Care Management Matters October 2013

CMM CAREMANAGEMENTMATTERS

OCTOBER 2013 ÂŁ4.00

LEARNING FROM THE US Managing the pressures on the sector

Dementia care in the community Opportunities for providers

Staff training Where to find funding

Values-based recruitment

Includes 4-page Skills Academy insert: Focus on Leadership and Interns: Giving Graduates a taste of Social Care Leadership

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in this issue

IN THIS ISSUE regulars 05

Is it just me...?

Editor in Chief, Robert Chamberlain studies the link between care home finances and council funding.

08

News

09

In Focus

10

Property News

12

Local Authority and Planning News

14

Corporate News

20

Business Clinic

26

editor s welcome

16

One in three care businesses is at risk of financial failure. Our panel gives their thoughts.

60 Seconds with...

features 16

Bridget Warr, Chief Executive of UKHCA and Chair of the new Social Care Guidance Development Group at NICE.

39

Spotlight on...

48

Conferences

49

What s On?

50

Straight Talk

Timothy Bolot and Scott Phillips draw comparisons between our sector and the US and explore what we can learn.

23

Infection control.

Deprivation of Liberty Safeguards ‒ woefully inadequate

38

Peter Grose delves into issues around DOLS and forthcoming changes.

CMM previews the forthcoming North West and Berkshire care conferences on The Future of Care and Commissioning.

28

Is politics interfering with effectiveness in regulation? Roger Wharton looks at the increase in warning notices and whether they re politically driven.

Mimicking the US and learning some lessons

Dementia care in the community

In conjunction with Care Show Birmingham, CMM explores opportunities for providers around dementia care in the community.

35

Finding the funding for training

Sharon Allen offers an insight into where you can find funding for staff training.

38

44 35 30

Driving up quality in learning disability services A new code has been developed to drive up quality in learning disability services. CMM brings you the details.

28

With increasing pressures on the sector, there are parallels that can be drawn from the US in the 1990s. The feature on page 16 explores this in more detail, looks at how the US responded to pressures on its system and what lessons we may be able to apply to our situation.

A new report by Company Watch has stated that one in three care homes is at risk of financial failure. After the downfall of Southern Cross, it s understandable that there are concerns around the financial viability of the sector. The Business Clinic on page 20 explores recent research into the finances of care businesses and asks the panel their thoughts on the strength of the sector s financial health.

In conjunction with the Care Show Birmingham, we have asked speakers at its Dementia Care Seminar Theatre to give you an insight into opportunities around dementia care in the community.

Now is the time to make inroads, to seize opportunities and be an integral part of the dementia journey for those in the areas you operate. Turn to page 28 to find out more.

Looking forward to our next issue, CMM will be celebrating its 10th anniversary. The sector has changed in so many ways over the last 10 years.

What are your memorable moments of the last decade? Drop me an email at emma.morriss@carechoices.co.uk or tweet us @CMM_magazine. I d be interested to hear you reflections on the last 10 years.

Emma Morriss Editor

Recruiting for values can add real value to services

Debbie Sorkin reflects on the benefits of value-based recruitment approaches.

Follow CMM on Twitter @cmm_magazine

CMM OCTOBER 2013 ÂŚ 3

contributors

CMM CAREMANAGEMENTMATTERS October 2013 Editorial and Production editor@caremanagementmatters.co.uk Editor in Chief: Robert Chamberlain Editor: Emma Morriss Associate Publisher: Matthew Tingey News Editor: Des Kelly Design and Production: Lisa Werthmann, Jamie Harvey, Nick Cade & Holly Cornell Editorial Assistant: Becky Northfield ADVERTISING sales@caremanagementmatters.co.uk 01223 207770 Advertisement Manager: Tracey Diplock tracey.diplock@carechoices.co.uk Business Development Manager: Paul Leahy paul.leahy@carechoices.co.uk SUBSCRIPTIONS info@caremanagementmatters.co.uk To request your free copy of CMM call 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 2013 ISBN: 978-1-909048-72-0 CCL REF NO: CMM 10.7

Publications

CMM magazine is officially part of the membership entitlement of:

editorial panel Des Kelly OBE,

Mike Padgham,

Executive Director, National Care Forum

Chair, UKHCA

Professor Martin Green OBE,

David L Jones,

Chief Executive, English Community Care Association

Partner, Deloitte

Andrew Sidwell,

Paul Ridout,

Partner, GVA

Partner, Ridouts LLP

Andrew Barnsley,

Zoe Farrell,

Managing Partner, Nexus Corporate Finance LLP

Training Development Director, Catalyst for Care

contributors Alan Rosenbach, Special Policy Lead, Care Quality Commission Alicia Wood, Chief Executive, Housing & Support Alliance Andrew Brookes, LLP Partner, Hazlewoods LLP Bridget Warr, Chief Executive, United Kingdom Homecare Association.

Chair, Social Care Guidance Development Group at NICE. Debbie Sorkin, Chief Executive, National Skills Academy for Social Care Michael Hurt, Commissioning Manager: Older People’s Mental Health and Dementia, Joint Commissioning Unit, NHS Walsall Clinical Commissioning Group / Social Care and Inclusion - Walsall Council Paul Birley, Head of Healthcare, Barclays Peter Grose, Partner, Lester Aldridge LLP Solicitors Professor Graham Stokes, Director of Dementia Care, Bupa Care Services UK Roger Wharton, Executive Officer, Registered Care Providers Association Somerset Scott Phillips, Managing Director, Bolt-HMP

ABC certified (Jan 2012 - Dec 2012) Total average net circulation per issue 16,302

4 | cmm october 2013

Sharon Allen, Chief Executive, Skills for Care Timothy Bolot, Managing Director, Bolt-HMP

is it just me...?

Is it just me...?

Editor in Chief, Robert Chamberlain, comments on the link between the financial security of care homes and council funding and questions CQC’s role in scrutinising providers’ accounts.

The new report from Company Watch highlights a worrying situation regarding the precarious financial situation of a significant number of care providers.

The findings (the focus of this issue’s Business Clinic on page 20) show that up to 30% of care home operators out of the 4872 analysed are classed as ‘financially vulnerable’.

Businesses falling into this category are claimed to have a one in four chance of requiring financial rescue in the future.

Almost 700 providers are described as ‘zombies’ with negative net worth.

In the wake of Southern Cross’ collapse, these statistics will be a great worry to commissioners and will add further justification for CQC’s new role of inspecting care groups’ accounts.

David Behan has stated that if a provider is in financial difficulty it could be ‘a predictor of poor care’ and if correct then the quality of care in almost one third of all homes is a cause for concern.

case, are we are looking at a funding issue rather than poorly run businesses? Is the level of, or reliance on, council funding also a predictor of poor care?

So as CQC embarks upon its new role to inspect the finances of the 50 to 60 largest providers, their objective is to provide an early warning to avoid a repeat of the Southern Cross situation. To quote

Cause and effect

Norman Lamb, ‘everyone who receives care and support wants to know they will be protected if the company in charge of their care goes bust’.

CQC’s new responsibility is clearly in the interests of the public who seek assurances that their chosen provider isn’t going under and it will, of course, be beneficial to commissioners too.

However, this reactive approach will do

I have yet to have the opportunity to study Company Watch’s data but I am confident that there will be evident trends relating to the financial situation of different providers. For instance, I would expect to see a direct correlation between providers that are heavily reliant upon local authority fees and financial vulnerability. If this is the

‘If the quality of care in residential and nursing homes amongst these providers is a major concern then we must assess the factors that have contributed to their situation, not just raise a red flag when they get there.’

little to highlight the issues that contribute to financial crises of operators.

Underlying issues need addressing If the quality of care in residential and nursing homes amongst these providers is a major concern then we must assess the factors that have contributed to their situation, not just raise a red flag when they get there. Surely it would be worthwhile for the Minister to take the Company Watch findings and research those deemed vulnerable to gain an understanding of how or why they have found themselves in this position.

If funding is the issue then this would lend weight for the need to address under-funding of the sector. Troubled providers could be advised on how to market themselves to self-pay care seekers to lessen reliance on council fees.

If, as the report states, the level of borrowing is a major factor then advice could be offered to help financial restructuring, especially for smaller providers.

I think a more pro-active approach to preventing these problems from occurring would be far more valuable to all concerned.

If you would like to comment please email robert.chamberlain@caremanagementmatters.co.uk

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Scottish Caterer Takes Good Care of His People With so many special dietary requirements to consider, catering for people in the care sector can be a challenging undertaking. Yet, for one chef, meeting these challenges head-on is a task he conducts with relish, ensuring that it is not just his food that leaves a lasting impression.

For the past 18 months, John Brereton has been Head Chef at Alexandra Court care home in Glasgow. The softly spoken Scot makes it his job to know the exact requirements of the 50 people he cooks for daily, ensuring he speaks personally or to the families of each and every one about their individual likes and dislikes, knowing intrinsically that good food can enhance their stay.

Everything we do is geared around the people who live here says John, I ll personally go to visit them in their rooms to find out their individual needs. We have two menus but if they want something else, they get something else. It really helps to bring you closer to them ‒ and for me, brings a great deal of satisfaction.

With a stoic focus on quality, an insistence on cooking from scratch and a variety of individual needs, there is one kitchen ingredient that John confesses he couldn t be without ‒ Pritchitts premium dairy cream alternative, Millac Gold.

As a chef in the care sector, the benefits of using Millac Gold are widespread ‒ firstly, it s a great product, really stable and so versatile you can use it in savoury or sweet dishes.

John s menus regularly contain a number of soups, quiches and desserts such as mousses and cheesecakes ‒ all made with Millac Gold and all firm favourites.

I ve worked out that I get about a 30% saving using Millac Gold compared to whipping or double cream. The versatility really helps me to

cater more effectively for each individual who lives here at Alexandra Court. As a pastry chef, I have dessert recipes that say to use whipping cream, double cream, you name it ‒ with Millac Gold you only have to use the one product and because of this we get a lot of usage out of it. Also, because it whips up to three times its own volume you don t need to use as much when you re adding it into food ‒ you gain volume and you gain a saving.

John has also found that Millac Gold is perfect for fortifying the food already on offer.

In Alexandra Court there are various dietary requirements and sometimes food needs to be modified to produce pureed meals that are tasty, attractively presented and fully nutritional so I use Millac Gold in potato, porridge and vegetables, for example. We don t add water we enhance it with Millac Gold. It provides nourishment and I can t recommend it highly enough for giving you that safety net.

As John clears down from another service he talks candidly about the activities laid on at Alexandra Court ‒ dances, afternoon tea with his own homemade cakes ‒ yet the subject that gets him most enthusiastic is when he speaks about the weekly cookery classes he conducts:

In my classes we might make some scones, then after we sit, have a cup of tea, reminisce, even have a sing-song, it s absolutely great for everyone involved.

So, does John have advice for other chefs in the care sector?

Know your people, know who you re cooking for and try to use the best products you can alongside brands you trust. Pritchitts Millac Gold is one of those products that I can trust and I would definitely recommend it to anybody catering for the care sector.

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news

Appointments Avante’s Chief Operating Officer Avante Partnership has appointed Mark Lloyd to a newly created position of Chief Operating Officer, following the restructuring of its Senior Management team.

Livability appoints new Chair National disability charity Livability has appointed Caroline Armitage as its new Chair. Caroline takes over from Interim Chair Chris Carr.

CIC appointment Community Integrated Care (CIC) has announced the appointment of Elaine Gilbert as its new Director of Organisational Development and Transformation.

Chief Admiral Nurse appointment Dementia UK has appointed Hilda Hayo as Chief Admiral Nurse to lead the charity in its strategic decision to concentrate solely on the promotion and expansion of Admiral Nursing.

Castleoak appointment Castleoak has recently appointed Susan James as its new Head of Marketing.

SureCare Head of Services Care company SureCare has appointed Neil Farnworth as its Head of Services. Neil will work closely with existing and new SureCare franchisees to ensure highest possible standards of service delivery.

He will also provide field support to SureCare branch managers.

GVA correction Regarding the news of Iain Lock’s appointment as Head of Independent Healthcare at GVA in our September appointments column, Iain’s position at Savills was not Head of Healthcare as printed.

8 | cmm october 2013

News

• Corporate • Local authority • Planning News editor - Des Kelly G8 dementia summit The UK is to host the first G8 dementia summit to lead international action on tackling the condition. The

summit, which will be held in December, will draw on the expertise and experience of the OECD, World Health

Organisation, industry, national research organisations, key opinion leaders, researchers and physicians.

National Care Home Open Day 2014 More than 2,500 care homes across the country collectively opened their doors to the public for the first ever National Care Home Open Day on 21st June.

Run by a group of leading care providers and associations, the National Care Home Open Day

aimed to connect care homes with their local communities, challenge misconceptions about residential care and show local people the excellent services that are at the heart of their community.

Care homes across the

country were delighted at the positive response from the public and politicians, and plans are under way for next year’s event on Friday 20th June 2014, with an ‘Around the World’ theme to coincide with the FIFA World Cup.

Under-payment of the NMW Some care workers are being paid as little as £5 an hour, well below the legal national minimum wage (NMW), reveals a new report from independent think tank, the Resolution Foundation. The study shows that, while headline pay rates for domiciliary care workers are set at or above the NMW of £6.19 an hour, in practice those workers often lose at least £1 an hour because they are not paid separately for travelling time and visits often take longer than the time

allocated.

The report, Does it Pay to Care? looks in-depth at the work diaries and payslips of domiciliary care workers to show how their real pay levels don’t reflect the hours they work. The report states that while breaches of the law are common, the enforcement regime for the NMW puts the onus on workers to raise a complaint against their employer, something they are often unwilling to do. At the same time, complex information

on timesheets and payslips makes it difficult to be clear about the real hourly rate being paid. The NMW Regulations clearly state that travel time, excluding the first and last trip of the day, should be paid – except in cases of self-employed workers. The Resolution Foundation report calls for stronger penalties for firms breaching the law on NMW and recommends tightening enforcement, protecting workers and reforming the process of commissioning care.

Registered Managers’ Support Programme The National Skills Academy for Social Care (NSASC) has announced that its Registered Managers’ Support Programme now has over 1,200 members, evidence that ‘this dedicated, professional group are in sore need of a support

programme dedicated to their professional well-being.’

