THE QUARTERLY MAGAZINE DEDICATED TO HOME CARE PROFESSIONALS
homecarefocus Ceretas, 21 Regent Street, Nottingham NG1 5BS. Tel: 0115 959 6130 Fax: 0115 959 6148 E-mail: info@ceretas.org.uk www.ceretas.org.uk
r te in ue WIss WINTER 2010
Power and Horizon Shift
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• Will we see a shift of power from Government to communities and people? • Will the Government’s vision for long term governance benefit social care?
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ALSO IN THIS ISSUE
• Page 6: Comprehensive • Think Local, Act Personal - • Page 32: Great Spending Review - the next steps for transforming British Care Awards impact for social care Adult Social Care - Page 9 - regional highlights
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inside THIS ISSUE
b The objectives and r But it also shows t
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The question i
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NEWS
SECTOR UPDATE
PEOPLE PROFILE
A quality team of
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BUSINESS
BRIEF
03 A Word from the Chair 31 Latest Business News
14 Keep Warm Keep Well 15 Good HR practice makes perfect! 04 Cover Story: How can providers support the DH in delivering integrated Health and Social Care Services? 06 Comprehenive Spending Review 07 Personal Budgets awarded to 1 million adults 07 Carers could earn ‘credits’ towards own future care 08 Ceretas response to LGA’s waring that cuts threaten home care for the vulnerables
16 Bribery Act 2010 what’s it got to do with me?
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CONFERENCES
We need to be challenging these preconceptions. Market conditions are
& EVENTS
It is a challenging environment: with immediate budgetary pressure, it is
17 The debate continues: Care Associations and Ceretas Corporate Members meet to discuss the issues face by our sector
25 Care to Talk?
18 Enabling risk, ensuring safety
25 Cityworx new appointment
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24 Up Close and Personal with Cheryl Baker
19 The CPBF overwhelmed by support 20 Calling excellent care workers to enter National Caring Competition
CERETAS REGIONAL 26 “Your Employees are your most valuable asset?”
32 2010 Regional Great British Care Awards
27 Eastern and Coastal Kent - Personal Health Budget Pilots
34 News on the Great British Home Care Awards finals 2011
20 Dates for your Diary!
09 Think Local, Act Personal 10 Sector News in Brief
28 Launch of Care at Home Study in Cardiff
12 Social Values in a Commercial World
21 Turning Point
13 Home care providers face human rights probe
contact
21 RBS Dinner
29 Nottinghamshire Multi Agency Mental Capacity Act Project
22 Standing up to the Authorities
30 The Challenges of providing live in care
Ceretas Administration Office 21 Regent Street So how can health and social c Nottingham NG1 5BS tel: 0115 959 6130 fax: 0115 959 6148 web: www.ceretas.org.uk e-mail: info@ceretas.org.uk
Like clinical triggers,
23 Social Care trigger points within the end of life care pathway
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NEWS
A word from the
Chair
At long last we now know the Government’s vision for adult social care; it embraces the 'p' principal of prevention, personalisation, partnership, plurality, protection, productivity and people. A summary of the vision and the timelines involved in the new regulatory framework to make it a reality are outlined for you in this edition. I hope you have all responded to the consultation document on how to put outcomes at the heart of social care its due imminently. Ceretas is currently chairing the Care Providers Alliance so it was great to sign up to and be involved in the launch of the new agreement to transform adult social care,Think Local, Act Personal. It was launched at the ADASS conference held in Manchester in November. It continues the work of the Putting People First programme when it ends in March. There is huge pressure on care organisations to reduce costs as well as cuts to care contracts and now VAT is back to its high level of 20%. One way to reduce costs of course is to share some back room costs e.g. HR, procurement, and payroll between agencies. I would be interested in hearing from anyone who has gone down this road so what and how it works and any lessons learned or not as the case may be. The reality check for all of us is that commissioners want more for less but when do we have the opportunity to influence. We all want to deliver a quality personalised care and support service and we could do a little more for a little less if we could sit down with our commissioning partners and strip out a lot of the bureaucracy. They cannot drive down costs any further if we are to realise on the personalisation agenda. Ceretas will continue to take this message to Government and Local Authorities until they listen, not to do so would be a betrayal of all those who need our support as well as our dedicated workforce who work tirelessly for small reward. As I write this, the snow is two feet deep in some parts of the country, blizzards and ice add to the problem, travel is disrupted but our care staff are still out there battling against the elements to support some of the most vulnerable people in their own homes. When will those who control the purse strings wake up and realise that without these dedicated staff there would be no service at all, personalisation or no personalisation.
MARY BRYCE, CHAIR,CERETAS
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Ceretas Home Care Focus
03
NEWS
How can providers support the DH in delivering integrated Health and Social Care Services?
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n 16th November future plans for adult social care services were published in A Vision for Adult Social Care: Capable Communities and Active Citizens. This is in addition to launching a consultation on a new strategic approach to quality and outcomes in adult social care – Transparency in outcomes: a framework for adult social care. The Vision is about making services more personalised, more preventative and more focused on delivering the best outcomes for those who use them. It encourages care and support to be delivered in a partnership between individuals, communities, the voluntary sector, the NHS and councils - including wider support services, such as housing. The vision sets out a new agenda for adult social care based on a power shift from the state to the citizen, by committing to: • Extend the rollout of personal budgets • Increase preventative action in local communities, • Keeping people independent and helping to build the Big Society • Break down barriers between health and social care funding • Encouraging care and support to be delivered in a partnership between individuals, communities, the voluntary sector, the NHS and councils - including wider support services, such as housing. Councils should provide personal budgets for everyone who is eligible by April 2013 and social care should help develop the Big Society, with more local preventative activity to support people’s independence. Information about care and support is available for all local people, regardless of whether or not they fund their own care. 04
Ceretas Home Care Focus
At the English Community Care Conference on 17th November, entitled ‘For Better or For Worse’ – Can Health and Social Care be Happily Married?’ keynote speaker David Behan told delegates about the Government’s vision to make two major shifts in the nation’s political and national life.
DAVID BEHAN SPEAKING AT THE ECCA CONFERENCE
David Behan opened his address with extracts from a letter on 3rd August 2010 to MPs from David Cameron and Nick Clegg. “Our government’s purpose is to make two major shifts in our political and national life. The first is a radical redistribution of power from government to communities and people, to reverse decades of over-centralisation. The second fundamental change is that this government will govern for the long term – taking the decisions necessary to equip Britain for long term success.” “Almost all our plans involve giving individuals, families and communities more control over their lives.” “The importance of this approach cannot be overstated.” “It underpins our attitude to public service reform.” “If we are true to this purpose then the people of this country will feel a new sense of power and responsibility in their daily lives.”
The White Paper: Liberating the NHS The big lesson, David Behan told delegates, is not to get disconnected from the purpose of Equity and Excellence. ‘Liberating the NHS’ he said, describes a system where, patients are at the heart of everything the NHS does. Healthcare outcomes in England are among the best in the world and clinicians are empowered to deliver results. According to David Behan, the White Paper proposes: • A GP Consortia with responsibility for commissioning local services. • An autonomous NHS Commissioning Board with responsibility for commissioning other services such as primary medical services, dentistry and community pharmacy.
NEWS • A new role for local authorities; to support local strategies for NHS commissioning and integration of NHS, social care, and public health services • All NHS Trusts will become foundation trusts , or be part of an Foundation Trust; with staff having a greater say in how organisations are run.
A Bigger Role for Government Within this new system, David Behan told delegates, local councils would have an enhanced role in health, leading joint strategic needs assessments (JSNA) to ensure coherent and co-ordinated commissioning strategies. Supporting local voice, and the exercise of patient choice, through local HealthWatch would also be a key focus as is promoting joined up commissioning of local NHS services, social care and health improvement. Finally a role in leading on local health improvement and prevention activity is crucial. What the NHS and Local Government share is a vision to dramatically improve the quality of people’s lives, and to address people’s health inequalities. There is also a bigger role for Government in the form of Health and Well Being Boards. These Boards would bring together elected councillors, patient representatives through HealthWatch, NHS commissioners, public health, social care and Children’s services. The statutory framework would be minimal, leaving maximum room for local innovation.
Public Health The vision for public health is in the early stages, David Behan told us, but what he confirmed so far is: • Directors of Public Health (DsPH) will be jointly appointed by the Public Health Service and Local Councils. They will be employed by the Council; • Councils, through DsPH will lead on health improvement for their area and will have use of a ring-fenced budget; • The first allocations to Councils will be in 2013/14 with shadow allocations set out in 12/13; • The Secretary of State will establish an outcomes framework for the Public Health Service; • Councils will be entirely free to define their own contribution to national outcomes; • The Public Health Service will need to work closely with the NHS to deliver public health interventions and to promote uptake of prevention opportunities in clinical practice. The release of the White Paper later this year is likely to include consultation on outcomes and the scope of the Public Health Service.
Social Care the Work Programme The Government plans to publish its vision for adult social care in Autumn 2010. It will set the context for the future direction of social care, setting out the key principles to guide: • The work of the Commission on funding of care and support • The Law Commission’s work on reforming the legal framework • The Social Care White Paper is due to be published in 2011 • The legislation to establish a modern and financially sustainable framework These will focus around personalisation, prevention, plurality, productivity, partnership, protection and people. Alongside the vision, the sector intends to publish a Partnership Agreement on concrete steps to be taken now to take forward transformation. The Carers Strategy is also been refreshed and is intended to be published in the Autumn.
Partnership Working David Behan informed delegates that although there are a a number of examples of integrated working, there is no systematic assessment of what works. However, he said that we could draw some emerging key themes from successful integrated working: • The patient/user must be at the centre of care services, with a unified understanding of the care pathway. This needs to take into account more than just health and social care.
• personalities and relationships are key to success; • no single method or structure, although bottom-up initiatives seem to have greater success; A very strong message coming back is that approach to the transition to the new system needs to be co-produced with Local Government at national, regional and local level. Messages that have been heard include • Importance of knowledge sharing and transfer; to ensure current expertise in system isn’t lost and enable local areas to pick from what others are doing and share learning in real time. • Local Government and the NHS need to be committed to understanding better their different language and culture. • Leadership and behaviours will make this work, not structures. • Importance of getting message about new strategic role for Local Government out there • There is a great deal of interest from Local Government in offering practical support services / commissioning support to GPs • Resources and HR will be key to making this work Older people are the biggest users of health and social care and joint working has potential for efficiencies. Joined-up, personalised care delivers better outcomes for older people and their carers. The Coalition are committed to breaking down the barriers between health and social care. Prevention for older people can improve quality of life and allow people to live independently for longer. There is the opportunity to deliver real change, improve outcomes for older people and their carers and realise vital efficiency savings. David Behan concluded, that the Government’s vision demonstrates the Government’s values of freedom, fairness and responsibility, shifting power from central to local, from state to citizen, from provider to people who use services.
