Deputy director for adult social care technology policy and senior responsible officer Alice Ainsworth reflects on progress at the half-way point of the three-year Digitising Social Care programme
I
t’s been 18 months since the Digitising Social Care programme formally kicked off, delivering the three-year £150 million investment in digitally transforming the adult social care sector that was set out in the adult social care White Paper, ‘People at the Heart of Care’. We have made huge progress in that time, and I can feel the sense of momentum building from the sector and among technology suppliers and innovators. Many care providers have jumped at the chance to access the funding and support made available through the programme and are positive about the opportunities for technology to transform the way they deliver care. And providers have matched this enthusiasm with their own time and financial investment, in the knowledge that digital social care records and care technologies can make their organisation more efficient and improve the quality and safety of care. It’s also been heartening to see the early adopters of digital, support others in the sector through sharing their experiences and best practice. At the half-way point of our three-year programme I have been reflecting on the progress that’s been made and also the lessons we’ve learned along the way. Major programmes rarely go entirely to
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plan, but we’re listening and learning and always striving to find the best way to respond to the needs of the sector. Where are we now? Almost 60% of providers now use a digital social care record – from a starting point of just 40% – with many more in the process of implementing the technology. Of the providers that have digitalised, 1,300 are now also able to access appropriate GP record information for the people they care for. A few weeks ago we announced the winners of the first wave of our Adult Social Care Technology Fund which is helping us to build the evidence base for how care technologies can help improve the quality and safety of care, reduce admissions or re-admissions to hospital, and improve independence and wellbeing for people in receipt of care. Take a look at our newly launched website to find out more about these projects at: digitisingsocialcare.co.uk What next? A huge part of the work that we do in our programme is about hearts and minds, and for the care sector to undergo such a major digital transformation we need to be solving real problems.
Alice Ainsworth
We are continuing to set out the benefits and the evidence, to support care providers to make the best decisions about what technologies to invest in, and to help them be more sustainable and competitive. We’re launching digital skills offers and we’ve launched the new Digitising Social Care website. We’re tackling the interoperability challenges, joining up NHS and social care and continuing to build the confidence and capability of the wider social care workforce. We also continue to work with the Care Quality Commission which has been clear about the important role technology plays in delivering safe and high-quality care.
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activities news | care
Creative Caring As always, carers have been demonstrating their creativity through fun and innovative events for their residents
Let’s dance Dancers from Bristol Ballet spent two hours entertaining residents at Healthcare Homes’ Oaktree care home with a variety of ballet acts, complete with colourful costume changes. The dancers engaged in friendly conversations, sharing stories and experiences with residents of the South Gloucestershire home.
Coastal cleaning Four environmentally-conscious residents from Colten Care’s dementia care home Fernhill, accompanied by three team members, took part in a beach clean along the seafront in Swanage. Holding litter-pickers, they enthusiastically removed pieces of discarded plastic, cigarette ends and other items of rubbish to support the Great British Beach Clean Week, an initiative of the Marine Conservation Society.
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Fancy that Residents, relatives and staff at Barchester Healthcare’s Maple Leaf Lodge in Grantham celebrated Fancy Dress Friday by dressing up as a pizza, a lobster, Snow White, a clown and much more. General manager Kerry Angeloni said everyone had so much fun “we can’t wait to make Fancy Dress Friday a regular event.”
Man shed Meallmore’s Daviot Care Home has opened its first men’s shed, a place to practise skills and enjoy making and mending, while building social connections. The shed provides tools for training and skills development and residents have already begun building garden benches and candle holders. It was officially opened by theatre, TV and film actor Ron Emslie.
Garden glory Residents from Cadley Hill View care home in Swadlincote, Derbyshire celebrated being crowned champions of Ideal Carehomes’ annual Gardens in Bloom competition, which saw 36 care homes bring their garden visions to life. The judges were particularly impressed by Cadley Hill View’s array of wildlifefriendly flowers, buzzing honeybee hives and fresh fruit and vegetable patches.
Paint the music HC-One’s Ferndale Court, located in Widnes, took part in the National Day of Arts in Care Homes on 24 September, which aims to champion, promote and encourage arts engagement in care settings. Residents combined music and painting by listening to music on headphones and representing their feelings and thoughts through visual art.
Greased lightnin’ Residents at Care UK’s Chandler Court stepped back in time as the home’s cinema was transformed into the golden era of the 1950s. Dinerstyle burgers and fries for lunch was followed by 50s-themed karaoke and a screening of classic film Grease, while team members and residents donned their best polka dot neck scarves, hair ribbons and leather jackets.