Since the official launch at the end of March, NSASC has worked with registered managers to establish local networks and to offer them events and workshops. There are resources available, online

discussions to be started and contribute to and a sense that joining together, whether in person or virtually, offers great benefits. A better-informed manager is in the best position to deliver even better care.

NSASC also has helplines in place.

news / in focus

Supporting carers would save money Better support for working carers would give businesses and the UK economy a much needed boost and would save taxpayers £1.3 billion a year, according to a new report. The report warns that businesses risk losing valuable, experienced employees if action is not urgently taken to enable people with caring responsibilities to remain in work.

The report, produced by the Government, major employers and the charity Carer’s UK, recommends that employers should renew their commitment to flexible working and actively promote the benefits of this approach with other businesses and should ‘carer-proof’ their policies and procedures to ensure they are fit to deal with the UK’s growing care responsibilities.

Adult safeguarding policy updated The Government has published an updated policy statement on safeguarding adults who are vulnerable to abuse and neglect. It includes the statement of principles for

local authority social services and housing, health, the police and other agencies to use, for both developing and assessing the effectiveness of their local safeguarding arrangements.

Your Care Rating results to be published on home by home basis From December 2013, following the largest ever survey of residential care for older people, Your Care Rating will publish home by home results to help people considering residential care, and their families, to make an informed choice. It will also drive continuous improvement by care home providers in the areas that residents themselves think most need improving.

This year saw the number of care operators signing up more than doubling to 30, covering

over 60,000 residents and more than 1,200 participating care homes. The 2013 survey is currently underway and market research company, Ipsos-Mori, will analyse the results before they are published at the end of the year. At a launch event earlier this year, Baroness Sally Greengross OBE, Co-Chair of the All-Party Parliamentary Group on Ageing and Older People, said, ‘Giving a clear picture of the care provided in residential homes has never been more important.’

In Focus: The Social Care Commitment What’s the story?

The Social Care Commitment is a voluntary agreement about workforce quality between all parts of the adult social care sector in England. It enables those working in adult social care to declare publicly their commitment to improving the quality of care and support services by signing up to a series of statements.

Employers and their workers are pledging to strive to deliver continually high quality care, ensuring the public can have confidence in the services they use. Employers and employees will each be asked to commit to seven statements, which are closely linked to the Code of Conduct. They will be given tasks and supporting resources to ensure they meet their commitment.

The Social Care Commitment has been developed following the Government’s White Paper Caring for our future: reforming care and support which set out its commitment to work with care providers, services users and carers to develop a sector-specific compact, including a skills pledge, to promote culture change and skills development

What is it for?

Its primary focus is to raise public confidence that people who need care and support services will always be supported by skilled people who treat them with dignity and respect. The commitment will also give clarity to employers and employees about what is expected of them.

The Code of Conduct, which sets out what is expected of adult social care workers. Making the commitment shows that the standards in the Code of Conduct will be put into practice.

The Social Care Commitment will give clarity to employers and employees about what is expected of them. It has been codeveloped with people who need care and support, employers and the workforce, to ensure long-standing and comprehensive support and a shared focus on quality and personalisation.

Who will it apply to?

It will apply to all job roles - including care workers, registered managers, social workers and other associated roles. It will be designed so that it integrates with any voluntary registration that may be developed in the future. The Department of Health will take the lead in signing up to the agreement along with other partners such as Skills for Care, Care Quality Commission and local authority commissioners. Each partner will sign up to a series of commitments relevant to their individual role within the Social Care Commitment.

What happens next?

The online system for sign-up is open to the care workforce.

Employers are encouraged to register their commitment. The website will open to the public from December 2013. www.skillsforcare.org.uk/thesocialcarecommitment

Care is all we do. www.castleoak.co.uk

cmm october 2013 | 9

property news

Pathways acquires Swinton Lodge

GVA and HC-One

Begbies Traynor instructed specialist property agents DC Care and their redevelopment arm Vertere to market the property. At the end of the process, Pathways Care was chosen as the new owner.

Swinton Lodge in Mexborough, Rotherham has been acquired by Pathways Care Group. The home was taken over by administrators Begbies Traynor earlier this year when the previous owner went into administration.

GVA has been appointed by HC-One to act as project manager and cost consultant for the refurbishment of five care homes across the North West and North East, as part of the Government’s £50 million fund to create pioneering care environments for people suffering with dementia.

GVA assisted HC-One in submitting its application for

the funding, from which HCOne was successful in securing seven projects nationally.

GVA will project manage the refurbishment of five out of HC-One’s seven care home projects. GVA will act as cost consultant for the projects whilst co-ordinating and managing the design teams carrying out the refurbishment work.

Danshell acquires Castlebeck All change at Hurstead House DC Care recently completed the sale of Hurstead House Nursing Home, in Rochdale, Lancashire. The client, Nick Frost, owned the home for over a decade but decided to relocate to Devon. DC Care was delighted to be part of the

team that helped him realise this ambition by finding a purchaser for the home. The purchaser owns a domiciliary care business and is expanding into nursing care.

to the Planning Committee who voted in support of the scheme for redevelopment of the Cornfactor building site for a three storey building of 26 sheltered apartments for the elderly together with two shop units for a café/restaurant and an hairdressing salon.

Building Construction Partnership ltd Excellence In Construction

DC Care has completed the sale of The Bay Nursing Home, in Tywyn, Wales on behalf of Joint Administrators, N Cropper, S Wilson and A O’Keefe of Zolfo Cooper.

Previously a hotel, the building has been in use as a nursing home for a number of years.

There were expressions of interest from a range of potential purchasers, including existing healthcare operators

and new entrants to the sector. The home was sold to Messrs Bains and this is their first venture into care home ownership.

The home was part of the Regency group which included companies that owned four other care homes: The Old Vicarage, Oak Lodge, Littlecoates House and Hazelmere House. All but one has remained in use for care.

Experts in the planning, design, development and build, of nursing, mental health and specialist care homes throughout the UK Call: 01924 910815

10 | cmm october 2013

occupancy of 180 patients and residents. Danshell Adult Healthcare specialises in supporting people living with learning disabilities and complex needs, autism and brain injury.

Daniel Smith, David Dunckley and Joseph McLean, partners at Grant Thornton UK LLP, and Joint Administrators of CB Care Limited (‘CB Care’), confirmed the completion of the sale to Danshell Group.

DC Care completes sale

Tanner & Tilley gets go-ahead A scheme to redevelop the site of a locally listed building that has remained derelict in the heart of Christchurch town centre has been been given the goahead by Christchurch Planning Committee.

Tanner & Tilley Town Planning and Development Consultants, working for their client Renaissance Retirement Ltd, presented the proposals

Danshell Adult Healthcare, part of the Danshell Group, has completed the acquisition of 20 services. The services, formerly operated by Castlebeck, had been in administration since March 2013. They comprise independent hospital assessment, treatment/ rehabilitation and residential care units from 20 sites located in the Midlands, North East and Scotland with a combined

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cmm october 2013 | 11

local authority & planning news

New home in Gloucestershire The Orders of St John Care Trust has officially opened Gloucestershire’s newest care facility – Windsor Street Care Centre. Developed as a state-of-the-art care home for older people, Windsor Street provides person-centred care; activities, hobbies, trips and entertainment; a high quality menu of food; and superb facilities built with residents’ needs in mind.

Windsor Street also offers nursing care and a specialist dementia unit, in addition to

respite care for those who may only require a short stay. Equipped with 81 beds, the £6.2 million care facility is divided into five separate household units, each selfcontained and providing all of the personal, communal and dining space needed to care for the residents who live there.

With a hairdressing salon situated on the ground floor, along with a number of ‘themed’ sitting rooms and pieces of textured and tactile wall art spread throughout,

Windsor Street’s design creates a stimulating environment for the residents and assists them with orientation when moving about the building. Among the home’s ‘themed’ sitting rooms are a Garden Room featuring realistic wooden fence wallpaper, live plants and an antique watering can, along with a Tea Room designed to look like the exterior of a cafe complete with stone brick wallpaper design, a scaled down front-of-shop facade with signage and ‘al fresco’ seating.

Extra care in Worcester A development agreement has been signed between Castleoak and Worcester Community Housing for an extra care scheme in Worcester. This will deliver 57 one- and two-bed apartments off Newton Road and adjacent to the Latimer Court care home which Castleoak completed for Barchester Healthcare in February. Work will start on site in September.

Dementia funding in County Durham Five care homes in the County Durham region, operated by Four Seasons Health Care, are amongst 116 hospitals and care homes selected to receive Department of Health funding that will facilitate projects to improve quality of life for

people living with dementia.

The five homes have been allocated a £232,439 portion of the £50 million Dementia Friendly Environments state fund for the progression of their services.

The Department of Health

earmarked £144,100 for Brockwell Court Care Home, and Barrington Lodge Care, a dementia specialist care home, is set to receive £13,839. £41,500 has been designated to Redwell Hills

Care Home, whilst Abigail Lodge Care Home has secured £25,000, and Langley Park will be given £8,000.

Project submissions were made in January and proposed work is to be completed by 31st March 2014.

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Information for Care. Everywhere.

local authority & planning news

North Yorkshire extra care scheme Work has started on an £8 million extra care project in North Yorkshire with Sanctuary Group, North Yorkshire County Council, the Government’s Homes and Communities Agency (HCA) and Keepmoat holding a sod cutting ceremony on the site at Eastfield, near Scarborough.

The leading housing and care provider is developing a 60 unit extra care scheme for the over 55s at the site, located to the north of Overdale in Eastfield.

This extra care scheme is part of the first phase of a wider development in Eastfield, named Middle Deepdale, whereby over the next 15 years, a total of 1,350 new homes will be created along with a primary school and community hall with retail provision, as well as footpaths, landscaping, and open plan spaces.

The extra care scheme, which will be managed by Sanctuary Extra Care, will include facilities

such as a restaurant, gym, library, sensory garden, hair and beauty salon and three retail units, some of which will be made available to the wider community. This development will also benefit the younger people of Scarborough, with two apprenticeship posts created and another seven apprentices, already working with contractor Keepmoat, to be given the opportunity to continue learning their trade on the site.

Housing 21 in Warwickshire Housing 21 has signed a joint contract with Warwickshire County Council for the provision of around 320 new extra care apartments across the county.

The partners gathered together at Rohan Gardens, Housing 21’s recently completed extra care scheme in Warwick, to sign the £37 million contract.

The developments will offer

opportunities for affordable rent and flexible shared ownership.

Housing 21 will work closely with local district councils and the building contractor, Willmott Dixon, in delivering the contract.

The Homes and Communities Agency has grant-funded the first three schemes under Housing 21’s affordable housing programme 2011-15.

In addition to the newly completed Rohan Gardens, the contract will provide extra care across Warwickshire, with discussions at an advanced stage to deliver even more extra care housing in the region as part of a successful tender. Work is due to start in September on two new schemes in Rugby and Bedworth.

Kingston homecare Eleanor Care, which provides homecare throughout London and Poole, Dorset, has won a tender to provide domiciliary care in the Royal Borough of Kingston upon Thames.

The care company, which has its head office in Lewisham provides a range of dedicated services, tailored to people’s individual needs and preferences.

The contract is for a three year period with an option to extend for two years at the council’s discretion, and Eleanor Care is now only one of three providers after Kingston Council reduced its number of providers from twenty four.

Following the contract win, Eleanor Care is in the process of setting up a new branch in Kingston, providing a significant boost for the area.

cmm october 2013 | 13

corporate news

CareTech refinance and acquisition CareTech has refinanced its £176 million of loan facilities and purchased two property portfolios, comprising, in total, 29 freehold properties for £38 million. CareTech acquired 28 freehold assets from The Quercus Healthcare

Property Partnership for a cash consideration of £29.5 million. In addition, the company acquired a property in Plymouth from Roborough Properties for £6.5 million.

Pinsent Masons advised both the refinance and acquisition.

expansion for Country Court Care Country Court Care has augmented its portfolio with the acquisition of a domiciliary care business. The speed of the transaction was driven by the fact that LeP Care Limited trading as At Your Home had gone into administration and it was essential for continuity of care for clients that the company was taken on by a business which could provide those services without delay.

The deal follows the addition of two care home sites to the estate in the spring, including a 90 bed unit in the south west, taking the number of residential homes operated by the group up to 12.

Daniel Corker of Freeth Cartwright’s Corporate Finance team provided legal advice to the Group on the acquisition, which was turned around in just three days

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Bupa acquires Richmond Villages Bupa made a further step into the care village sector by acquiring Richmond Care Villages.

Richmond currently owns and operates five care villages, which are home to over 660 people. The acquisition also includes three further sites for developing new care villages.

The five villages, in

Gloucester, Northamptonshire, warwickshire, Cheshire and Oxfordshire, include independent living apartments and assisted living support, along with residential care, all on one site.

Under the deal, all existing 600 Richmond staff and management will move to Bupa.

Quantum Care in Bedfordshire Quantum Care has announced a new development in Bedfordshire starting this summer and due to open in Autumn 2014, adding to Quantum Care’s existing home, Trefoil House in Luton.

The new home is positioned next to a stop on the new guided bus way, offering easy transport links to Luton and Dunstable.

The new home will feature 75 individual bedrooms, each with en-suite shower facilities divided into small households, providing residents with a personal service within personal spaces.

It will also feature a specialist dementia care area that has been designed using leading research by the University of stirling.

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Busy time at Castleoak Castleoak has started work on part of the two-year £45 million suffolk reprovisioning programme in partnership with Care UK. An 80-bed care home in Ipswich was the first of the 10 suffolk care homes to get underway. It was shortly followed by a 60-bed care home in Mildenhall, a 60-bed care home in Bury st edmunds and an 80-bed care home in Lowestoft. The care homes will provide residential as well as specialist nursing and dementia care, and incorporate a wellbeing centre for use by residents and those still living in their own home.

Castleoak has also successfully achieved planning

permission for three further care homes as part of the suffolk reprovisioning programme. These comprise a 60-bed care home in Framlingham, an 80-bed care home in Ipswich, and a 60-bed care home in Haverhill.