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Ceretas Home Care Focus
05
NEWS
Comprehensive
Spending Review The Impact for Social Care The coalition government set out its spending plans for 2011-2015 in its Spending Review on 20 October. It was announced that the health budget will increase over the course of parliament. However, an increase of 0.1 per cent a year in real terms is unlikely to keep pace with demand for services and cost pressures. At the same time it was revealed that social care will receive an extra £2 billion a year by 2014-15, with £1 billion of this being provided by the NHS.
Impact on social care Central government funding to local councils is reported to be cut by as much as 25% in the Comprehensive Spending Review. Past experience suggests that this could translate into reductions in the provision of social care. Further cuts to social care budgets will mean people who are unwell, recovering from surgery or dealing with long term conditions will struggle to get the care in the community they need. We also expect to see a reduction of the amount of preventative work that can be done to help people stay as independent as possible, for as long as possible. If the needs of these vulnerable people and their families are not met by social care, people will turn to the NHS. Some will present as emergencies in A&E departments and GP surgeries, others will find themselves trapped in hospital unable to get home, blocking the bed from someone else who badly needs it. The cost pressures on the health budget and the social care budget cannot be seen in isolation from each other.
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Ceretas Home Care Focus
Tackling the social care challenge Whether in the form of unplanned care or preventative work, health budgets will inevitably be spent on social care. This may be appropriate in some cases but careful thought needs to be given at a local level on how health and social care resources can be best utilised. This cost will only increase as a result of a population and the corresponding increase of patients with complex long-term conditions and multiple conditions. Strong local partnerships between health and social care bodies will be vital in tackling this issue. Work to reduce the burden of bureaucracy may be necessary to enable pooling of budgets to become widespread. The existence of shared, flexible and personalised health and social care packages will also be crucial. At present these are available to relatively few of those who would benefit. A greater focus on prevention continues to be essential. As such, it appears positive that the government’s recent announcement that £70 million would be invested in reablement services, designed to support people who are leaving hospital, in settling back in at home and retaining their independence for as long as possible. A robust and sustainable settlement for social care is urgently needed if the NHS is going to find the savings needed. We need to see a sustainable and universal social care system that gives people the reassurance of security in their old age and the NHS capacity to work with local government and plan care for patients through their whole care pathway. It is recognised that a long term solution is unlikely to happen until we are well into this parliament. There is therefore a strong case for an interim solution. Local and central government need to urgently work together to consider how we can all mitigate the impact of this spending squeeze on some of the most vulnerable people in society.
Source: NHS Confederation
NEWS
Personal Budgets Awarded to 1 Million Adults On the 17th November it was announced that up to a million elderly and disabled people are to be put in charge of choosing their own social care. Personal budgets are to be awarded to all those entitled to support by 2013 Liberal Democrat MP and Care Services Minister Paul Burstow said. The announcement which is part of the Government’s overall vision for social care will allow people who receive social care provision from their local authority to decide for themselves how to spend the money they are entitled to. The amounts involved range from a few hundred pounds to tens of thousands of pounds.
Carers could earn 'credits' towards own future care
While the idea was introduced in 1996, only about 250,000 of the one million people eligible currently have them. Mr Burstow said, "Personal budgets can make an incredible difference to people's lives. They give people choice, control and independence," "They look to people, not the state, to shape services, and improve outcomes, making a reality of the Big Society. I want councils to provide everyone eligible with a personal budget by 2013." Mr Burstow also announced that the Government was to spend £400 million over the next four years to pay for carers to take breaks which is a key Lib Dem manifesto pledge and will be regarded as a victory for their preelection campaign.
The government is considering bringing in a care credit scheme where people who volunteer to help the elderly or disabled can bank credits for their own care later in life, it emerged recently. The Government is examining whether a form of the care credit system, which successfully operates in Japan, could also work in the UK. Care Services Minister Paul Burstow, told the BBC is was a way to "enable communities to take social care responsibilities
on for themselves". "What they do in Japan is effectively a way of people sharing their time and giving of their time to make a difference for people in different parts of the country," he said. "We have some of those schemes here in the UK such as time banks, and what we are doing is making sure we take some of those lessons learnt in Japan and transfer them to our own domestic circumstances." In Japan, a system called Hureai Kippu - literally translated as "Caring Relationship Tickets" - was established in 1991. It has since been expanding as a way of helping to manage the country's increasing elderly population. • Different kinds of tasks earn different amounts of credits. • More credit is given for helping at anti-social hours or with personal body care, while household chores and shopping earn less. • The credits are available to the volunteers themselves later in life, or to someone else they choose, either in or outside their family. • Voluntary groups warned that carers must be properly trained and that access to proper care is a right for all elderly people. • The Government is due to outline details of care service reforms in a upcoming public health White Paper.
Ceretas Home Care Focus
07
NEWS
Our response to LGA’s warning that cuts threaten home care for the vulnerable “These are challenging times and despite the extra significant investment in Social Care, overall cuts in Council budgets will impact on services”, says Ceretas In response to a statement from the Local Government Association that "Virtually all" councils in England and Wales could be forced to end home help for elderly and disabled people, Ceretas has warned that “we must recognise the importance of private sector investment to develop their services to meet the Personalisation Agenda” The LGA, which represents 422 authorities, has warned MPs that budget cuts may result in services being restricted to those with "critical" needs. In a statement recently, Mary Bryce, Chair of Ceretas said, “We must recognise the importance of private sector investment to develop the services to meet the Personalisation Agenda. “Partnership working with Providers to understand the financial efficiencies required to ensure business viability and continuation of quality services, is more important than ever at this significant time. “The difficulties will not be solved by Councils making small reductions around services and/or just changing eligibility criteria. Both local and national Government needs to recognise the professionals and the dedication of those working in the sector. They need to engage with all providers of the service to find the solutions; essentially, “The Home Care service needs to work more closely at the interface with Health and be recognised as not ‘merely a home help’. “Stopping the duplication of contract monitoring, regulation and inspection between local authorities and the Care Quality Commission but maintaining the focus on quality by ensuring that the Commission develop
and continue to use the rating system, that has been acknowledged and used by the sector over the last two years. “Allowing front line staff to become professionals again and move away from the culture of minute by minute billing. “Using front line staff and the expertise of providers more widely in the assessment and monitoring of care “To rapidly outsource the remaining in house provision (20% +) and therefore save significant millions “To ring fence the monies allocated in the NHS for social care and ensure the money is supplementary to existing funds - not replacement monies. “Despite the agenda for keeping people at home longer we are faced on an almost daily basis with authorities imposing a limit on the amount they will pay for domiciliary care. We must look more intelligently at efficiency savings which can be made in partnership working to deliver public services and processes more cost effectively by utilising the expertise of the private sector. “This efficiency saving agenda can only encourage councils to become pre-occupied with budgets instead of focusing on better partnership working to promote outcomes and future efficiencies. In many cases this can lead to some excellent providers not completing tenders because they are unviable due to the maximum figure they expect to pay. “More assessment and monitoring of individual care packages could be devolved to providers, leading to far more proactive and reactive ways in which care can be provided. This will ensure that services are delivered to those of the greatest need and not to those who do not.”
This statement was released at the recent ADASS conference at which Ceretas had a joint stand with the Great British Care Awards and the English Community Care Association. 08
Ceretas Home Care Focus
NEWS
Think Local, Act Personal Next Steps for Transforming Adult Social Care 1. Introduction
“The Spending Review has given social care a strong base. The settlement shows our determination to protect hundreds of thousands of vulnerable adults and families by investing an additional £2 billion each year by 2014. It will ensure we can meet the needs of an ageing population all those in need of services and protect access to vital care and support. But this does not mean business as usual. The sector must step up the pace of reform. There needs to be a focus on increased productivity, more innovation and greater personalisation so people have more choice and control. Think Local, Act Personal brings together 21 leading organisations across health and social care to support this move to more personalised andintegrated services.Think Local, Act Personal shows how much we have done together already in achieving this, but also how far we still have to go. I am happy to commend it to local government and our wider partners.” Care Services Minister Paul Burstow To download a copy of the full agreement in full visit www.ceretas.org.uk
The Government’s Vision for 21st Century Adult Social Care: Everyone’s Responsibility and its White Paper, Equity and Excellence: Liberating the NHS, maintain the drive towards the personalisation of public services in health, social care and beyond. The key delivery partners across the sector share this ambition, alongside those who use social care support, their families and carers, and the paid staff vital to delivering it. This Partnership Agreement represents a joint commitment to go forward together. The delivery of Putting People First, whilst widely supported, has required major change from providers and councils. The scale and complexity of those changes has inevitably led to uneven progress across the country. Most areas have, however, taken significant steps in redesigning systems and models of care and support, and we intend to build strongly on progress to date. This agreement draws on learning from implementing Putting People First across England over the past three years and focuses on areas where further action is required. The agreement: • Underlines the necessary connection between preventative, community-based approaches and personalised care and support. • Provides a general framework for action; supported in the next few months by examples to assist partners in benchmarking progress, and by co-designed tools to aid delivery.
2. A personalised, communitybased approach for everyone Personalisation and community are the key building blocks of a reform agenda, shaping around an individual’s own expertise and resources. When people need ongoing support, this should help them to retain or regain the benefits of community membership including living in their own homes, maintaining or gaining employment and making a positive contribution to the communities they live in.
3. A Framework for Action Care providers, councils and their partners will work to further develop and deliver a
personalised, community-based care and support system with a focus upon effective prevention and the shifting of resources from crisis and acute interventions. Transformation will take time, but a strong basis has been established over the past three years. This now needs to be firmly consolidated.
3.1 A community-based approach for everyone Joint Strategic Needs Assessments (JSNAs) and Community Budgets can be used to identify the needs of local communities and utilise all available resources. Commissioners across all public services will increasingly focus on people within their ‘natural’ communities, rather than service and organisational boundaries. The financial and productivity challenge will require integrated working between councils, public health bodies and emerging GP consortia to identify and meet local health and social care needs efficiently, using existing mechanisms and the new public health structures.
3.2 Personalisation In parts of the country, people eligible for ongoing funding from the council may comprise only a minority of those using care and support services. A whole community approach is therefore essential to help all people exercise choice and control. However, those who are eligible for ongoing council support, will receive this by way of a personal budget, with direct payments as the preferred delivery model for most. Successful personalisation of social care will require increasingly efficient delivery, with further attention to important elements of council operating systems, and a strong focus on workforce development.
4. Measuring and supporting progress To help deliver the next steps in this agenda, the sector will develop a new set of benchmarks so local partners can check progress. There will also be a supportive tool providing links to a range of materials to aid delivery, based on the best practice from implementation to date. Councils and their partners can use these benchmarks with effect from 1 April 2011. Ceretas Home Care Focus
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Sector News in Brief
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Ceretas Home Care Focus
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sectornews NEWS
Government pledges to reduce use of antipsychotic drugs in people with dementia
The Government has pledged to reduce by two-thirds the use of antipsychotic drugs in people with dementia by November 2011. Paul Burstow, Care Services Minister, announced that the Government will produce a plan on dementia research next year. The interim chief of executive of the Alzheimerâ&#x20AC;&#x2122;s Society said â&#x20AC;&#x153;nearly 150,000 people with dementia are currently having their lives put at risk because of dangerous antipsychotic medication. A largescale reduction in the scandalous levels of inappropriate prescription cannot come soon enough and we are delighted to see the government back up its previous assurances by setting a firm deadline.â&#x20AC;? The National Dementia Declaration, drawn up by the newly-formed Dementia Action Alliance, was also launched It is estimated that a million people will have dementia within 15 years, rising to 1.7 million by 2051 as the population ages.
