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in this issue
IN THIS ISSUE regulars 05
editor s welcome
Is it just me...?
Editor in Chief, Robert Chamberlain considers the conclusions of a recent TEASC report on local authority commissioning.
Local Authority and Planning News
60 Seconds with...
Who s Who...
What s On?
Chris White MP, the Government s new Social Value Ambassador.
Our panel consider how to solve a problem like homecare.
In finance and financial services.
CMM reviews the Health+Care conference and exhibition.
Joe Levenson gives his thoughts on end of life care after the decision to phase out the Liverpool Care Pathway.
p3 contents.indd 3
Nowhere to hide
Quality in a time of budget cuts
Investing in ordinary lives
Changes to employment law
The importance of eye health in falls prevention
Peter Grose explores the Department of Health s consultation on corporate accountability in health and social care.
Sharon Wood offers guidance on maintaining quality with diminishing income.
Alicia Wood breaks down a new initiative to deliver housing for people with learning disabilities.
In conjunction with Care Show Birmingham, CMM brings you a round-up of employment law changes.
Kamlesh Chauhan looks at the link between eye health and falls in older people.
Welcome back to the first issue after our summer break, I hope you re all suitably refreshed and ready for the remainder of 2013. As is the case with our breaks, the Government pushed out lots of announcements and consultations before the end of Parliament. One largely-anticipated consultation was that on corporate accountability. In the light of too many scandals around poor practice, abuse and negligence, in health and social care the Government wants to set out clear lines of responsibility and accountability. Peter Grose looks at the proposals on page 18 and the implications for the sector. As everyone is facing tighter budgets, increased costs and limited fee increases from local authorities, it is important that quality does not slide as a result of less money being available. Sharon Wood shares her tips on maintaining quality on reduced income on page 22. With the announcement that the Liverpool Care Pathway is to be phased out, Joe Levenson gives his thoughts on this move and the future of end of life care in Straight Talk on page 46. Finally, if you re based in the North West or Berkshire regions, don t miss our regional care conferences. Looking at the pressures on care and commissioning nationally and regionally, you can meet like-minded providers, discuss specifics to your service and get ideas from nationally-respected speakers and workshops. See the feature on page 34 for more information and the What s on? listings on page 45 for date and location details.
Emma Morriss Editor
Follow CMM on Twitter @cmm_magazine
CMM SEPTEMBER 2013 ÂŚ 3
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CMM CAREMANAGEMENTMATTERS September 2013
Editorial and Production email@example.com 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 ADVERTISING firstname.lastname@example.org 01223 207770 Advertisement Manager: Tracey Diplock email@example.com Business Development Manager: Paul Leahy firstname.lastname@example.org SUBSCRIPTIONS email@example.com 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: 978-1-909048-67-6 CCL REF NO: CMM 10.6
CMM magazine is officially part of the membership entitlement of:
editorial panel Des Kelly OBE,
Executive Director, National Care Forum
Professor Martin Green OBE,
David L Jones,
Chief Executive, English Community Care Association
Partner, Ridouts LLP
Managing Partner, Nexus Corporate Finance LLP
Training Development Director, Catalyst for Care
contributors Peter Grose, Partner, Lester Aldridge LLP Solicitors Chris White MP, Social Value Ambassador Sharon Wood, Quality Assurance Manager, Meridian Healthcare Sandie Keene, President, Association of Directors of Social Services Colin Angel, Policy and Campaigns Director, United Kingdom Homecare Association Paul Tarsey, Group Managing Director, Bluebird Care Alicia Wood, Chief Executive, Housing and Support Alliance Liz Strama, Chief Executive, HR Protected Allan Fernie, Manager - Employment Law, Wirehouse Employment Services Clare Jacobs, RCN Employment Relations Adviser, Royal College of Nursing Nick Jones, Partner, Employment Law Group, Lyons Davidson
ABC certified (Jan 2012 - Dec 2012) Total average net circulation per issue 16,302
Kamlesh Chauhan is President of the College of Optometrists Joe Levenson, Director of Communications, National Council for Palliative Care
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is it just me...?
