MAY 2018
www.caremanagementmatters.co.uk
IS IT NOBODY’S BUSINESS? Supporting LGBT+ people
Inside CQC
Registration changes
Resource Finder
Care sector accountants
Workforce development If not now, when?
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Improve your quality of care
In this issue 05
Inside CQC Joyce Frederick talks about CQC’s work to improve registration.
07
CMM News
09
Business Clinic CareRooms has announced its UK launch and is looking for hosts in Cambridgeshire. What does our panel think of this new approach?
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A View from the Top Former Health Minister and Founder of Oak Retirement, Dr Stephen Ladyman is the subject of this month’s interview.
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Rising Stars Paula Southgate, General Manager of The Old Parsonage in Hampshire run by Brendoncare is our Rising Star.
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Event Review CMM reviews the Surrey and Sussex Care Showcase 2018.
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What’s On?
49
Straight Talk Laura Cope discusses a new community engagement toolkit for care homes devised by Alzheimer’s Society’s Airedale Social Movement.
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FEATURES 43
REGULARS
From the Editor
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If not now, when? Developing the social care workforce Debbie Sorkin looks at the need to develop the social care workforce, the benefits of doing so and the role of good leaders in achieving a trained, valued workforce.
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Is nobody’s business everybody’s excuse? Making care services inclusive of older people who are lesbian, gay, bisexual or trans Sally Knocker explores recent developments in supporting older people who are lesbian, gay, bisexual or trans.
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Social media in social care: Boosting business, transparency and sharing Jonathan Papworth sets out the benefits of using social media to increase transparency and boost your business.
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Resource Finder: Accountants CMM brings you details of care sector accountancy firms to help you run your business. CMM May 2018
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EDITORIAL editor@caremanagementmatters.co.uk Editor in Chief: Robert Chamberlain Editor: Emma Morriss Content Editor: Emma Cooper
CONTRIBUTORS
PRODUCTION Lead Designer: Holly Cornell Director of Creative Operations: Lisa Werthmann Studio Manager: Jamie Harvey
ADVERTISING sales@caremanagementmatters.co.uk 01223 207770 Advertising Manager: Daniel Carpenter daniel.carpenter@carechoices.co.uk Director of Sales: David Werthmann david.werthmann@carechoices.co.uk Senior Sales Executive: Aaron Barber aaron.barber@carechoices.co.uk
@CQCProf
@DebbieSorkin2
@SallyKnocker
@SaraMcKeeFRSA
Joyce Frederick Deputy Chief Inspector for Registration, Care Quality Commission
Debbie Sorkin National Director of Systems Leadership, The Leadership Centre
Sally Knocker Rainbow Memory Café Coordinator, Opening Doors London
Sara McKee Founder, Evermore
@ColinTWAngel
@Cutler_Nicola
@StephenLadyman
@Brendoncare
Colin Angel Policy Director, United Kingdom Homecare Association
Nicola Cutler Associate, Royds Withy King
Dr Stephen Ladyman former Health Minister and Founder of Oak Retirement
Paula Southgate General Manager, The Old Parsonage
SUBSCRIPTIONS Non-care and support providers may be required to pay £50 per year. info@caremanagementmatters.co.uk 01223 207770 www.caremanagementmatters.co.uk Care Management Matters is published by Care Choices Ltd who cannot be held responsible for views expressed by contributors. Care Management Matters © Care Choices Ltd 2018 ISBN: 978-1-911437-86-4 CCL REF NO: CMM 15.3
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From the Editor Editor, Emma Morriss summarises this month’s features and announces that CMM is working towards CPD certification. Following our inaugural Inside CQC column from Andrea Sutcliffe CBE, we now welcome to the magazine Joyce Frederick, Deputy Chief Inspector for Registration at CQC. In her column on page 7, Joyce explores in more detail the Commission’s plans for the future of registration. With four key outcomes, it’s worth reading to gain an understanding of the Inspectorate’s direction of travel on the subject.
Summer and that is only the first step to reform. Action is needed now to address the social care crisis.
FEATURES
This month, we have a broad range of features including an important piece on making care towards CPD certification for the from Debbie Sorkin exploring and support services inclusive magazine. Our April issue has been the importance of workforce of older people who are lesbian, certified by The CPD Certification development and training, as well gay, bisexual or trans. Written by Service and we are working as the role effective leadership Sally Knocker, the article starting towards having each issue certified has in this. With recruitment GREEN PAPER on page 26 discusses why it’s to enable those of you who claim and retention a real problem so important that the sector CPD points to be able to do so for the sector, Debbie says that The big news this month was gets support right for this oftenfrom reading CMM. valuing and developing your the Secretary of State for Health excluded group. Whether you can claim and workforce can address these and Social Care, Jeremy Hunt MP Also this month, we bring you how many points is dependent on issues. Debbie also draws on the setting out the Government’s our Resource Finder. With a focus your individual professional body. importance of leaders pursuing seven key principles ahead of the on care sector accountancy firms, We are upgrading the Member Green Paper. We’ve covered it in the companies included along with their own continuing professional area of the CMM website to development. our In Focus on page 15. Response their lead individuals can play an enable you to request your CPD to the speech from across health important role in supporting your certificate. To claim your points, CPD and social care was generally business whatever your plans. The sign-up to the website, it’s free. positive, and recognition of the feature starts on page 43, we hope At CMM we work hard to support Don’t forget, you can also issues facing the sector was you can find a useful adviser from the sector, so I’m pleased to receive CPD points from attending broadly welcomed. However, the the entries. announce that we are working our CMM Insight events. Green Paper itself is not due until On page 20 we have a feature R075 CMM_reports_ad_Layout 1 04/09/2017 15:25 Page 4 Email: editor@caremanagementmatters.co.uk Twitter: @CMM_Magazine Web: www.caremanagementmatters.co.uk
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Hot on the heels of last month’s update from our Chief Inspector, Andrea Sutcliffe CBE on the key changes CQC is making to improve registration, I would like to thank Care Management Matters for the opportunity to bring you more detail about why we are doing this work and what we aim to achieve. Here at CQC, our registration function is essential to making sure those organisations who intend to provide care, or wish to vary the way existing care services are delivered, understand their legal responsibilities. This is to ensure people always experience good quality and safe care. Since our new approach to inspection was first introduced in 2014, we have already strengthened our registration work by making the checks we carry out as robust as possible, being satisfied that those who want to register or change services with us are fit to do so and taking action against unregistered services. So, what’s next for the future of registration? In 2017, we formally consulted on our next phase for registration which led us to set out four key outcomes. Registration is a quality test We want to build on making sure that registration is a barrier to poor care. Registration is the first port of call for those wishing to deliver regulated care activities, so we need to be confident that we only register services which are Good. We will do this by making consistent, proportionate and risk-based decisions about which providers to register – and by being clear to providers that we expect them to be able to demonstrate good, safe and person-centred care for people, their families and carers, who rely and depend on these vital services. Registration inspectors will use the same assessment framework as inspection based on the five key questions, and registration teams will work closely with inspection teams to identify the findings at registration (ie what a provider said they would do) and align this with the findings at the point of first inspection to ensure providers maintain their standards. The register will enhance public confidence and accountability We are looking to use our website to share clear, accessible information about who is accountable for the quality of care across provider organisations, and the nature of those services. We will also ensure that services do not
Inside CQC J O Y C E
F R E D E R I C K
In this month’s Care Quality Commission column, Deputy Chief Inspector for Registration Joyce Frederick talks about CQC’s work to improve registration.
lose their ratings and inspection history when their ownership changes or when there are other registration changes. This transparency is vitally important because it helps people make more informed choices about their care. It also links to our aim to make registration a quality test – if we get that right then appearing on the register will serve as a badge of quality. Registration supports innovation We are already seeing, and will continue to see, new care models and marketplace innovation; CQC needs to reflect this change by enabling all types of providers to register with us as they emerge. To do this, we are working to make it clearer what the legislation means by ‘carry on’ a regulated activity (ie providing a service). We will also define providers, not only those that deliver care but those responsible for ‘directing and controlling’ systems of care. This will support us to hold the right people to account for care quality and help the public understand who this is. Registration will have open, transparent streamlined processes We will improve our registration processes so that we target our assessment approach to the level of risk. We want to reduce the burden
on good providers, for example, by developing a more streamlined registration application process. We are also developing a digital service to make the process of understanding what standards are required and submitting a registration application easier and more efficient. Our registration inspectors and providers know how frustrating it is when applications are rejected due to simple formfilling errors and the digital service will help make this a thing of the past. These are big ambitions. By making these changes and getting them right we can make sure registration is at the cutting edge: maturing the national understanding of what are expected standards of care and what are unacceptable risks. To make sure we get this right, we are involving providers at every step, through coproduction of our approach and testing of our digital products. We are also going to introduce changes gradually, so while you will begin to see some over 2018/19, it won’t be a case of everything suddenly changing at once. Keep an eye out for our monthly newsletters to stay up-to-date with changes and find out about opportunities to get involved in testing the service. You can sign up by going to the ‘News’ page of our website.
Joyce Frederick is Deputy Chief Inspector for Registration at the Care Quality Commission. Missed Andrea Sutcliffe’s column? Read it on the CMM website www.caremanagementmatters.co.uk Sign up today. CMM May 2018
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APPOINTMENTS SKILLS FOR CARE Sue Bott CBE, Dr Ben Maruthappu and Mandy Thorn MBE have joined the Skills for Care Board.
CERA
Older people’s experiences of receiving care A new report by Age UK Why call it care when no one cares? summarises the results of a series of listening events the charity has held with older people who are receiving care and their family carers. 127 people participated in 13 sessions, which took place in the North, Midlands and South of England, in urban and rural places, and in more affluent and poorer areas. At each event the local MP joined for the final hour to hear directly from their constituents. These events included the Prime Minister, the Secretary of State for Health and Care, and the Shadow Secretaries of State for Health and Social Care and of Housing, Communities and Local Government. Most of the older people who took part and their family carers
were receiving care at home, but some were receiving care in a care home or supporting a loved one there. Although the listening events took place in very different places, the same issues came up over and over again, showing that the problems facing adult social care are national. The top five problems were: too many care workers are in a rush and there’s no continuity; care often it isn’t very good; social care is very expensive and often not good value for money; family carers feel abandoned and unsupported by the NHS and social care; the social care system is dysfunctional and navigating it is a nightmare. Almost everyone had struggled to find out how to arrange care. People were confused about what care is available, who provides it and how it is funded. Many had
wrongly assumed care would be provided free by the NHS. There were often delays in receiving information and basic help, and some didn’t get it at all. Council delays in assessing older people were a particular bug-bear and attendees heard about older people with dementia locking themselves out, setting fire to their kitchens, or going days without food while waiting to be assessed. When it came to possible solutions and ways of funding a better social care system, the top five points were: everyone should contribute in some way; we’re only willing to pay more if we get a better service in return; we want any extra funds that are raised to be ring-fenced for care; we believe we need a new and better contract with family carers in our society; and we older people and our families desperately want security.
CQC fees for 2018-19 The Care Quality Commission (CQC) has announced its fees for the next financial year. They come after a public consultation. In a letter to providers, Chief Executive David Behan explained that CQC has made a number of decisions on its fees scheme for the coming year. These are separated into two themes tailored to each sector it regulates. The first was to remove CQC’s banding structure and charge fees in proportion to a provider’s size. For community social care providers, CQC will charge fees
in proportion to the number of service users at a location. CQC has announced that it will also introduce a minimum (floor) and a maximum (ceiling) fee for community social care providers and NHS GPs. David Behan said that, ‘This will ensure that there is no distortion due to outliers, and is particularly an issue where the range of the size of providers is large.’ Mr Behan went on to explain that, ‘Only the community social care sector will see an overall increase in fees, in line with our
Former deputy prime minister, Sir Nick Clegg has been appointed as Chairman of Cera’s Advisory Board.
DEMENTIA UK Dementia UK has appointed Paul Edwards as Director of Clinical Services.
CARING HOMES Caring Homes has announced the appointment of Tracey Fletcher-Ray as its new Managing Director.
RANDOLPH HILL NURSING HOMES The Randolph Hill Nursing Homes Group has appointed Katie Wood to the newlycreated position of Care Standards Manager.
MHA MHA has announced Sam Monaghan as its new Chief Executive.
HICA GROUP agreed four-year trajectory to full chargeable cost recovery.’ Examples given in the letter are: • A community social care provider with one location and 15 service users will see their fee decrease from £2,192 to £926. • A community social care provider with three locations and 50, 100 and 45 service users at each of the locations will see their fee increase from £6,093 to £9,643. The CQC’s website has further information along with a fees calculator.