A consultation on proposals - Transparency in outcomes: a framework for adult social care Alongside the Social Care Vision, the Department of Health has launched Transparency in Outcomes: a framework for adult social care - a consultation on a new strategic approach to quality and outcomes in adult social care. The consultation envisages an enabling framework which
places outcomes at the heart of social care, improves quality in services, and empowers citizens to hold their councils to account for the services they provide. The next stage will be coproduced with partners, based on responses to this consultation.
For information on how to respond to this consultation or to download the Impact to Assessment pdf files visit www.dh.gov.uk/en/Consultati ons/Liveconsultations/DH_ 121509
Longer Living Survey Highlights Fears for the Elderly Some councils in England fear budget pressures will hit care services which help elderly and vulnerable adults live at home, a BBC survey has found. Out of 87 English councils surveyed, 46 said they were concerned about funding for services. They said many aimed at preventing or delaying people developing more dependent care needs could be affected. Charities urged councils to continue to prioritise social care spending. The Association of Directors of Adult Social Services warned there would be "tough decisions" to make. A total of 58% of England's councils responded to the survey, conducted as part of BBC English Region's Living Longer project which looks at how areas of England will be affected by the ageing population. Almost all councils - 86 out of 87 - said they were already investing in intervention services such as reablement, the intensive temporary care in the home to help people regain their independence.
But 46 said they feared budget pressures next year and beyond will impact upon these services. A spokesman for the charity Carers UK said: "It is absolutely vital that local councils continue to prioritise spending on social care. "Unless they do, the dignity and independence of older and disabled people will be undermined and more families will be forced out of work and pushed to breaking point in order to care for them."
Director appointed to run new campaign to end loneliness Four organisations are working together on a new Campaign to End Loneliness and create connections in older age. Age UK Oxfordshire, Counsel and Care, Independent Age and WRVS are founder members of the campaign which has been initially funded by the Calouste Gulbenkian Foundation. The campaign will work with many other organisations to provide solutions to this pressing problem at a time when our population is ageing and funding cuts will impact on the lives of older people. In October the founder members appointed Laura Ferguson as the Director of The Campaign. Laura joins after 5 years managing a range of development projects at Volunteering England. The Campaign to End Loneliness will raise awareness of the problems caused by loneliness and why they matter; promote what works in reducing loneliness in older age; identify gaps for further action; create a vision of a society where loneliness in older age is ended and identify what we all can do to future-proof our lives against it.
or news NEWS
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CQC assessment of council adult social services
On 25 November the Care Quality Commission published the results of the latest Annual Performance Assessment of councils responsible for adult social care services. The findings show that councils continued to commission a high standard of adult social care throughout 2009/10. • 95% (145) of all 152 councils were assessed as performing well or excellently. • The seven remaining councils were assessed as performing adequately, and must improve. • For the seventh year running, no councils were rated poor. • Joint commissioning and monitoring of services were more common, and this was a key strength in half of all councils. • Areas such as dignity and respect, choice and control, and emotional health and wellbeing continued to improve. Paul Burstow, Minister of State for Care Services, recently announced that they will no longer conduct an annual performance assessment of councils under the existing framework. CQC are currently working with various organisations to design a new system. To download an overview of the assessment visit http://www.cqc.org.uk/pub lications.cfm?fde_id=16504
Sector News in Brief
CSJ publishes report on Older Age
On 23 November the Center for Social Justice published "The Forgotten Age: Understanding Poverty and Social Exclusion in Later Life" An Interim Report from the CSJ Older Age Working Group. The report broadens the debate on Older Age, outlining how loneliness, isolation and social breakdown have fuelled poverty in later life for millions of Britain’s pensioners for too long. Although the majority of older people maintain healthy relationships and vibrant social networks, there is a group who experience persistent loneliness, isolation and severe social exclusion. The tragedy of loneliness in older age is often triggered by the death of a spouse or by the common experience of being alone in later life. The report highlights the isolation and loneliness faced by an increasing amount of older people in Britain and calls for prevention and early detection of loneliness as an essential part of policy development to help older people. To download the report visit www.centreforsocial stice.org.uk//default.asp? pageRef=38&newsID=207
Counsel and Care welcomes new Chief Executive to lead the cause of better care and support for older people
Counsel and Care, the national charity working with older people, their families and carers to get the best care and support, announces today (12 November) the appointment of its new Chief Executive, Peter Watt. Peter joins Counsel and Care from The Campaign Company, where he has been Chief Executive for two years. Prior to this, he was General Secretary of the Labour Party. Peter also brings hands on experience from his former career as a Registered General Nurse specialising in acute medicine for older people. He replaces Stephen Burke, who led the charity for almost six years. Peter Watt said: “I am very pleased indeed to be joining Counsel and Care. The changing nature of the provision of care for older people makes this a challenging and exciting time to be joining the team. I know that over the coming years we can build on Stephen’s achievements by continuing to provide quality advice and support to older people, their families and carers. In fact as the shape of care provision changes the demand for our service can only increase.”
Skills for Care publish new CPD guide for adult social care workers
Skills for Care has published a new easy to use guide to support continuing professional development (CPD) of more than 1.6 million workers in adult social care. Keeping Up The Good Work gives practical help to employers of all sizes, including people who directly employ their own care workers, on how to develop their staff’s knowledge and skills to meet the challenges ahead for the sector. For more information visit www.skillsforcare .org.uk/developing_skills/
Homecare Re-ablement Toolkit The Department of Health’s Care Services Efficiency Delivery has put together this toolkit to help councils looking to introduce a new homecare reablement service or extend or improve an existing service. It has been developed as a practical project support to councils and builds on extensive work done by CSED in: •
compiling a body of evidence on how homecare reablement services are helping to appropriately reduce the level of ongoing homecare support required
•
working actively with councils to identify successful approaches, learning points and best practice
For more information visit: www.csed.dh.gov.uk/ homeCareReablement/ Toolkit/
Ceretas Home Care Focus
11
NEWS
Social Values in a Commercial
And rightly so: by
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World
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The question
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BY PUSHPA RAGUVARAN CHIEF EXECUTIVE HOUSING21
Of course, acquiring new skill sets can be a major outcome of the acquisition.
H
One year post acquisition, Housing 21 is looking to the future ousing 21’s acquisition of Claimar Care with ‘social values in a commercial world’. It is a challenging last year was celebrated as the first environment: budgetaryprocess pressure, itpresents is vital that home The speedwith of immediate the acquisition acquisition of a listed company by a notcare providers and commissioners maintain a long term view of care c for-profit organisation. And rightly so: by being bold provision. We are already seeing cuts to services for people with and innovative, we have taken a huge step forward substantial needs – the danger is that this creates an explosion of and are now positioned to offer many more more expensive hospital and residential care in the future. Innovation, quality and economies of scale are key to meeting this challenge. services to many more people. The objectives We need to be challenging In these preconceptions. Market conditions are the cost vs quality debate, commissioners are prioritising the and rationalet were clear for us: with looming r achieving volume is key to staying former. Doing the same or more for less is now essential; doing less spending cuts, for much less is a very real prospect in some areas. This creates competitive. But it also shows that the corporate challenges for providers lacking economies of scale and we will see entity - charity, RSL, non-profit etc- need not greater consolidation of what remains a highly fragmented market. limit an organisation’s ambition. The question Organisations that manage to preserve their reputations for quality It is a challenging environment: with immediate budgetary it is isn’t ‘what type of organisation are you?’ but while remaining competitive will exercise growing pressure, influence. v ‘do you have the right attitude?’ Increasing alignment of Health and Social Care opens new
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Part of this is about skill sets; is there the tactical awareness and commercial focus for the organisation to position itself against competitors? A quality team of financial, legal and communications expertise needs to be assembled to help navigate the organisation through the commercial and regulatory concerns of a listed takeover. Of course, acquiring new skill sets can be a major outcome of the acquisition. There is also a balance to be struck between an empowered project team that can deliver, and effective governance at Board level. The speed of the acquisition process presents challenges for any organisation not used to working in these conditions, but clear lines of delegation enable swift decision making. There is a certain perception that non-profit organisations can not or should not participate in the M&A world. We need to be challenging these preconceptions. Market conditions are right for further consolidation and not-for-profits shouldn’t be ruling out these opportunities if they fully align with strategic goals. 12
Ceretas Home Care Focus
opportunities for organisations that can work across a broader spectrum of acuity. The NHS spends almost as much on home care as Local Authorities do; providers that can build links with a wider range of professionals will be best placed to win contracts and offer the holistic services that people want. Innovation is also becoming a key differentiator between providers. Preventative services to reduce hospital admissions are gaining acceptance but demonstrating the value is essential. Re-ablement services are showing that investment up front can reap huge benefits for service users and the public purse. Telecare can deliver real savings in a safe and sustainable way for many people if providers can evidence the value robustly. But beyond contracted provision, the current environment presents opportunities to develop direct relationships with service users. As significant levels of need stop being provided for by the state, gaps open up for providers who can engage with people directly to offer flexible and responsive services entirely built around what people want – very much the vision of Housing 21.
NEWS
Home care providers face human rights probe
A
n investigation starts today into the protection of human rights of people receiving home care. The Equality and Human Rights Commission will consider whether adequate safeguards are in place and whether reform is needed.
The roles of the Care Quality Commission, providers and commissioners in guaranteeing that human rights are protected will be assessed. The EHRC hopes its findings will inform the practice of councils, providers and the CQC as well as influence the Commission on Long-term Care Funding, which is due to report next summer.
"By highlighting deficiencies in the present system, as well as learning from examples of good practice, the commission's inquiry
will ensure that the legal and regulatory framework in which home care providers operate, protects and promotes the human rights of older people, preventing abuses and transforming the way that social care is delivered in England," said EHRC commissioner Sally Greengross. The United Kingdom Homecare Association, which represents homecare providers, said it would help with the inquiry. However, it pointed to regulations which already govern provision which, it said, are underpinned by human rights principles.
"We are particularly pleased that EHRC will include in its inquiry how the human rights of service users directly employing personal assistants will be safeguarded because these services fall outside the legislation that applies to regulated providers," said UKHCA chief executive Bridget Warr.
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13
SECTOR UPDATE
Keep Warm Keep Well The Government has launched its annual Keep Warm Keep Well Campaign for 2010/11.The government's advice on staying warm over the winter aims to reduce cold-related illness and deaths.