Is it just me...? Editor in Chief, Robert Chamberlain discusses the findings of a new report on the progress of social care commissioning towards excellence. The sector-led improvement group Towards Excellence in Adult Social Care (TEASC) has released its report on the progress of local authority commissioners for 2012/13, based upon the detailed analysis of data submitted by all councils. Key findings • There has been little change in the numbers of social care assessments but a noticeable reduction in the numbers of assessed individuals that go on to receive a council-funded service. The findings could reflect the success of intervention delaying the need for immediate ongoing support post assessment. ADASS approximates that 20 councils have increased their support charges and this may have deterred people from taking the support on offer. A further consideration is that a proportion of people go on to fund their own support as a result of the increased charges or following advice given during the assessment. • The number of people receiving council support and care has reduced. The reported increase in individuals receiving interventions such as re-ablement may partly explain the reduction of longerterm support. However, in light of the demands of an ageing population the report’s conclusion is that there is ‘a clear possibility that fewer people are getting the support they need and may be at increased risk’.
• There are a ‘static or slightly reducing’ number of older people in care homes. The report did advise that care home placements for older people have
increased in the period 2012/13 but their statistics include short-term admissions for preventative services. • The numbers receiving homecare has grown marginally but there is a sharp drop in traditional community-based services such as meals, equipment, day care, professional support and shortterm residential care. Preventative support through low-level home care has further reduced and more quickly than reductions in intensive support. • Formal reviews of care and support have reduced again in all but one council area. Though the report states it is unclear whether these statistics represent increased risk to service users, it does conclude that there may be ‘a cause for concern in some areas’. • Almost 56% of those with council funding chose to arrange their own packages through self-directed support. The use of Direct Payments also increased marginally to 16.4% (13.7% in the previous year). TLAP’s 2013 survey demonstrates a ‘mainly positive experience’ amongst those using SDS. • The report also considered the challenge of meeting increased demand for social care within the resources afforded. The evidence suggests that needs are being met in different ways and, whilst the number of intensive homecare packages has dropped, intervention and short-term help will offset the reductions. The growth in self-directed support demonstrates progress towards personalising support. There is however
some concern regarding the quality of commissioned services and brief home care visits were highlighted as an example. Research value In my opinion, this is a valuable piece of work that demonstrates the impact of reduced council budgets on all stakeholders concerned. Meeting a higher demand for care and support services with less money will inevitably result in fallout and the research draws attention to how the system is creaking to sufficiently support those most in need. Less council-funded support, reduced care packages and increased charges are all symptoms of the difficult choices made by commissioners to stretch inadequate budgets. The concerns regarding an increased risk for those receiving inadequate services and the quality of home care visits should be of grave concern to commissioners and the minister alike. Innovation in service delivery, intervention services and the growth of self-directed support are all examples of how councils are attempting to make ends meet but ultimately there is not enough money in the system to achieve the goal of safe, quality and affordable care for those who need it. Whether the Government injects an appropriate amount of money depends on whether those being failed are considered collateral damage in these austere times. The full report can be found at http:// www.local.gov.uk/c/document_library/ get_file?uuid=451a081c-fab4-4fba-b99311405f669032&groupId=10171 If you would like to comment please email firstname.lastname@example.org
The Future of Learning Disability Care The Renaissance Hotel, Manchester M3 2EQ • 25th February 2014
Now in its 6th year, this national conference will once again bring together the most influential organisations to explore current and future developments in the specialist sector.