The Hica Group has appointed Heather Joy as Regional Director for the East.
HILL CARE GROUP Louise Hawksby has been named as Home Manager at Hill Care’s Mandale House Care Home in Stockton-on-Tees, John Paul Wilson is her deputy.
CEDAR COURT Cedar Court Care Home in Oxfordshire has appointed Phil Chapman as Home Manager.
CMM May 2018
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NEWS
Care home performance across England The quality of care homes got worse in one in five local authorities in the last year, according to new research on care home performance across England. The analysis by Independent Age found that the proportion of care homes rated Inadequate or Requires Improvement increased in one in five local authority areas in 2017. It also identified that a dramatic variation in the quality of care homes at a regional and local
authority level across England continues to exist. According to the analysis, the North West is the worst performing region when it comes to the proportion of satisfactory care homes, while London and the East of England are the best performing. In some areas such as Tameside or Portsmouth, older people and their families continue to face little choice of quality care, with around one in two homes rated
not good enough by the Care Quality Commission. The main regional findings are: • The North West contains five of the eight worst performing English local authorities on care home quality, with more than one in four care homes across the region performing poorly. • The North West (28.2% of care homes performing poorly), Yorkshire and The Humber (26.1%) and the West Midlands (21.3%) are the worst performing
regions of England for care home quality. • London (17.4% of care homes performing poorly), the East of England (17.4%) and the East Midlands (18.2%) are the best performing regions for care home quality. The analysis is based on CQC inspections of care homes and regarded homes rated Requires Improvement or Inadequate as being poor performers.
Emergency admissions at end of life set to rise Marie Curie says that the NHS is struggling to cope with A&E admissions of people who are in the last year of their lives. The charity says the situation will hit crisis point if community care is not significantly improved. Marie Curie data reveals there were over 1.6 million emergency admissions for people in the last year of their life in Britain in
2016, costing the NHS £2.5bn and amounting to around 11 million days in hospital. Emergency admissions can often be avoided with adequate community care. The charity warns that the significant rise in the number of deaths over the next 20 years means the cost of emergency admissions for people in the last year of life could almost double
– costing the NHS an extra £2bn, and up to 8,000 extra hospital beds could be needed by 2038 – the equivalent of an extra ward in every hospital with a major A&E unit. Marie Curie’s analysis of the data paints a particularly bleak picture in England compared to Scotland and Wales. The average number of emergency admissions in the last year of life in England is nearly
twice as many as in Scotland and Wales. Research by the Nuffield Trust has shown that hospital costs are by far the largest cost involved in end of life care – with the bulk of this due to emergency hospital admissions – and that potential savings might be made if community-based support were made more widely available.
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NEWS
Encouraging new workers Skills for Care has launched new guidance for providers on offering meaningful work experience to encourage new workers to social care. The guidance looks at how providers can support people who are new to the sector to start work in their organisation. Skills for Care says that offering pre-employment training as part of the recruitment process is a great way of ensuring people have realistic expectations about
working in social care, and can develop the skills and knowledge they need before they apply for a job. This can help providers to stem the flow of wasted resources in recruiting people that aren’t going to stay. Providers can decide what to offer, based on the needs of the business, such as an apprenticeship, a traineeship or work experience as part of the local sector routeway.
Care England planning tool Care England has launched a practical tool to enable the creation of a recorded, person-centred care plan, which will provide evidence of consideration of the Mental Capacity Act (MCA) key lines of enquiry that are pursued in all inspections of services. There is relevant information which will enable accurate, personcentred care planning within the empowering ethos of the MCA.
Reforming social care The Centre for Welfare Reform has published a report on how to reform social care. The report’s author, Robin Jackson explains why decades of failed policy has left social care economically unsustainable; efforts to integrate health and social care have failed and will continue to fail and insufficient attention has been
paid to the true nature of social care and how to sustain it. The report offers seven policy proposals: 1. Create a ministry for social care. 2. Fund social care properly and as a universal entitlement. 3. Create a distinct social care research council. 4. Create a meaningful training
model for social care based on social pedagogy. 5. Return to a social care inspectorate with a local and accountable structure. 6. Create a social care enterprise agency to foster innovation. 7. Explore the use of national service to engage young people in their communities.
Personal health budgets consultation The Government has launched a consultation on extending legal rights for personal health budgets and integrated personal budgets. The Government is consulting on: • Extending the right to have a personal health budget to specific groups of people. • Extending the right to have an integrated personal budget to specific groups of people. • Whether individuals would welcome the opportunity to incorporate additional funding streams into integrated personal budgets. The personal health budgets’ consultation is available on the Department of Health and Social Care’s consultation site http://consultations.dh.gov.uk and closes on 8th June.
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CMM May 2018
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NEWS
Tackling health inequalities Greater awareness of the health issues experienced by disabled people and the use of reasonable adjustments are vital if individuals are to have better health outcomes. These are among the good practice steps for health and care staff outlined in a new publication on tackling health inequalities. The VODG discussion paper, Tackling Health Inequalities, sets out what social care providers believe can help or hinder the health treatment of people supported. Its publication follows a recent event on the issue as well as the re-launch of the learning
disability health charter, which now includes dealing with overmedication. According to registered managers and frontline leaders that contributed to the paper, good practice in health for disabled people is localised, rather than consistent across the country. The paper lists care providers’ most common successes in ensuring good health for the people they support, including: • Improved monitoring of health, and setting or achieving health goals, including collecting good health data and monitoring of health conditions.
• Training on health issues for staff or people supported, including increasing staff confidence to raise important issues with health professionals. • Initiatives to promote healthy lifestyles like diet, exercise and smoking. Meanwhile, common challenges faced by providers tackling health inequalities include: • Staff and the people they support having a low awareness of the importance of living a healthy lifestyle, including a healthy diet and exercise. • Poor access to mainstream NHS community services.
Attitudes and practices that support positive health outcomes include reasonable adjustments, such as the use of interpreters or creating ‘wellbeing logs’, enabling clear communication between patient, health staff and care staff. Equally vital is equipping staff with the knowledge to advocate for people regarding their health, and to engage in equal conversations with health professionals. Collaborative relationships, record-keeping and a willingness to engage in important conversations with people and families also result in better health outcomes.
Impact of falls on hospital admissions The number of hospital admissions due to an older person falling is set to rise to nearly 1,000 a day by the end of the decade, according to figures obtained by the Local Government Association (LGA). The worrying forecast has prompted renewed calls by council leaders for more funding for adult social care to invest in cost-effective prevention work to reduce falls, which can have devastating and life-threatening consequences on a person’s health and wellbeing.
Research shows that falls prevention programmes run by councils reduce the number of falls requiring hospital admission by nearly a third (29%) and produce a financial return on investment of more than £3 for every £1 spent. The LGA says that extra government funding for councils to scale up this prevention work to address a rising older population would help the NHS by reducing the need for people to be admitted to hospital after a fall and cut costs to the public purse.
Falls are said to cost the NHS more than £2bn a year – the amount needed to plug the annual funding gap that councils face in adult social care by 2020. Councils, many of which already offer comprehensive advice and guidance to help older people stay on their feet, want to invest more in prevention work but are being restricted due to government funding reductions. Latest figures show that in England in 2016/17, there were 316,669 hospital admissions of people aged 65 and over due to
falling, amounting to two-thirds of all fall-related admissions. Around a fifth of these were as a result of slipping, tripping or stumbling. The number of fall-related hospital admissions among older people has increased by 9% over four years, and based on this trend, will continue to rise to around 350,000 by 2020/21, the equivalent of approximately 950 cases every day. In contrast, the number of admissions for those aged under 65 has remained constant.
The hospital and social care interface The Nuffield Trust has published a new report looking at the hospital and social care interface and what works when it comes to interventions targeting older people. It makes a number of recommendations for policymakers and local hospital leaders. Managing the hospital and social care interface: Interventions targeting older adults explores the actions and strategies that providers and commissioners have put in place to improve the interface between secondary and social care, with a focus on what hospitals can do. The report’s authors look at collaboration 12
CMM May 2018
to prevent avoidable hospital admissions; the interface between hospitals and social care providers when patients are discharged from hospital; the relationship between commissioners and social care providers; and whole-scale organisational integration. Drawing on the experience of seven case study sites, as well as evidence of what has worked to-date, the authors make five recommendations for national policy-makers and seven for local hospital leaders. Recommendations for policymakers are: 1. Move beyond a focus on delayed
transfers of care. 2. Consider small-scale as well as large-scale organisational change. 3. Focus on increasing the health and social care workforce. 4. Understand the capacity of community-based services. 5. Make use of other sectors where possible.
types of integration. 4. Consider pooling budgets to facilitate progress. 5. Make sure that integrated teams have appropriate processes to support them. 6. Make sure that commissioners are on board. 7. Collaborate with housing partners.
Recommendations for local hospital leaders are: 1. Think imaginatively about the workforce. 2. Do not make decisions about social care without social care. 3. Think carefully about different
The authors conclude that, ‘None of this is easy. But as both the health and social care sectors face the biggest challenges that they have ever faced, improving collaboration is more important than ever.’
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NEWS
Advinia acquires Bupa homes Care home provider, Advinia Health Care has acquired 22 Bupa care homes in a deal that closed in February. The acquisition follows the completion of Bupa’s transfer of 110 care homes to HC-One in December. The deal means Advinia Health Care now operates 38 care homes in the UK, comprising 3,250 beds, an increase of over 500%. The company is now among the top 10 private care providers in the UK, and has taken over the employment of more than 3,700 staff who previously worked at Bupa. No reductions in overall
staff numbers are expected. The equity for the Advinia purchase, whose price has not been disclosed, was provided by Dr Sanjeev Kanoria, a liver surgeon and ex-McKinsey consultant from London, who co-founded Advinia with his wife Sangita Kanoria. With strong financial backing, the expansion will see Advinia’s quality of service applied across the new homes. Debt was arranged by Credit Suisse Bank in London, and Austrian Anadi Bank, which is fully-owned by Dr Kanoria. Legal counsel was provided by Allen & Overy.
Resources for older adults with mental health concerns Older people worried about their mental health will be able to seek advice with new tailored resources published by the Royal College of Psychiatrists. MindEd for Older People is a new online educational resource that explains a range of mental illnesses commonly experienced by older people, and offers practical advice for dealing with them. The new resources cover a range of common problems such as insomnia, depression, medications to be aware of,
anxiety and alcohol-related issues. The resources are a vital crutch at a time when demand for mental health services is increasing whilst supply of the mental health workforce for older people is falling. MindEd for Older People aims to equip older adults, families worried about their older relatives, and professionals and volunteers working with older people, with the necessary information to manage their mental health needs.
Care home staff survey identifies positive and negative behaviours The largest-ever survey of care home staff in England, led by University College London (UCL) researchers, has identified positive behaviours were much more common than abusive behaviours. However, the researchers say that instances of neglectful behaviours are widespread and may be linked to staff burnout. For the study, published in PLOS ONE, care home staff were asked anonymously about positive and negative behaviours they had done or had witnessed colleagues doing. From 92 care homes across England, 1,544 care home staff responded to the survey. The staff were asked whether they had, in
the past three months, witnessed a range of positive and negative behaviours. Their responses were linked to data from each care home describing a measure of burnout in care home staff. Some negative behaviours were categorised as ‘abusive’, using a standard definition, and based on the behaviour reported, rather than the intention of the care home staff. The most common abusive behaviours were: • Making a resident wait for care (26% of staff reported that happening). • Avoiding a resident with challenging behaviour (25%). • Giving residents insufficient time
Wellbeing guide for registered managers Skills for Care has launched a wellbeing guide to support registered managers and care home managers to better manage their own professional and personal wellbeing. The new guide, Wellbeing for registered managers; a practical survival guide is available to registered manager members of Skills for Care who all have busy and complex leadership roles. Many of these members are already on their wellbeing 14
CMM May 2018
journey and part of a growing community of managers who improve the quality of care in adult social care. The guide introduces registered managers to the Five Ways to Wellbeing – Connect, Be active, Take notice, Keep learning and Give – based on evidence by the New Economics Foundation. The guide includes practical information, top tips, case studies, action plans and workbook exercises.
for food (19%). • Taking insufficient care when moving residents (11%). Verbal abuse was reported by 5% of respondents and physical abuse was reported by 1.1%. At least some abuse was identified in 91 of the 92 care homes. Positive behaviours were reported to be much more common than abusive behaviours, however some positive but timeconsuming behaviours were notably infrequent. For instance, more than one in three care home staff were rarely aware of a resident being taken outside of the home for their enjoyment,
and 15% said activities were almost never planned around a resident’s interests. The study is part of the UCL MARQUE cohort study, which is also looking into cost-effective interventions to improve the quality of care for people with dementia, and will be using this anonymous reporting as a measure of how well training interventions are working. The study was conducted by researchers at UCL and the Camden and Islington NHS Foundation Trust, and funded by the Economic and Social Research Council and the National Institute for Health Research.