For more information visit
Top Tip 1
Top Tip 2
Top Tip 3
FIND OUT MORE
KEEP WARM
KEEP YOUR HOME WARM
EAT WELL
• Wear several thin layers of clothes rather than one thick layer
• Fit draught proofing to help seal gaps around windows and doors
• Choose clothes made with wool, cotton or fleecy materials
• Aim to have at least one hot meal a day and have hot drinks regularly through the day
• Ensure your hot water cylinder and pipes are lagged, including pipes in the loft
• In the coldest weather wear bed socks and a hat, as well as thermal nightwear
• Lay insulation in the loft to reduce heat loss
• Check your heating system is working properly and serviced at least once a year • Make sure you know how to set the heating controls
• Have a hot drink before bedtime • Prepare a thermos flask of a hot drink to have by your bed in case you feel cold in the night
http://www.dh.gov.uk/en/About us/Campaigns/DH_121156
The Keep warm Keep well booklets contain useful tips on heating and preparing for winter, financial support and staying healthy during winter.they are available from GP practices, pharmacies, nhs walk-in centres, hospitals, care homes, benefit offices and voluntary organisations.
NHS DIRECT Visit the nhs direct website (www.nhsdirect.nhs.uk) for additional advice on keeping warm in cold conditions.
We lead. Others only follow. 28 years of service to the care industry. Call us on 020 0 8336 0099 or visit our webs website ite www www.carehome-insurance.co.uk .careho ome-insurance.co.uk o.uk Towergate T owergate Patrick is a trading name nam me of T Towergate owergate Underwriting Group Group Limited. Limited. Register Office: T Towergate owergate House, House, Eclipse Park, Sittingbourne Sittingbourne Road, Maidstone Maidsttone ME14 3EN. Registered Register ed in England no. 4043759. 404375 59. Authorised and regulated regulated by the Financial Finan ncial Services Authority. Authority.
14
Ceretas Home Care Focus
Good HR practice makes perfect! T
rends, KPIs and good statistics don’t lie. Good care providers who monitor their HR performance undoubtedly have the edge over those who do not. A well recruited, trained, motivated and engaged workforce can do incredible things in the home care sector but exactly how is that achieved? After 11 years as a home care provider and now with more than 600 employees, Springfield Homecare, a Yorkshire and Humberside based company, believes the answer is in promoting good HR and its role in delivering tangible results. This focus on HR and its elevation to most important company function has paid off for Springfield with the company reporting an unbelievably low staff turnover of only 11%, less than half the national average, whilst growing organically at rates in excess of 25% per annum for the past three years.
Three years ago Springfield had staff turnover in excess of 54%, significantly worse than the national average. It identified that 76% of all new starters left in the first three months of employment with a staggering 50% of those falling within the first two weeks. The company set about changing these statistics with staggering results. The company channelled its HR efforts into four main areas with a strong focus on each of the following activities;
1. Pre-employment • Display advertising ensuring that the employer looks more professional than its competitors’ one line entries. • Quality job descriptions and person specifications that enable prospects to understand whether the role is right for them from the start. • Interview skills training for all staff expected to interview new candidates. • Assessment centre style interviewing is utilised where large numbers of recruits are required to ensure consistency in approach. • All the usual pre-employment checks are in place but references are rigorously followed up to ensure that good people are selected in the first instance not just “anyone with a pulse”. • A 6-8 week Induction Plan is created and given to each new employee • Personality profiling / aptitude testing / presentations are expected of new recruits for all senior management positions. 2. Induction, training and shadowing • Induction and mandatory training is spread over 4 weeks and delivered by highly competent trainers. Trainers feedback at this stage whether they think carers will actually make it into the community. • New recruits shadow key workers in the community who are responsible for mentoring them for their first few weeks of employment. • Shadowing in the community for 2-4 weeks depending upon experience, competency and readiness of the individual to work alone. • Once a new recruit is ready they have to be signed off as competent by a key worker. Further shadowing or sign off is determined at this point. 3. The first 3 months in the community • Hours and welfare telephone checks are completed weekly for the first 3 months to ensure that carers are getting the hours they stated that they were available for at interview. Often carers leave at this point because they don’t want to cause trouble by raising issues. We estimate this saves us 25 carers per annum. Catching carers coming out of training sessions or utilising feedback from trainers can often save potential leavers too. • Changes to availability must be done by carers in writing with four weeks notice • Further Competency Checks / 1-2-1s /
•
• •
•
Supervisions / Spot checks are completed to check suitability to the role Rostering for that new starter is done to match carer availability and preferred geographic area of working Any further training needs are identified by a carer’s supervisor Where specific training is required supervisors may organise the use of community / district nurses to assist with stoma / catheter care for example until company training courses are organised All Absence and Sickness is recorded and strictly managed in accordance with the Company’s policy and often used to identify issues early with unhappy staff. This is the early warning signal that things may not be quite right.
4. Beyond the first 3 months • Good quality HR stats are produced weekly detailing capacity, split of full-time / part-time workers, applications posted out, interviews booked and completed, jobs offered, number of leavers, exit interviews and return to work meetings completed. Quarterly moving average statistics are generated detailing staff turnover and workforce stability i.e. those employed over 12 months. • HR files are kept up to date and a care management system used to log all carer issues / exclusions from clients’ homes. • More than two exclusions from clients’ homes for reasons other than gender are fully investigated with the carer • Communication is championed with morning huddles for the care team, monthly meetings for care staff and supervisors, weekly memo’s and quarterly newsletters often containing further training information perhaps on palliative care or from the stroke association • Open door policy and whistle blowing is promoted to highlight poor performers or issues management may be unaware of. • Recognition is always given for great work – thank you is often enough • All poor performers are supported to improve or managed out which the remaining staff respect • Recommend a friend bonuses paid to existing staff for introducing a new carer to the business. This gained us 35 new starters in the last 12 months. • Ongoing personal development and training demonstrates commitment to carers as well as increasing skill levels.
This intensity of HR involvement has driven a new culture through Springfield. From a standing start it has taken two years to feel the difference in the organisation’s culture. And whilst HR may feel like an expensive pass time initially, compare the cost of recruiting to replace a further 40% of staff turnover per annum like we were three years ago and most other domiciliary care agencies are doing now.The company currently has its sights set on a staff turnover in single figures and believes that this is totally achievable with consistent and good HR practice. Ceretas Home Care Focus
15
SECTOR UPDATE
Bribery Act 2010
what’s it got to do with me?
T
he Bribery Act 2010 was introduced to strengthen the existing bribery and corruption laws in the UK. When it comes into force in April 2011, the new act will have implications for all businesses, as it is significantly wider than the current law. The effect of the new Act is to create: • two new general offences of bribing a person and being bribed; • two further new offences of bribing a foreign public official and (for commercial organisations only) of failing to prevent bribery; • penalties of up to 10 years’ imprisonment for individuals and/or unlimited fines; and • unlimited fines for corporate entities for failure to prevent bribery.
The first two offences will replace the current common law offence of bribery. The offences may apply where an advantage is “improperly” offered or accepted in connection with the performance of a business activity. The concept of “improper” will be judged against the reasonable expectation that the activity would be performed in good faith or impartially. So for example A, a local authority employee, invites tenders for a home care contract, but makes it clear to B privately that he will look favourably upon B’s bid if he is rewarded personally. The advantage does not have to be monetary so, for example B offers A tickets to the World Cup final if A looks favourably on his contract bid. Lavish corporate hospitality could be problematic under the new law. The offence of failing to prevent bribery is a strict liability offence, which can apply if any person associated with the organisation is guilty of bribery. There is no need to prove negligence or knowledge on the part of the organisation, which makes the offence easier to prove and may lead to more corporate prosecutions and convictions. Organisations can defend themselves against the offence by demonstrating that they had “adequate procedures” in place to prevent acts of bribery from taking place. However, there is no definition of adequacy and the procedures required will vary significantly according to the size of the organisation, the market sector and territory in which it operates, and accordingly the risks faced. Draft guidance has recently been published by the UK government, which sets out 6 principles which organisations should follow: regular assessment of risk, commitment to preventing bribery from top level management, establishing due diligence procedures which cover all business partners, clear and accessible policies and procedures, effective implementation of policies and procedures, and setting up monitoring and review mechanisms to ensure compliance. It is essential that organisations take active steps to eradicate bribery and corruption, not only because it is good commercial practice and demonstrates effective corporate governance but also due to potential criminal liability under the Act. Required changes may take some time to implement as, in addition to training, changes to organisational culture may also be required. Organisations therefore need to start work now.
Freeth Cartwright will be running a series of seminars on the new bribery legislation in November. For further details please contact Caroline Williams on 0845 274 6927 or e-mail caroline.williams@freethcartwright.co.uk Whilst every effort has been made to ensure the accuracy of this review, it does not provide complete coverage of the subjects referred to, and it is not a substitute for professional legal advice and should not be relied upon as such.
16
Ceretas Home Care Focus
SECTOR UPDATE
the debate continues... Care Associations and Ceretas Corporate Members meet to discuss the issues faced by our sector The second of the Ceretas networking events, to bring together the Care Associations across the Country along with Ceretas Corporate members, was successfully held on 12th October 2010. This time it was the prestigious Westminster Marriott Hotel, sitting appropriately across the river from our first venue location,The House of Commons, at which the superb lunch, followed by a lively discussion, sponsored by Care Insurance specialists Towergate Patrick, took place.
JEFF JEROME
Jeff Jerome, The National Director of Social Care Transformation, along with Alan Rosenbach of The Care Quality Commission were invited on this occasion by Ceretas to discuss and further debate the future of social care in light of the Coalition Government’s forthcoming comprehensive spending review announcement.
Jeff Jerome confirmed that the Government are still committed to Personal Budgets for all people in receipt of Social Care funding and the law says that recipients must receive a ‘reasonable amount’. He confirmed that the implementation process, as well as the links between Health and Social Care are now speeding up. Local Authorities will need to focus on arrangements for people to take their budgets, along with advice for better use of their money. Organisations should also be looking at managing services and how to advise people on the best use of their money. There needs to be a balance on individual allowances and contracted/ managed services. Local Authorities will then be in a position to concentrate on safeguarding and high quality service delivery and may not need to have further involvement, we may see more and more people taking the cash and the Local Authority withdrawing. Jeff Jerome felt that, at present, there are too many rules around the giving of money and the process is too beaurocratic. He confirmed that the Social care vision of Personal Budgets for all by March 2013, currently the figure is believed to be 30%. Jeff Jerome then took part in a lively, general debate which revealed that Direct Payments should be based on a very local economy, that the ‘allocation system’ means that individuals will still be means tested, safeguarding will be a high priority and not connected with Personal Budgets, and that more and more private money will come into the system therefore individuals will choose if they have a regulated or unregulated service.