Best in show Emma Cranstone, activities coordinator at Friends of the Elderly home The Lawn, decided to arrange the Hampshire home’s first Dog Show. > NOVEMBER 2023 | 43
care | activities news > Residents love animals and frequently reminisce about pets they have loved during their lives. Ten dogs of varying breeds took part in ten award categories, while two residents acted as judges of the Dog Show and awarded hand-made rosettes.
Golfing glory Park Avenue Care Home resident Alan has been offering one-to-one golf lessons to the people who live and work at the Excelcare home since receiving a set of clubs. A keen and accomplished golfer since the age of eight, Alan managed to pass on his passion to fellow residents who have since shown an interest in watching the golf on TV.
War memories Residents of Highfield House, Eastbury House and Ivehurst care homes in the Southwest have pooled their wartime memories in a new book. ‘I remember the War’ was created by memoir writer Mandy Bloom, who spent time with residents listening to their experiences.
Tanks for the memory Resident Michael Cunningham at Barchester Healthcare’s Chater Lodge has always wanted to drive a tank. Staff made his wish come true after Michael put a letter in the home’s ‘post a wish’ box. Zoe Postgate, general manager, said: “It was wonderful to see how happy Michael was – and the staff loved being a part of this as well.”
Harvest home Residents at Rotherwood’s Dorset House Nursing Home celebrated Harvest Festival with a child-friendly service attended by youngsters from Blue Giraffe Nursery. This was followed by an afternoon of music from Droitwich Ukulele group and a themed afternoon tea, featuring harvest-themed cakes.
In the pink Four Seasons care homes across the UK held pink-themed ‘TEAth’ parties to educate team members, health care professionals, residents and families on the importance of good oral hygiene as a sepsis prevention measure. The parties took place during Sepsis Awareness Month, and guests were given new toothbrushes, shown the best way to clean teeth and took part in discussions and quizzes. Challenge yourself Quantum Care’s 23 care homes competed with each other during October to complete 15 challenges designed to build stronger connections between residents and local communities. Challenges include having animals come to the home,
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holding a Halloween party and taking a picture of residents with the local fire brigade or police.
Welsh walk Staff and residents of Balhousie Care Group’s Dalnaglar home in Perthshire have been clocking up thousands of steps as they take on a virtual walking challenge – the 870-mile Wales Coastal Path. At the time of writing the walkers had covered 639 miles. The original plan was to scale Mount Everest but when activities coordinator Julie Davis found this was only 45 miles she looked for a more substantial challenge.
Play the game Qualified instructors have been visiting nine care homes in Swindon supporting residents to take part in the Senior Games. Chair-based exercises to classic songs aim to improve health and prevent falls, and residents can also compete in games such as foam javelin throwing, tin-can alley and golf putting. The programme is funded and organised by Swindon Borough Council, working with the Wiltshire & Swindon Sports Partnership and members of the Swindon Falls Collaboration.
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dementia care | care
Transformative care Chief executive Hayden Knight discusses the transformative effects of Orchard Care Homes’ Dementia Promise, one year after its launch
H
ayden Knight joined Orchard in the summer of 2019 with a background in specialist care focused on autism and mental health. “I knew dementia care wasn’t where it needed to be, it was very behind the times,” Knight says. “My vision for the business was to become the dementia specialist with a ‘person-centric’ approach to care. For us to do that, we had to change behaviours, culture and our expertise in dementia.” Knight described the Dementia Promise, which was launched in September last year, as the “bedrock” of Orchard’s transformation of its dementia support. The programme was developed by Knight, with input from his own specialist care background, as well from dementia lead Hannah Miller and quality director Cheryl Baird. “We looked at different concepts of dementia care and how to evolve those and think outside the box to
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develop new concepts,” Knight says. “We used a lot of overseas research, particularly from Australia. It’s about seeing the person behind the diagnosis, being person-centred and adopting a therapeutical environment and engaging with residents. The Dementia Promise is about looking at distressed responses and understanding why people are behaving as they are and supporting the individual, not the disease.” In developing the model, Orchard began by looking at its designated dementia Reconnect Communities, the first of which was launched at Ashlea Lodge in Millfield in 2020. There are now six Reconnect Communities at its 23 care homes with more in the pipeline. Each Reconnect Community is between 18 and 21 beds with a higher staffing ratio, including six support workers who are paid enhanced wages because of their specialist roles with a qualified nurse also on every shift. “The communities are focused on
Hayden Knight
outcomes in a therapeutic environment,” Knight explains. “It’s all about reablement through activities.” Specialist support workers at the communities are developed through an extensive 12 to14-week, training programme at the Orchard Academy. >
NOVEMBER 2023 | 45
care | dementia care
> “Dementia is still quite a complex,
confused part of the sector,” Knight says. Some people do it well, some profess to do it well, some people don’t even touch it. For me, I’m very proud in saying we do a fantastic job in supporting dementia at all levels of acuity. We are now also looking at early onset dementia to support the whole spectrum of the disease.” All homes have implemented the Dementia Promise in terms of ways of working, policies and procedures, and the adoption of supportive digital technology, including PainChek’s AI pain assessment system, which has seen over 60,000 pain assessments completed in the past 12 months. Assessments are completed pre and post pain relief and when a person becomes withdrawn, “The CQC has set the objective of becoming fully digitalised by 2024 and we have been there for two years.”