Avante Care & Support in Kent Avante Care & Support has been approached to operate a £15m care village in Canterbury. The proposed care village would be a new venture for the charity which already owns and operates nine care homes and provides homecare across Kent and South-East London. Senior staff and Trustees from Avante Care & Support joined Simon Wright, Chief Executive of developer, Corinthian Land to visit the ground-breaking Dutch facility, Hogeweyk in Amsterdam where a similar scheme is running
successfully. After experiencing the Dutch facility and seeing for themselves how the concept can work for people living with dementia, Avante Care & Support and Corinthian Land were keen to see how this could work in the UK. The dementia care facility would be similar with residents living in houses of eight. Each house would be themed around a particular culture or lifestyle. The care village would include a selection of 200-250 one- and twobedroom extra care apartments.
NEWS / IN FOCUS
Council incorrectly charged top-up fee Norfolk County Council has agreed to investigate whether more care home residents have been incorrectly charged a top-up fee, after one family’s complaint was upheld by the Local Government and Social Care Ombudsman. When the family placed their mother in a care home and needed to sell her house to pay for her care, the council should have offered the woman a so-called ‘affordable’ care home. This would not require the family to pay a top-up fee above what the council would contribute, for 12 weeks while the home was being sold. Instead, the Ombudsman’s investigation found the council charged the family for those
12 weeks, wrongly arguing that because the woman’s capital, including her property, was above the £23,250 threshold, it did not have to offer her an affordable placement. The council has waived the fee, and has agreed to check if it has charged other people in the county in error. It has also agreed to improve the information it offers to families when they are seeking help with care home placements. The council has agreed to apologise to the family and pay the son £300 for his distress. It will also review its policy on charging to ensure it contains sufficient detail about when the council should ask for a top-up fee.
Consultation on regulation of nursing associates The Nursing and Midwifery Council (NMC) has launched a consultation on its proposed approach to the regulation of nursing associates. Nursing associate is a new role created to bridge the gap between healthcare assistants and registered nurses in England. As part of the proposals, the NMC has outlined its approach to education, including ambitious standards of proficiency for the role that will enable nursing associates to deliver first class care. The NMC has also set out how it expects the existing Code to
apply to nursing associates as well as nurses and midwives, ensuring that the same high standards of professional behaviour and conduct will apply to everyone on the register. Under the plans, nursing associates would also be subject to the same revalidation requirements as nurses and midwives when renewing their registration with the NMC as well as the same fitness to practise processes should something go wrong. The consultation will run until 2nd July 2018.
Planning permission for extra care in Kemsing Sevenoaks District Council has approved plans for Rapport Housing & Care to develop an extra care housing scheme in Nightingale Road, Kemsing. Work will start on the site in the autumn and the extra care housing scheme will comprise 51 oneand two-bedroom apartments, available to purchase and for affordable rent, through Sevenoaks
District Council. With two other extra care housing schemes currently on-site and a third due to commence shortly, the Kemsing development will see a further continuation of the company’s ambitious development plans. Once completed, these will see the provision of a total of 235 new extra care apartments across Kent.
IN FOCUS Government’s seven key principles for Green Paper WHAT’S THE STORY?
In a speech, Minister of State for Health and Social Care, Jeremy Hunt MP has set out the Government’s seven key principles ahead of the Green Paper due this summer. They will guide the Government’s thinking and give an indication of the direction of the Green Paper. The seven principles are: Quality of care; Integration; Control; Workforce; Carers; Funding; and Security.
QUALITY, INTEGRATION AND CONTROL
Mr Hunt has called for a commitment to tackle poor care with minimum standards enforced throughout. He also announced three pilots of single health and social care plans based on joint assessment by both systems to drive wholeperson integrated care. The Government will also consult on personal health budgets.
WORKFORCE
Regarding workforce, Mr Hunt said the value of social care workers must be recognised and action must be taken on ‘the wider set of challenges facing the workforce’. He also announced a NHS and social care 10-year workforce strategy.
CARERS
The Government also intends to publish an action plan to support carers prior to the publication of the Green paper, and make carers’ needs central to the new social care strategy.
FUTURE FUNDING
Mr Hunt was clear that there is a need to create a sustainable
funding model for social care supported by a stable market. He said, the Green Paper will consider ‘how we ensure a sustainable financial system for care, delivering a stable and vibrant market which delivers cost-effective, quality services for all, including the debate we need to have with the public on the challenges of sourcing additional social care funding.’ He added that, ‘We should not assume that the best longterm answer will be necessarily the same for different age cohorts.’ This principle also includes increasing public awareness of where social care costs currently lie. As part of this work, the Government will also look at how it can, ‘prime innovation in the market, develop the evidence for new models and services, and encourage new models of care provision to expand at scale.’ This will include the role of housing and replicating best practice models that combine a home environment and quality care, plus the role of aids and adaptations.
SECURITY
The final principle is security for all, focusing on shared responsibility and a partnership between the state and individuals.
WHAT’S NEXT?
The full speech is available on the GOV.UK website and the Green Paper is expected before the summer recess on 24th July. The Government has already opened the consultation on personal health budgets. See page 11 for more information. CMM May 2018
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NEWS
CQC’s review of Coventry’s local health and social care systems The Care Quality Commission (CQC) has published its findings following a review of health and social care services in Coventry. The report is one of 20 targeted local system reviews looking specifically at how older people move through the health and social care system. The reviews
look at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for people aged 65 and over living in a local area. CQC found there was a systemwide commitment to serving the people of Coventry well. Coventry
was at the beginning of its journey in ensuring all services worked well in a ‘joined up way’ together. However, the review also highlighted some areas where further work is needed to ensure all those responsible for providing health and social care services work effectively together.
This review is the latest in CQC’s commitment to carry out 12 local area reviews by early 2018, only the review of Birmingham’s systems remains to be published. CQC will then review eight further local areas with a view to publishing a national report later in the year.
2017 Your Care Rating results published The 2017 Your Care Rating survey, the UK’s largest and most authoritative on perceptions of care, has revealed that care home residents in South Yorkshire are, on average, the most positive about the care they receive. The Your Care Rating surveys produce an Overall Performance Rating (OPR) out of 1,000, and across all participating homes, this resulted in an average score of 878 for the Residents’ Survey and 836 for the Family and Friends’ Survey in 2017/18. Residents living in participating
care homes in South Yorkshire achieved an average OPR of 906 out of 1,000, closely followed by those in Humberside and Lincolnshire with an average rating of 902. Conducted by Ipsos MORI, the survey also shows that family members and friends of care home residents are most positive about the care their loved ones receive in East Anglia (854), just ahead of North Yorkshire, including York (851). Now in its sixth year, the Residents’ Survey achieved its
highest ever response rate of 40.5%, with over 16,500 responses from 820 care homes. Meanwhile, the Family and Friends’ Survey also achieved a high response rate of 48%, over 12,000 questionnaires from 686 homes. In terms of performance in the Residents’ Survey, Methodist Homes’ Mayfields care home in Ellesmere Port, Cheshire received the highest possible OPR score of 1,000. This is closely followed by Grange Crescent care home in
Sheffield (Sheffcare Limited), Marnel Lodge Care Home in Basingstoke (Barchester Healthcare) and Lloyd Court near Holt in Norfolk (NorseCare Limited) all scoring 996. In the Family and Friends’ Survey for 2017, Queen Elizabeth House in Kent (Greensleeves Homes Trust) achieved an OPR score of 986, followed by Silk Court in London’s Bethnall Green and Kimberley Court in Newquay, Cornwall (both provided by Anchor), with an OPR score of 970 and 967 respectively.
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CMM May 2018
NEWS
Tools to support STOMP Progress with STOMP, the commitment to stop overmedication of people with a learning disability, autism or both has been evaluated a year after VODG took over promoting it. A commitment to the campaign has been steadily building in social care with over 160 social care providers, supporting over 52,000 people, pledging support
in the past year. Adding to this, 33 providers, supporting over 26,000 people, are now delivering on a STOMP action plan. To support this, VODG has published a set of tools to equip providers to implement their commitment to STOMP, including the STOMP pledge for social care and Preparing to visit a doctor. VODG has also hosted a STOMP
conference, launched STOMP News and discussed the importance of STOMP with over 1,100 sector leaders. Providers who have been early adopters of the commitment have recently been reviewing their progress. They are reporting increased staff confidence in raising medication issues with health professionals and there
is a small but growing body of case studies of people who have successfully reduced or stopped their psychotropic medication. A wider, more academic review of progress will be taking place this year. VODG will also be focusing on how to support providers to embed their commitment to tackling overmedication in practice on a longterm basis.
Making Space partners with new initiative to introduce innovations
Welsh care home sold
Making Space is working with person-centred care pioneer, Helen Sanderson to bring a new model of care to Wigan. In so doing, Making Space is poised to introduce a number of innovations across its services. In a bold move towards new ways of delivering services in a climate of funding cuts and policy, the social care charity has taken
DC Care has recently completed the sale of The Laurels Care Home in Aberdare, South Wales on behalf of their client, Mr Keith Jones. The Laurels has been acquired by Siva Sriplan and his business partner. It has been sold for an undisclosed sum off an asking price of £650,000 for the freehold.
Helen’s developing care initiative Wellbeing Teams under its wing. The joint venture came about as a result of discussions with the commissioner at Wigan Council about the challenges and possibilities of delivering care services in their local area. Wellbeing Teams are inspired by the pioneering work carried out by Buurtzorg nurses in
the Netherlands, which has improved the quality of care and raised work satisfaction for employees. Buurtzorg translates as ‘neighbourhood care’. Support from Wellbeing Teams will be available to older people in Ashton, Wigan who receive a personal budget for their care from the council and also to selffunders.
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CMM May 2018
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NEWS
Care and support of older Care home pharmacists to cut people with learning disabilities overmedication The National Institute for Health and Care Excellence (NICE) has published a new guideline on care and support of people growing older with learning disabilities. NICE says people need to have annual health checks to help them manage conditions that can quickly affect them as they grow older. These checks should be recorded in a ‘health action plan’ that can be updated annually. The guideline describes how to help people receive appropriate support at the right times, preventing delays in care. Staff should be proactive and set up plans in advance which take into account people’s hopes and wishes, and who they want to spend time with. Staff should also consider the needs of family
and carers and help people with learning disabilities maintain important relationships. The guideline also advises local authorities to ensure there are opportunities for people to socialise and be active in their communities. The guideline is intended for providers of social care, health and housing support; practitioners, commissioners and people with a strategic role in assessing and planning local services; and people with learning disabilities and their supporters. It covers integrated commissioning and planning; service delivery and organisation; accessible information, advice and support; identifying and assessing changing needs; care planning; and supporting access to services.
Barriers facing older renters Half a million older private renters are ‘invisible’ in policy decisions on housing and age-related issues, according to a new report from Independent Age. The findings say that older private renters are invisible despite being more likely to report cold and damp in their homes, expecting to get into financial difficulty in the future, and many being in poverty after housing costs. According to the report almost one third (32%) of older private renters feel their accommodation isn’t suitable for their needs. One in 10 of all private rented households are occupied by older people, an estimated half a million people. Over the next 20 years, it is projected that the number of older households living in private rented accommodation will increase by around twothirds, from 338,000 households to around 549,000. Many older people who rent have done so all their lives. Older private renters are disproportionately more likely to move than older people in 18
CMM May 2018
other household tenures, with more than three-quarters (77%) moving to another privately rented home or to social housing. Other findings from the report, Unsuitable, insecure and substandard homes: The barriers faced by older private renters include: • Twice as many private renters aged 65 and over say they have cold and damp in their homes compared to older homeowners or social renters. • More than one in four (29%) older private renters say they sometimes or often have too little money, with one in seven saying they don’t go out socially because they can’t afford it. • One third of private renters aged 65 and over are living below the poverty threshold after they have paid their rent, with poverty levels higher among private renters than older people in other housing situations. • Older private renters are more likely to have paid for adaptations to their home themselves.