He also believes there must be a whole ‘community approach’ which was not just connected to personalisation. Alan Rosenbach explained that there are 12,000 Direct Payment recipients who sit alongside self funders and there is no evidence to prove there is more abuse, although obviously risks, control and balances will be debated. It was felt that the Local Authorities have fallen short for self funders in the past. Jeff Jerome accepted that the CQC will ask how Local Authorities will meet their responsibilities. And Alan Rosenbach stated the importance of those in leadership roles making the right kind of decisions rather than just open sentiments. Those decisions also need to come from the provider settings. Sue Lee, from Towergate Patrick, gave a very interesting presentation on the importance of specialist insurance for the Social care sector, and explained that they were there to learn how the changes will affect the sector and how they can ensure their product suits the needs of providers in these changing times. Sue also treated the audience to a DVD presentation to SUE LEE show what Towergate Patrick are good at, this was entitled ‘Doing Good’ and showed how the organisation has made lots of money for charity, their slogan is ‘Make money, Have fun, Do good’, perhaps we may see others now using this slogan! Thanks were given to Jeff Jerome, Alan Rosenbach and Sue Lee for their presentations and debate. All attendees, whose representation covered the Home Care Sector from all regions across the Country, agreed that the event had been extremely useful and informative and that the attendance of Jeff Jerome showed that the Government were taking the views of providers seriously during these huge changes in the sector, and it also showed that our voice is getting bigger! The day provided a catalyst for associations to present a unified picture where they can map out a vision to take forward at a time when the Government are looking for a combined voice. Following this second event it was agreed that Ceretas continue the momentum of the day by organising a small working group from the network to formulate ‘Terms of Reference’ going forward and develop a proposal of priorities for the wider group to sign up to regarding the sharing of ideas, good practice and collaborative working nationally.
He confirmed that domiciliary care is the community, and believes that this is where individuals will receive a quality and safe service. Ceretas Home Care Focus
17
SECTOR UPDATE
Enabling risk, ensuring safety
P
ersonalisation is about promoting independent and fulfilling lives by giving people more choice and control over their care and support. Having real choice and control includes having the right to take risks as well as being able to determine how to stay safe. Personal budgets, including the option of direct payments, are one way of ensuring people who use services are able to make their own decisions about the risks they take. For home care support workers this means helping the service user to identify their own risks and evaluate them. Relationship-based working is vital to this – in order to understand what positive risks the cared-for person can take, the carer must first understand the individual’s history, their wants and needs and their families and friendships. This responsibility can make professionals feel they are being put in a difficult position between balancing personalisation with their duty to manage risk and keep people safe. It is therefore extremely important that they feel confident and equipped to support people they are caring for to assess and evaluate their own risks. Enabling risk, ensuring safety: self-directed support and personal budgets is the first research-based publication on the issue, authored by the Social Care Institute for Excellence (SCIE). It presents recent research and examples of emerging practice in enabling people to take positive risks, like the story of Andy, who has autism. After leaving college, Andy was offered a place at a day centre for adults with learning disabilities, but he knew he could do much more and a job working with cars. Andy found a course but people around Andy were worried he would be vulnerable to abuse or exploitation 18
Ceretas Home Care Focus
and that he might not cope with the course, managing money, meals and day-to-day life. Andy got a personal budget and wrote a support plan, which made it clear that the course was so important that the risks were worth it. The SCIE report promotes this level of independence, choice and control for the people using services, highlighting the need for both risk enablement and safeguarding to be a core part of personalisation. David Walden, Director of Adult Services at SCIE, explains:
“Giving people who use services choice and control over the care they receive is very important if personalisation is to become a reality. However, there also must be support for family carers, social workers and other care staff so they feel comfortable enabling people to take risks. This new SCIE report on enabling risks brings together the current state of new research and practice in this area, so that the right support can be provided.” The key messages from the briefing include: • Providing real choice and control for people who use social care means supporting people to take the risks they choose, particularly in the use of personal budgets • Practitioners and care staff need to be supported to encourage sensible risk-taking while not jeopardising people’s safety • Risk enablement should become a core part of placing people at the centre of their own care and support.
You can access the SCIE report and the related At a glance summary online now at www.scie.org.uk/enablingrisk
The CPBF overwhelmed by support
SECTOR UPDATE
T
he Care Professional’s Benevolent Fund went mad for tea on the 29th September with supporting care homes, domiciliary agencies and industry related organisations staging their very own on Mad Hatter’s themed tea parties all in aid of carers who have fallen on hard times.The event raised a magnificent £6,174.47 in total, proof that it is not all doom and gloom at the moment.
The CPBF has been inundated with heart-warming stories from homes and organisations that pulled out all the stops to make their day as special as could be. Carers dressed up as their favourite characters from Alice in Wonderland, tables were set for afternoon tea, family and friends were invited along to take part in the fun and of course everyone wore the obligatory silly hat. Residents at Berrystead Nursing Home in Leicester used the time to reminisce on the brands of tea they used drink as youngsters as well as tea card collections, tea strainers, tea caddies and knitting tea cosies, nearly every tea related thing you can think of!. Most organisations baked delicious cup cakes to sell and organised fun and games to keep guests entertained such as raffles, hat decoration and croquet to name but a few. The charity has been overwhelmed with the support it has received in terms of the number of people participating and the amount raised and would like to say a special thank you to all those who took part. The money raised from this event will go towards supporting current and former care professionals, who are suffering financially through no fault of their own. In the past the CPBF have been able to provide carers with grants helping to relieve debt, paying rent and mortgage arrears, and purchasing essential equipment such as mobility vehicles. For further information please visit our the CPBF website www.cpbenevolentfund.org.uk
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19
SECTOR UPDATE
Calling excellent care workers to enter National Caring Competition Would you be able to demonstrate the core skills and knowledge needed to deliver excellent care within a competitive environment, under time constraints and in front of a panel of expert judges? That’s the challenge facing participants in this year’s Worldskills UK Caring Competitions run by the National Skills Academy for Social Care. The employer-led Skills Academy was established in October 2009 in response to a need in the sector to develop leadership and management skills in the workforce and establish excellent training and learning to in order to be ready to face the challenges of the future. As part of that, we have teamed up with Worldskills UK - the UK’s premier set of skills competitions for young people and adults - to run the caring competition. Now in its second year, this unique event highlights all that is positive and valued in social care, gives caring status as a skilled career and allowing people whose daily work often goes unnoticed - except by those they are caring for - the chance to shine. As well as giving a boost to their self-confidence previous competitors have gone on to enjoy promotions and increased responsibility. The final of the 2010 competition was held in London on 23 June and was won by Chantelle Challender, who had actually came second in her regional heat in Telford but was able to outperform the rest of the field on the day. The Judges praised her for: “The way in which she used the service user’s personality to assess his care needs; she went above and beyond the usual standards of care delivery.” Chantelle was thrilled to take home the gold medal, commenting after her win: “I put everything I have in my job and sometimes it can be stressful, but most of the
time the satisfaction of seeing a smile outweighs everything else.” Participants are tested on a series of scenarios and role playing exercises that have been developed by specialists at the Skills Academy. These include daily living activities, where you will be asked to demonstrate how you would help a service user with common tasks and a health promotion task. Raising the profile and status of social care is one of the key aims of the Academy and we are looking for capable, confident participants who are willing to showcase their abilities at a series of heats to be held across England next year. The deadline to register for the heats is 24 March 2011 and the competition is open to anyone who has relevant experience. Or you could nominate an employee or a student if you are unable to take part. Outstanding front-line carers make a huge difference to care provision across the country and they change lives – this is a great opportunity to demonstrate their excellent skills and knowledge.
For further information, contact Emily.bari@nsasocialcare.co.uk
DATES FOR YOUR DIARY! Ceretas Winter Conference 2011 Great British Home Care Awards hosted by Ceretas Spending Review Saturday 14th May 2011 The Impact on Home Care Thursday 17 February 2011 The Inmarsat Conference Centre, 99 City Road, London EC1Y 1AX
Ceretas IT Conference 2011 Assistive Technology 29th March 2011 Over-Seas House, Park Place, London SW1A 1LR 20
Ceretas Home Care Focus
The Royal Courts of Justice, London
Great British Care Home Awards hosted by the English Community Care Association Saturday 11th June 2011 The Royal Courts of Justice, London
SECTOR UPDATE
By Jason Gregory, Regional Manager, Turning Point Learning Disability Services.
P
eople with a learning disability face appalling levels of discrimination everyday, but those extreme stories that gain media attention are sadly only the tip of a very large iceberg. Those of us working with people with a learning disability know that there are unreported acts of bullying and harassment that occur everyday.
At Turning Point, we place a great emphasis on supporting people with a learning disability live independently in the community. This often means looking to private landlords as opposed to relying on supported housing. There are many advantages to this approach, however, our experiences have demonstrated that discrimination can be a real barrier. Our story starts in February where staff at one of our learning disability services, The Beeches, approached all local letting agents with the view to renting a bungalow for four individuals who were staying with us. We approached them in person explaining in detail what each of our individuals needed. We did not get many of our phone calls returned and those that did get back to us said that landlords had strict lending criteria. Taking a new course, we then joined letting websites, whilst also remaining in weekly contact with agents. After viewing several properties we found somewhere that was perfect, however the letting agents again did not return our calls. When we finally established contact we were told the property was no longer available. Similar experiences occurred several times. A myriad of excuses were given,
for example we were told that one property was advertised by mistake, only to find it had been reinstated on property listings just days later. At one point we got as far as giving a holding deposit, only to be told a week later that the property had been rented out to someone else. There was a pattern occurring; letting agents were reluctant to let us view properties and we were constantly being told that we did not meet the criteria of landlords. We can only assume that what we were facing was discrimination, after all, we did not have particularly stringent restrictions on what we could spend and we were flexible in when we could move. Finally we came across a very helpful and supportive letting agent, Jordan’s Property Services, who were able to find two suitable bungalows that met our needs. At every stage they were welcoming and helpful of the individuals we support. Thanks to them the individuals are now enjoying living more independently in somewhere they can call their own. We have been able to develop a very positive relationship with Jordan’s. It is only with the support of letting agents such as these that people with a learning disability will be able to enact their choices in how they want to live. We must therefore look to improve the understanding of the needs of those with a learning disability amongst all landlords and letting agents and ensure those who support them feel comfortable in challenging any discrimination that may be encountered.
www.turning-point.co.uk
RBS Dinner Ceretas hosted a dinner during the ADASS conference in Manchester in November which was generously sponsored by the RBS. The dinner was a round table discussion and was attended by representatives from social care including the UKHCA and Glenn Mason from the DoH. The focus of the evening was on the vision for social care and how as social care providers we could work together to ensure high quality care and support is available, deliverable and the challenges and solutions that can be achieved. Partnership working and maintaining a pluralistic market to maximise choice for the people who use our services was a key theme. John Ivers Nestor’s CEO and Treasurer of the UKHCA said “It was an interesting and enjoyable evening. As social care providers, we have a responsibility to provide high quality services, maximising choice for the people who use our services and supporting commissioners by offering solutions during these challenging times”. Following the dinner it was agreed that another meeting would be held in the coming few months. Ceretas Home Care Focus
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SECTOR UPDATE
Standing up to the Authorities
JOANNA SHARR
Joanna Sharr, a solicitor at Ridouts LLP, discusses the need for providers to take a robust approach when dealing with local authorities.