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distressed, or has a fall. The addition of PainChek in 2021 into falls prevention policy and post falls protocols has helped reduce falls by 20% with the number of severe injuries including fractures dropping by a significant 91%. “As a business we are fully digitalised,” Knight notes. “The CQC has set the objective of becoming fully digitalised by 2024 and we have been there for two years.” The last stage of implementation of the Dementia Promise is an advanced training programme, which has been rolled out to 60% of services. The chief executive says all staff will be accredited with its internal training qualification by January. “We have had an overwhelming response from residents, families and staff to the programme,” Knight says. “Everybody has embraced the training and every member of the team up to senior leadership goes through it. We have made a significant investment of over half a million pounds in the programme and we are well on our journey to becoming the dementia specialist that we set out to be.” Knight says there is “far more awareness of dementia” across the business since the launch of the initiative, adding it has made a huge
difference in terms of the reablement of basic living skills. “We have seen non-verbal people become verbal and more articulate,” Knight highlights. “We had a gentleman who moved into one of our homes in Warrington who had been on a longterm stay in hospital who had been heavily medicated for about two years. He is now not on the medication and is interacting with his peers and accessing the community. We are really giving our people the best quality of life they can have.” Additionally, the chief executive says homes had seen an 8% reduction in antipsychotic and sedation medication. “As less medications are required, we have seen a 42% decrease in medication related incidents in 12 months,” Knight added. Furthermore, Orchard has seen a decline in safeguarding incidents because of a proactive approach in managing distressed responses. Word has spread following the success of the programme, with Orchard having been approached by several local authorities to provide training for other care providers. Going forward, Knight says Orchard plans to have a Reconnect Community in every care home over the next three to five years.
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support staff | care
Housekeeper of the month
In association with
The housekeeper plays an important role in maintaining the wellbeing of residents and staff. Continuing our new column sponsored by WASHCO, Deborah Warren, domestic assistant at Doddington Lodge care home in Shropshire, shares how she goes the extra mile How did you get into care housekeeping? By a twist of fate. For five years I worked in residential and mobile care for the elderly and people with special needs. For a further 15 years, I worked with children in schools with autism and challenging behaviour. When lockdown happened I became a carer for my mum in her independent living home. When lockdown finally ended, I applied for a job at Doddington Lodge as a carer, but because I had a lockdown dog with separation anxiety and could only work four hours a day, this wasn’t the job position for me. Then a job came up as a domestic assistant and the hours fitted me perfectly. I was very nervous because I hadn’t had experience in this field before. How do you meet the needs of residents? I realised that there were some residents whose clothes I wasn’t washing because they were not handing them over to the laundry trolleys. I wrote a questionnaire and explained to the residents that it was to see if there was anything that they needed from me working in the laundry. I found some residents were very anxious about their clothes being lost, or that they were embarrassed to hand over soiled underwear. I explained that I would put a bag in their room, collect that bag every morning and I would label, wash and bring their clothes back to them the same day, rather than having their clothes mixed with all the others on the laundry trolleys. Now I collect all the individual bags from those residents who are particularly anxious, and wash those first. I then go and collect the home’s laundry trollies. I put the clothing in the driers while the rest of the laundry is being done, iron them, and get them back to happy residents. No one is