NHS England has announced plans to introduce care home pharmacists to help cut overmedication and unnecessary hospital stays for frail older patients following successful trials. Around 180,000 people living in care homes and care homes with nursing will have their prescriptions and medicines reviewed by the new pharmacists and pharmacy technicians. NHS trials have identified that when pharmacists reviewed medicines it improved people’s quality of life by reducing unnecessary use and bringing down emergency admissions, with less time spent in hospitals. The use of clinical pharmacists and pharmacy technicians to undertake structured medicines reviews of all new and discharged residents in Northumberland
showed that one hospital readmission could be avoided for every 12 residents reviewed. In East and North Hertfordshire, where this model was applied across 37 care homes, an annual drug cost saving of £249 per patient was seen. Results from the pilots show that they: • Reduced reported emergency hospital admissions by 21%. • Reduced oral nutritional support usage by 7%. • Reduced ambulance call outs by up to 30%. • Made drug cost savings of £125 to £305 per resident. As a result of these trials, NHS England will roll out the approach by funding recruitment of 240 pharmacists and pharmacy technicians.
Target Healthcare REIT acquisitions Target Healthcare REIT Limited and its subsidiaries has entered into contracts to acquire and forward fund two new care homes located near Shrewsbury, Shropshire and in Preston, Lancashire, for a cost of approximately £15.6m. The completed care homes will be let to Rotherwood Healthcare and L&M Healthcare respectively. Both properties received planning consent in 2017 and the Group intends to fund the development of the sites into
a 68-bed and a 74-bed home respectively. The Shropshire home will replace an existing 45-bed home, being one of six care homes currently operated by Rotherwood Healthcare. On completion, the Preston care home will become the fifth high-quality care home operated by L&M Healthcare across the North West of England. Both operators will be new tenants to the Group. Both homes are due to open during 2019.
Heathcotes in Nottinghamshire Heathcotes Group will soon be opening two new residential care services in Newark, which it has developed in partnership with Nottinghamshire County Council. The two neighbouring buildings, Enright View and Enright Lodge, will employ 40 care staff to provide support for adults with learning disabilities, mental illness, autism
and dual diagnoses or associated complex needs. The services have been designed to support Nottinghamshire County Council’s Transforming Care plans with a bespoke community provision comprising eight bedrooms within a shared environment alongside five selfcontained apartments.
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If not now, when? Developing the social care workforce James Bloodworth’s recent book much of an outcry in the sector, a Debbie Sorkin looks at documenting what it’s like to work sense of red lines being drawn, as the need to develop the in low-wage sectors in Britain. there had been over Winterbourne Many of us would object to View. social care workforce, such a description. But it’s how the I think it’s matched in some the benefits of doing sector is commonly portrayed. areas by a sense of wanting someone else, some deus ex so and the role of good MEDIA COVERAGE OF machina, to come in and rescue the leaders in achieving THE WORKFORCE sector. a trained, valued In March, University College London WORKFORCE POLICY workforce. published a large-scale study of
‘The author then decamped to Blackpool to work in that fecund and oxymoronic sector, “caring”…twenty minutes per visit, maximum. The carers had trained themselves to use loaded questions to speed visits along… “You don’t need any shopping today, do you?”. The elderly client, not wishing to cause bother, would invariably answer the questions, “No”. That’s the care industry for you.’ This is Rod Liddle – not someone I often quote – reviewing 20
CMM May 2018
staff in care homes – more than 1,500 staff across 92 homes. The vast majority of the feedback, as reported in the study, related to acts of kindness and compassion that staff had seen. What was the headline? ‘Half of care home staff have seen the elderly neglected.’ It could be argued that the sector has resigned itself to this view of social care. Earlier this year, when abuse of residents with learning disabilities was revealed at Mendip House, a residential care home run by the National Autistic Society in Somerset, there was not nearly as
In March, Secretary of State for Health and Social Care, Jeremy Hunt MP’s speech on social care was pored over for signs of hope for the workforce. They are there. ‘A valued, respected and nurtured workforce’ is one of the seven principles that will underpin the forthcoming Green Paper. Mr Hunt called the social care workforce, ‘Our society’s modern-day heroes’, noting that although they were often highly-skilled, they were typically the lowest-paid, and that the value of social care work should be recognised. The speech committed
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IF NOT NOW, WHEN? DEVELOPING THE SOCIAL CARE WORKFORCE
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to publishing an ‘aligned’ 10-year workforce strategy for both the NHS and social care later this year. Personally, I’m hoping for something daring and dramatic: for example, to open up the NHS Graduate Scheme to people in social care with and without degrees, along the lines of the Open University, with a view to professional recognition for registered managers. Also, I hope it’s backed by real money. At the moment, as the National Audit Office (NAO) noted in its recent review, The Adult Social Care Workforce in England, the sector spends just £14 per person on training and development. Lack of money is a major issue: both providers and commissioners told the NAO that funding constraints meant they prioritised provision of care in the short term over training and development in the longer term, although both said better training would be a priority if more funding were available.
VALUING THE WORKFORCE Whilst we’re waiting for the radiant future, that doesn’t mean we can’t value the social care workforce and nurture and develop them in the here and now. This is valuable not just in itself, but in order to foster a sense of self-worth and belief across the workforce – which in turn will help develop a workforceled push for recognition. What we need is more of the attitude set out in a report from the House of Commons Communities and Local Government Committee in March 2017, which quoted one care worker as saying, ‘I am often frustrated to hear people conflate low pay with low skill and low value. Most people working in adult social care are undertaking very skilled roles and they need high skills and personal attributes and high levels of resilience to be
able to do what they do.’ When it comes to valuing and developing your staff, if you’re an employer, I think the first thing is to see training and development as something that actually saves you money. In February, the NAO review noted, ‘The widespread public perception [is] that care work offers limited opportunities for career progression, particularly compared with health.’ This then acts as a barrier to recruitment and retention.
STAFF RETENTION Staff retention is a key issue in the sector, with annual turnover of all care staff amounting to 27.8% in 2016-17, and turnover being especially high in homecare, across the south of the country, and amongst care workers and registered nurses. Overall, turnover has been increasing since 201213 which creates an issue for providers because high vacancy rates and turnover can disrupt the continuity and quality of care for service users. The Care Quality Commission (CQC) has also found a link between high vacancy and turnover rates and poorer levels of care being provided. High turnover leads to providers incurring regular recruitment and induction costs. It’s estimated that the cost of recruiting one new member of staff, taking into account time of senior staff in interviewing, selection and induction, amounts to £2,000 to £3,000 per individual. If money is tight, and if net migration continues to fall so that the pool of potential workers is smaller, you can save significant sums by addressing turnover and, therefore, not needing to recruit as many replacement frontline workers. This means there is an opportunity cost here: why not put the money you use on recruiting new people towards retaining the good people you’ve got? Thus, reducing the number of new recruits you’ll need in the future.
ROLE OF LEADERSHIP Once you have the people you want to retain working with you, being a good leader will help you to keep them. This involves exhibiting the behaviours in the Leadership Qualities Framework for Adult Social Care (LQF), which sets out what good leadership looks like at all levels of a team or organisation and is intrinsic to being a good employer. Continuing your personal development and that of your staff is one of the four components of leadership around Demonstrating Personal Qualities that are set out in the LQF. It says that good leaders: • Actively seek opportunities and challenges for personal learning and development. • Acknowledge mistakes and treat them as learning opportunities. • Participate in continuing professional development activities. • Change their behaviour in the light of feedback and reflection.
IMPLEMENTING TRAINING When looking at training and development, it is important not to see it as something ancillary to people’s day-to-day jobs, but as part and parcel of their values and their everyday leadership behaviours, because care work, by definition, is highly-skilled work. Implementing training also doesn’t always mean external training courses. For example, frontline workers – care assistants, care workers or apprentices – can be, in the words of the LQF, ‘Open to learning from others and willing to share knowledge and experience’. As such, buddying with co-workers, or using coaching approaches can constitute forms of development. There is plenty of advice available on low-cost and innovative ways to develop yourself and your teams. The King’s Fund,
in its recent report on Enhanced Health in Care Homes, mentioned many creative approaches to training. One extract is, ‘We did some training for activity co-ordinators. We developed a Facebook page off the back of that where homes can see live feeds and we share information through there, we also use Twitter. Some homes are agreeable to open their doors up and share with other care homes, so…we might go into a home that’s not doing so well on something just down the road from one that’s got it sorted and we’ll pair them up. Or if we’re doing training with them we’ll help them to contact local homes in the area because the more training places get booked, the cheaper it is per person, the more you can share the cost.’
GETTING IT RIGHT All this said, social care employers must be doing something right. In its last State of Health and Social Care report, CQC stated that the proportion of adult social care services rated ‘Good’ had increased from the previous year, with 78% achieving the rating versus 71% in 2016. Moreover, strong leadership played a pivotal role, with good leaders characterised by individuals who actively sought out best practice to steer improvements. The report also explicitly stated that good managers truly valued their staff, supporting them to maintain their knowledge of best practice and person-centred care through training and establishing ‘champions’ in different areas of care. It added that leadership was not restricted to registered managers: everyone could play a leadership role through exhibiting good everyday behaviours. Despite everything, training and development is happening, and it’s showing through in excellent care. How about we make some more noise about what we do? We don’t need Rod Liddle to define social care for us. CMM
Debbie Sorkin is National Director of Systems Leadership at The Leadership Centre. Email: Debbie.sorkin@leadershipcentre.org.uk Twitter: @DebbieSorkin2 CMM is working towards CPD certification. See page 5 more information. 22
CMM May 2018
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A selection of care businesses successfully sold by DC Care so far in 2018...
Futures Care Limited, Essex
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Rosecroft Care Home, Bromley, Kent
The Laurels, Aberdare
Havengore House, Leigh on Sea, Essex
Carrying on from where we left off in 2017, more care business sales are imminently completing. In the elderly care sector the demand remains incredibly high for homes with 30 beds and above, a good CQC rating and with an experienced manager. In the specialist care sector we are experiencing unprecedented success with a number of well-funded purchasers acquiring learning disability and/or mental health businesses. There is huge interest with some sales completing in less than 3 months.
Buyers are clamouring for the right care business. Call us now on 01937 849 268 or email sales@dccare.co.uk for a no-obligation confidential chat with our dedicated and experienced team. When industry knowledge and wisdom are needed, when a discreet sale is desired, our clients choose DC Care to sell their healthcare business.
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Is nobody’s business everybody’s excuse? Making care services inclusive of older people who are lesbian, gay, bisexual or trans
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Sally Knocker explores recent developments in supporting older people who are lesbian, gay, bisexual or trans and why it’s everybody’s business to get support right.
‘Is it really our business to know what people do in the bedroom?’ ‘We don’t have any gay people here, so it is not really an issue for us.’ ‘We aren’t prejudiced, we treat everyone the same.’ All of these comments have been heard in recent years by care managers in a range of settings. They are sometimes offered as an excuse for why looking at the particular needs of older people who are lesbian, gay, bisexual or trans (LGBT+*) are not considered a priority. Behind these attitudes are, of course, many underlying misunderstandings and assumptions. For people who are LGB or T, what ‘they do in the bedroom’, ie people’s sex lives, is only a part of what is integral to people’s core identity. Being LGBT+ shapes many aspects of a person’s life, interests and experiences, and especially whom they feel able to trust. For an older generation of LGBT+ people who have lived through a time when they were criminalised, seen as ‘sick’ or had to hide who they were for fear of losing family, jobs, homes or even their children, trust is a huge issue. Some LGBT+ people can feel genuinely fearful about contacting care services when they need support. Most research evidence suggests that older LGBT+ people are more likely to be single and less likely to have children and, therefore, potentially more likely to be isolated and in need of support services. Yet in Stonewall’s 2011 survey, six out of ten lesbian, gay and bisexual people said they weren’t confident that social care and support services would understand or meet their needs. In data collected by the Commission for Social Care Inspection (now Care Quality Commission) in 2008, only 7% of care homes and 8% of homecare providers reported carrying out
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specific work around equality for LGBT+ people. Added to this, there was no specific reference to LGBT+ issues in the National Dementia Strategy published in 2009. The second statement that there are ‘no gay people here’ stems from an ageist assumption that sexuality is generally perceived as a ‘non-issue’ for older people. Yet, as people become grey, do we become any less gay? If people are still having sexual and romantic relationships into their 70s, 80s and beyond, it is seen as unusual and ‘sweet’ at best and ‘distasteful’, ‘unthinkable’ and ‘wrong’ at worst. There is also a danger that people who have been married to someone of the opposite sex in their earlier lives, as
“The encouraging news is that there is a definite current wave of interest in the sector in raising the profile of the needs of LGBT+ older people and translating this into positive action.” many lesbian, gay or bisexual people were, are automatically assumed to be heterosexual. When initial information is gathered about a person, many forms do not have open enough questions to enable people to talk about the important people in their lives, whether a lover or LGBT friends. ‘Family’ may mean very different things to LGBT+ people than conventional family constructs. Many assessment forms are also very gender specific, which can be excluding and difficult for trans people. All this means that at a time when people are at their most vulnerable, many find themselves feeling guarded and afraid to be open about themselves with care professionals. There are an estimated 1.2 million older LGB people, and an estimated
300,000 to 500,000 trans people in the UK, though there are no official statistics available for trans people and both numbers are guesses. This is a significant population, and the next generation, currently in their 50s and 60s, who might need care services are much more likely to be open about their LGBT+ identity and to want these services to be equally open about how they might recognise and support them as they age and/or develop a dementia. This brings us on to the final excuse; ‘We don’t discriminate, we treat everyone the same’, which fails to capture what truly person-centred care is about. As the recent guide produced by Age UK and Opening Doors London (ODL) Safe to be Me explains, ‘It is through recognising and giving regard to difference in a positive way, that services can distinguish themselves.’