For more information please email email@example.com or call 01223 207770 www.caremanagementmatters.co.uk/events.asp Keynote Presentations • Workshops • Exhibition • ‘Live’ Business Clinic • Panel Discussions
cmm september 2013 | 5
Appointments Appointments New COO for Voyage Care
• Corporate • Local authority • Planning News editor - Des Kelly The future funding of care The Government has published its consultation on reforming care and support funding. It proposes to protect people’s savings and homes from unlimited care costs and allow them to plan financially. The proposals are based on sweeping reforms. From 2016, the reforms will deliver a new cap of £72,000 on eligible care costs, additional financial help for people of modest wealth with less than £118,000 in assets including their home and, from 2015, a scheme to prevent anyone having to sell their home in their lifetime. For the first 12 weeks in
residential care, no-one will be expected to use the value of their home to pay their fees. For the first time, all local authorities will offer people the option of a deferred payment. The consultation proposes that anyone in this situation should be able to defer their care fees for their lifetime and pay from their estate, providing more time for decisions and choice and peace of mind over how they use their home – for example, so that a relative or tenant can live there. People should be able to access good information on the costs of care, the financial
support available, financial products and other options, and on practical arrangements such as appointing a lasting power of attorney. The consultation looks at how councils can arrange access to independent financial advice and what can be done to encourage people to think about their future needs. The Government has said that people who have eligible needs when they turn 18 will receive free care and people who have eligible needs who are below state pension age will have a lower cap. The consultation closes on 23rd October and can be found on www.gov.uk.
Recruitment and retention toolkits The National Skills Academy (working with Skills for Care and care provider MacIntyre) has launched a values-based recruitment toolkit. The new toolkit brings together a range of tools and resources. It puts core values such as compassion, dignity, integrity, respect and responsibility at the heart of
social care recruitment and retention. The toolkit will improve outcomes for people being supported and for workforce retention. It has the potential to create both multiple benefits for the sector and contribute to the transformation of social care. Also Skills for Care has
updated its recruitment and retention toolkit Finders Keepers. This practical resource is designed to help care providers, particularly smaller organisations, to improve the way they recruit staff and keep them on board. More information on the NSA toolkit can be found in this issue’s NSA pull out section.
for Excellence (SCIE) has produced a short briefing on the subject, in association with the Care Providers Alliance.
Dr Simon Duffy The Housing and Support Alliance (H&SA) has appointed Dr Simon Duffy, Director of The Centre for Welfare Reform, as its new chair. Simon is a philosopher, social innovator, writer, public speaker and government policy adviser, both nationally and internationally, who has worked for over 20 years to find practical ways to improve the welfare system. Signature Senior Lifestyle Carole Hunt, former Chief Operating Officer for Barchester Healthcare, has joined Signature Senior Lifestyle. She joined the board as a result of Signature’s continued expansion plans and brings with her over 14 years of expertise in this field. Tracscare Paul Constable has joined Tracscare as Chief Executive. Paul has over 25 years’ experience in social care, managing and developing services in both the public and private sectors. GVA
Phasing out LCP The Liverpool Care Pathway will be phased out and replaced with an end of life care plan. The Social Care Institute
Kevin Roberts has joined Voyage Care from Four Seasons Health Care as its new Chief Operating Officer. He will be responsible for the day-today operations of services. The appointment follows the acquisition of Solar Care and Independent Living Group by the learning disabilities care provider.
This can be found at www.scie. org.uk. Joe Levenson explores this announcement in Straight Talk on page 46.
Iain Lock MRICS has joined GVA as national head of its Independent Healthcare team. Iain was Head of Healthcare at Savills.