With imminent cuts to local authority funding and an increased demand for adult social care, local authorities need to find significant savings on their health and social care budgets. There are increasing examples of local authorities setting unattainable contractual targets for providers and threatening to reduce contracted hours in an effort to reduce their expenditure. The inevitable budget cuts will mean that providers will need to get used to challenging local authorities more robustly.
The provider responded by strongly disputing the authority’s criticisms and by establishing that much of the problem stemmed from the local authority’s systems, as opposed to fundamental breaches on the part of the provider. By responding in this way, the provider gave the local authority very little room to legitimately reduce its hours. The provider renegotiated its electronic targets with the local authority and improved its performance so that the authority had no basis for complaint.
We recently encountered a novel attempt by a local authority to reduce a provider’s contracted hours by issuing the provider with a default notice in relation to the provider’s electronic time keeping. The provider was required to record 90 percent of its contracted hours using service user’s own phones, which was impossible because more than 10 percent of users did not have telephones or did not permit carers to use them.
Providers must become more confident at challenging local authorities in this way. Whilst this particular issue is hopefully not too widespread, providers across the country will be facing attempts by local authorities to reduce costs in one way or another. The most common approach we see is unilateral reductions in fees, for example by the imposition of funding calculators and other similar models. Providers must appreciate that they do not necessarily have to accept these strategies. Local authorities which have contracts with providers are bound by the terms of those contracts and cannot change the terms without the express agreement of the providers. It is up to you to take a stand. If in doubt, feel free to call us for an informal chat. We’re here to help.
The local authority’s system made compliance with the written contract unattainable. These issues were raised in an environment in which there were no material issues of quality of service, issues of abuse or unacceptable levels of complaints.
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Ceretas Home Care Focus
Electronic Monitoring: 394 Monitoring & Rostering: 394R
SECTOR UPDATE
Social care trigger points within the end of life care pathway
So how can health and social
c
ONE OF THE MOST DIFFICULT ASPECTS IS KNOWING WHEN TO START THE DISCUSSION
How can social care staff recognise when someone is approaching the end of life? Tes Smith lists some useful ‘triggers’ that offer clues to where someone is on the pathway. Good communication skills underpin all aspects of care - and those skills are never more vital than when initiating that first conversation about someone’s end of life care plans. One of the most difficult aspects of this is knowing just when and how to start that discussion. And that in turn depends on t recognising when people are reaching this stage in their lives. So how can health and social care professionals be helped to identify those people who are nearing the end of their lives? And how should they respond to individual needs?
PREPARATORY CLUES (Denoting readiness to start the conversation)
I won’t get better, will I? I don’t want to be a burden on my family I have been wondering how I will manage Comments about what they don’t need any more – acceptance of life’s limits • Individual begins asking about legal Like clinicalassistance triggers, for writing a will • Considering funeral arrangements • Conversations around the completeness and finality of life • Lack of fear around the ‘inevitable’ • Small ‘leave-taking‘ conversations • Expression of thanks.
A number of projects are currently under way to identify condition-specific clinical triggers that would indicate when someone is approaching the end of life. These include the development of supporting information for identifying agreed clinical indicators, information materials to support communication and advance care planning. Social care staff have an important part to play in this process since they will often have knowledge or input into an individual’s care and practical needs before their illness enters the final phases – and sometimes before the patient is known to other services. As well as clinical triggers, individuals can give other clues that indicate they are accepting and facing their end of life. These can often be very subtle but with care and time can be detected. Like clinical triggers, they do not stand in isolation and will require further discussion before any action is taken. These ‘social triggers’ are particularly common in older frail people and can be useful in residential and nursing settings as well as extra care schemes and within the individual’s own home setting.
• • • •
‘These triggers can be very subtle but with care and time can be detected’ WITHDRAWAL CLUES (Denoting a level of acceptance)
• Psychosocial withdrawal – for instance, no longer wanting to join others at meal times or go to existing group activities • During family visits they may stop asking about others • Where they have previously asked the carer about their family they now stop showing an interest • Less interest in personal care or hygiene or wanting to have their hair done N sweets or food • Less interest in favourite • Stop listening to or watching favourite programmes on TV
• No longer read books or the paper • Becoming muted and stifled in conversation • Napping more, preferring to stay in their room if in residential care.
AMBIGUOUS CLUES (Denoting a position between readiness and acceptance)
• Talking of past holidays or significant events, acknowledging they won’t travel again or do something they had wanted to. • Looking at photos • Waiting for and then the passing of a significant event – for instance, birthday, Christmas, anniversary - and the sense that that passing marks the beginning of closure in a significant way.
DECISION CLUES (Denoting readiness to make a decision)
• Default answer of “I don’t know” is used when they feel their preferred d answer may not be heard or accepted • Questioning the efficiency of long-term medication or treatment • Declining medication or hospital appointments • Telling stories about friends who have died • Suggesting carers or professionals talk to their families/significant others about any decision they are being asked to make • Asking specifically to stop ongoing treatment. Being very clear about decisions on resuscitation and invasive treatments • Making decisions such as above resulting in a sense of calm and relief.
Tes Smith Joint Social Care Lead, National End of Life Care Programmeinformation@eolc.nhs.uk Article from the National End of Life Care Programme Issue 26
Ceretas Home Care Focus
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PEOPLE PROFILE
Up Close and Personal with...
Cheryl
Baker
What are your experiences with social care? My father-in-law who passed away in July of this year, lived with us for the last 15 years of his life and in his latter years, suffered from leukaemia and heart failure. He did not want his son (my husband, Steve) or any of us to have to help him with his personal hygiene - he was a very proud man and he did not want to be a burden to us. He had a great rapport with with carers from Social Services who never complained about any of the "jobs" they had to do for Harry no matter how demeaning they were.
Who has been the biggest influence in your life? My mum and my sister, Sheila. They let me believe that I could do what I wanted to do if I really tried. For a young girl with no GCSE's, living in East London, who had nothing but pipedreams in her head, their influence was invaluable.
What has been your biggest challenge in your personal life? I wasn't married until I was almost 38 years old and the biological clock was ticking away so Steve and I decided to try for a family as soon as we were married. It wasn't to be. I had blocked fallopean tubes and the only alternative was to go for IVF treatment. IVF is costly to your purse, your body and your mind, but for me it was a small price to pay. After the third attempt, our twin daughters, Kyla and Natalie, were conceived.
How do you relax? I am afraid I relax the same way as my children do - I play games on the computer, I read, I do crosswords and I watch tv.
What do you consider to be your greatest achievement? Personally, it is having my twin daughters. Professionally, it is winning the European Song Contest. If you think that the UK has only won 5 times and I am part of one of those winners, it makes me very proud.
What is your favourite film? There are two films - "Finding Nemo" and "50 First Dates".
Which TV personality, past or present, do you most admire? I love Ant and Dec - I think they are fantastic.
If you were stranded on a desert island, what would be your one luxury item? Moisturizer.
What it was like hosting the Great East Midlands Care Awards in Nottingham in October, this year? I said on stage that I felt priviledged to be in a room with so many good people and I really meant it. To do the job that carers do, takes tremendous dedication. I had the most wonderful time with them all.
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Ceretas Home Care Focus
PEOPLE PROFILE
CaretoTalk?
Cityworx Announce New Appointment Cityworx are proud to announce that due to continued growth we have a new addition to the team.
DAVID COSTA
David Costa has worked in the recruitment industry for a number of years. Initially beginning as a resourcer specialising in social care he developed in to a fully experienced recruitment consultant in a very short time. David’s solid background as a resourcer has enabled him to apply the most innovative techniques when searching for candidates. He is able to identify the best talent in the market and then employing the most effective head hunting techniques he is able to secure clients the very best individuals thus tailoring the service to their specific needs. Recruitment Specialists
Q A
Question: With the government's requirement for cuts to local authority funding, will this mean that care packages will be cut to the bare minimum? This would be a backward move and would mean that we are 'doing to' clients and are not able to have sufficient time to work with them to help them regain their independence. Answer: Local Authorities do have some challenging times ahead in terms of budget cuts, but also in terms of the ever increasing numbers and complex needs of service users. This is both in terms of social care and health care.They are now working much more closely with health care services and the private and third sector support services. Investment is being made in Reablement Services, which work very closely with clients to enable them to be the 'best that they can be', which will promote their indendence and wellbeing. Statistics from the Department of Health (CSED) study has shown that of clients going through reablement, 40-50% have no ongoing social care needs for up to 2 years.
Putting People First • • • • •
leading recruiter in the sector over 15 years experience specialist in the social care market retained relationships with service providers care coordinators through to senior management and directors
If you are a service provider seeking strategic long-term people solutions we can search and select the ideal individual, tailored to your specific requirements. If you are an individual seeking a new challenge we will take the time to listen to you. All conversations are in the strictest confidence. T: 07956 19 60 63 E: sanjay@cityworx.co.uk T: 07889 77 10 52 E: charmain@cityworx.co.uk www.cityworx.co.uk
Recruitment Specialists
Ceretas Home Care Focus
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REGIONAL
“Your Employees are your most valuable asset?”
I
asked a question related to this statement whilst judging at the Great East Midlands Care Awards recently. The question was asking how as an employer, did the finalists, invest in there staff, the importance of workforce development and how did they create a learning environment.
STAGE 1
We heard some wonderful examples of how teams and individuals are being developed and how important learning is, along with the acknowledgement of its link to motivation, staff feeling valued and how this impacts on care delivery.
Though the main aim is, training should ignite their interest for the chosen subject and lead to the person wanting to develop themselves further through learning.
Identify development needs
Cycle for using CPD to achieve a more competent workforce and improved outcomes for people who use services
STAGE 6 Record outcomes
As a development manager myself, I have a strong belief in the fact that we should be creating person centred learning organisations, throughout social care.
OK, yes, the training programme would hopefully bring them up to a certain standard, which would then be reflected in their behaviour through practice.
STAGE 5
STAGE 4
Implement learning opportunities
Plan development opportunities
CPD should reflect an individuals preferred ways of learning and could include
then plan development opportunities. Remember to record, review and update learning.
• Formal learning leading to Qualification and Credit Framework (QCF) recognised awards
Also remember to involve all key stakeholders when developing a workforce plan ~ this will lead to everyone owning, promoting and delivering the plan.
• In House Courses • Shadowing • Mentoring and Coaching
Every organisation no matter how large or small, should implement continuing professional development (CPD)
• Informal Learning
• Secondment Opportunities
Why? Because it contributes to ~
• E Learning
• The quality of the service being provided
• Reading
• Meeting the standards and legal requirements
• Workshops and Conferences
• People understanding their role in the organisation ~ feeling competent and confident
• Research
• Reflective Practice
It’s important to do a learning need analysis for both the individual and the organisation, identify learning needs, objectives, and resources and
• People feeling valued 26
Ceretas Home Care Focus
STAGE 3 Identify learning objectives opportunities & resources
Reference The CPD Cycle Skills for care “Keeping up the Good Work”
My rule is ~ everyone has a role to play in encouraging a learning culture ~ so how is that achieved?