POSITIVE CHANGE IS HAPPENING The encouraging news is that there is a definite current wave of interest in the sector in raising the profile of the needs of LGBT+ older people and translating this into positive action. In terms of dementia, Alzheimer’s Society, the Dementia Action Alliance, the National Care Forum and ODL all have focused strands of work to identify specific areas in which practice could be improved. This work is still in progress, but the idea is that there will be some action areas which might be taken forward, for example in positive publicity initiatives, staff training and support for LGBT+ people who are affected by dementia. With over 1,600 members, ODL is the largest organisation providing a wide range of services and support to the older LGBT+ community in the UK. Its monthly afternoon Rainbow Memory Café is well-attended by LGBT+ people with dementia, their partners and friends, as well as people with concerns about memory loss and cognitive decline. One of the gay men caring for his partner with dementia said at the first meeting he had a huge sense of
relief and feeling as if he had ‘come home’ in the group without having to explain himself as he might in a generic dementia support group. Another Rainbow Café has recently been launched in Brighton. There is still work to be done in reaching and including older trans people, who are often more immediately visibily identifiable as trans and so can face even more prejudice and ignorance. More generally in health and social care services, there is an increasing interest in how care providers might positively identify and prove themselves as an inclusive and welcoming service to older LGBT+ people. ODL has just started to pilot a Pride in Care Quality Standard, which would enable services to sign up to implementing a range of clearly identified steps to ensure they were LGBT+ aware and inclusive. Once these steps have been taken, the service will then be assessed by trained ODL ambassadors and if successful, given a quality assurance certificate which will be monitored and renewed annually.
BE PROACTIVE The starting point, as with any change initiative, is an inspiring manager in any care service who has a genuine interest in making sure that any trans, lesbian, gay or bisexual person who contacts their service will feel safe and comfortable. They cannot just assume this will happen as they need to ensure their whole staff team is proactive and committed, not just ‘tolerant’. This is starting to happen, and it was particularly heartening at the ODL LGBT+ Rainbow Café consultation event last year to meet so many heterosexual colleagues keen to show their support. At the end of the day, it must surely be ‘everybody’s business’ to get this right? CMM *The term LGBT+ is used to recognise inclusion of those who are not exclusively lesbian, gay, bisexual, or transgender, encompassing spectrums of sexuality and gender.
Sally Knocker is Rainbow Memory Café Coordinator at Opening Doors London and Consultant Trainer at Dementia Care Matters. Email: sally@dementiacarematters.com Twitter: @SallyKnocker Are you an inclusive provider? Share your approaches on the CMM website, where you can also access the references and links from this article. www.caremanagementmatters.co.uk Sign up today. CMM May 2018
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‘CARE BNB’ – CAREROOMS LAUNCHES IN UK CareRooms has announced its UK launch and is looking for hosts in Cambridgeshire. What does our panel think of this new approach to supporting people out of hospital? CareRooms hit headlines in October 2017 when Southend University Hospital NHS Foundation Trust was said to be considering a pilot of the approach to support people out of hospital and into ‘host’ homes for recuperation. The hospital quickly stepped back from this in a statement saying that it encouraged new ideas and innovation but had no intention to support the pilot at this time. After the false start, CareRooms has announced its UK launch and is looking for hosts in Cambridgeshire, although it is yet to contract with the council, local hospitals or clinical commissioning group.
CAREROOMS Disruptive approaches to care and support have been developing over the years and CareRooms is the newest innovative approach. Motivated by his family’s experiences of caring, CareRooms was developed by Paul Gaudin. Paul’s mother cared for his father, who had Parkinson’s Disease, up until he passed away in 2016. The loss of Paul’s father left his mother alone and socially isolated. From this situation, CareRooms was born. The CareRooms approach is to enable people who are medically fit for discharge, but unable to leave hospital due to lack of suitable ongoing care or accommodation, to be discharged into the home of a host. A representative from CareRooms told CMM, ‘It’s for those who would have nobody there to look after them in the short term when they got home or it’s for those whose homes may need adjustments to enable their 30
CMM May 2018
continued independent living and while the work is ongoing. We offer a safe space for them to continue their recuperation.’ It gives the individual somewhere to stay while they recuperate and CareRooms says that it also supports hosts who may otherwise be lonely or isolated. As an alternative patient choice to help ease pressure on the NHS and local authorities, CareRooms’ target demographic is older people who live alone and/or at a distance from family.
SELECTING HOSTS The model involves hosts offering guests a spare room or annexe, with access to a private bathroom. CareRooms says that the process for becoming a host is highly-selective. Although it doesn’t specifically use valuesbased recruitment, CareRooms told CMM that, ‘We have our own questions for interviews that enable us to understand that people are a good fit for our business’ culture. ‘Although someone’s ability is of course important, their personality and commitment are very important. That means we only recruit the highest calibre candidates.’ The vetting process includes an initial telephone interview, inperson interview and vetting of the room to be let and communal rooms, ongoing DBS check for host and all residents over 16, and three references. Once selected, hosts undergo online training in adult safeguarding, Mental Capacity Act, food hygiene, and cleaning and infection control. This includes training on how to clean the room and wash the bedding.
Hosts will also be required to provide home insurance, proof of home ownership, approval from their mortgage lender and have a home visit from a CareRooms area manager before being approved. They must also be registered as having a room for rent so the local authority can inspect them.
HOW IT WORKS Hosts are not employed by CareRooms and do not deliver care, CareRooms says that hosts ‘are simply there to offer food and beverages and conversation’. Prepared food is delivered to the host’s home and requires the host to heat it. There is no obligation for hosts to be at home. CareRooms says, ‘As long as the patient is provided with three meals a day and has access to what they need, we do not expect the host to be there all day.’ If necessary, CareRooms will undertake a makeover of the host’s spare room, install safeguarding technology and any equipment required by the patient. As part of their on-site Property Suitability Assessment, an area manager will determine whether a room is ready for use and just needs finishing touches or whether it needs a partial or a full refurbishment. There may be a cost to this which is discussed in advance. CareRooms provides a webbased platform with available room capacity, host recruitment and management, plus a package of support and services. CareRooms has also engaged with insurers to arrange specialist cover for the host and guest. CareRooms also works with third party suppliers to provide telecare, emergency triage facilities and video GP consultations.
CareRooms says this ensures that a medical condition is detected as early as possible and allows early intervention from the patient’s medical team to prevent unnecessary readmission.
COSTINGS CareRooms is paid £125 per night and hosts are paid up to £50 per night from this fee. Hosts may be charged a fee for setting up the room which can be deducted from the room rate, plus a £200 sign-up fee and per night charges. The money goes towards the technology, guests’ food and CareRooms’ staff. Hosts sign an initial three-month contract, after which time it can be terminated. CareRooms expects that facilities will typically be paid for by the local authority or patient, or both as an alternative to the existing care provision. Guests can register their interest with CareRooms who will find suitable accommodation. Personal care, if required, will need to be commissioned by the guest at an additional cost. The model is positioned as an additional, more personal choice for people. CareRooms says, ‘We are additional rooms that local authorities currently don’t have. Our job is to work alongside the current pathways to create additional choice. We’re not here to replace anybody.’ CMM
OVER TO THE EXPERTS... Is there a market for CareRooms in adult social care? Will it help to extend the spectrum of choice? Does it offer anything more than an alternative setting in which to receive homecare?
WE SHOULD SUPPORT BRAVE THINKERS The desperate need for new approaches in health and social care is an undeniable fact. Everyone knows both systems are at breaking point and we should support brave thinkers like Paul Gaudin who are prepared to try something different. If we bring people down for thinking outside the box, we’re not providing an environment conducive to innovation. After all, ‘the definition of insanity is doing the same thing over and over again, but expecting different results.’ There could potentially be a market for CareRooms. In Manchester, Local Care Organisations are actively looking to reduce the use of hospitals and institutions like nursing homes, providing care closer to people’s homes. They urgently need to boost community capacity so are trying new ways of working that help people recover more quickly after illness. This includes factoring companionship into the solution,
like we do in Evermore’s small household model, as the health impact of social isolation is finally being recognised. However, I think there are critical aspects to the CareRooms approach that need addressing. The NHS and local authorities have very low appetites for risk and I don’t know if the safeguarding measures are enough. I’m also not convinced people have the commitment to provide the emotional support needed by an older person recovering after a hospital stay. If the host is at work all day, the person could end up feeling even more alone than if they were on a ward. There’s also the practicalities of supporting a person’s rehabilitation and the need to truly engage with it to make their recovery a success. Simply providing a room and microwave meals is not enough.
Sara McKee Founder, Evermore
WHO HAS LEGAL DUTY OF CARE IF PROBLEMS ARISE? CareRooms appears to offer an innovative concept to reducing avoidable delayed transfers of care, by using technology to support people leaving hospital. However, people being ‘medically fit’ for discharge does not necessarily mean that they can meet all their personal care needs independently. Unless additional homecare has been arranged in advance, this could mean that the hosts offering rooms may be asked to offer personal care to people, even though this is not part of the arrangements. At £125 per night, excluding any personal care, CareRooms needs a clear rationale for why it is a more attractive proposition than enabling someone to return to their own home (usually the preferred option) along with five to seven hours of homecare per day from a regulated social care provider, at a similar cost. The benefit to some people might be the use of sensors
and alarms not quickly available for home installation, but this is an important question, both for people funding their own care, and for prospective council and NHS commissioners. Patients using CareRooms need to be aware that they are buying a service which will not be registered with the Care Quality Commission, but comes close to the threshold of services which do. CareRooms doesn’t employ the hosts offering rooms, and customers ought to be helped to make an informed decision about the benefits and risks of this type of service to them. This means that customers will need to understand who owes them a legal duty of care, and how they might seek redress, if problems arise. This isn’t at all clear from the terms and conditions publicly available on the company’s website.
Colin Angel Policy Director, UKHCA
THE RISKS HEAVILY OUTWEIGH ANY BENEFITS Lawyers are frequently tasked with carrying out a risk:benefit analysis of proposals. It seems that with the CareRooms concept the risks heavily outweigh any benefits. Although founded on the basis that hosts will not provide personal care, what happens if, while sitting down for a chat, the patient falls out of bed or asks for a hand taking their tablets? Suddenly the situation calls for activities they are not trained or regulated to provide. Whilst CareRooms says that rooms will be equipped with technology for monitoring the patient’s health, contacting a GP and triaging situations, what is the likelihood that the host wouldn’t intervene in an emergency or request? Furthermore, who actually needs a CareRoom? Delayed transfers from hospitals into care are not caused by a physical lack of places to go. Anyone who needs personal care will have to commission these
services, so why not go home and have the domiciliary care worker visit you there? The model is aimed at people living alone or without family to help them convalesce, with a view to alleviating social isolation. If the host is not required to remain at the home save to provide food and drinks, CareRooms doesn’t solve that problem. Why wouldn’t you commission a professional, regulated service to do this in your own home, on hand to assist with personal care if needed? I can’t see local authority funding being available for the rent on top of commissioned care if the patient has a home to go to. The sector needs innovation, but until these fundamental issues are addressed to safeguard service users and uphold the hard work of the regulated providers, I’m not convinced that CareRooms is the answer.
Nicola Cutler Associate, Royds Withy King CMM May 2018
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Ben Hartley analyses the provision of ensuites and wetrooms in UK care homes and draws some interesting conclusions.
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It is said that, apart from death and taxes, the only certainty in life is change - a truism, for sure, but one that warrants some reflection when we consider how society thinks about the way we care for our older people, and particularly in relation to residential settings. Before launching into the research I’d like to draw comparisons with the hotel and guesthouse sector. It’s not that long ago that ensuite bathrooms in hotels and guesthouses were a dream for the future. Today, it’s as standard as the beds in the room.