The company has also handed over two care homes for Barchester Healthcare, Ritson Lodge in Hopton-onsea and Beaufort Grange in north Bristol, as well as starting work on a 68-bed care home in Pinhoe, exeter, for new care operator, Portsound, and a 60-bed care home backed by its CarePlaces Fund for Care UK in stansted Mountfitchet, essex.

Amore Care rebranding complete Late 2012, the Priory Group of companies announced it was rebranding their older people’s services into the new Amore Care name. Paul Brennan, the Priory Group’s Chief Marketing Officer, commented, ‘whilst the Priory name has a very high level of awareness, the breadth and depth of services delivered by our 275 units wasn’t effectively communicated.

To address this, at a macro level, we introduced cohesive messaging and a brand promise so that, externally and internally, there is clarity of understanding.

‘Plus, to differentiate our offering and specialisms, we

are operating as four divisions - so the Priory mental health and complex care hospitals, specialist education schools and colleges, the Craegmoor name retained as the brand for the areas of autism, learning disabilities and positive behaviour support, plus the Amore brand for our older people’s division.

‘A phased programme has taken place to rebrand all of the Amore Care 45 homes across the UK into the new livery.

This includes homes originally branded under Craegmoor, acquired by Priory in spring 2011.’

Home Instead, england’s top homecare provider Home Instead senior Care has been revealed as england’s leading homecare provider according to Laing & Buisson’s Care

Compliance Monitor. The league table shows the percentage of inspected that are fully compliant with CQC’s core standards

covering care, safeguarding, staffing, management and respect for service users. Home Instead, which achieved the number one

position, scored 97.8%. Mencap and Carers Trust were second and third, achieving 93.4% and 93.3% respectively.

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cmm october 2013 | 15

Mimicking the US and learning some lessons The pressures on our sector are seeing changes in policy and approaches to take us into the future. Timothy Bolot and Scott Phillips explore the pressures we’re facing and the similarities with the United States, how the US has responded and what lessons we can take forward.

Since the break-up of Southern Cross in 2011 and the difficult economic situation faced by the entire country, many operators within the sector have continued to struggle in an extremely challenging market environment.

However, it could be said that many of the challenges currently being faced by UK operators, as shown in the panel opposite, are not new – in fact they draw significant parallels with the United States some 20 years ago.

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16 | cmm october 2013

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Pressures on the UK system Over recent years, there has been a ‘perfect storm’ of factors that we have seen come together to cause distress to many operators.

There has been an increased downward pressure on revenue, driven by like-for-like reductions in state-funded fee rates. There has also been a tightening of admission criteria for new placements. Local authorities have had to find care and support for more individuals whilst facing a continued squeeze and reduction to their budgets. In order to control their spending in the face of these pressures they have been increasing the eligibility criteria for those receiving support and placements in care homes.

Occupancy rates have seen extreme variation, as residents and potential residents admitted to acute settings are not being discharged to the care home sector. Partly due to the increase of re-ablement, the drive for supporting people to return at home and the use of homecare to bolster this government policy.

Increased outgoings Pressure on services, revenue and occupancy has been exacerbated by above inflation rises in operational costs and outgoings faced by many. This is driven by a fixed cost base that is heavily dependent on staff costs, with many staff already on minimum wage and an inability to offset marginal occupancy falls. It has also seen general inflationary pressures not offset by a corresponding increase in fees.

Research by Laing and Buisson found that, ‘average fee rates being paid by councils for residential care is £50 per week below the “floor” rate (a rate intended to apply to a physically poor quality care home whose physical environment is “on the borderline of acceptability”) and substantially below the “ceiling” rate (intended for those providers which have invested in their facilities).’

Difficult to respond A lack of financial flexibility has made it harder to respond to the changing market conditions. Many of the larger care home groups entered 2008 with high levels of leverage, based off historic property values. These legacy financial issues for many care home operators have hampered their ability to re-invest in their businesses and reposition their homes and services at a time of rapid change in the market. This means that providers have struggled to respond to changing pressures on local authority budgets and position themselves for the growing private pay customers, where fee rates can be set at a more sustainable and realistic level.

Impact of bed blocking At the same time, from our experience managing acute hospital facilities in the UK, there are significant capacity issues at many NHS hospitals, when hospital bed capacity is stretched to breaking point. A large number of beds are occupied by patients who do not necessarily need to be treated in an acute hospital setting and who could be better cared for elsewhere. Not only does this cause significant operational issues at the hospital, given the manner in which the national tariff operates for NHS acute providers, but this is also causing significant financial issues for the affected NHS hospitals and has a knock on for care homes.

In this context, and given that these pressures are unlikely to disappear soon, it is clear that the UK healthcare sector needs some innovative solutions that come at a lower overall cost to the public.

cmm october 2013 | 17

mimicking the US and learning some lessons

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Key understanding of the situation

In the US in the late 1990s, many large publicly-traded nursing homes were forced to resort to bankruptcy or voluntary restructuring as a result of spending cuts. At that time and in the years since, there are two key lessons that US regulators learnt which have gone on to inform policy there and are filtering into the UK market too.

1 2

In the long run, it is much less expensive, and more effective to provide health and social care services in the home than in a hospital or care home setting (ie whenever possible, move treatment closer to home).

The Government cannot afford to pay the cost of longterm residential, social or health care services for the entire population; rather individuals must be expected to assume responsibility for their housing needs in old age (with the Government providing a safety net for the poor, and a regulatory structure to govern the private market appropriately).

How the US responded While we would not suggest the US has resolved all the issues being faced, it has made significant progress in delivering higher quality elderly care more efficiently. As the UK is in the midst of Government proposals to address these issues, the US has made key changes.

Its growth in delivering private assisted living and continuing care retirement communities has been highly successful when combined with effective and available homecare, and is proving to be one of the most effective strategies to contain costs while also making available a wider range of services. Obviously the US has a large availability of land which makes the development of these communities far easier than in the UK, however it is clear that the UK market understands the benefits of such communities and, economic and market pressures aside, are growing here where land is available.

The US is now focusing on delivering true economies of scale. In an environment where like-for-like fees are static or reducing, providers must increase productivity year-on-year if they are to remain viable. Single care homes and smaller care home groups in an increasingly diverse market will have

18 | cmm october 2013

mimicking the US and learning some lessons

significant difficulties containing their costs and achieving this sustained improvement in productivity. One of the most effective strategies to meet this challenge, without negatively affecting residents’ lives, is either to group a number of care homes together, or to provide services within a defined local area to residents with different needs. Such ‘care clusters’ mean providers can secure economies of scale. Much of the consolidation that has taken place historically in the UK market has been transaction driven, as opposed to operational, meaning this could be an alternative avenue to consider.

Moving activity to the lowest cost setting that is appropriate.

As demand for services grows, discussion by policymakers and care providers is shifting away from focusing only on price, to the mix of what will be needed and where services should be located, whether that’s private homecare, care home or hospital.

The changes implemented by the US are filtering through the UK market and could be very relevant to the challenges currently faced here. Without such changes, local authority budgets and commissioning budgets will be overwhelmed.

The role of the private sector There is a significant role for the private sector to play in providing high quality services. Specifically, we believe that private care providers are best placed to be instrumental in: • Developing innovative solutions to providing care in an appropriate manner in the most cost-effective setting.

• Using information technology and economies of scale to drive down unit costs, while not reducing quality.

• Providing investment funding for new products and services, when the ability of the Government to invest is likely to remain constrained.

Although the UK care sector is facing unprecedented pressures, there are similarities to the US and you can see some of the solutions already filtering into the market. These will continue and, with other lessons to be learnt, should see an adapting market emerge as the economy begins to pick up. cmm Timothy Bolot and Scott Phillips are Managing Directors of Bolt-HMP (a joint venture of Bolt Partners LLP and Healthcare Management Partners LLC (US)). Email: tbolot@boltpartners.com / sphillips@boltpartners.com

cmm october 2013 | 19

business clinic

Financial failure – are you at risk?

New research states that one in three care home businesses are on the verge of going bust. Is this the case? Are you one of them? Or are they just managed risks? Our panel share their thoughts.

New research from corporate financial health monitoring specialists, Company Watch, into the financial health of UK care home companies, has concluded that almost a third have an above average risk of financial failure. For organisations identified as being in the ‘warning area’ it doesn’t necessarily mean that they will require financial rescue but that they are at a higher risk.

Company Watch looked at the financial accounts of 4,872 care home companies, which are responsible for the estimated 20,000 care homes operating in England, Wales, Scotland and Northern Ireland. Out of this sample, 1,449 care home companies had a financial health rating, based on the company’s unique methodology, or H-Score™, of 25 or less out of a maximum of 100. Over the past 15 years, since the

company started conducting this analysis of the financial health of businesses, companies identified as being in the warning area have had a one in four chance of needing financial rescue of some type.

Breaking down the data Company Watch’s research also concludes that amongst the 4,872 care home companies analysed, there were 693 ‘zombies’, which are those companies that have negative net worth. Collectively, these zombies had a total negative net worth of £217 million. Despite an increase in consolidation over the last decade, most care home operators are still smaller businesses. Company Watch found that the average UK care home company has total assets of £2.4 million, a net worth of

just under £1 million and borrows around £812,000.

It was identified that the average gearing of care home companies was 82 per cent.

Company Watch’s Business Risk Analyst, Nick Hood explained, ‘Gearing of this level is unusually high, reflecting the fact that the principal asset for most care home businesses is likely to be their property.

High levels of gearing make companies financially vulnerable to unbudgeted interest rate rises.’

Administration increases Company Watch’s research comes just four months after chartered accountants and business advisers, Wilkins Kennedy, reported a 12 per cent rise in care home insolvencies. According to the firm, 2012

Balance is needed

Not all are genuine zombies

Paul Birley Head of Healthcare Barclays

Andrew Brookes LLP Partner Hazlewoods LLP

Having a sector with a stable financial position must be a good state of affairs as it allows operators to focus on providing quality care.

The sector has been capital hungry over the last few years, as care homes have become complex businesses offering more specialised services and, therefore, the cost to develop these services has increased.

To fund these developments, many operators have borrowed money. However, at the same time we’ve seen rising running costs combined with pressure on local authority fees, which has reduced profits and caused some operators to struggle and become the so-called ‘Zombie Companies’.

For those operators, they have a window of opportunity, whilst interest rates are low, to look at what they do and offer different services to meet the changing market demands. For example, do they need to reposition their offering to provide higher margin, more specialist services? If they

20 | cmm october 2013

continue to do what they have always done, nothing will change; therefore they need to be creative and flexible in their offering.

Over time, they should be able to reduce gearing. Whilst interest rates aren’t expected to rise in the short term – at some point they will rise again and if businesses haven’t addressed their level of gearing, they may not survive.

However, there are many of our clients who are performing well.

They typically have borrowed in line with their strategic plan whilst also ensuring that they have a good equity stake in the business.

They continue to invest in their business, offer services that are needed by the community, and develop new sites. Care homes over the years have changed and they will continue to do so – what hasn’t changed is that overleveraged businesses will always be more vulnerable to changes in market conditions than those that aren’t and maintaining a good balance between care and borrowing is the key for a successful operator.

The article by Company Watch makes interesting reading, but before considering the risks, one must consider the companies that form part of this data. There are some that are really zombies, with poor assets, performance and stability, but...

There are some that will be privately-owned businesses that might be funded or structured in a way that suits them, or they might be remunerating shareholders or directors in a way that means the trading and balance sheet picture is not what it might seem at first sight.

There are also those that are backed by private equity that are likely to look like zombies, but only have a poor balance sheet and profit and loss account due to the likes of goodwill amortisation and the level of accrued interest on investor loans, which only gets paid on an ultimate sale.

That said; a good number are genuine zombies. It is without question that funding cuts in the sector are hurting many

operators, with wage and cost inflation running ahead of fee increases. The resultant margin erosion is something that operators need to work hard to mitigate, although for those with poor quality stock, it is difficult, if not impossible, to do this. We have seen less stock leaving the market due to a lack of alternative use opportunities and it is these businesses that should disappear with time.

The businesses to focus on are those with good underlying assets (bricks and mortar) which have a high level of debt or those which need to reinvent themselves before they reach a point of no return.

For those with high levels of debt, it is about pursuing a refinancing or restructuring of the debt such that the business can prosper. For those that need to re-invent themselves it is about, amongst other things, assessing options management, marketing, sector specialisation or changing focus.

business clinic saw 67 care homes going bust despite a decline in the total number of UK corporate insolvencies, which fell by 5 per cent.

Stephen Grant, Partner at Wilkins Kennedy, said at the time, ‘Care homes have been really hurt by local authority cutbacks. Local authority referrals are a major revenue stream for a sector that is weighed down by very high fixed costs.

‘Many care homes used the boom years to borrow heavily to fund growth. While the boom is over and occupancy levels are down in some homes, the debts remain.

As well as those care home businesses that have already gone into administration, there are a large number of care homes that risk breaking banking covenants.’

Wilkins Kennedy added that many care homes will struggle to raise much needed new funds by selling their property assets.

Stephen Grant continued: ‘Where care homes own their properties, they will struggle to sell for a high enough price in today’s property market. Many of today’s care homes were bought at the height of the property market and would be sold at a loss if put on the market. ‘...Several care home operators actually sold their properties during the pre-crisis property boom and have been renting the property back since. They don’t have any

major assets to sell. Care homes have less leeway than other businesses in drastically cutting costs to match shrinking revenues.

High standards of front-line care need to be maintained if a home wants to keep its operating licence.’

CQC policy In May 2013, the Care Quality Commission (CQC) announced that it was to undertake a series of financial checks on up to 60 of the largest care home operators, in order to avoid a repeat of the Southern Cross care home crisis, which collapsed under the weight of its debt in 2011, affecting around 30,000 residents. However, this will only focus on larger providers; the CQC will not be in a position to check the financial stability of the smaller care home operators identified as at risk by Company Watch.