Care is all we do. www.castleoak.co.uk
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Appointments Chief Inspector for Social Care The Care Quality Commission has announced that Andrea Sutcliffe, current CEO of the Social Care Institute for Excellence, will be taking on the role of Chief Inspector of Social Care at CQC. This role is key to implementing CQC’s new vision for inspection and regulation and signals a move to more specialist inspections. Carterwood appointment Social care specialist surveyors Carterwood have appointed Matthew Drysdale as a graduate surveyor in the practice’s growing valuation and consultancy team. NICE appointments Bridget Warr, Chief Executive of UKHCA, has been appointed Chair of the NICE Social Care Guidance Development Group (GDG) for Domiciliary Care. Bill Mumford, CEO of MacIntyre has been appointed nonexecutive director. Livability CEO National disability charity Livability has appointed Dave Webber as its new Chief Executive. Dave has been the charity’s Interim Chief Executive and was previously Director of Operations. SCIE’s Board appointments SCIE has appointed five new Board members Alex Fox, Chief Executive, Shared Lives Plus and Chair, Care Providers Alliance, Mary McKenna, Co-founder and Director, Learning Pool, Terry Moran, retired Civil Servant, former Second Permanent Secretary, Department for Work and Pensions, Bev Searle, Director of Corporate Affairs, Berkshire Healthcare NHS Foundation Trust and Sally Warren, National Director of Programmes, Public Health England.
Your Care Rating expands The deadline for care providers to sign up for the care home survey, Your Care Rating 2013, has closed with the number of participating organisations more than doubling to 30, covering over
60,000 residents in 1,600 care homes. Your Care Rating is a survey of care home residents designed to promote quality improvement and help those choosing care homes. The 2013 survey will be carried
out in September and October by market research company, Ipsos-Mori, who will also analyse the results before they are published by participating care homes in December 2013.
Cavendish Review All healthcare assistants and social care support workers should undergo the same basic training, based on the best practice that already exists in the system, and must get a standard Certificate of Fundamental Care before they can care for people unsupervised, according to a new independent report. The Cavendish Review, carried out in the wake of the Francis Inquiry into Mid-Staffordshire
NHS Foundation Trust, makes a number of recommendations on how the training and support of healthcare assistants and social care support workers employed in care homes and people’s own homes can be strengthened to ensure they provide care to the highest standard. The Cavendish Review acknowledges that some ‘excellent and skilled’ care and support is taking
Homecare innovation challenge Norman Lamb MP, Care Services Minister has launched the Homecare Innovation Challenge. Providers and commissioners are being encouraged to share best
practice. The Minister wants to use the Challenge to improve homecare services and the status of homecare workers. See Business Clinic on page 26.
SfC Accolades - nominate now Don’t forget there’s still time to nominate someone in the Skills for Care Accolades for 2013/14. The Accolades provide an opportunity to celebrate the best in workforce development in adult social care. Entering the Accolades gives providers the chance to recognise the great work they do in the sector and also to share best practice across the sector and Skills for Care learns about the innovative and important work being done across England. There are eight categories: Best employer of under 250 staff, Best employer of over 250 staff, Best individual employer
who employs their own care staff, Best provider of learning and development, Best employer support for Apprenticeships, Best employer support for the Assessed and Supported Year in Employment, Best recruitment initiatives and Most effective new approach to service delivery. Nominations close on 5th September and the awards ceremony will be held on Thursday 27th March at the Hilton Birmingham Metropole. For more information on how to nominate visit www. skillsforcare.org.uk. CMM is a proud sponsor of the 2013/14 Accolades.
place, often under difficult circumstances, and that her report has been informed by learning from, and building upon, the best examples. Nevertheless, the reason for this review is the worrying evidence of poor care practices. The Government will provide a formal response to the Review, along with its response to the Francis Report, in the autumn.
Associations to merge The English Community Care Association and National Care Association intend to merge into a new body, Care England, from 1st January 2014. Chairs, Nadra Ahmed OBE and Jane Ashcroft, said, ‘Our sector faces a period of considerable challenge which will require robust representation on behalf of our membership. For some time now, our two organisations have been working together so it felt like the natural next step in our relationship. We believe that combining the two strong and respected organisations will strengthen the voice of health and social care and give our membership a wider range of services.’ Chief Executives, Sheila Scott OBE and Professor Martin Green OBE, said, ‘We welcome the opportunity to bring the wealth of experience of these two organisations under one banner, and to work together to make Care England strong and vibrant as well as a one-stop-shop for providers, to support them in delivering a quality service.’