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Residential care for older people though might not be keeping up with the ablution revolution, which was our starting point in deciding that there needed to be some in-depth work to establish the current position. We embarked upon a thorough and extensive research project, carrying out a comprehensive survey over six months involving more than 6,000 telephone interviews. It reveals a very interesting picture. The research includes data from the whole of the UK and comprises information from private, not-for-profit, local authority and some NHS care homes.
overview of the UK’s dementia bed provision
Where we were unable to contact a care home directly, we made a number of assumptions based on data from other sources including the A-Z Care Homes Guide and the Care Quality Commission. The principles of what we did and why are relatively easy to convey. The detail, however, is trickier and, unless you are a stats lover, a little less inspiring. Definitions For the purpose of this research, we describe an ensuite bedroom as one where there is at least a WC and wash hand basin. Such a room may also provide, though this is not a requirement for the purposes of our definition, a shower cubicle, bath or wetroom.
Outstanding managers
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By contrast, our definition of a bedroom with an ensuite wetroom is one where there is a full wetroom, i.e. a walk-in shower complete with level access as well as the WC and wash hand basin. In effect, this is a subset of the ensuite bedroom provision – simply characterised by a higher level of facility. Headline results
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We know that care homes aren’t keeping pace with the rate of change witnessed in hotel stock, however, although we knew that provision was more limited, the findings have shown an even bigger gap in provision than anticipated.
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A VIEW FROM THE TOP
D R S T EP HENL A DY M A N Dr Stephen Ladyman is a former Health Minister and Founder of Oak Retirement.
REFLECTIONS ON THE LAST DECADE When I was a minister for social care, budgets were beginning to tighten, councils were being squeezed and there was a need to restrict rises in council tax. I was frustrated that the only budget that wasn’t ring-fenced was adult social care. I was fighting a tough and losing battle which hasn’t got any better since. Budgets have been slashed. Some councils have succeeded in reducing expenditure without cutting back on care budgets, but the impact for most has been a considerable budget reduction. I’ve also been disappointed with the failure of a lot of councils to understand the benefits of extra care housing. In the main, planning departments aren’t aware, but the model can have a real impact on social care and NHS costs. I also Chair a community mental health trust and see the difficulties in bringing together health and social care. In Somerset, we’re trying to work together, but it’s not happening everywhere. One of the reasons is that we all have financial issues which pull us apart as opposed to bringing us together. Extra care has had an additional dilemma because in two-tier authorities, social care is managed by the county council and housing and planning by the district council. In that respect, we thought it’d be easier to work with unitary authorities because housing, planning and social care technically work together. However, that’s not the reality and many still don’t see the benefits of the model on each other’s budgets.
PROJECTIONS FOR THE NEXT DECADE If the current strategy doesn’t change and sustainability and transformation partnerships (STPs) continue, there’s reason to hope that the NHS and local authorities might work together more closely. I also hope that STPs will involve councils with housing and planning responsibilities. At the moment, the STP mechanisms are for getting budgets under control, however, once they start driving system change and pull in housing, things will move forward towards better outcomes. There also needs to be increased public awareness of extra care. The advantages are great. There are benefits for all, including the housing market because extra care frees up larger family homes for others. People’s health can also improve which reduces time in hospital. However, people don’t know what’s on offer and don’t understand the different models of retirement housing. At Oak Retirement, I’m looking to keep expanding and want to get another 10 schemes underway over the next five years. In this market, it all depends on financing. We are backed by Frogmore who are financing our developments. That is a positive relationship, and I hope they will continue to back our expansion. INSIGHT I’m enjoying myself at the moment as I have a portfolio career. I have my role at Oak Retirement as well as Chair of Somerset Partnership NHS Foundation Trust and I Chair the Somerset STP too.
I see the current situation with health and social care from lots of angles; as part of a public body trying to make ends meet, and as a private organisation trying to establish developments and make a profit. I can see how complicated the world is at the moment. We need to make it simpler and better for all. INFLUENCES I got into politics because my dad was a big fan of Harold Wilson. I was brought up thinking about the important role of the public sector and making society more equal. I’d have to say my time working with Tony Blair was inspirational. It’s sad that the incredible things he did whilst in office have been forgotten. We were close to full employment, child poverty fell; he was driving the country in the right direction. Unfortunately, Iraq has tainted his legacy in the public’s mind. It’s true that no-one gets everything right, but it would be nice to forgive each other for our mistakes and for people to recognise the great work done under his leadership as well as learning the lessons from what went wrong. LESSONS I’ve learnt not to lose my temper in the work environment as it never works out well. Better decisions and outcomes happen when everyone stays calm. Also, work hard and think about the other person; put yourself in the position of others when making big decisions. CMM
Read the extended interview with Stephen on the CMM website www.caremanagementmatters.co.uk Sign up today. CMM May 2018
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RISING STARS
CAREER HISTORY I qualified as a nurse in 1997 and started my career on a surgical unit. Following relocation, I moved to a rehabilitation unit as a senior staff nurse, before moving on to become a ward manager. I loved this setting and I found it very rewarding to assist people to return to their own home. If individuals were unable to return home it was an essential part of my role to help them to adjust and choose where to move on to. Following my time there, I undertook a brief stint in the private sector working with people with dementia and enhancing the dementia care they received. During this time I assessed individual residents and developed their care plans alongside their relatives to ensure their care was tailored to their individual needs and wishes. It was from there that I joined Brendoncare, in 2016. I’ve been here ever since. I came straight into The Old Parsonage as Deputy Manager, shadowing the existing manager for three months before he retired, and I stepped up to General Manager.
YOUR ORGANISATION
Paula Southgate is General Manager of The Old Parsonage in Hampshire run by Brendoncare.
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CMM May 2018
The Old Parsonage is a lovely home, the first time I walked through the door I felt at home and knew that was where I wanted to be. There’s a real family atmosphere. I call it my first family because I spend more time here than I do at home. At The Old Parsonage, we have 27 nursing care beds which are funded privately and by local authority. We also have 16 flats and six bungalows within Old Parsonage Court which are privately-owned, and the owners live independently with support from The Old Parsonage if required. They come over to the home to join in activities. We have a fantastic team at The Old Parsonage and we all help and support each other. I have a philosophy that I won’t ask anyone to do something that I wouldn’t do myself. The residents are just wonderful too. I always say that I want the home to be somewhere I would want my own relatives to live and The Old Parsonage most definitely is that home. Relatives are so important to us as well. We do not want them to worry that their loved one isn’t happy or safe and we do everything we can to reassure them and ensure they are involved in their loved one’s care as much as possible. Brendoncare is a wonderful organisation to work for. They have a great philosophy of improving the quality of life of older people. They’re really committed to their staff, too. They offer great staff development with person-centred care across all their homes. Anyone can undertake training and develop their skills and career. I have two team members who started working for us in the kitchens in the evening. Seeing how they were with the residents and how caring they were, we supported them to undertake their training to become care staff.
It’s great for the company that we can nurture our valued staff and help them progress.
CURRENT ROLE I made the move from nursing to management as I was getting older and as the saying goes, ‘A nurse’s back doesn’t last very long.’ I’ve been in management for a while now and it felt like a logical step on from being a nurse. Giving good care is what I’ve always wanted to do. In management, you can make a bigger difference by supporting staff to care well and subsequently helping more people. I really enjoy developing my staff, recognising their potential and helping them achieve that. They undertake wonderful work and it deserves to be recognised. I support staff to ensure people’s wishes are maintained when they live with us, it involves a lot of planning and working with others. When I came into the role, I was excited for the challenge and to put my mark on it. I wanted to get on and build the team because a happy team means a happy home. I work very closely with my staff and help them to grow in order to build a solid team who trust each other and work together. I enjoy coming to work and I want my staff to feel the same way. Of course, it’s emotionally and physically draining at times and can be hard, but the good moments always outweigh the bad. I’m really passionate about good care and treat people like family. I love spending time with people; residents, staff and especially relatives. It’s important to make them feel comfortable and confident in the work we do here. We have a great atmosphere in the home, which is fantastic. I always think that the day I don’t have my heart in the job is the day I make a change. In care you have to care.
RISING STARS I was touched to be nominated and chosen to be a Rising Star. I had heard about the initiative at the National Care Forum’s Managers Conference and thought it sounded like a great opportunity. I’ve loved networking with the group, sharing experiences, learning and getting to know each other. It’s been a fantastic year and I think we’ll all keep in contact for years to come. The conferences and networking have been incredible, I’ve learned a lot about my strengths, and weaknesses. My mentor has been phenomenal. She’s really supported me. We’ve discussed so much, she came to visit me at The Old Parsonage and I went to stay with her and visit her homes. It was brilliant to be able to see the inner workings of another care home and how we all face similar issues. I realised that things are not unique to my home, others are dealing with the same pressures and I could see how they go about addressing them. We’ll definitely keep in touch.
THE FUTURE From July this year, I will be changing roles from General Manager of The Old Parsonage to Project Manager for The Brendoncare Foundation. I will be delivering training on electronic care planning to all staff across our 10 homes. I previously delivered training on nurse revalidation whilst working in the Chief Nursing Team in the NHS which I really enjoyed. I’m excited to get going and take on new challenges. Ultimately, I want to be part of the bigger picture and make an impact on a wider group of people. Spending time doing planning work with the other Rising Stars in London really helped me to step back and think about where I am, what I’ve achieved, how far I’ve come. That has given me the confidence to go further. I think that opportunity for self-reflection has helped me to move forward. I also completed my Level 5 Diploma in Leadership for Health and Social Care through Brendoncare. That achievement just highlighted how much I love learning and looking at different ways of working. I’m also fascinated by people, their behaviours and how to support them best.
ADVICE My advice is to reach for the stars and follow your dreams, because you can achieve anything. As I said earlier, I think the self-reflection has really helped me. Even in negative situations, reflecting on what happened, what can be learnt from this, what you could have done differently and what went well too can help you to move forward. There’s always a way to turn a negative into a positive. Also, appreciate yourself, especially as the role of manager can be lonely at times. You need to look after yourself to be able to support your team. My advice to other senior managers would be to recognise potential in your team. Have regular contact with people so that you can identify their aspirations and dreams. This will benefit the company and residents and will help you to retain people too. Doing this builds loyalty amongst your staff team and makes sure that you don’t lose motivated staff. Instead, you support them to grow. CMM Paula is part of the first ever cohort of Rising Stars. This innovative programme, developed by National Care Forum and supported by Carterwood, is designed to identify leading lights within organisations who will shape and form the care sector in the future. More information about the programme, the candidates and future opportunities can be found at www.nationalcareforum.org.uk
CMM May 2018
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CMM May 2018
SOCIAL MEDIA IN SOCIAL CARE Boosting business, transparency and sharing
Jonathan Papworth sets out the benefits of using social media in social care to increase transparency and boost your business.
Facebook’s creator Mark Zuckerberg said that, ‘By giving people the power to share, we’re making the world more transparent’. For a sector that is not well-understood by the general public, being open and transparent can have a big impact. Added to this, transparency is a key message of the Care Quality Commission (CQC), with the lack thereof identified in Inadequate care, such as, ‘Complaints are not dealt with in an open, transparent, timely and objective way.’ Whilst Outstanding care includes, ’All staff are open and transparent, and fully committed to
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CMM May 2018
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SOCIAL MEDIA IN SOCIAL CARE
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reporting incidents and near misses.’ Therefore, there ought to be some connection between transparency in social media and meeting the objectives of CQC, which logically should lead to better care. There are lots of statistics that show people increasingly make buying decisions based on online research. A study in America by Software Advice showed that 72% of patients use online reviews as their first step in finding a new doctor. Translate this to social care and potential residents’ families will be using the internet to try to find the best care for their loved ones, and engaging with social media can help them achieve this. By having a presence on social media, you also demystify social care, increase transparency and give people a window into the quality care you deliver.
STEPS TO SOCIAL MEDIA SUCCESS There are a lot of social media platforms, but the most used in the UK are Facebook and Twitter. As such, it makes sense to start any kind of social media initiative with these. Other platforms like YouTube and Instagram are also widely used, but a good engagement on one platform is better than poor engagement on several. There are four fundamental steps to success with social media: • Strategy and foundations. • Engaging content. • Building a following. • Achieving your goals.