Good news overall Although nearly 30 per cent of care home companies are at risk of financial failure, and insolvencies rose last year according to Company Watch, the sector looks fairly healthy overall. Nick Hood continued, ‘We noted that the average H-Score™ for the sector of 52 is significantly higher

than that calculated for the economy as a whole, which is between 43 and 44. This indicates that there is a higher than average concentration of financially healthy care home operators. The research concluded that there was, in fact, an average of 32.4 per cent of companies in the upper quartile, when the normal number would be expected to be nearer 25 per cent.

‘With the demand for care home beds rising to around 600,000 as people live longer, and with demand from Baby Boomers for better quality care homes when they need them, the pressure is on the Government to ensure the sector meets people’s needs. With almost a third of care home companies currently in our warning area, it is clear the sector has some financial issues that need attention.’ cmm

Over to the experts...

With almost 30 per cent of care homes facing financial failure, what can ‘at risk’ operators do? Is it simply a case of managing the risks for most providers?

Are we likely to see another increase in care home insolvencies at the end of this year? What do our experts think?

CQC will inspect finances Alan Rosenbach Special Policy Lead Care Quality Commission From 2015, the Government has proposed that the Care Quality Commission (CQC) should take on additional responsibilities to inspect the finances of large care providers in the sector.

The Government’s proposal [as detailed in the Department of Health’s publication Oversight in Adult Social Care The Consultation Response] is that we will be able to require regular financial and relevant performance information from large care providers, require them to develop sustainability plans to manage their financial risks, and to commission independent business reviews to help them return to financial sustainability.

These plans and proposals are subject to the Care and Support Bill which is currently receiving Royal Assent.

The finances of most adult social care services will continue to be examined by

local authorities and so we estimate that between 50 and 60 providers are likely to benefit from this new financial monitoring regime – the exact number will depend on regulations, which the Department of Health are planning to begin consultation on in Spring 2014.

We welcome this proposal as our priority is for those people who require care, to receive care that is safe, effective, caring, well-led and responsive to their needs.

Alongside the Government’s consultation, we will work with care providers across the country, and our wider partners to develop the plans for taking on this role, depending on what is set out in the regulations.

For more information on the Government’s proposal for the CQC to inspect the finances of large care providers see CMM July 2013.

Our turn to look after you Helping you maintain a healthy business With over 20 years of health and social care experience, you can rely on Hazlewoods to provide support at all stages of your business lifecycle.

Our dedicated team can provide expert advice on accounting, tax, business strategy and sales across the full spectrum of health and social care.

To find out more, please contact Andrew Brookes Tel: 01242 246670 Email: andrew.brookes@hazlewoods.co.uk Web: www.hazlewoods.co.uk @HazlewoodsCare

cmm october 2013 | 21

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Deprivation of Liberty Safeguards – woefully inadequate Since their introduction in 2009, the Deprivation of Liberty Safeguards (DOLS) have been the cause of much controversy in the sector. A recent report from Parliament now highlights the issues around DOLS with a view to making improvements as soon as possible. Peter Grose explains more.

Despite having now been in force for over four years, there is still no clear definition of a deprivation of liberty. The extent of DOLS remains unclear and is open to varying interpretation by different local authorities, but care providers can face strong criticism if they get it wrong.

Whilst the press tells of ‘restraint orders’ there remains a widespread lack of understanding (amongst care providers and local authorities alike) as to what constitutes a deprivation of liberty.

Health Select Committee report The House of Commons Health Select Committee published a report on 14th August 2013 entitled Post-legislative scrutiny of the Mental Health Act 2007 (The Commons Report) which assesses the implementation and operation of the Mental Health Act 2007 (the MHA).

The MHA established a single definition of mental disorders as it was felt that some were not obviously covered by the Mental Health Act 1983. The Department of Health (DH) published its own post-legislative assessment of the MHA in July 2012, which stated that, in drafting the new definition of

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cmm october 2013 | 23

deprivation of liberty safeguards - woefully inadequate

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mental disorders, they sought to ensure that this would not result ‘in people being detained solely on the basis of learning disability’.

Where can DOLS apply?

DOLS apply to hospitals and care homes in relation to adults aged over 18. They can apply to those: - who suffer from a mental disorder – such as dementia or a learning disability; - who lack the capacity to give informed consent to the arrangements made for their care and/or treatment; - who are considered to be at risk of harm if they are not deprived of liberty (as per Article 5 of the European Convention on Human Rights (ECHR)); - where it is in their best interests, according to the MHA, to be deprived of their liberty in a hospital or care home.

in authorisation rates between local authorities and a much lower overall use of DOLS than predicted. It attributed this to differences in training and guidance between local authorities who determine their own policies and interpretation.

In its July 2012 report, the DH acknowledged the variation in implementation of DOLS but said that an overall growth in the use of the safeguards meant that ‘the safeguards are becoming better understood and there is increasing awareness’. By contrast, the evidence heard by the Commons Health Committee revealed a ‘profoundly depressing and complacent approach to the matter’.

The Committee found that there is extreme variation in their use due to a lack of understanding concerning the original legislation. Care providers ‘did not know when they were exceeding the powers it gave them’ and there was a ‘lack of understanding amongst providers and care

‘The Commons Report describes the DOLS regime as “woefully inadequate” and that people who lack capacity “are currently widely exposed to abuse”.’

The DH described the purpose of DOLS in its July 2012 report as follows: ‘to provide a statutory framework for authorising the deprivation of liberty for people who lack the capacity to consent to treatment or care where, in their own best interests, that care can only be provided in circumstances that amount to a deprivation of liberty’.

The Commons Report describes the DOLS regime as ‘woefully inadequate’ and that people who lack capacity ‘are currently widely exposed to abuse’.

Implementing DOLS The implementation of DOLS has proved problematic. The Mental Health Alliance has pointed out the disparity

24 | cmm october 2013

staff regarding the meaning of deprivation of liberty in practice and a resistance to use DOLS because of the complex processes involved and widespread anxiety and defensiveness about care standards in practice’. The Commons Report also identified a ‘high level of legal and procedural errors caused by the complexity of the scheme coupled with inadequate staff training’.

Other issues The Monitoring the Mental Health Act 2011/12 report published by the Care Quality Commission in January 2013, also highlighted confusion amongst staff as to the legal status of those cared for, resulting in uncertainty regarding deprivation of

liberty. The Mental Health Alliance has also stated that the absence of a standard definition of deprivation of liberty has hampered the ability of staff to properly interpret the guidance in relation to DOLS. Whilst the Commons Report recognises the need for more sophisticated data, it states that the great variability of applications suggests that there is not equal access to safeguards. The fact that care providers have to refer themselves to supervisory bodies was found to be a significant consideration in this.

The Committee also heard evidence that there was a lack of compliance with the requirements of ECHR Article 5(4), as the individuals concerned lack capacity and their representatives may have no knowledge of the DOLS system. It was suggested that Independent Mental Capacity Advocates (IMCAs) could help those with learning disabilities or their representatives through the system.

However, the statutory right to be referred an IMCA is very limited, leaving the Court of Protection as the only option, which can be a lengthy and costly process.

Urgent review required The Commons Report recommended an urgent review of the implementation of DOLS, which should be undertaken by the DH and presented to Parliament, together with an action plan for improvement, within 12 months.

The Commons Report has presented some alarming conclusions and highlighted the need for urgent action.

It could be argued that the issues surrounding DOLS should have been recognised sooner. However, this type of safeguarding was only introduced in 2009 and time had to be given for training, implementation and data collection. It is unfortunate that no clear definition has been provided during the last four years, which may have assisted care providers in implementing the DOLS system, the future of which is now uncertain.

In a post Winterbourne and Stafford Hospital environment, fed by increased media scrutiny, it is likely that reform will be implemented sooner rather than later. cmm Peter Grose is Partner at Lester Aldridge LLP Solicitors. Peter.Grose@LA-Law.com

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Bridget Warr Bridget Warr is Chief Executive of United Kingdom Homecare Association and the Chair of the new Social Care Guidance Development Group at NICE.

How do you feel about your role as chair?

I am delighted to have the opportunity of chairing the Homecare Guidance Development Group. It’s early days; we’re still at the stage of planning work and NICE is currently consulting on the scope and recruiting members.

Are you glad that someone with such a strong homecare background is leading the group?

Having an understanding of the work and complexity of homecare will, I believe, help me to keep the Group focused to ensure we deliver what is needed.

It is, however, the members of the Group who will bring knowledge of every aspect and expectation of homecare.

What is the aim?

It will use the research findings, feed in its own experience and knowledge and identify the factors of high quality homecare.

Members will then help the Social Care Institute for Excellence, its other partners and NICE to draft the guidance. It will need to be teamwork.

What do you hope to achieve?

Guidance for homecare that identifies high quality and is achievable, but will not be compulsory. The guidance is intended for providers of homecare seeking continuously

26 | cmm october 2013

to improve their services and for people who may be seeking support at home. It will also inform others across health and social care provision.

What impact will NICE have on social care?

Homecare is the first social care issue NICE has tackled. It is approaching it with customary thoroughness and I am impressed by the range of skills and information we can draw on. All NICE social care guidance (and, eventually, standards) will be developed in close partnership with people who use services, carers, practitioners, providers and other relevant organisations.

NICE is well-positioned to encourage collaboration and integration between health, public health and social care; a crucial ingredient of high quality care and support for individuals.

There is real potential for a positive benefit to individuals and the sector, but that will depend not only on the quality of the guidance, but also on clarity about how NICE guidance and CQC standards work together. The working relationship between SCIE and CQC should help with this.

How do you like to spend your spare time?

At my home in Devon, with my husband and my horse, or overseas travelling.

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Focus on Leadership and Interns: Giving Graduates a taste of Social Care Leadership Welcome to the National Skills Academy for Social Care’s Leadership Section Welcome to our latest issue. Earlier this year, we reported on the growing demand for graduates in the sector. Since the Skills Academy started its national Graduate Training Scheme in 2009, the number of candidates and host organisations coming forward has grown exponentially. Last year, we received almost 1,000 applications for some 22 places on the scheme, and over 60 high-quality business cases from organisations interested in hosting a trainee.

This growth in demand reflects the increasing recognition across social care of the contribution that Graduate Trainees can make. At the Academy, we have been tracking the return on investment, and it is clear that Trainees can add significant value to organisations.

Amongst our trainees from amongst Cohort 3 (in place during 2011-12), one Graduate saved their host organisation £80,000 in recruitment costs. Another developed an online ‘Dementia Academy’ to capture the full range of activity and interventions taking place across a large regional care provider. A third helped develop a service improvement programme and accreditation framework for day services that has been rolled out across a local authority. And many trainees were involved, alongside their front-line roles, in researching and developing new market opportunities for their organisations.

With this in mind, and bearing in mind that similar schemes in sectors like health, teaching and social work aim to recruit hundreds of graduates at a time, we want to extend our scheme for social care.

As a starting point, we launched a paid Internship programme for Graduates over the summer, so that we can broaden the reach of the Scheme and make graduate resources available to a wider range of organisations.

We want to give as many Graduates as possible, who are considering social care as a career of choice, the opportunity to get their foot in the door. Recent research

Debbie Sorkin, Chief Executive of the National Skills Academy for Social Care, explores the value of paid Graduate Internships in social care has shown that Graduates who have had work experience or undertaken internships are three times more likely to be successful in job hunting.

We had some clear objectives when we launched the programme. One of them was to pay our Interns. We are acutely aware of how competitive the graduate market is at the moment, and of the growing trend to offer unpaid internships to Graduates. We were conscious that we wanted our interns to be delivering on significant pieces of work and, consequently, it was important they were rewarded accordingly.

Another objective was to give our Interns an accurate impression of leadership within social care, warts and all.

Some may leave the programme and feel that the Social Care Sector is not for them. That is absolutely fine – we want people with the right values who are committed to working in our sector and to improving the lives of people using care and support services. We know there are many Graduates out there who have this passion. Our job is to find them.

Thankfully, the majority of our Interns seem to feel they have made the right choice. The success of the programme has been wonderful. I spoke at the Welcome Event for the first cohort of interns at the end of July, and it was fantastic to see such enthusiastic, passionate people in the room. I hope, and believe, that the majority of them will go on to have long and successful careers in social care. Overleaf, you can find out more about them.

For more information on the Graduate Scheme and the Internship Programme, including how you could apply as a trainee or host, please visit our Graduate Scheme web page at www.nsasocialcare.co.uk/programmes/ graduate-scheme-internship-programme, or contact Andy Williamson, the Graduate Scheme Programme Manager, at andy.williamson@nsasocialcare.co.uk.

The National Skills Academy for Social Care Graduate Internship Programme Andy Williamson, Graduate Scheme Manager The Skills Academy launched its inaugural Graduate Internship Programme this summer, to complement the already established Graduate Management Training Scheme. The programme, according to Graduate Scheme Manager Andy Williamson, has been an overwhelming success: Last year, in the build up to recruiting for our Graduate Management Training Scheme, we ran two taster days to give graduates more information about the Scheme and about leadership in Social Care. Almost 100 people turned up to those two days, and it made me realise that there is a real appetite out there from Graduates who want to learn more about working within the Social Care Sector.

Furthermore, when we went through the recruitment process for the last intake of our Graduate Scheme, we had almost 1,000 applications for 22 places. That meant that over 900 graduates who were interested in joining the Social Care Sector missed out.

Ever since then, we have been really passionate about launching an Internship Programme to complement our Graduate Scheme. From graduates who have just left university and wanted to add to their CVs with some practical work experience, to those who simply wanted to learn a bit more about what life in Social Care was like, this programme presented a unique opportunity.

Our interns have been placed in a variety of host organisations, and we are paying them a salary while they are on the 6-week programme. We wanted the placements to develop the interns, push them out of their comfort zones

and give them something tangible they could put on their CVs. Critically, we also wanted to ensure they would be adding value to their host organisations in the short time they were with them.

As a result, we asked organisations interested in hosting an intern to identify a specific project their intern would be working on while they were there. Crucially, as a result of undertaking the project, the intern should be able to clearly demonstrate where they have made a difference.

I think this has helped to ensure that the programme has been such a success. I have been visiting each of our interns over the last few days, and what has struck me the most is how many managers are so grateful to have had such a bright graduate, with a fresh pair of eyes, to complete a piece of work they have wanted to do for a long time but haven’t had the resources.