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anxious about handing in their clothes anymore. What do you enjoy most about your job? All the residents are always so grateful and happy when they get their clothes back. It’s wonderful. It sounds like hard work but it’s not. What are the most challenging parts of being a care housekeeper? The most challenging part of my role is having days off ! I like to be there to make sure that the laundry is running smoothly, which it does because the care and domestic staff make sure that it is, to the best they can. What would surprise people about your job? At first my friends thought the job wouldn’t meet my need to engage and interact with other people, and I thought I would be stuck in a laundry room, washing, ironing and putting clothes in boxes. It has been far from that. Is there a time when you feel you have made a real difference? I constantly wonder how I can improve on what I can do. I am lucky enough to have built up relationships with the residents. I sit and listen to what is happening in their lives, and they ask me about mine. My son got married and they couldn’t wait to hear about it. Bringing the outside world into their lives is great for the wellbeing of us all. Residents with dementia recognise me as the wash lady, and some help me put towels and bedding away in the linen cupboard. It’s very rewarding to see the satisfaction of the residents helping others. What is special about the care home you work for? Teamwork. The domestic team, our amazing head leader, laundry, and
Deborah Warren
the cooks all talk to care staff, and we have very approachable managers and receptionist. Everyone has a role, and everyone is valued. What skills and talents do you need to be a great housekeeper? If you’re a person who likes people and has respect for others, then you are halfway there. You need to have patience with the fact that everyone is different and understand what is needed from you by the resident, that’s important. What would you say to people thinking about working in care housekeeping? I wish I had done it years ago. I’m proud that I work in a laundry because you are the person that gives people their identity. I was brought up by two deaf parents and my mum worked in a laundry for 20 years. When I told her that I had got a job in a care home laundry, I’d never seen her so happy and proud. She said to me “You can make a difference.” When my Nan was in care, she was always getting the wrong clothes delivered back after washing. Mum said to me “Your Nan never wore her own clothes – you make sure your residents do!"
NOVEMBER 2023 | 47
care | business & property Bedfordshire Name of property sold:
St Margaret’s
Location:
Bedford
Registration:
Closed vacant care home
Purchaser:
Magic Life
Seller:
Calsan Ltd
Price:
£1,500,000
Business transfer agent:
Christie & Co
Contact person:
Jordan Oborne – 07736 615 870
Cornwall Name of property sold:
Asheborough House
Location:
Saltash
Registration:
31 nursing
Purchaser:
Asheborough House Care Centre
Seller:
Sheval Ltd
Price:
£1,050,000
Business transfer agent:
Christie & Co
Contact person:
Simon Harvey 07764 241310
Somerset Name of property sold:
The Firs
Location:
Taunton
Registration:
40 nursing
Purchaser:
The Firs Care Centre Ltd
Seller:
Care West Country Ltd
Price:
£1,295,000
Business transfer agent:
Christie & Co
Contact person:
Simon Harvey – 07764 241310
IF YOU’RE THINKING OF SELLING YOUR CARE BUSINESS, SPEAK TO THE EXPERTS: Contact our award-winning team on: 0207 448 8826 | care@christie.com 48 | NOVEMBER 2023
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business & property | care Warwickshire Name of property sold:
Everycare Rugby
Location:
ugby
Registration:
Domiciliary care business
Purchaser:
Undisclosed
Seller:
Nick and Lisa Brooke
Price:
£120,000
Business transfer agent:
Christie & Co
Contact person:
Paul Reilly 0779 197 9041
West Midlands Name of property sold:
The Garth
Location:
West Bromwich
Registration:
33 nursing and residential
Purchaser:
Aman Sharna
Seller:
The Prior family
Price:
£2,500,000
Business transfer agent:
Christie & Co
Contact person:
Paul Reilly – 0779 197 9041
Worcestershire Name of property sold:
Chase Rest Home Ltd
Location:
Malvern
Registration:
41 residential
Purchaser:
Lee Cox Spring Care
Seller:
Anthony Reeley
Price:
£2,200,000
Business transfer agent:
Christie & Co
Contact person:
Paul Reilly – 07791 979 041
ww w.wa lto n h p c.co m
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en g l a n d & wa l e s : Paul Burford paul.burford@waltonhpc.com 01926 760 116 | 07808 764 748
S COT l a n d : Gary Walton gary.walton@waltonhpc.com 0141 279 1111 | 07554 009 244
NOVEMBER 2023 | 49
Credit: LNT Care Developments
OUT N O W
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FOR SALE
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Care Home, Sutton Coldfield
Former specialist care facility, Gloucester
Freehold £1,500,000
Freehold £1,750,000
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• 24 bedrooms over four floors
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• Potential to redevelop (STPP) 3470741
Nursing Home, West of Scotland
T: 07702 809 198
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6870580 T: 07701 315 068
Care Development Opportunity, Uttoxeter
Wren House Care Home, Warminster
Freehold £695,000
Freehold £1,185,000
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• Registered for 14
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5873252
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Nursing Home, Cornwall
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• Registered for 20
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• Detached & extended home
3270390 T: 07764 241 310
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