STRATEGY AND FOUNDATIONS The first step is to decide what you want to achieve. This is not necessarily the number of followers or likes, it is the end goal. That goal could be to have a certain number of enquiries through social media, which should in turn increase occupancy; or it could be to engage with a different demographic of potential service user. Next is to set out the plan to achieve your goal, including what platforms you will use, what type of content you will post and how often. Also consider who is going to be responsible for keeping to the plan. It’s important to ensure there are clear measurements, it is very easy to start an initiative like social media and then let it flounder. People who are successful tend to allocate 30 minutes a day to managing their online content, and whilst this might seem onerous, it is necessary to allocate some time to keep information fresh. From here you should optimise your social media accounts. You have a split-second to grab people’s attention as they flit around the internet, so make sure the message you want to convey is very clear and concise, and put it on your header and cover image. The best header image is not a picture of your home, or happy clients. The best picture has words which tell prospective clients what you do, such as ‘Specialising in dementia care’ or ‘Focused on keeping clients active’. Whatever you want people to know about you, put it on the header and cover image, and keep it
consistent across all platforms. In that split second mentioned above, people need to see the same message everywhere. Your biography text should explain what you do and clearly detail the benefits of what you provide. Remember to make it personal and engaging. Also, make sure your social media accounts link through to the right page on your website. This might not be your home page, it could be the page that invites people to visit you, or details a special event. If you participated in the Care Home Open Day recently then this would have been the perfect place to link social media, although now it needs to be moved to another page because that day has passed, and you don’t want your link going to an out-of-date page. This is one of the reasons time needs to be allocated to maintaining your online presence, the passage of time changes things and it is important to keep everything up-to-date.
“By having a presence on social media, you also demystify social care, increase transparency and give people a window into the quality care you deliver.” ENGAGING CONTENT With the strategy and foundations in place, it is time to move on to providing engaging content. One important rule is not to use social media to sell to people. Instead, use it to provide information and entertainment so that people get to know you, and from there to like you and finally to trust you. Even when using social media as primary sales tool, the rule is that no more than 20% of the information posted should contain a sales message. There are four types of content that work well: 1. Talk about what you are doing, recent activities, birthdays or other highlights. Show your personality. 2. Tips and advice to help and educate people. 3. Ask questions, because people are inclined to answer questions on social media. This can be about your organisation or something generic, just to get a conversation going. 4. Share interesting content that other people have written, such as National Care Forum, CQC or Care England. Alternatively, use sites such as BlogLovin.com or Google Alerts to draw relevant content from the web that might be of interest.
BUILDING A FOLLOWING Next, we come to building a following, which can take a long time although there are some shortcuts which some might be willing to use.
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SOCIAL MEDIA IN SOCIAL CARE The simplest way on Facebook is to follow them and comment on their posts. By doing this, you will pick up followers, however it will take time, which may be fine for your business and aims, but there are ways to get there quicker. For Twitter, there is a tool called ManageFlitter which has a free version and a more powerful paid version. ManageFlitter allows you to search the biography text of all Twitter’s users, including their location. From this, you can follow the people who meet your search requirements. Statistics show that in so doing, 30% to 40% will follow you back. It is also possible to use ManageFlitter to find the followers of other care providers, and follow them to build a following, but I suggest this might be a step too far. Another option is to use Twitter’s advanced search strategy which allows you to search the contents of people’s tweets whether they follow you or not. Set the location to your target area and then search what people are likely to be looking for – such as ‘looking for a residential care home’, or maybe their issue, such as ‘caring for elderly parent’.
ACHIEVING YOUR GOALS
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It is important to identify the type of person you want to engage with. This will probably be people with elderly parents if you provide older people’s services, or those with children with learning disabilities, if you provide specialist services. If your market is older people, your target audience will normally be the eldest daughter, or eldest son’s wife as these tend to be the people who decide on the care. By all means engage with other people, but remember the strategy at the outset and ensure you are focusing on what it is you want to achieve from your social media. To reach the people you want to engage with, simply think about complementary organisations they could be following. If you specialise in dementia care, then the people you want to be in contact with might be using an Admiral Nurse, and could be following them on social media. One option to get to know your target audience would be to ask existing clients’ relatives if they use social media, and what type of organisations they follow. It might be that the local church or golf club has a big following. Don’t forget to ask them to follow you or like your page too. Once you know your complementary organisations, consider how you want to target their followers.
Once you have followers who are engaged because of the content you are providing, then you should be on your way to achieving your goals, whether that’s increasing enquiries or the number of people interested in visiting you, an increase in visits to your website or ultimately more customers. Ideally, one goal will be that everyone who visits your website will contact you. However, not every care provider can handle inbound enquiries at all hours of the day. One option to address this is to set up a chat box on your website. These can be automated, but there are also options that mean for a monthly fee you can have enquiries handled by a real person, which could be better than your busy care staff being interrupted at all hours. Social media can be really effective as a way to boost business. However, it has other benefits when used by clients and families. I know of a family whose father has dementia and lives in a care home. When the family went on holiday to New Zealand they used a photo sharing platform to send pictures to their elderly father via the carer’s tablet. When the family returned, their father who normally couldn’t remember them when they come back from a break, remained engaged with his family and remembered them all. His dementia symptoms were improved simply by sharing holiday pictures online. Social media is a fantastic tool to use in social care; whatever the application, it can help you grow your business, open up your organisation to potential clients and help to improve the quality of life of the people you support. CMM
Jonathan Papworth is Co-Director of Person Centred Software. Email: j.papworth@personcentredsoftware.com Twitter: @PersonCentredSW How do you use social media? Share your experiences on the CMM website and access the references from this article. Sign up today. www.caremanagementmatters.co.uk 40
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NCF supports its members to improve social care provision and enhance the quality of life, choice, control and wellbeing of people who use care services. We work directly with not for profit providers of care and support services across the UK offering: Me Mbe rsh
• Expert response to government consultations and engagement with senior politicians and staff • Innovation focus - influencing the future of the health and social care sector
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Bishop Fleming Tel: 01392 448800 Email: healthcare@bishopfleming.co.uk Website: www.bishopfleming.co.uk/sector/care-homes
SECTORS • Nursing and residential care homes. • Learning disability. • Supported and assisted living. • Challenging behaviour and special needs. • Rehabilitation. • Domiciliary care agencies. • Foster carers.
SERVICES • Accounting, tax and business consultancy. • Business planning. • Refinancing/business acquisitions and sales. • Payroll. • Tax. • Wealth Management.
LEAD INDIVIDUAL
RESOURCE FINDER
Care sector accountancy firms A good accountant can help with the smooth running of a care business. They have the skills to advise on a range of accountancy and business services. These include business planning, due diligence, financing, tax, acquisitions, restructuring, outsourcing and more. Whatever care business you operate, the following accountancy firms should be able to support you now and into the future.
Tim Godfrey heads up the healthcare sector for Bishop Fleming, with over 20 years’ experience in advising ownermanaged businesses. Being recognised for his knowledge of healthcare and more specifically for the care home sector, Tim has been instrumental in developing and growing the firm’s specialism, providing key professional services to over 250 healthcare clients. Tim commented, ‘The sector is currently facing many challenges, particularly on funding, rising costs, ongoing viability tests and increased regulation. My focus is on helping clients maximise their business performance
and value in the face of these challenges. Using Cloud-based, real-time financial reporting data, we empower the aspirations of our clients. Our specialist benchmarking tools and reports, together with our proactive advice, enable our clients to manage their businesses more effectively, whilst keeping their fingers on the pulse of the dayto-day financials.’
COMPANY INFORMATION Bishop Fleming is a leading provider of accounting, tax and business consultancy in the UK. Currently ranked as number 30 in the Accountancy Age league table, Bishop Fleming has a wealth of knowledge and experience in areas such as healthcare, personal tax, corporate finance, business recovery and insolvency, business and international tax, payroll services, forensic and litigation support, grant services, VAT, audit assurance and accounting. The firm is a top financial adviser for UK small and mid-market transactions. With seven offices spanning from the West Midlands to the South West, Bishop Fleming has 29 partners and over 340 staff in the UK, and is ranked 26th in The Sunday Times 100 Best Companies to Work For. Bishop Fleming is a member of Kreston International, a network of independent accounting firms in more than 100 countries.
Tim Godfrey Partner and Head of Healthcare Tel: 01392 448800 Email: TGodfrey@bishopfleming.co.uk CMM May 2018
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GDPR Compliance Tool
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Hazlewoods
Moore Stephens
Tel: 01242 237661 Website: www.hazlewoods.co.uk
SECTORS • Residential and nursing homes for the elderly. • Learning disability/challenging behaviour. • Specialist needs education colleges. • Assisted living/close care/extra care. • Drug, alcohol and eating disorders independent hospitals. • Domiciliary care. • Supported living. • Children’s services. • Secure units. • Foster care agencies. • Primary healthcare.
SERVICES • Accounts preparation and audit. • Tax advisory services. • Benchmarking. • Sales/disposal advice including preparing the business for sale. • Acquisitions advice. • Innovative tax planning. • Financial and tax due diligence. • Raising finance. • Estate planning.
• Valuations and disputes. • Commercial valuations.
Tel: 0207 334 9191 Email: carehomes@moorestephens.com Website: www.moorestephens.co.uk/healthcare
COMPANY INFORMATION
SECTORS
If you are looking for support in the healthcare sector, our team of over 40 dedicated accounts, audit, tax and corporate finance professionals have unrivalled experience. We are renowned for clear advice for care operators, acting for well over 350 care businesses on a national basis. We act for care providers, including individual care home owners, corporate groups, not-for-profit organisations and private equity investors. Hazlewoods Healthcare Corporate Finance Lead Advisory and Transaction Services teams have continued to see an increase in deal volumes in 2017. During the year, the team advised on 60 completed transactions valued at £408m, representing an increase of 57% over 2016. Deal flow remains high in 2018, despite the pressures that the sector is facing.
• Care homes. • Nursing homes. • Residential homes. • Retirement homes.
SERVICES • Accounting. • Audit. • Business outsourcing. • Corporate finance. • Governance. • IT consulting. • Restructuring. • Risk. • Tax. • Wealth management.
LEAD INDIVIDUAL Neville Side, Director and Head of the Care Homes Group specialises in business review projects and advising secured lenders and other stakeholders of a business. He has over ten years’ corporate advisory experience and understands the issues faced by care homes.
COMPANY INFORMATION Accountancy and advisory services provided with care. Moore Stephens is a leading accountancy and advisory firm, providing solutions to individuals, entrepreneurs, large organisations and complex international entities, helping them to thrive in a changing world.
Our dedicated Care Homes team has a wealth of experience in the care sector and acts for a wide range of clients, including care homes, nursing homes and retirement homes. Whether you’re looking to buy or sell a care home, streamline your back-office systems, need help with an end of year tax return or financial advice in difficult times, Moore Stephens has the professional resources to help you and your care home stay more connected. With offices throughout the UK and globally, we ensure clients have access to the right people whenever they need them, so decisions can be made quickly and confidently, supporting clients’ aspirations and contributing to their success. The pressures on local authority funding, combined with residents and their families becoming more cost-focused and a continuing emphasis on individuals being self-funded, have all meant that the care sector is becoming more challenging. Moore Stephens provides as little or as much support as needed in dealing with new risks and opportunities and, if your business or personal interactions need to expand, we’ll help make it happen – co-ordinating advice from a global network of offices in more than 100 countries. To find out how we can support you and your business, contact us.
Andy Brookes Email: andy.brookes@hazlewoods.co.uk Rachael Anstee Email: rachael.anstee@hazlewoods.co.uk John Lucas Email: john.lucas@hazlewoods.co.uk David Main Email: david.main@hazlewoods.co.uk
Neville Side Director & Head of the Care Homes Group Tel: 0207 334 9191 Email: neville.side@moorestephens.com CMM May 2018
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RESOURCE FINDER
Morris Lane Tel: 01202 715950 Email: heather.moncaster@morrislane.co.uk Website: www.morrislane.co.uk
SECTORS • Care homes. • Care homes with nursing. • Domiciliary care agencies. • Charities. • Property Development.
SERVICES • Acquisitions and disposals. • Accounts and auditing. • Business plans, support and advice. • Company secretarial. • Corporate finance. • Payroll services. • Tax advice and services. • Management accounting.
LEAD INDIVIDUAL Roger Morris heads up the Morris Lane team of specialists working with their healthcare focused clients. Roger is an award-winning member of the Chartered Institute of Taxation and has over 30 years’ experience in the sector. Roger is ably supported by their lead accountants specialising in the sector, Michelle Cordy, Dan Baker, Jon Hoyle, Michelle Pettifer and Sam Turner in providing a proactive service to enable clients to achieve their ambitions, to maximise their profitability, and to increase and protect their wealth.