As you will see below, the programme has been fantastically well received by the interns themselves, and the organisations within which they have been placed. We hope that most of our interns will stay within the sector, with many having already expressed an interest in either staying within their host organisations or applying for the next cohort of our Graduate Scheme.

The Mystery of Being an Intern!

Stephanie Mitchell, Graduate Intern, Based at Sanctuary Care Having recently finished my degree in Psychology I was starting to contemplate where to take my career next. When the advert was emailed to me through my Psychology Department, I had never really considered going into social care, thinking I had no relevant experience and just generally knowing very little about the sector. By researching social care and the Graduate Internship Scheme I soon realised that my time spent volunteering in Salisbury District Hospital where I went onto the wards and spoke to the elderly patients, a lot of whom had dementia, was incredibly useful.

I soon found myself placed with Sanctuary Care where, under the supervision of the Area Client Relations Manager, I attended training days relevant to all aspects of care; from safeguarding and fire risk assessment to sales and marketing training. Alongside this I shadowed different members of the team involved in running a care home, from carers to Home Managers. This provided me with a good insight into all areas of the care industry, and educated me in what standards are expected both from CQC and Sanctuary Care specifically.

The second half of my placement involved mystery shopping. I was given the responsibility of going into care homes around the country, both Sanctuary homes and the competition’s, and looking at the first impression given out by the establishment. My training and shadowing had informed me that the first impression and the show-around is of vital importance in bringing new residents into the home. It also informed me what to look for and what should be happening in the first meeting with a prospective client.

I feel like I have contributed to Sanctuary, as they will be able to act on my feedback from mystery shopping and as a result will give prospective clients a much better experience when first looking around a Sanctuary care home. Following the placement, I feel much more educated in the sector of social care and have been able to see first-hand how care homes can help all members of families and the community.

I am now incredibly keen to apply for the full Graduate Scheme in hope of progressing into the area of social care management as a career.

Driving Improvements for Good Care Zoe Elkins, Head of Care Strategy, The Good Care Group The Good Care Group is delighted to be working with the National Skills Academy as a host organisation for an intern from the Graduate Internship Programme.

The Good Care Group is a professional provider of high quality home care services, enabling older people to remain safely and happily in the comfort and familiarity of their own homes and communities. We were formed in 2009 by a management team who came together with the desire to make a real difference to the lives of older people who are finding it harder to cope alone. We wanted to set new standards and bring a level of professionalism that may not have previously been visible in the sector.

We were thrilled when we discovered that we had been selected as a host organisation by the National Skills Academy for Social Care. We recognised the opportunity to work with a fresh and innovative young mind, whom we could support and develop to become one of our future Care Managers.

Our intern is Holly Turner – she is intelligent, articulate, highly

organised, with strong analytical skills and a great work ethic.

Holly has undertaken two projects during her six weeks with The Good Care Group, both focussed on quality auditing and driving improvements across carer reporting and client reviews by implementing change management systems.

The benefits of having an intern in our organisation have been immediately realised. Holly brings a fresh approach to our team; being new to the care sector she often sees things in a different light. She spots areas of opportunity and novel ways of approaching issues, whilst her intelligence and natural empathy ensure that all actions are grounded in our company values. The value that Holly is already adding to our organisation can be seen through improved carer reporting which has enabled managers to be better informed about each client placement leading to improvement care management. In addition she is supporting the management teams to improve the client review process, leading to improved outcomes for our clients.

Using our Intern to Seek “Views on Growing Older” Toby Williamson, Head of Development and Later Life, Mental Health Foundation Natalija Webb, Graduate Intern, Mental Health Foundation The Mental Health Foundation (MHF) was really pleased to be selected as a host organisation for the National Skills Academy for Social Care (NSASC) Graduate Internship Programme.

MHF is a UK charity that carries out social research and service development projects, as well as providing information and doing public affairs work on mental health and wellbeing in general and particular issues affecting people with mental health problems, dementia, and learning disabilities. We don’t provide frontline services, have a membership or local branches and therefore we have to find other way of ensuring that our work is relevant and useful to people. The Internship Programme has provided us with an innovative opportunity to do this as well as giving our intern, Natalija Webb, a useful and positive experience of working in a national research and development organisation.

We asked Natalija to set up a ‘virtual’ panel of people who are interested in the work we do on mental health in later life, called ‘Views on Growing Older’. The aim is to be able to collect people’s views on key mental health issues affecting later life, find out what people think of the work we are doing (or proposing to do) in this field, and possibly even to invite people to participate in our work. The project required dedicated staff time, an understanding of the issues involved, an ability to work collaboratively with colleagues in the organisation (especially in our communications department), and project management skills to successfully complete the project in the time available. Natalija more than demonstrated her abilities in all these areas and has also had time to assist colleagues with other work.

The panel got off to a flying start with 320 people expressing an interest in joining. Natalija invited them to respond to two questions about mental in later life and the work that we did which got a very good response rate.

Consequently Natalija is leaving MHF with a panel of people engaged with the organisation but also a good indication of what they consider to be the important mental health issues in later life, and the work that MHF might consider doing in the future.

Natalija has given us a lot and in return I hope that the experience of using research in this strategic way has given her useful experience for her future career.

Natalija writes: After graduating with an MSc in Social Work I was very keen to expand my knowledge about issues for vulnerable adults, in order to better support service users in future. So I was delighted to be chosen as a Skills Academy intern for the Mental Health Foundation. Working on this project has been invaluable. I’ve been able to ask people with hands-on experience about the most important mental health issues that affect later life as well as to hear real suggestions and solutions on tackling these issues. These answers will help steer the work of the Foundation towards a more tailored approach to research, information sharing and developing support services.

The internship has not only enabled me to learn about mental health and later life. It’s confirmed my desire to help people in feasible and tangible ways on the front line, supporting excellence in service provision.

Using Social Media to Enhance Care Jenny West, Graduate Intern, Based at Sheffield City Council Having completed an undergraduate degree in Social Work, I have developed a strong interest in a career in improving the quality of care in social care organisations. I felt that the leadership and management skills offered by the NSA would be useful in achieving this, and the Internship Programme seemed like a perfect opportunity for me.

I am placed within Mental Health Commissioning at Sheffield City Council, and my project is based on the use of social media in increasing the resilience of people with mental health problems. I have explored this through secondary research, and connecting with a range of individuals, organisations, service users, and projects taking place locally.

The council have been extremely welcoming, supportive, and provided opportunities for shadowing and working with anyone I felt relevant.

A presentation will be produced for providers, demonstrating how they can support service users to become more connected online. A report will also inform the commissioning of a new information contract with Sheffield MIND. Having sufficient time and resources has meant I have

been able to be flexible and innovative in my approach, from speaking to the creators of tele-care apps and networking sites, to meeting with local digital innovation companies providing new and exciting ways of working with vulnerable groups.

Additionally, I have enabled service user perspectives to be incorporated in the commissioning process, by conducting 3 focus groups. I hope the report will provide a comprehensive overview of what is taking place elsewhere, and will provide recommendations as to how Sheffield can work with local organisations to do the same.

I have thoroughly enjoyed developing a range of skills, including my ability to manage a project, utilise resources, be professionally confident, and network. I have found it valuable to gain an insight in to the political and strategic influences on Adult Social Care, especially at a time of significant budget cuts. With the skills I have developed I would be more confident to apply for the Graduate Scheme with NSA and also other jobs requiring project management or leadership skills.

Helping to Deliver the Business Plan Shane Carroll, Organisational Development Manager, Avenues Group The Avenues Group were very pleased to be involved in the new Graduate Internship Programme. At an early stage we were involved in the recruitment and selection process and then were fortunate enough to be able to provide a placement for Leah Boylan.

At Avenues our purpose is to challenge and overcome the disadvantages that people face through illness and disability, whilst ensuring that the individuals that we support have the opportunity to be actively involved in their local communities.

In planning Leah’s’ placement it was important for us to not only get Leah involved in a key project that we were undertaking, but also to give her the opportunity to visit and experience what it was like for the people that we support.

The key project that we got Leah involved in was with a team that was going to deliver a key objective in our current Business Plan. Leah’s role as part of the project team was to assist with identifying what processes needed to be put into place, what training may be required for staff and more importantly how we would measure the outcomes. Leah

brought a ‘fresh pair of eyes’ to the group and was actively involved in with the project team helping them to prepare the final proposal document that would be presented to our Board of Governors.

Leah thoroughly enjoyed her time with us and said “The placement gave me the opportunity to get involved in a real work place project. I liked getting involved in the research elements, and a real learning opportunity for me was realising you have to be flexible and prepared to change direction to deliver the results”.

At Avenues we realise that Graduates currently constitute a very small proportion of the adult social care workforce, and we were very keen to get involved to give a graduate the opportunity for some hands-on work experience. What was really important for us was that during the 6 week placement we wanted to give Leah the opportunity to get involved in something that would have a real impact on the organisation whilst, at the same time, supporting Leah in her own personal development. The way the scheme was planned certainly gave us the opportunity to do this.

For more information on the Graduate Scheme and the Internship Programme, including how you could apply as a trainee or host, please visit our Graduate Scheme web page at www.nsasocialcare. co.uk/programmes/graduate-scheme-internship-programme, or contact Andy Williamson, the Graduate Scheme Programme Manager, at andy.williamson@nsasocialcare.co.uk.

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Dementia care in the community E

veryone knows the statistics around the rise of people with dementia; it’s well-documented and isn’t going to go away.

As the baby-boomers reach retirement age, we’ll see a spike in the numbers of people with dementia. Diagnosis of dementia is low, with around 46% of people receiving a formal diagnosis. Whether they receive a diagnosis of not, in the main they find themselves left to their own devices to discover what’s available to meet their needs. Now is the time to respond.

‘We have a window of approximately five years to get services right, to be prepared for the tidal wave of dementia,’ explained Professor Graham Stokes, Director of Dementia Care, Bupa Care Services UK. ‘We have to be smart, we can’t wait.’

Time for innovation

In conjunction with Care Show Birmingham, CMM looks at opportunities around dementia care in the community.

28 | cmm october 2013

Historically, people with dementia have been cared for in care homes, increasingly towards the end of life or if they have particularly complex needs or behaviour that challenges. Alternatively, care is delivered in the home by traditional domiciliary care

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dementia care in the community

 services. Sitting between this is respite to give carers an opportunity to have a break from their role, and give the person with dementia a chance to try new things, meet new people and have, what we’d all hope is, a pleasurable break.

However, the time has come to innovate and offer flexible services that are based around the individual and their carers.

Responsive and adaptive care providers will find that they are best placed to offer these services. The NHS and social services have stepped back from dementia, and social care providers have taken over the care and support of these people. This means that the expertise lies with social care providers and now is the time to draw on it to improve the lives of people with dementia in the community.

receive a diagnosis) and they don’t know what is available for them in the community.

If someone was available to guide them on their journey, offer practical and emotional support to help the family carer to access services and cope with their role of caring, it can also take the pressure

that they have some time to themselves – which might not be a full day or longer period traditionally associated with respite – and that their family member is being cared for, enjoying their time and have trained carers with them.

Graham explained more opportunities that come

can do the same. If they have managed care workers to help and support people, signpost information, and offer advice, they can still offer helpline support and a corner of the office can be turned into a place for a cuppa and a chat.

They can have care workers available for bookings for

C

t

‘Care providers should look at ways to support people from the start of their journey to the end.’

MOVING UPSTREAM Care providers traditionally sit at the end of the dementia journey, offering personal care and support as people reach the end of life and have high needs.

There is now an opportunity to move further ‘upstream’, take the expertise that they hold through staff training, existing services and years of caring for dementia and apply that to help people on their journey with the condition. Graham Stokes explained a new role that is emerging around managing the dementia journey, ‘As people are living with dementia in the community, there is an opportunity for care providers to have someone to advise and help people with dementia and their families navigate their dementia journey. The Alzheimer’s Society has some Dementia Advisers who take on a similar role, but there are only a few, and more are needed to give this sort of support to people.

‘People are diagnosed and discharged (or they don’t

30 ¦ CMM SEPTEMBER 2013

off of the health services as they’re more likely to be able to cope with the caring role.’

COMMUNITY HUB Care providers should look at ways to support people from the start of their journey to the end. They should become the central hub of the community.

They can offer day services or respite, signposting people to other support in the area. The concept of pop-in sessions is a huge opportunity, giving carers the ability to call the care home or domiciliary provider and arrange a specific pop-in slot for their family member, while they go off and do what they need to do.

They’re safe in the knowledge

from innovative thinking, ‘Care providers should bring the walls down, metaphorically. They should become community hubs, offering intermediate care, helplines, drop-in centres for information or just a chat. And those individuals that support people on their care journeys, let’s call them managed care workers, they are there to help facilitate the journey, offer advice and guidance and be a port of call for family carers whether they need emotional or practical support.’

Care homes should be able to see the obvious opportunities here because they have the space to invite people in. However, domiciliary care providers

pop-in visits, to drop off resources, leaflets, and have details of new services in the area. Working closely with organisations like Citizens Advice can help set this up too.

MONEY MATTERS With a drive to personalisation there are obvious benefits to giving people control over the services they access. But uptake is low and convincing people that personal budgets can work for them can be tricky. Bupa has been working with local Citizens Advice Bureaux to signpost people to information around money matters. This can help them to understand the benefits of direct payments, there’s



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dementia care in the community

still a role for the care g provider and the individual has more control over their life.

Win, Win By becoming involved in the lives of people with dementia and their families earlier in their journey, care providers are perfectly placed when the time comes for more intensive care and support.

Being known to people and the community, having those relationships, and being able to support their journey means they are more likely to come to you when they need social care services.

The time has come for care providers to position themselves further ‘upstream’ in the journey of someone with dementia. However, in order to achieve completely joined up care pathways, there is a real need for integration between the NHS and social care providers.

LoCaL aUTHoriTieS Obviously, it’s great for providers to have the innovation and drive to improve the lives of people 32 | cmm OCTOBER 2013

with dementia in the community, and it to be earlier in their journey, but without local authorities and commissioners being open to these it can be hard to push forward. Commissioners are acutely aware that they have more people to support with less money. If care providers can prove that what they’re doing will reduce crises and pressure on the services by helping family carers, they are more likely to be open to ideas. Walsall Council is very forward thinking and is already making huge leaps in the support for people with dementia in the community.