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in focus / property news
In Focus: New
Commission on future of health and social care
What’s the story?
The King’s Fund has launched a new Commission to consider whether the post-war settlement, which established separate systems for health and social care, remains fit for purpose.
Why has it been established?
The challenges facing health and social care are significant and urgent. The Commission’s work will seek to inform the debate on the sustainability of the current NHS and social care funding models and ensure that questions about funding are addressed alongside analysis of how best to meet the needs of 21st-century patients and service users. It will report before the next General Election, in time to influence the party manifestos and inform the incoming Government’s agenda at the start of the next Parliament. The King’s Fund says that huge social, demographic and technological changes have taken place since1948. With health and social care services facing unprecedented challenges, the Commission will examine the way that entitlements, benefits and funding are currently organised and whether they could be better aligned to meet the needs of patients and service users. The Commission will undertake its work at a time when the NHS is undergoing significant change and with proposals to reform social care currently before Parliament in the form of the Care Bill.
What will it seek to answer?
The Commission will ask whether the post-war settlement – which established the NHS as a universal service, free at the point of use and social care as a separately funded, means-tested service – remains fit for purpose. It will explore whether, and if so how, the settlement should be re-shaped by bringing the NHS and social care system closer together. Questions include: • Does the boundary between health and social care need to be redrawn? If so, where and how? What other ways of defining health and social care needs could be more relevant? • Should the entitlements and criteria used to decide who can access care be aligned? If so, who should be entitled to what and on what grounds? • Should health and social care funding be brought together? If so, at what level (ie local or national) and in what ways? What is the balance between the individual and the state in funding services?
Who will chair and what is the membership? The Commission will be chaired by Kate Barker, a former member of the Bank of England’s Monetary Policy Committee and now a holder of a number of non-executive posts. Other Commissioners will include: Geoff Alltimes, Lord Bichard, Baroness Greengross and Julian Le Grand. Although it has been established by The King’s Fund, its reports and recommendations will be produced independently.
When will the Commission report?
An interim report will be published early next year and a final report in September 2014, in time to influence thinking ahead of the next General Election.
Gracewell Healthcare expands Gracewell Healthcare has acquired Shelbourne Senior Living care village in Sway, Hampshire. The 68-bed care home and 14 assisted living cottages is the latest addition to the rapidly growing group which is combining boutique hotel interior design with leading-edge dementia and innovative specialist care facilities and services. Shelbourne of Sway is split into three accommodation
areas: Support Cottages, Assisted Living and Nostalgia Neighbourhood (Dementia Care) - all with services tailored to each resident’s needs. Gracewell Healthcare acquired the home from Brabston, Shelbourne Senior Living Ltd whose team has in excess of 20 years’ experience in operating excellent care homes for senior living in the UK.
Himley Manor Care Home Himley Manor Care Home, in Dudley, has undergone a complete refurbishment and has opened its doors to residents. Formerly Grange Park Care Centre, the home was bought from administrators FRP Advisory LLP as an empty property. FRP Advisory LLP appointed DC Care and Edward Symmons as joint agents for this and another home in administration. Mr and
Mrs Qayum have transformed Himley Manor, providing a bright and welcoming environment.
Country Court Care acquisition Country Court Care has announced its fifth acquisition in the last three years, Summer Lane Nursing Home in Weston-Super-Mare. The 90 bed purpose built care home, constructed by renowned care home contractor Castleoak in 2006, had been acquired by Nightingale Premier Care Homes Ltd in 2007 it fell into administration and was acquired by Country Court Care. Country Court Care
hopes to promote a strategy of sustainable growth, saving jobs and improving the lives of elderly people. This acquisition has opened up a new region for the group who seek to create a cluster of homes in this area as part of planned future growth. The transaction follows the addition of two new nursing homes earlier this year, advised by Daniel Corker of Freeth Cartwright’s specialist care team.