COMPANY INFORMATION Whilst based in Dorset, the firm
has clients located throughout England and Wales and are believed to advise more care home operators than any other accountants in the UK. Their strength lies in listening to their clients about their business and personal goals, and providing timely advice through the business cycle on how to achieve these, so they can fund their preferred lifestyle and ultimate exit from the business. This includes preparation of budgets and forecasts, regular and timely advice on any changes in tax and accounting law, as well as keeping them up to date on financial matters relating to the sector. The firm ensures clients are compliant in terms of producing their annual accounts and tax returns, as well as providing management accounts if required by lenders in accordance with specific loan covenants. They pride themselves on providing bespoke advice, including the structuring of acquisitions and disposals in order to maximise value and minimise the effects of income tax, corporation tax, capital taxes, VAT and Stamp Duty Land Tax. Morris Lane also works closely with other professional advisers in the sector, including finance and capital allowance specialists together with their client’s legal teams. The firm is a proud supporter of its local care association and a lead sponsor of the Pinders Healthcare Awards.
Roger Morris Partner Tel: 01202 715950 Email: roger.morris@morrislane.co.uk 46
CMM May 2018
Smith & Williamson Tel: 0238 082 7631 Email: greg.palfrey@smithandwilliamson.com Website: www.smithandwilliamson.com
SECTORS • Residential care homes. • Nursing homes. • Dental. • Healthcare professional practices. • Charities.
SERVICES • Acquisitions and disposals of care homes and groups. • Business valuations. • Financial due diligence. • Cash planning, management and forecasting support. • Reporting services and resolving financial questions/challenges. • Pension scheme deficit advice. • Support with preparing for closure, disposal of assets and dealing with surplus funds. • Accounts preparation and audit. • Business outsourcing. • Business and employment taxes. • Employee benefits consulting.
LEAD INDIVIDUAL Greg is a Chartered Accountant with 30 years’ experience advising clients and is National Head of the Restructuring and Recovery Services team. Greg has extensive experience in the care sector through both his restructuring advice to care homes and businesses, as well his expertise when covering insolvency matters.
COMPANY INFORMATION Smith & Williamson LLP is an
independently owned financial and professional services group that has been looking after the affairs of businesses and their owners for over 100 years. One of the top 10 accountancy firms in the UK, Smith & Williamson LLP has over 1,700 staff and partners across 12 offices in the UK, Ireland and Jersey. Through its wider network, it can draw on skills and resources from around the world through the Nexia International network. Businesses in the care sector have come under intense financial pressure recently, such as the reduction in public funding, the effect of the minimum wage and staff shortages as well as increasing regulatory and compliance requirements. Where these factors are putting pressures on margins and cash, we offer support and advice tailored to the needs of the operator. This advice is designed to help management make informed decisions about the best route forward, including cash flow, funding and working capital support and reorganisation of the business. External expertise can help at crucial stages of a business lifecycle. Our experts are ideally placed to assist in discussions with key internal and external stakeholders. As well as restructuring advice, Smith & Williamson LLP provides regular accounting and audit services to care sector clients. Through our corporate finance team, we are able to offer support for major transactions.
Greg Palfrey National Head of Restructuring and Recovery Services Tel: 0238 082 7631 Email: greg.palfrey@smithandwilliamson.com
BUILDING A BETTER FUTURE FOR CARE N EW C o policy u ntent, leading pdates, supplie rs.
REGIST E TODAY R
THE ONE EVENT WHERE EVERYTHING JUST CLICKS Make sure your service is always the number one choice by attending Health+Care 2018 on 27th and 28th June at ExCeL London, where over 4600 owners, directors and senior managers from care providers gather to gain access to a world class conference, products and services that will help you achieve more positive outcomes. Find solutions to your challenges, and how the long-term integrated healthcare plans will affect your care business.
OVER 400 LEADERS in the sector WILL BE SPEAKING, INCLUDING:
Andrea Sutcliffe Chief Inspector of Adult Social Care, CQC
Matthew Swindells National Director: Operations & Information, NHS England
Bridget Warr CEO, UKHCA
REGISTER NOW TO ATTEND FOR FREE to boost your business and improve levels of care healthpluscare.co.uk/CMM or call 0207 013 4688 Health+Care is run in association with
NCF THE NATIONAL CARE FORUM
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Prof. Martin Green OBE CEO, Care England
Rt Hon Stephen Dorrell Chairman, LaingBuisson
Jane Silverster Associate Director - Social Care and Leadership, NICE
Incorporating
Official Care Media Partner
Organised by
EVENT REVIEW
SURREY AND SUSSEX CARE SHOWCASE 14th March, Brighton
The Surrey and Sussex Care Showcase 2018 helps care providers to look to the future. The Care Quality Commission’s Chief Inspector of Adult Social Care, Andrea Sutcliffe CBE was the keynote speaker at the region’s biggest business event for adult social care providers. With the adult social care sector facing increasing challenges and mounting financial pressures, local care providers flocked to the Surrey and Sussex Care Showcase to learn how to meet these challenges head-on and prepare their businesses for the future.
MAKING CONNECTIONS IN SOCIAL CARE This year’s showcase theme of Making Connections in Social Care reinforced the importance of how all areas of social care, health and community services need to work together to ensure a sustainable long-term future for the sector and help care providers plan ahead with creativity. The Showcase seminar programme was headed by keynote speaker Andrea Sutcliffe CBE. Other speakers from the sector included Margaret Willcox, President of the Association of Directors of Adult Social Services (ADASS); David Williams, Chief Executive of St Monica’s Trust; Avnish Goyal, Chair of Care England; Brian Morton from the Royal College of Nursing and Vic Rayner from the National Care Forum.
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The programme also featured plenty of practical advice sessions for providers, covering subjects such as medication, speech and language therapy, epilepsy awareness, technology, recruitment, training and legal matters. Andrea said, ‘I always enjoy the Care Showcase – it is a great opportunity to share information, understand new developments and support the improvement of care for the benefit of people using services, their families and carers.’
KEEPING ABREAST OF DEVELOPMENTS Erica Lockhart, Chief Executive of Surrey Care Association and one of the Showcase organisers said, ‘The shortages of nursing and care staff, pressure on council finances and uncertainty about how health and social care services will be integrated are some of the biggest challenges facing local care providers today. Our annual Care Showcase helps keep providers abreast of developments to ensure they can continue to offer high levels of quality care to the vulnerable adults they serve.’ Now in its twelfth year, the Surrey and Sussex Care Showcase attracts over 700 visitors every year. As well as the topical seminar programme and networking opportunities, the event’s extensive exhibition area also offered a ‘one-stop-shop’ for products and services from
over 70 training providers, IT companies, legal and business advisers, care associations and suppliers to the care industry. The Lord-Lieutenant of East Sussex, Mr Peter Field officially opened the Care Showcase 2018 and the Mayor of Brighton and Hove, Councillor Mo Marsh was also in attendance. The Surrey and Sussex Social Care Showcase 2018 was supported by Surrey Care Association, East Sussex County Council, Brighton & Hove City Council and West Sussex County Council. The Surrey and Sussex Care Showcase 2018 media partner was Care Management Matters magazine and event support partner was Cura Systems.
WHAT’S ON? Event: Naidex Date/Location: 25th-26th April, Birmingham Contact: Naidex, Web: www.naidex.co.uk
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Media Partner
Event: Delivering the Future of Health and Care Date/Location: 27th-28th June 2018, London Contact: Health + Care, Web: www.healthpluscare.co.uk
Media Partner
Event:
NAPA Annual Conference London: Getting Activity Right for Everyone Date/Location: 11th July, London Contact: NAPA, Tel: 0207 078 9375 Event:
National Conference of the Older People’s Diabetes Network Date/Location: 27th September, London Contact: Older People’s Diabetes Network, Web: www. eventbrite.co.uk/e/opdn-5th-national-conferencetickets-43473125288 Event: ILC Future of Ageing – 2018 Date/Location: 29th November, London Contact: International Longevity Centre - UK, Web: www. ilcuk.org.uk/index.php/events/the_future_of_ ageing_2018
CMM EVENTS Event: Date/Location: Contact:
The Transition Event Midlands 17th May, Coventry Care Choices, Tel: 01223 207770
Event: Date/Location: Contact:
BAPS – SEND Blogging Awards 17th May, Coventry Care Choices, Tel: 01223 207770
Event: Date/Location: Contact:
CMM Insight – Learning Disability and Mental Health Services 21st June, Manchester NEW DATE Care Choices, Tel: 01223 207770
Event: Date/Location: Contact:
CMM Insight Lancashire Care Conference 27th September, Blackburn Care Choices, Tel: 01223 207770
Event: Date/Location: Contact:
CMM Insight – Berkshire, Buckinghamshire and Oxfordshire Care Conference 11th October, Slough Care Choices, Tel: 01223 207770
Event: Date/Location: Contact:
The Transition Event East 2018 15th November, Newmarket Care Choices, Tel: 01223 207770
Please mention CMM when booking your place. CMM May 2018
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LAURA COPE • PROGRAMME MANAGER – AIREDALE SOCIAL MOVEMENT • ALZHEIMER’S SOCIETY
Alzheimer’s Society’s Airedale Social Movement has developed and launched a Community Engagement Toolkit for Care Homes. Laura Cope explains more.
Alzheimer’s Society has been running the Airedale Social Movement Programme in Airedale, Wharfedale, Craven and Leeds since August 2016. This programme has been funded by NHS England as part of its New Models of Care; Health as a Social Movement Programme until May 2018. The programme aims to bring local communities into the care home, and put the care home at the heart of the community. Through our work on the programme, we have set up lots of initiatives in care homes. Different community groups including schools, bowling clubs and arts students have linked up with eight care homes and are
regularly running activities with the care home residents to improve quality of life, reduce isolation and ensure residents feel part of both the care home and the wider community. One of our objectives is to spread the programme so that others can replicate the work that has been undertaken locally, and as a result we have launched resources to support this, including a How to Guide for care home staff. On 22nd March 2018, we launched the toolkit and supporting resources at an event in Leeds with over 50 care home managers and commissioners in attendance. At the launch, we had four speakers. I spoke about the toolkit and what we have learned. Julie Duerden, the Project Officer discussed how care homes can become involved in their Dementia Friendly Communities. Helen Sanderson explored person-centred care and the importance of one-page profiles. Finally, Caroline Baria from Leeds City Council discussed what the city is doing to encourage community engagement, how to find volunteers, and the council’s expectations around community engagement in care homes We also had various stands to talk to attendees about how to take practical steps towards involving the community in their homes. These were Dementia Friends; Dementia Friendly Communities; Airedale Social Movement resources; inter-generational work; volunteering; asset mapping and engaging groups; and person-centred care. We know that activities and being involved in the local community allows care home residents to have increased confidence. It also improves mood, general wellbeing and happiness; reduces anxiety and stress levels; and improves social life, self-esteem and communication skills. The many activities and community connections set up by the project have been evidence of this. For example, Maureen is a resident
in one of the area’s care homes. She is only 62 but has a progressive condition and is on an end of life pathway. She is unable to live alone anymore due to her care needs. Maureen has made friends with Doreen, another resident. As their friendship grew, they realised that they had knitting in common and as a result have become the core of a Knit and Natter circle that we set up in the care home. Between them, Maureen and Doreen have been busy knitting scarves and the project team arranged for these to go to the local food bank for inclusion in the Christmas food parcels. Maureen has been determined to reach the knitting goal we have agreed, and this has spurred her on when, at times, she could just have stayed in her room. She needs to keep mobile to help her condition, so this helps her a great deal and supports her health. Maureen has had a hard time accepting her condition and the group helps her to focus on something positive and gives her a purpose, increasing her wellbeing and quality of life. For Maureen, the group is also a very sociable time and she is able to speak very openly about her worries to her new friends. Care home staff said, ‘Only a small number of residents attend the Knit and Natter group but those that do really seem to enjoy it, have made friends in the home and talk about the scarves they are producing in between sessions and how they will be helping vulnerable people in the local community.’ The project team said that, ‘The great group of residents at Beanlands Care Home quickly established friendships and were determined to make the blankets and scarves for the food bank.’ To ensure this work can continue in care homes across the UK, we have produced a number of resources including the How to Guide, and letter and poster templates. CMM
Laura Cope is Programme Manager – Airedale Social Movement at Alzheimer’s Society until the end of May. Email: laura.cope@alzheimers.org.uk Links to the toolkit and the How to Guide can be found on the CMM website. Sign up today. www.caremanagementmatters.co.uk 50
CMM May 2018
Support with your
recruitment and retention Change your approach to recruitment and widen your talent pool and find more people with the right values to work in care. At Skills for Care, we have online tips and tools to support your recruitment and retention process. Removing barriers to employment and recruiting people for their values rather than experience and qualifications can:
save time and wasted resources attract a diverse range of candidates for your roles bring fresh ideas and solutions to your organisation.
Our free online toolkit has practical ideas, guidance and templates to help you meet your recruitment and retention challenges. Visit www.skillsforcare.org.uk/recruitmentandretention.