THe WaLSaLL WaY Walsall Council has been working hard to implement the National Dementia Strategy through a whole-system commissioning approach. The main aim of this is to offer people with dementia in the town solutions that don’t tick boxes, encourage positive risk-taking to maintain independence, are personcentred, are age inclusive and age appropriate, focus on outcomes and integrate

services.

They are developing a new memory clinic service due to start in December. This will include new support worker roles similar to the managed care workers mentioned above, who will support people upstream. They will become involved in the lives of the person with dementia and their families to help improve their life, home, access to benefits, adaptations and anything else that can help them on their journey.

They have an incentive scheme for care homes who want to raise the quality of life for people with dementia.

This funding can be up to £10,000 and can be used for things like dementia-friendly gardens as long as the care home can show the benefits and outcomes of it for people with dementia. Several care homes have already benefited from this scheme and have implemented quality improvements with more on the way.

Walsall has invested in its independent living centre which has equipment available for loan, including iPads with dementia-related apps loaded.

These are available for anyone to borrow, including care providers, to see how they could be used with the people they care for.

The Council is also taking forward the ‘errorless learning’ approach with people with dementia, helping them to relearn skills and reduce their deterioration without them making mistakes. With the expertise care providers have available to them this is something that could be taken forward by providers across the country.

Time To move forWarD Given the drive to care for people in the community and to keep people with dementia living in their own homes for as long as possible, there are a wealth of initiatives and opportunities for dementia in the community. Care providers, whether care homes or domiciliary care providers, should look to the people in their communities, identify what they need and see how they can get involved in their lives earlier. This will help to improve the lives of people with dementia and their families as well as giving providers more opportunities to diversify their business whilst being seen as a supportive partner to people with dementia, and an obvious port of call when the time comes for more intensive social care services. cmm

With thanks to Professor Graham Stokes, Director of Dementia Care, Bupa Care Services UK and michael Hurt, Commissioning manager: older People’s mental Health and Dementia, Joint Commissioning Unit, nHS Walsall Clinical Commissioning Group / Social Care and inclusion Walsall Council. for more information on dementia, innovation and opportunities, you can see Graham, michael and other top experts speak live at the Dementia Care Show’s Dementia Care Seminar Theatre at the Care Show in Birmingham on 12th and 13th november. www.careshow.co.uk

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The annual Transition Event is a one day forum for young people with additional needs, their parents and professionals to explore the move into adulthood. The event offers main presentations, workshops, interactive sessions and an exhibition of service providers.

Having been running for six years, the Transition Event attracts national delegates including: • • • • • • • • • •

Young people with additional needs, their parents and carers, Commissioning managers, Learning disability transition teams, Personalisation and individual budget teams, Housing option teams, Special educational needs co-ordinators (SENCO’s), Providers of care and support services, Brokers, Special schools and colleges, Advocates.

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Solihull Life Opportunities (SoLO)

FINDING

the

FUNDING for

TRAINING Employers know that investing in learning and development for their staff is not only essential for quality care but also makes good business sense. Sharon Allen shares details of funding streams for social care training.

To help employers continue to invest in their people, Skills for Care disseminates funding for learning and development, on behalf of the Department of Health, through a network of employer-led partnerships.

WorKforCe DeveLoPmenT fUnD The Workforce Development Fund (WDF) is designed to support the continuing professional development of staff within the adult social care sector by funding the achievement of qualification units.

A recent evaluation revealed that employers felt the support from WDF had helped to drive their workforce development plans, boosting the reputation of their business and leading to an increased take-up of services.

One employer told Skills

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finding the funding for training

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finding the funding for training

for Care that through WDF, g ‘there are more opportunities for staff to develop their skills, therefore they are more motivated and recruitment (and) retention improves.

‘This then ensures our residents receive a high standard of care from our qualified staff.’ This is a strong testimony for businesses in a competitive marketplace.

WHaT Can Be CLaimeD? In these tough times, employers can now claim a significant contribution towards the costs of their workers completing accredited health and social care qualifications and units with £15 per credit available for eligible units. The amount of funding that can be claimed will depend on the qualification, the units selected and the number of credits that make up those units.

To help employers understand what can be claimed, here are some examples of contributions to funding: • Level 2 Diploma in Health and Social Care (minimum of 46 credits) - £690.

• Level 3 Diploma in Health and Social Care (minimum of 58 credits) - £870.

• Level 5 Diploma in Leadership for Health and Social Care (minimum of 80 credits) £1200.

• Level 2 Award in Supporting Individuals with Learning Disabilities (12 credits) - £180.

• Level 3 Certificate in Stroke Care Management (26 credits) - £390.

WDF is an employer fund so specific eligibility criteria is based around the employer rather than the learner. To access WDF you must: • be an adult social care employer, • ensure that your organisation is registered on the National Minimum Data Set for Social Care (NMDS-SC) and that your account meets the advertised requirements, • have staff who have completed qualification units from list of funded units between the advertised dates.

Employers can claim WDF towards the cost of training delivery or wider costs associated with staff completing training, such as employee salary costs, wage replacement costs and coaching/ mentoring. They can claim WDF alongside other sources of public funding, but they cannot claim the same cost from multiple funding sources.

aPPrenTiCeSHiPS The number of apprenticeships in our sector continues to grow with more than 60,000 apprentices working towards qualifications.

Funding to increase the number of social care apprenticeships is available through the National Apprenticeship Service (NAS).

Intermediate and advanced apprenticeships in Health and Social Care are open to new entrants into the sector as well as existing employees aged 16 and above. Higher apprenticeships have been designed for managers in residential and non-residential settings, as well as senior practitioners needing to develop a deeper, specialist knowledge of care.

Apprenticeships are fully funded for 16 to 18 year olds who are eligible and part funded for those aged 19 to 24. WDF can be used to help fund the delivery of Apprenticeships, with a minimum of £1185 available to be claimed dependent on the optional units.

This rises to a minimum of £1470 for a Higher Apprenticeship.

Another source of funding is the Apprenticeship Grant for Employers (AGE) for 16 to 24 year olds, and it is a grant of £1500 and is available until 31st December 2014 subject to eligibility and availability from the National Apprenticeship Service. An enhanced London AGE 16-24 grant of £3000 is available to eligible employers with London postcodes.

Wage incentives of up to £2275 are also available to employers across England who can offer an 18-24 year old a job through the Work Programme or from

Jobcentre Plus. Employers cannot apply for both the wage subsidy and the AGE grant.

24+ aDvanCeD LearninG LoanS Employers may not be aware that there have been some recent changes funding criteria set out by the Department of Business, Innovation and Skills and the National Apprenticeship Service which impacts on the way some learning, including for apprenticeships, is funded for people aged 24 or over. These 24+ advanced learning loans are now available for learners who are starting courses at level 3 or above on or after 1st August 2013. They help learners aged 24 or above to pay course fees. Individuals only start to repay the loan once the course has been completed and they are earning over £21,000 per annum.

The learner takes out the 24+ advanced learning loan so this does not form part of the employer contribution and is then not recoverable by claiming WDF. But WDF can be claimed for adult social care workers of any age who are undertaking an eligible qualification unit.

finD WHaT WorKS for YoU WDF is a recognition that we need to support employers to develop the skills and knowledge of their staff, so I would urge them to think about what funding works best for their needs and apply for it because it will make a real difference to their organisation.

The funding available across the sector is designed to help employers make sure they continue to support their staff to develop their skills and knowledge, which ultimately benefits the people who access those services they provide, day in and day out, on the frontline. cmm Sharon allen is Chief executive of Skills for Care www.skillsforcare.org.uk

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DRIVING UP

QUALITY IN

LEARNING

DISABILITY

SERVICES

The Driving Up Quality Alliance, who support providers of housing and care, has developed a new code to drive up quality in learning disability services to deliver a better future for individuals with challenging behaviour and complex needs.

ABOUT THE CODE

TAILORING FOR THE INDIVIDUAL

The Driving Up Quality Code is a new development from the Driving Up Quality Alliance, a group of organisations that represent and support providers of housing and care. Supported by the Care Quality Commission, the Department of Health, the Association of Directors of Adults Social Services and NHS England, the Driving Up Quality Code is part of the postWinterbourne View action plan and the Concordat. The Code has a particular focus on individuals with challenging behaviour who have long-standing and complex support needs, but the code can be applied to all people with learning disabilities.

The Driving Up Quality Alliance wish the Code to achieve high standards of service for people with learning disabilities that extends beyond the minimum expectation; to initiate and build a passion in the learning disability sector, providing high quality, values-led services. The code also aims to provide a clear message in what is and what is not acceptable practice, to promote a culture of openness and honesty in organisations and to celebrate good work.

The Code’s principles are based on the individual’s needs and wishes; the person and their family is fully involved in making life decisions, such as where they live and who they live with; their care is based on dignity and human rights. Services are provided within the individual’s community; the person has maximum freedom possible.

In addition, care and support workers have the correct guidance, knowledge and skills to support people in positive ways and to manage behaviour. Recruitment of workers is focused on their attitude and the organisation values the workers by providing the appropriate training, support, mentoring and development. Workers will then have the ability and authority to make decisions with and for individuals. The training is co-produced with the people being supported and their families.

The individual’s needs are the most important; therefore the organisation adjusts and changes due to the people, families’ and workers’ views, moderating how the service is run. They encourage whistleblowing, complaints and suggestions for improvement and independent advocacy is a central part of the support individuals receive.

CMM

HOW IT WORKS The Code is voluntary; providers will be asked to sign up to it publicly and evidence how they meet, or how they will meet, the Code. A self-assessment tool is available and providers will be encouraged to use Experts by Experience to independently verify self-assessments. Commissioners will be asked to sign up and commit to using the Code actively through their commissioning processes, to improve quality in learning disability services.

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For more information about the Code, how you can sign up, who has signed up and how organisations are working towards meeting the code, visit: www.drivingupquality.org.uk With thanks to Alicia Wood, Chief Executive, Housing & Support Alliance.

SPOTLIGHT ON… INFECTION CONTROL AS WE MOVE INTO AUTUMN AND ONTO WINTER, INFECTION CONTROL MUST BE THE HIGHEST PRIORITY. IN ANY CARE FACILITY, GOOD MANAGEMENT AND ORGANISATIONAL PROCESSES ARE CENTRAL TO ENSURE THAT EXCELLENT STANDARDS OF INFECTION PREVENTION AND CONTROL ARE ARRANGED AND MAINTAINED.

Although needed to be kept on top of all year round, the seasonal changes can see increasing incidences of Norovirus, influenza and infections like C.difficile and MRSA. Given the communal arrangements of care and nursing homes it easily strengthens the infections’ capacity to spread rapidly.

Rigorous measures must be taken to avoid the spread of infection and illnesses, protecting residents and reducing unnecessary admissions to hospital. These measures should be enforced at operational level, through the use of effective hygiene, cleaning, laundry and infection control products and services. This must be supported from above through the introduction of infection control training programmes.

INFECTION CONTROL STRATEGY: • • • • • • •

Take into consideration the roles and responsibilities; Monitoring and reporting of infectious diseases; Surveillance of infections and communicable diseases; Isolation of residents with infections; Training and education; Occupational health; Risk assessment.

If necessary, it may be logical to make use of external assessment consultants to identify where you may require specific training and aid.

The following organisations offer a range of infection control products, training and solutions for the care sector. Please contact the organisations directly, mentioning CMM to discover how they can meet your company’s needs. cmm october 2013 | 39

spotlight on… infection control

AQUACERT

AquaCert is an easy and inexpensive procedure for screening water for legionella bacteria.

your hot taps and showers • You let us know the sample is ready and place it in the supplied bag • We collect, perform the laboratory analysis and send you your certificate.

Our complete service costs from just £44.50 + VAT, anywhere in the United Kingdom. In the event of a positive legionella result, we offer advice and guidance on eliminating the bacteria and also on future control and monitoring - all free of charge.

If you are responsible for a care home, then your clients are just about the most susceptible group. AquaCert is used at over 3000 premises in the care sector.

Just three easy steps to peace of mind: • We send you a sterile bottle; you fill it from

We carry out Legionella Risk Assessments in accordance with the HSE’s L8 Code of Practice.

Telephone: 0800 048 1737 • Email: info@aquacert.co.uk • www.aquacert.co.uk

BVS TRAINING LIMITED

Infection Prevention and Control is a key element identified by Skills for Care and is vital to the wellbeing of service users and staff alike. This care home based DVD provides substantial support in making sure you understand and comply with legal obligations as well as significantly improving the skills and knowledge of staff in this area.

Some of the subjects covered in this training resource are: • Chain of Infection • Legislation and Guidance • Systems to Manage and Monitor IPC • Clean Environment • Cleaning Equipment • Adopting Good Practice (Effective Hand Hygiene, Personal Protective Equipment, Preventing Exposure to Blood and Bodily Fluids, Safe Management of Urinary Catheters and Safe Handling of Food) • Managing Individuals with an Infection • Handling and Storage of Specimens • Managing Laundry • Staff Health

Telephone: 0845 644 2866 • Email: info@bvs.co.uk • www.bvs.co.uk

CONTAIN-ER PROTECTION SOLUTIONS LTD

Body Fluid Spill Kits clean up body fluid spillages such as blood, vomit, urine, semen and saliva.

What is more, the body fluid spillage kits can be used on most hard flooring, carpet, upholstery and fabric.

Contain-ER’s Body Fluid Spill Kit contains everything necessary to allow the user to perform this usually unpleasant task, quickly and efficiently, ensuring that the risk of cross-infection and cross-contamination is minimised.

Body fluid spillage kits are non-toxic, noncorrosive, non-bleaching and are completely ready to use.

Telephone: 0800 87 999 87 • Email: info@contain-er.co.uk • www.contain-er.co.uk

DANFLOOR WWW.DANFLOOR.CO.UK

danfloor, who are part of the Ulster Group, have been distributing carpets to the healthcare market for around 30 years and as a specialist manufacturer and supplier to this sector we ensure that the carpets within the healthcare collection have unique design features and performance characteristics to withstand the demands of the market.