• People recognising development needs and asking for opportunities
STAGE 2
Review, accredit and refine learning
In particular the overall winner of the category Church Farm Nursing Home talked extensively around education of staff and the importance of investing in the learning of its whole team.
Anyone who knows me well, knows my pet hate is, managers who see training courses as the answer to a perceived problem, for example someone who struggles to understand dementia, send them on a course, then they’ll be alright.
Assessment of individual and organisational need
STAGE 7
As someone tasked with the development of a workforce, I was particularly interested in the question and the answers! It became quickly apparent why these people being interviewed, had made it through as finalists in the Care Employer Award.
SUSANNAH SPENCER
And the list goes on....
Learning can benefit all, the employer, employee and the people receiving care, it’s important to invest in CPD and in return you will have a workforce that feels valued, is motivated and is proud to be part of your organisation. I saw this sense of pride demonstrated once again, when I attended the Great East Midlands Care Awards on October 16th Get everyone celebrating achievement. Bottom line:Your employees truly really are your most valuable asset
REGIONAL
Eastern and Coastal Kent - Personal Health Budget Pilots What is a personal health budget? A personal health budget (PHB) is a way for patients to understand what their care costs and to have input into how the money is spent to meet their identified healthcare needs. PHBs can be delivered in three ways: a notional budget, a third party budget and a direct payment. The notional budget enables a patient to understand what their care costs and to discuss how the money is spent to meet their needs with their health care professional, but care continues to be commissioned by the NHS on behalf of the patient. A third party budget is where the budget usually spent by the NHS to commission services for a patient is held independently by a third party organisation who commission services on behalf of the patient to meet their identified health care needs. The direct payment option allows patients to commission their own services using a four weekly payment to a bank account held by the patient.
Why are we doing this? Direct payments for social care have been successfully rolled out across England in recent years. Several key benefits of direct payments have been documented: improvement in quality of life by enabling the recipient to manage and support their own
lifestyle, allowing recipients to use the budget to meet their needs in more creative ways which are effective for them and recipients have commented that they have greater self esteem and confidence as a result of organising their own care. At the moment PHBs are a pilot scheme and the benefits that they may bring to patients are currently being evaluated, it is hoped that results will include the benefits listed above and more.
What has the reality been in Eastern and Coastal Kent? NHS Eastern and Coastal Kent have been selected as an â&#x20AC;&#x2DC;in depth pilot siteâ&#x20AC;&#x2122; which means that the processes implemented and the outcomes for patients and staff will be evaluated by research teams at the University of Kent and the University of York. The project in Kent is examining four pathways of care: continuing health care, maternity, end of life care and mental health. As part of the research there are target numbers of patients who must be recruited to the pilot (to support statistical significance of findings) Over half of the target number have been recruited to maternity and continuing health care, with recruitment to mental health beginning in November and end of life care to follow.
Those recruited to the pilot will be supported in planning their care to meet their agreed health care outcomes by a health care broker. Within maternity some participants will be supported by local childrenâ&#x20AC;&#x2122;s centre staff, building upon existing services offered to the community. There is excellent partnership working between health and social care professionals, and payment mechanisms already established by the local authority are being used to deliver direct payments onto the innovative Kent Card. Recruitment to the pilot has been supported by forward thinking staff in the PCT who recognise the potential benefit to patients. Close links between the project team, providers and NHS staff have ensured that to date, recruitment is on track to support the evaluation team and ensure that identified benefits
Georgina Walton Project Manager Personal Health Budgets Project NHS Eastern and Coastal Kent
Ceretas Home Care Focus
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REGIONAL
Launch of Care at Home Study Marriott Hotel, Cardiff, 28th September 2010
T
he findings of an important study of the domiciliary care workforce in Wales were presented at a major conference in Cardiff on 28th September. Ccommissioners, service providers, workforce leads, service user and carer groups, senior managers, elected members, planners in health and social care, and education providers from all sectors were invited. Around 150 people attended the event, which was free of charge. Ceretas was represented by Chris Brooks-Dowsett, Executive member for Wales.
The Welsh Institute for Health and Social Care (WIHSC), University of Glamorgan with Insight Social Research and The Management Standards Consultancy were commissioned by the Care Council for Wales to undertake a study on the care at home workforce and the implications for the workforce of moving towards new ways of working. The Care Council for Wales (CCW) was established in 2001 as an Assembly Government Sponsored Body (AGSB) which performs similar functions in Wales to the General Social Care Council and Skills for Care in England. These include regulation and training of the whole social care workforce including front line care workers as well as Social Workers. CCW aims to ensure that the social care workforce is safe to practice; has the right skills and qualifications to work to a high professional standard and is attracting enough of the right people into its ranks to deliver quality care, now and into the future.
The WIHSC was commissioned to answer three key questions: 1. What does the care at home workforce currently look like? 2. What is the future vision for care at home and its workforce? 3. What do we need to do to move the current workforce towards the vision? Dr Mark Llewellyn of WIHSC, the author of the report, which began in Autumn 2008, presented his findings and recommendations.
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Ceretas Home Care Focus
The study engaged closely with the experiences of the workforce and those they serve and included interviews, discussion groups and questionnaires with 160 service users and carers, 119 front line care workers and their direct line managers/supervisors; and 17 other stakeholders – service managers, commissioners and representatives of local and national organisations, charities and voluntary sector bodies.
Recommendations 1. Recognise the Value of the Care at Home Workforce This recommendation acknowledges the way in which care at home workers, in all sectors, have responded to the evolving challenges posed in meeting the support needs of vulnerable people. The response of such workers has often required the application of new knowledge and skills. The extent of that knowledge and the nature of those skills often go unrecognised and this is reflected in the low status that is often ascribed to ‘care jobs’. Much of these changes have been made for little additional reward. Care at home services are perennially short of resources and need improved funding however as an era of cuts begins, there need to be stretched further.
2. Enhance the Role of the Workforce in Assessing Needs, Planning, Co-ordination, Reviews and Working Alongside Others. This recommendation responds to the clear need to move from what may sometimes be regarded as overly prescribed and narrow task driven roles for care and support workers to ones that are more choice and opportunity driven. This reflects the need for more flexible approaches involving partnerships that can deliver on well-being (with both its social and health components) as well as supporting ‘activities of daily living’.
3. Address the Workforce Implications of Developing Integrated Services This recommendation responds to concerns about the compartmentalisation
of care at home within service and professional silos. As recognised in the ‘Rural Health Plan’19, ‘despite the progress made in service integration and joint commissioning, health and social care sectors still have difficulty in understanding each other’s context, culture and financial and governance constraints’. The call for integrated services reflects the need for them not just to be person-focused but to respond to user and carer choices. Integration means the development of frameworks and nurturing of skills that cross divisions between social care, health, housing and others.
4. Support the Workforce in Delivering Outcome and Person Focused Services This recommendation responds to the need to counter the worst effects of task driven approaches where few or limited choices are available for users and carers. It underpins the notion that person focused outcomes must expand those choices and should relate, in key respects, to user rather than management outcomes.
5. Explore the Consequences for the Workforce of New Service Options around SelfDirected Support This recommendation acknowledges that as the expectations of users and carers change, new service norms and practices will be established. These norms can provide challenges for some providers who have been used to doing things in traditional ways. They directly follow, however, from the agenda associated with personalisation, a key aspect of which relates to self-directed support. Copies of the full report and summary report can be downloaded from the Care Council for Wales website (www.ccwales.org.uk) or from the WIHSC website (http://wihsc.glam.ac.uk) or from Dr Mark Llewellyn (mrllewel@glam.ac.uk). Reference: Llewellyn M, Longley M, Fisk M, Boutall T, Wallace C and Roberts M (2010) Care at Home: challenges, possibilities and implications for the workforce in Wales – Summary Report Care Council for Wales: Cardiff
REGIONAL
Nottinghamshire Multi Agency Mental Capacity Act project
2
007 saw the introduction of the Mental Capacity Act – a landmark piece of legislation that provided a statutory framework to empower, support and protect people aged 16+ who may not be able to make all their own decisions all the time.
Its aim is to give clarity as to who can make these decisions on their behalf, how they can make them and when. Nottinghamshire Multi Agency Mental Capacity Act project was set up in 2007 to ensure this legislation was implemented and understood by the many diverse groups and organisations across the care sector. Tina Morley-Ramage - a qualified social worker and manager – was appointed as Implementation Manager for Nottingham and Nottinghamshire, and since then has undertaken 185 events and trained nearly 4500 care staff, service users and unpaid carers. A Nottinghamshire County Council employee, Tina is currently based with Nottinghamshire Healthcare NHS Trust. She has led on setting up innovatory courses such as ‘Mental Capacity Act Champions’ and ‘Train the Trainers’ – the latter won a national Department of Health award in 2009 for the associated training pack. Tina has come up with many ideas about how to reach different organisations including specific training for particular groups. “I try to look at what each organisation wants and make it bespoke for them and the people who work for them,” she says. “My enthusiasm comes from my belief that the Mental Capacity Act is a very good piece of legislation.” Tina says whilst 80% of her job is designing and delivering training she also provides support to organisations on their policies, procedures and training. About 10% of her time is spent with the home care sector; meeting with agency managers and trainers to advise on their policies and training, and to produce a training resource pack which can be used to train staff throughout the organisation. For organisations with over 40 staff, Tina can deliver training events. “The project is due to end by March 31st 2011 so take advantage of the training and support available now” says Tina. Courses are booked up until Christmas but in early 2011 there will be 4 training resource pack events and 3 training events for managers and deputies. There will also be 3 Mental Capacity Act Champions events across the county in January, February and March 2011. Places are allocated on application. If you are interested in attending any of these courses or want to contact Tina for advice about implementation of the Mental Capacity Act email Tina.Morley-Ramage@nottshc.nhs.uk Last month Tina picked up the award for Outstanding Contribution to Social Care at the Great East Midlands Care awards. Praising Tina for her inspirational enthusiasm, commitment and innovative approach to training on the Mental Capacity Act, the judges said: “Tina loves her work and has come up with many innovative ideas, reaching out to different organisations to orchestrate training for specific groups including carers and GPs. She is outcome focused and her enthusiasm is infectious to all who work with her."
AWARD WINNING TINA AT THE GREAT EAST MIDLANDS CARE AWARDS WITH HOST CHERYL BAKER
Ceretas Home Care Focus
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REGIONAL
THE CHALLENGES OF PROVIDING LIVE IN CARE
T
he biggest challenge in providing live in care is recruitment and retention of staff. We have found that the majority of our workforce come from overseas and are from all walks of life. They can be younger people who wish to go into the medical profession as a nurse, physio or OT and want to gain some experience, or they can be more mature people who find that there is little or no work in their own countries and live in care provides an income and accommodation all in one go.
From an agencyâ&#x20AC;&#x2122;s perspective we have to invest a huge amount of time and money in interviewing and training our staff before they can be placed in a suitable assignment. Unfortunately this all takes time and having to wait for enhanced CRB disclosures to be returned, often means that candidates
who have already undergone costly training cannot wait for work and find employment elsewhere. Visa rules are also an issue and until recently a very large proportion of our workforce were South Africans on working holiday visas. These were stopped some time ago and with more nationalities being restricted entry to the UK, this will become a bigger problem for us. We believe strongly in having a well informed and well trained workforce and this begins with their statutory 4 day induction training which takes place in our own training room by 3 experienced in house trainers. During this time we do get to know our prospective care workers extremely well, observing how they interact with each other in the group, their practical skills and their understanding of the English way of life. Once in an assignment we visit regularly, at least once a month for supervision, each care worker completes a series of workbooks to increase their knowledge and also undertakes NVQ level
2 and 3 in Health and Social Care. Until recently the government helped with the funding of this qualification and we have been able to offer this to all our staff. Unfortunately this is not the case now and for us to move forward in this capacity will mean extra financial costs for the agency. None of us relish the thought of leaving our own homes, particularly in our latter years. Upheaval, change, the unknown are all daunting prospects for anyone feeling vulnerable, so despite the difficulties and extra financial costs for live-in care providers in the future, we believe passionately that this should be an option for everyone. We believe you should have the choice to stay in your own home with the support of a live-in care worker. Staying in familiar surroundings where you can live your life at your pace and as you wish is a perfect solution to many people and one which we aim to achieve.
Hillary Ball Director, Rest Assured
email address request Any questions? Want to receive e-Updates? If you have any questions or would like to receive all the latest news on awards, conferences and events in your area, please send your email address to
info@ceretas.org.uk 30
Ceretas Home Care Focus
BUSINESS BRIEF
Business Brief CHRISTCHURCH COURT Northampton healthcare business has been sold to private-equity firm Sovereign Capital.The deal involved more than £24m of acquisition and development capital. Christchurch Court provides care for victims of brain injuries acquired as a result of car accident, assault or other trauma at its homes in Northampton. SEVACARE the national domiciliary care provider, continues to make a big impact on the market with a number of recent contract wins across the country. Sevacare has been awarded contracts in Buckinghamshire, Salford, Coventry and Nottingham to provide Domiciliary Care Services to a number of people including: older people, people with learning disabilities, people with physical disabilities and people with mental health needs. . CAREWATCH CARE SERVICES has acquired New Directions Care and Support Services Limited, a provider of care and supported housing services. The deal is the 13th add-on acquisition made by Carewatch since Lyceum Capital backed the company in October 2008. CITY & COUNTY HEALTHCARE GROUP has acquired Guardian Homecare, a provider of domiciliary care and support services, from BUPA for an undisclosed sum. The deal is the company’s second bolt-on acquisition in six months following the purchase of Sterling Homecare. SERVOCA PLC has acquired Phoenix Employment Services, a provider of outsourcing and recruitment services to the domiciliary care and nursing markets, from administration for £780,000. ARABELLA HEALTH STAFFING has acquired the agency nursing and medical services business of Pinnacle Staffing Group plc for £2.75m.
SAGA ACQUIRES NESTOR care business for £124 million. Saga has established a nationwide care network with acquisition of Nestor Healthcare Group for £124 million. Nestor provides a range of managed social and primary care services including domiciliary care. It will help develop Saga’s care base giving it nationwide coverage. Nestor has a care network the north of England while Saga is currently focused on the South.
PLC RESULTS •
CareTech Holdings expects to announce its preliminary results for the year ended 30 September 2010 on 9 December 2010. Farouq Sheikh, Executive Chairman commented: “Capacity growth is again ahead of management expectations.”
•
Mears Group plc has announced record interim results for the six months to 30 June 2010. The domiciliary care division has increased revenue by 64% to £47.8m including organic growth of 7%.
ROUND UP •
The Directors of Nestor Healthcare Group plc confirm that they have received a revised indicative approach from Acromas Holdings Limited of 100 pence per ordinary share. The Board believes that this offer would continue to undervalue the company but intends to meet with Acromas.
•
Acromas Holdings Limited is also in early stage takeover talks to buy Allied Healthcare, one of Britain’s largest providers of home care and healthcare staffing services, for more than £65m. However, they are yet to make a formal offer.
LIFEWAYS COMMUNITY CARE has acquired Highbourne Limited (Highbourne Care), a provider of domiciliary care and support services to individuals with physical disabilities, mental heath problems, complex behaviour and autistic spectrum disorders. SOVEREIGN CAPITAL has backed the management buy-out of Eden, one of the largest, independent supported living businesses in the UK. Based in Newark, the business operates from six offices across Nottinghamshire and South Yorkshire and its 560 staff provide long-term care for over 250 adults with a range of learning disabilities.
Andrew Durbin is a partner in Smith Cooper Corporate Finance, the Midlands based advisor to acquirors and vendors in deals of £2m to £25m. For more information, email andrew.durbin@smithcooper.co.uk or call 01332 374419.
www.care-awards.co.uk ( 0115 959 6133
CONFERENCES AND EVENTS
Regional Great British Care Awards CELEBRATING EXCELLENCE ACROSS THE CARE SECTOR The regional Great British Care Awards 2010 have now drawn to a close. We were absolutely delighted by the reaction to last year’s inaugural event and the response again this year has been fantastic! Ceretas are proud to be the founder members of the National Home Care Awards and are delighted to be hosting the home care finals in 2011.
If anyone needed convincing that – in these economically challenging times – there is a desire to celebrate excellent social care in England, then your embracing of our awards demonstrates just that! Once again, the quality of entries for the 2010 awards has been magnificent and the judges have been hard pressed to come to their decisions. We were extremely proud to see nominations that demonstrated innovation, creativity, entrepreneurial spirit and above all, dedication and commitment. The Great British Care Awards are a calendar of 9 celebration evenings across the length and breadth of the country. Not bad for an event that kicked off just a couple of years ago with our first ceremony in York! As we travelled across the country last year, we were overwhelmed by the warmth of the welcome we received and the genuine gratitude our winners felt for their awards. This year, more than ever, we need a reason to celebrate. Surrounded as we are by news of gloom and despondency and predictions of terrible things to come, the awards are an opportunity to close the door and celebrate. We are extremely grateful to our main sponsor HET Software and to all our sector partners and commercial sponsors for their support. Without their help we would not have been able to stage these fantastic events across the country. Our chosen charities for this year’s awards are Maggie’s and the Care Professionals Benevolent Fund (CPBF.) Maggie’s has centres throughout the UK which provide support for people suffering from Cancer. The CBPF is the registered charity for the Care Sector which supports current, former and retired care professionals, by providing assistance to relieve financial hardship or sickness. Finally, our sincere congratulations to all those who have been shortlisted for an award and indeed to everyone who was entered – you are all winners!
We look forward to seeing the winners at the national finals for both home care and care home on 14th May and 11th June at the splendid Royal Courts of Justice in London next year.
LISA CARR, DIRECTOR
MIKE PADGHAM, DIRECTOR
A Word from our Minister I am delighted to support the Great British Care Awards and the fantastic job they do in celebrating excellence in social care across the country. In these challenging times, the Department is proud to give its backing to an exciting initiative that demonstrates the commitment, innovation and dedication of a sector that does so much for so many.
PAUL BURSTOW, MINISTER FOR SOCIAL CARE, DEPARTMENT OF HEALTH
A Word from ADASS The Association of Directors of Adult Social Services are proud to be supporting the Great British Care Awards which help promote best practice and excellence in social care. Congratulations to all the finalists for the skill and dedication they have shown. The awards are a fitting way in which to recognise such a special workforce and the difference they make to people's lives.
RICHARD JONES PRESIDENT THE ASSOCIATION OF DIRECTORS Please see the next page for some of the highlights of the regional Great British Care Awards
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Ceretas Home Care Focus
CONFERENCES AND EVENTS
Highlights of the Regional Great British Care Awards 2010
Ceretas Home Care Focus
33
News on Finals
CONFERENCES AND EVENTS
The Great British Home Care Awards May 15th 2011 at The Royal Courts of Justice, London Presenter for the evening, Daybreak’s Kate Garraway
Ceretas are proud to host the Great British Home Care Awards finals 2011
C
eretas are delighted to once again join forces with the Great British Care Awards, organisers of the regional awards throughout the UK for the social care sector. Winners of the regional finals held in the Autumn of 2010, have been invited to attend the Great British Home Care Awards finals at the splendid Royal Courts of Justice in London.
DAYBREAK’S KATE GARRAWAY
Guests will be wowed by the prestigious Victorian building, one of the last great wonders of Gothic revival architecture in England, and a spectacular backdrop for a glittering awards ceremony. The Great British Home Care Awards, aim to promote best practice within home care and pay tribute to individuals who have demonstrated outstanding excellence within their field of work. The awards will be representative of all those working within home care whether it be older people or specialist services. From frontline staff such as care workers and home care managers to people who have made an impact in other ways such as training, specialist care and innovation.
All finalists will be invited to attend a judging day on 23rd March at the Marriott Hotel, County Hall, London. From here they will beinvited to attend the superb gala dinner at the Royal Courts of Justice, where the winner will be announced. The gala dinnerwill include a champagne reception, dinner with celebrity presenter Kate Garraway and entertainment. The Awards aim to benefit individuals, organisations and sponsors. By nominating a colleague you will be supporting their dedication and commitment whilst also helping to raise the profile of the home care industry as a whole. Organisations who nominate their employees will be demonstrating pride in their hard work and excellence. The awards also present an excellent publicity opportunity. Should a nominee be successful, you and your guests will have the chance to attend a superb gala dinner - what better way to raise the profile of your organisation and motivate your staff! So don’t miss out on your chance to pay tribute to those people who really do make a difference to the lives of others. Without people like these, the older people and vulnerable members of our society would be unable to remain independent and stay in their own homes.
Let’s celebrate social care and help it get the recognition it deserves. THE ROYAL COURTS OF JUSTICE
www.care-awards.co.uk
Finals of the Great British Care Home Awards hosted by ECCA, 11th June 2011, Royal Courts of Justice, London. 34
Ceretas Home Care Focus
Ceretas Winter Conference 2011
Thursday 17 February 2011
spending review
the impact on home care Invited Guest Speakers: Stephen Dorrell MP Chair of the Health Select Committee, Commission on Future Funding for Social Care, A GP Commissioning Consortia, Department of Health, Directors of Adult Social Services and National Home Care Providers Sponsored by
Venue: The Inmarsat Conference Centre 99 City Road London EC1Y 1AX
Technology for the home care sector
Ceretas Assistive Technology Conference Date: 29th March 2011 Venue: Over-Seas House, Park Place,
St Jamesâ&#x20AC;&#x2122;s Street, London SW1A 1LR Supported by
you take care of your clients... ...weâ&#x20AC;&#x2122;ll take care of you
join us!
Ceretas aims to promote best practice and raise the status of home care in all sectors by helping all staff working in home care to be recognised as professionals in their field. If you would like more information on how to become a Ceretas member please email heather@ceretas.co.uk or call 0115 959 6130 or visit our website www.ceretas.org.uk
www.ceretas.org.uk