The Healthcare collection; which includes our Equinox, Tones and Stripe ranges, has many innovative features making it ideal for the care sector: • maedical i-Link - is an anti-microbial coating that is applied to our carpet fibres and provides a 4 log reduction of 99.99% in the presence of harmful micro-organisms including the bacteria that causes MRSA and E-Coli. maedical i-Link also controls the growth of a variety of fungi, yeast and moulds that aid with the spread of infection and can cause odours. maedical™ i-Link™ kills the micro-organisms when they come into contact with the fibre and doesn’t lose strength over time, creating an environment which microorganisms can’t adapt to.

• An Impervious membrane – This ensures that liquid spills remain on the surface of the carpet making them easy to clean. Without an impervious layer liquid spills will seep through to the subfloor and can cause those unpleasant odours.

• Carpet fibres which are easy to clean – Without getting too technical not all carpet fibres are the same but those which are used for carpets in the healthcare sector

should have a ridged cross section which stops dirt and dust particles from sticking to the fibre making them easy to clean.

Due to these innovative product features our carpets are recommended for use throughout the whole of the home with the exception of some areas like bathrooms. danfloor have also been awarded best broadloom carpet provider for the last six years in a row by the readers of the Contract Flooring Journal, who are just some of the people who purchase and fit our carpets.

All floors must have an appropriate cleaning schedule in force to ensure they remain clean and do not become a source of infection. For the cleaning of carpets to be effective, and to minimise the spread of infection, the carpet must be suitable for the care sector and have a proper cleaning and maintenance schedule in practice. Guidelines on how to maintain a danfloor carpet can be found on our website http://www.danfloor.co.uk/ installation-maintenance danfloor supply into many of the large groups including HC One who have recently received funding from the King’s Fund, an independent charity working to improve health and social care in England, to refurbish seven homes across the country. Our carpets will be featured in all these homes which have a special emphasis on interior design for people living with dementia.

Telephone: 0844 915 1000 • Email: info@danfloor.co.uk • www.danfloor.co.uk

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Self-determined living

Düsseldorf, Germany 25 – 28 September 2013 www.rehacare.de

For further information contact ITSL Ltd _ Ramsay House _ Marchmont Farm Link Road _ Hemel Hempstead _ Hertfordshire _ HP2 6JH Tel 01442 230033 _ Fax 01442 230012 info@itsluk.com

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Trade Fair and Congress

Reflecting the latest trend colours Equinox welcomes new colours to its evolving carpet collection.

Compliment and create a stunning design scheme with the new Mushroom shades.

For more information visit our stand E94 at the Birmingham Care Show or www.danfloor.co.uk/healthcare Call 0844 915 1000

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spotlight on… infection control

ELECTROLUX

When hygiene is critical, there is no room for compromise, so it is always wise to put yourself in the hands of a company who is an expert in their field.

The new Evolution Range of Barrier Washer-extractors from Electrolux Professional offer the healthcare industry, hospitals and nursing homes a laundry solution with the best ergonomics and user-friendly technologies. It provides the most durable solution to help regain full control of laundry quality, maintenance and hygiene, whilst optimising cost, safety and labour effectiveness.

Within the Choice Framework for the local Policy and Protocols 01 – 04: Decontamination of linen for health and social care recommends thermal disinfection; the recommendations state that linen should be washed at 65 degrees for no less than 10 minutes, 71 degrees for no less than 3 minutes and sluice washing should be used when dealing with fouled linen. Electrolux has always recommended thermal disinfection and the new Evolution Range is designed to meet the utmost hygiene standards in order to provide healthcare institutions with guaranteed linen safety and ultimate control of laundry management. With its unique Hygiene Watchdog function, the Evolution Barrier Range ensures 100% fulfilment of linen hygiene including RABC requirements. Quite simply, the machine will only open on the dirty side, guaranteeing the linen has been properly washed and disinfected before unloading on the clean side.

The Evolution Barrier Range has been built to maximise ergonomics, performance, safety and labour effectiveness. Machine lifetime is enhanced, as well as energy and water savings with Electrolux’s unique Power Balance detection system. Power Balance

allows the wash cycles to have the maximum amount of dewatering by adjusting the G-force throughout the entire extraction. This means optimum stability, quieter, faster operations and better water extraction, therefore lowering drying costs and, of course, a better balanced drum means less wear and tear on the machine. The user-friendly Compass Pro® interface offers up to 55 programmes and is available in 18 languages, allowing for ease of programme selection, whilst the machine’s structure features a USB port to facilitate installation of the latest process validation Certus Management™ Information System (CMIS) software. CMIS is a highly valued process monitoring system allowing users to control and document all operations to achieve ultimate hygiene and cleanliness.

The Evolution Barrier Range is available in three models: • WSB5180H 180 litre drum volume • WSB5250H 250 litre drum volume • WSB5350H 350 litre drum volume.

Electrolux also offers a host of benefits as a sole or preferred laundry supplier including: • One point of contact • Group pricing agreement • Service contract options • Machine replacement programme and group inventories • Bespoke laundry solutions based on individual requirements • Laundry and hygiene audits • Full staff training • Information and updates on current hygiene legislation.

In addition, Electrolux works in partnership with the National Care Association in order to understand the needs of the care establishments as providing the right care for their residents is of paramount importance.

Telephone: 08444 631 260 • Email: amanda.desousa@electrolux.co.uk • www.electrolux.com/professional

GIRBAU UK

For care and nursing home on-premise laundries, Girbau’s 6 Series range of high spin washers with the latest LOGI PRO controls offers infection control, greater operational flexibility and lower consumption of energy and water.

All LOGI PRO washers come with Girbau’s Just in Load feature, which allows users to quickly and easily adjust the consumption of water and detergent according to the weight

of the load and the wash programme. Simply select one of four buttons on the front control panel for quarter, half, three-quarters or full load.

Other features include Rinse Hold and Delay functions. The Rinse Hold button halts the machine on the final spin cycle, leaving the load to soak. The Delay function can be used to take advantage of off-peak energy tariffs. Both buttons can be used together to start the machine in the evening and complete the final spin in the morning.

Telephone: 01462 427780 • Email: sales@girbau.co.uk • www.completelaundrycare.co.uk

GERMSTAR UK

Germstar UK is pioneering the use of touchless hand sanitiser and soap dispensers as a key weapon in vital care home infection control programmes.

being provided to residents.

The importance of hand hygiene in the prevention of cross infection, particularly in care settings, is widely accepted and is probably the single most significant factor for reducing the spread of infection.

The Germstar touchless device, designed for constant use, eliminates the dispenser as a potential for cross-contamination.

Users just have to place a hand under the infrared, motionactivated dispenser to receive a measured dose of sanitising liquid rinse capable of killing 99.9 per cent of bacteria and viruses.

Infection control guidelines covering care homes say the use of alcohol hand rub is particularly important and this should be easily accessible to staff where direct care is

Unlike gels and foams, Germstar leaves no sticky residue and will not dry out the hands.

Telephone: 01980 616800 • www.germstarhygiene.co.uk

THE GREY MATTER GROUP

Our system checks and evidences what workers know and identifies what they need to learn against relevant competencies, including QCF units IC01, IC02 and IC03. This supports providers to train in-house, use work-based coaching and practice observation to evidence competence to CQC. It reduces time/costs, minimises rota/service disruption, ensures training focuses on people’s needs, evaluates if training methods are successful and gives managers structured supervision discussions.

Telephone: 0845 873 0373 • Email: support@tgmgroup.net

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Assessments are performed online at a time, place and pace to suit workers. CQC and Skills for Care guidance say, ‘assess the need for refresher training’. Our system supports you to do this. Customer case studies on our website show time/cost savings, increased evidence of compliance and lots of other benefits.

Assessment subjects are funded/free in some locations. From £2 per person for 12 months access, and discounts are available for purchasing more subjects and years.

Monthly payments also available.

• www.CIS-Assessment.co.uk

spotlight on… infection control

THE INCOMASTER

The Incomaster from Haigh isn’t only the quietest unit on the market, it also disposes of all makes of pads*, and now comes with Hands Free Autostart function.

Fast, efficient, low cost and easy to use, it is able to process four small or two large pads in under two minutes. The benefits are clear: • Reduced cross infection • Reduced energy and utility bills • Reduced odour • Increased patient comfort • Increased cost efficiency • Market leading levels of service and support.

With a range of unbeatable benefits, it is no surprise that it has become the preferred disposal unit for care homes throughout the UK.

*Based on results of independent tests carried out at Haigh Engineering.

Telephone: 01989 760200 • info@haigh.co.uk • www.haighmed.com

OTEX OZONE LAUNDRY DISINFECTION

Developed by our own chemists and infection control experts, the groundbreaking OTEX system is acknowledged by the Department of Heath as a system that disinfects laundry ‘more effectively than any conventional thermal alternative’.

cut utility bills and extend the life of fabrics.

How it works: • Air collected in oxygen concentrator • Electrical charge splits oxygen (O2) into single oxygen (O), which reform to create ozone (O3) • Ozone injected into washer drum via patented interfusor • Laundry disinfected, fibres opened to enhance wash quality • Wash cycle verifi ed toOCTOBER confirm disinfection CMM 2013 ¦ 43– receipts printed for auditing • Fresh smelling, clean, decontaminated laundry items unloaded.

It does this by turning oxygen from the air around us into ozone, and injecting it into your washing machine’s drum to kill 99.999% of harmful microorganisms such as MRSA, E.Coli, Norovirus and C.Difficile spores. While traditional thermal cycles use high temperatures, our eco-friendly solution works at low or ambient temperatures to Telephone: 0800 591 903 • info@jla.com • www.jla.com

PURELL® ADVANCED

PURELL® Advanced is a new formulation from GOJO, the makers of the world-renowned PURELL®.

The new gel formulation feels great to use and is clinically proven to maintain skin health*.

Representing a breakthrough in skin care science, the new ‘entire hospital’ formulation combines exceptional antimicrobial efficacy with clinically proven skin conditioning, to enhance the PURELL® range.

As part of its commitment to delivering total solutions to clients and users, GOJO also provides superior back-up support programmes; helping to promote education and training about hand hygiene best practice and encouraging compliance building behaviour.

This scientifically advanced hygienic hand rub spearheads a total hand hygiene system that promotes infection control by maximising compliance.

* Reference: Four-week clinical field study #2011-F10233, Akron, OH, February – March 2011.

Telephone: 01908 588444 • Email: info@gojo.co.uk • www.gojo.com/united-kingdom

REGIS:CTV

Infection Control is one of the newest DVDs in the range from regis:ctv and runs for approximately 30 minutes. Like all of the DVDs in the regis:ctv range, this comes with a CD-ROM that can be freely downloaded. The CD-ROM contains training notes and resources, providing vital evidence for inspection and also includes certificates of attendance for staff records. Priced at £125 plus VAT this is a very cost-effective way

of delivering training. Most of regis:ctv products are available on a no obligation, 14 day trial.

Topics covered include: • What is Infection? • Recognising an outbreak • Keeping records • Risk assessment • Chain of infection • Hand hygiene • Personal protective equipment • Safe handling and disposal of sharps • Managing spillages • Food handling • Soiled laundry management • Disposal of waste

Telephone: 01243 555444 • Email: pmisselbrook@regis.co.uk • www.regis.co.uk

Next issue: Spotlight on Medication Management, Pharmacy Services and Training In the November issue of CMM we will be putting our spotlight on products, services and organisations that focus on medication management, pharmacy services and training.

CMM CAREMANAGEMENTMATTERS

If you would like the opportunity to be featured in our next spotlight on Medication Managment, Pharmacy and Training please drop us a line at editor@caremanagementmatters.co.uk or send a tweet to @CMM_Magazine. www.caremanagementmatters.co.uk CMM OCTOBER 2013 ¦ 43

Recruiting for values can add real value to services Debbie Sorkin reflects on how bringing in valuesbased approaches to recruitment and selection in social care can pay dividends for providers.

Sometimes, when I talk with employers about values in social care and how they might bring them into their recruitment processes, the response is that it’s too time-consuming, or expensive, or that they don’t see the immediate benefit. I’m always tempted to point them in the direction of Castlebeck at this stage and to suggest that if they think recruiting the right people is expensive, they should try recruiting the wrong ones and see where it gets them.

Recent reports It may be a glib response, but there’s an underlying truth to it, and it’s one that has been thrown into sharp relief by three recent developments. The last three months have seen the launch of the Skills Academy’s Values-Based Recruitment Toolkit for Employers, the publication of the Cavendish Review, with its explicit identification of the positive effects of recruiting for values, and the launch of the National Care Forum’s (NCF) 2013 Personnel Statistics Report. The NCF Report, in particular, highlights serious and continuing problems with staff retention and ‘churn’ rates, suggesting that many care providers still have work to do in attracting the right people who will stay and build a 44 | cmm october 2013

career with them.

Camilla Cavendish drew on case studies to illustrate, not only the range of models available to employers to draw on in order to bring values into recruitment processes, but also the benefits – qualitative and quantitative that resulted. She was also clear that recruiting for values had to be part of a wider workforce strategy, including training and developing people so that they felt valued by the organisation.

Putting it into practice In the case of MacIntyre, a national provider of services for people with learning disabilities, she drew attention to the work they had done in psychological profiling. MacIntyre started out by asking a simple question to staff, to people who used their services, and to their families. They asked, ‘What makes a great care worker?’ In other words, what were the traits and behaviours of people who were consistently excellent in their jobs?

Working with an occupational psychologist, they discovered that excellent workers had a distinct psychological profile; they were more empathetic and more introverted, in the sense of being more reflective, observant and employing principles in the service of others. They built this into the MacIntyre Profile which they have been using for the past four years when recruiting new staff.

The results have been significant, with much better staff retention, less sickness absence and fewer disciplinary and performance issues. Feedback from those using services, and their families, suggests that the quality of the services has also risen over the same period. All of this translates into saving the business money.

Likewise, Macmillan Cancer Support has developed a ValuesBased Standard, working over eighteen months with more than 300 staff members and people living with cancer across the country. The Standard is structured around eight behaviours including private communication, communicating with sensitivity, control, acknowledgement and decision-making. For each of these, there is an associated set of expected leadership behaviours and prompts to encourage staff to set themselves personal goals that challenge what they do on a day-to-day basis.

And there are analogous examples from overseas. The Hermann Memorial Hospital in Texas uses the Hartman Values Profile Tool in recruiting nursing staff. This tool measures an individual’s capacity to make value judgements concerning the world and themselves, and the hospital has reported that the outcomes have included not only better quality care, but also a reduction in staff turnover of between 25 and 35 per cent.

Staff churn This last statistic is especially striking in the light of the figures in the NCF 2013 Personnel Report. Two particular figures that stand out relate to the number of recruits leaving the sector.

32.4 per cent of staff, almost a third of recruits, were reported as leaving within 12 months, with 56.7 per cent leaving within two years. The figures were largely unchanged from last year. There was also a dispiriting reduction in the number of people employed in-house to undertake training, down year-on-year from 297 to 122.

The Report covered a total of 51,297 staff, so this is the equivalent of some 17,000 recruits that leave each year. And all this related to 44 NCF members in the not-for-profit sector

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recruiting for values can add real value to services

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alone. This is not just a waste of training and development resource; it also impacts directly on continuity of care, something that people using services commonly identify as important to them and the quality of care they receive. It is estimated that any vacancy costs an organisation, on average, £3500 to fill. If this is the case, it’s possible that some £60 million is leaching out of social care each year to pay for filling all these vacancies alone.

That’s money that most providers could find much better uses for in improving their services.

Recommendations Camilla Cavendish recommends that all employers should consider using values-based approaches to recruitment and then developing staff in order that values can be translated into action.

But the difficulty lies in how to make this a practical possibility, especially for smaller employers who may not have easy access to HR expertise, or lack familiarity with the approach. Also, how can it be applied to entry-level roles?

This is where the Skills Academy’s Values-Based Toolkit for Employers comes in. Available at https://www.nsasocialcare. co.uk/values-based-recruitment-toolkit, it gives employers access to a range of tools they can try out for themselves, and that they can use for recruitment at all levels of their workforce.

The tools include: • an introduction to social care values, • guidance on how to recruit and select based on social care values, • examples of job advertisements and interview questions to draw on, • an online personality profiling tool, tested across the sector, which employers can use with potential candidates, • signposting to the Leadership Qualities Framework (LQF), with an explanation on how it can help in recruiting for values,

• signposting to other sources of information and advice.

Since the launch of the toolkit in mid-July, the advertisements, interview questions and LQF have been especially popular, along with the personality profile.

Important benefit to the sector We think this is something really important in social care, which will have a real impact on reducing churn and improving service user satisfaction. If you have better continuity of care, better quality of care and fewer staff issues, my guess is that you have a real competitive advantage as a provider.

Any organisation that aims to improve the quality of care that it’s providing, and that’s every organisation I’ve ever come across in social care should use all the tools, information and assistance available to them to make that happen. Recruiting for values is now available for everyone to use, free of charge and looking at the cost of recruiting and replacing those new starters that leave, it’s certainly not the expensive option after all.

These values underpin all the training, skills and competences that people have. They are the kinds of values that make the difference in the delivery of care and support services. Recruiting people with these values is about having the right people in place from the start, who will not just do the right thing but do it in the right way, so that you can deliver, or obtain, truly person-centred services.

These social care values are at the heart of the Care and Support Bill; the national nursing and midwifery strategy, Compassion in Practice; and the Government’s responses to the report on Winterbourne View and the Francis Report into MidStaffordshire NHS Trust.

cmm Debbie Sorkin is Chief Executive of the National Skills Academy for Social Care. Email: debbie.sorkin@nsasocialcare.co.uk.

Understanding values

How to recruit for values

What are values in adult social care recruitment?

How can they help?

The easiest way to find out about someone’s underlying values is to ask them about how they behave in their everyday lives.

People experience our values through our behaviours, and a good indicator of how people will behave in the future is how they have behaved in the past.

When we talk about values in social care, we mean things like: Compassion Courage Respect Responsibility Empathy Imagination Treating people with dignity Adaptability Integrity Responsibility

46 | cmm october 2013

To recruit for the right values, you can: • Put together your job advertisements in a way that asks candidates to evidence their behaviours.

• Use the kinds of questions at job interviews that ask candidates to give examples of how they’ve behaved in the past.

• Get candidates to undertake a personality profiling questionnaire, to provide you with some indicators and points to discuss around behaviours at the interview.

• Use other existing tools and information sources to help you identify the behaviours and values you’re looking for.

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Austerity, Demographics & Health & Social Care Reforms 14th Annual Healthcare Conference A One-Day Conference, Monday 21st October 2013 One Birdcage Walk, Westminster, London, SW1H 9JJ Organised by LCS International, in partnership with The Sunday Times, this conference is being held this year against the background of the new Health and Social Care legislation, the Care and Support Bill before Parliament and implementation of Dilnot. We anticipate discussions on the day around: funding issues; quality regulation and workforce challenges; new approaches to services more in line with the way we work and live; proposals to enhance Social Care commissioning; and new models of integrated care.

Participants include: • Lord Norman Warner, former Minister of State, DoH • Dr Daniel Poulter MP, Minister of State, DoH • Rt Hon Paul Burstow, former Minister of State, DoH • Sir Cyril Chantler, Chair, UCL Partners • Dr Charles Alessi, Chair, NAPC • Ian Smith, Chair, Four Seasons Healthcare • Julia Manning, CEO, 2020 Health • Steve Gay, Director, Association of British Insurers

• • • • • • •

Anita Charlesworth, Chief Economist Nuffield Trust Stephen Collier, CEO, GHG Mike Farrar CBE, CEO, NHS Confederation Sir Stephen Bubb, CEO, ACEVO Sebastian Habibi, Director, DoH Dr Phillip Lee, MP Baroness Martha Lane-Fox of Soho CBE, Chair, Government Digital Service Advisory Board

The price* for this event is £225 plus VAT per attendee for the public and voluntary sectors or £450 plus VAT for the independent sector. To book please visit our website at www.lcsic.com or call LCS on 0207 387 6828 / e-mail: info@lcsic.com *10% discount if you book before 1st October 2013*

CMM CAREMANAGEMENTMATTERS

cmm october 2013 | 47

conference preview

The Future of Care and Commissioning

North West and Berkshire

After the success of the Derbyshire and Nottinghamshire regional care conference, CMM is taking to the road in the North West and then Berkshire to look at the future of care and commissioning on a local and national scale. Giving providers the opportunity to take part in content-led sessions from national and regional speakers who will offer guidance, information, debate and ultimately, advice on how to improve your business.

Attending either event will provide you with the opportunity to develop your knowledge, keep up-to-date with the latest regulations and allow you to network with other providers in the region. You will be able to share experiences with like-minded people, gaining new perspectives on the job you do and the difference you make to people’s lives.

The exhibitions, running alongside the conferences, will showcase more than 30 manufacturers and service providers who will be demonstrating the very latest care supplies, ideal for your organisation.

The North West Care Conference 2013 17th October 2013 De Vere Venues Whites, Bolton Presentations • Market facilitation by LAs to benefit providers Andrew Kerslake, Oxford Brookes • Implementing funding reforms Department of Health • Merging with health • Bank finance - what’s happening in reality?

Mark Ellis, Head of Social Care Banking Services, Key Markets, Lloyds TSB • The role of inspector managers - CQC Workshops • Efficiencies that don’t impact on care quality John Lucas, Partner, Hazlewoods • How to market your care home – 3 simple steps to full beds Simon Beck, Founder, Care Home Marketing Expert Safeguarding Panel Discussion • Panelists include: Ken Nolan Chair, Lancashire Care Association • Understanding the local care market: Roger Harcourt Partner and Head of Healthcare, Shakespeares For further information, visit www.mcculloughmoore.co.uk/ northwestcare

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Berkshire Care Conference 2013 7th November 2013 Hilton, Reading Presentations • Interpretation of the Care Bill Des Kelly, Executive Director, National Care Forum • Providers’ guide to safeguarding • Rebuilding public and provider confidence in the care sector Alan Rosenbach, Special Policy Lead to CEO, Care Quality Commission • Understanding the local care market John Roddy, Consultant, Shakespeares • Sharing sector experiences John Lucas, Partner, Hazlewoods LLP Workshops • Leadership Debbie Sorkin, Chief Executive, National Skills Academy for Social Care • Berkshire demand and supply analysis – what’s happening in practice that will affect your business future Amanda Nurse, Director, Ben Hartley, Director, Carterwood • How to market your care home – 3 simple steps to full beds Simon Beck, Care Home Marketing Expert • Dementia architecture Karen Ross MSc PgC NRAC, Inclusive Design Consultant, Robinson Lloyd Architecture Ltd For further information visit www.mcculloughmoore.co.uk/ berkshirecare Or to book your delegate place for either event, call Denise Woodhatch on 01293 854401

what’s on?

WHAT’S ON? Event:

RehaCare 2013

Date/Location:

25-28 September, Dusseldorf, Germany

Contact:

Messe Düsseldorf, Web: www.rehacare.com

Event:

Integrating Health and Social Care: Next Steps for Delivery

Date/Location:

8th October, London

Contact:

Westminster Health Forum, Tel: 01344 864796

Event:

The LCS 14th Annual Conference

Date/Location:

15th October, London

Contact:

LCS, Tel: 0207 387 6828

Event:

Choice Unlimited

Date/Location:

18th October, LCIL Events

Contact:

Tel: 0116 222 5005

Event:

Safeguarding Adults

Date/Location:

23rd October, London

Contact:

Capita Conferences, Tel: 0207 202 0593

Event:

Safe and Sound - ECCA 2013 Conference and Exhibition

Date/Location:

6th November, London

Contact:

ECCA, Tel: 020 7492 4846

Event:

Managing Complexity in Older People in the Community

Date/Location:

20th November, Harrogate

Contact:

British Geriatric Society, Tel: 020 7608 1369

Event:

ALTENPFLEGE 2014

Date/Location:

25-27 March 2014, Hannover, Germany

Contact:

Sector Marketing, Tel: 01275 335911

CMM EVENTS Event:

North West Regional Care Conference

Date/Location:

17th October, Bolton

Contact:

McCullough Moore Ltd, Tel: 01293 854401

Event:

Berkshire Regional Care Conference

Date/Location:

7th November, Reading

Contact:

McCullough Moore Ltd, Tel: 01293 854401

Event:

The Future of Learning Disability Care Conference 2014

Date/Location:

25th February 2014, Manchester

Contact:

CMM, Tel: 01223 207770

Please mention CMM when booking your place.

cmm october 2013 | 49

straight talk

straight talk Is politics interfering with effectiveness in regulation? Roger Wharton explores how the sector can respond to the recent increase in warning notices and whether it’s politically driven.

Roger Wharton Executive Officer Registered Care Providers Association Somerset The recent CQC New Start consultation signals a strong appetite to return to targeted and specialist regulation and inspection. This comes alongside Sir Bruce Keogh’s review of quality in the NHS, the Francis Report, Winterbourne View and other more recent unsavory disclosures. The concern is that with all this media attention, a political appetite naturally develops to make the most of the attention and this can run the risk of swamping the work of the regulator to make cogent, accurate, consistent and defensible observations on care compliance.

We hear that over the last year CQC has issued over 900 notices to the health and social care sector, up over 40 per cent on the previous year, 818 of these in adult social care. It looks like they are already responding to the political message to unearth poor care and make it public. One level below this is the knowledge that 20 per cent of social care services are assessed as non-compliant in at least one standard.

The latter sees room for providers to step up to the mark and work hard to improve in a measured and responsive way. But the former is much more difficult for providers to wrestle with because warning notices generally set very short timeframes for improvement. At the same time, local authority and NHS commissioners take a view on continuing with placements, which reduces cash flow at exactly the same time as greater investment is required to accomplish the improvements that are rightly demanded.

Whilst corporate bodies may be able to withstand the loss of income at this crucial time, smaller care groups and individually-owned care homes (who make up the vast majority of care delivery) are much less resilient and, therefore, much more likely to run the risk of closure, either through lack of funds or by CQC if they are unable to summon the resources to respond in time. This also means that the very people they are trying to keep safe, and the good quality care they receive, is placed at greater risk by increasing incidences of notices and enforcement action. Residents may need to be moved to keep them safe but survivability rates are fragile.

Poor care is unacceptable but the sector needs less knee-jerk reaction and a more balanced approach to collaboration

between the regulator, the sector and commissioners if we are to stamp it out. How can we achieve this? The sector itself needs to develop much stronger measures of assurance to balance CQC’s appetite for increased surveillance and tougher inspections. Boards need to be able to tell from their internal assurance measures whether good care is being delivered and, where it is not, have the understanding of what can be done. This isn’t about placating the regulator but about active participation by board members in the delivery of care. Care managers need to be much smarter about their understanding of quality care and have the confidence and be given the authority by their employers, not just the responsibility, to deliver it.

Local authorities need to be smarter about how they can develop their risk-based consideration of quality care delivery and because The Reform Bill suggests that this should extend to all care services, not just those who contract with the local authority, they will need to extend their attention to a much broader market. This is not an easy task for them considering the enormous downward pressure they are experiencing on budgets.

Somerset County Council is leading the way in this respect.

They have thoroughly overhauled their systems, starting with risk-based contract management processes linked directly to revised quality policy, for the sector which seeks to identify diminishing quality care long before it reaches the point of CQC issuing notices and doing something positive and supportive about it. In this way, the risk of poor care developing beyond manageable proportions can be minimised. What the sector doesn’t wish to see is local authorities developing their own inspection teams that duplicate CQC’s work. The sector needs an assurance that CQC will continue to inspect care homes on an annual basis regardless of the rating they receive.

Finally, integration between health and social care or at least, cohesive collaboration between the two, is an essential development if we are to balance political grandstanding with practical and achievable objectives in delivering good quality care. Clinical commissioning groups’ health and safety quality assurance boards need a complete overhaul to provide the inextricable link between the NHS and social care.

Do you agree with roger?

Please email your thoughts to editor@caremanagementmatters.co.uk.

50 | cmm october 2013

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