Off-market deal Christie + Co has brokered an off-market deal to sell South Cary House to Avon Care Homes. South Cary House is a Grade II Listed residential home in Castle Cary. The
care home, registered for 23, is a delightful Georgian property set in an acre of land with a fantastic reputation for excellent care in a homely environment.
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Barclays funds Peverel Court Barclays has provided funding to support Peverel Court’s expansion plans. The loan has helped facilitate a £1.1million expansion project and complete the first phase of a new 14 bed extension at the Bartlett’s Residential Care Home in Buckinghamshire. Bartlett’s Residential Care Home, which is owned and
traded by Peverel Court Limited, is a Victorian country house built in 1856 and offers residents around the clock personal care including those with the early onset of dementia. The newly completed extension will allow the care home to increase the number of residents at Bartlett’s to 38.
HPC completion Specialist healthcare property consultant HPC has acted on behalf of YMCA London South West in the sale of a care home in Surrey. The Summers in West Molesey was previously registered to accommodate adults with physical disabilities, and has been sold as part of a strategic review to enable the organisation to focus on its
broad range of other services and accommodation. The home has been acquired for an undisclosed sum by Surrey operator CHD Living, which has already completed the first phase of work developing specialist small-scale units for clients requiring specialist dementia care services.
Financing for Approach Community Homes Approach Community Homes Ltd (ACH), owners of a learning disability home in Hunstanton, has acquired its second site, with a little help from specialist commercial mortgage broker Christie Finance. Milton House in Bedford is the latest acquisition for ACH whose principals, Kaye Bailey and Antony McNeillis, are already on the look-out for a third
property as they seek to expand their group. Milton House is a 13-bed home for people with learning disabilities, which ACH is currently refurbishing. Christie Finance worked with ACH to secure funding for the acquisition. A nearyear-long process finally ended when a major high street lender provided a 15-year loan at competitive rates.
Tanner & Tilly assist Tanner & Tilley Town Planning and Development Consultants have been involved in Barlavington Manor Care Home and Assisted Living Bungalows, a family-run facility in the South Downs National Park. Their involvement in
this project included gaining approval for three additional assisted living bungalows and further consent for the erection of an extension to the dayroom to provide an additional dining room.
Clacton care home purchased A care home in Hollandon-Sea has been purchased from administrators by a Lewisham-based independent and family-owned healthcare group. Eleanor Healthcare Group has bought York House and Aldersmore, which was previously run by Doson
Limited before the company was placed in administration in July 2012. York House and Aldersmore is a residential care home for up to 18 people providing personal care for people with a learning disability or autism spectrum disorder.
Buckinghamshire site acquired Salmon Harvester Properties and Rock Care Partnerships have acquired a circa 25 acre development site in Buckinghamshire on an unconditional basis with a view to constructing a large retirement village next year which will have a £45m completed value. Salmon Harvester Properties and Rock Care Partnership were advised by Jones Lang LaSalle and successfully acquired The Wycliffe Centre conference
site at Horsley’s Green, High Wycombe with a delayed completion allowing time to obtain planning consent. If successful, construction will take place in early 2014. Jones Lang LaSalle is retained to provide continued advice to the developer in working on their planning application which is likely to include 100+ assisted living units, a 30-bed dementia care home and a club house/communal facility providing services into the village.
HPC wins award giants including Savills, Knight HPC has won the Property Frank, Jones Lang LaSalle and Consultants of the Year title at CBRE. the prestigious HealthInvestor Awards. HPC was established in 2009 to provide specialist transactional and consultancy services to the care sector. The independent firm beat strong competition in the capital markets category from property
Rehab services acquisition Rehabilitation services have returned to the Royal Buckinghamshire Hospital in Aylesbury, following the acquisition of this historic site in a deal brokered by specialist property adviser
Christie + Co. New owners Affinity Group re-opened the hospital to provide specialist spinal injury and neurological rehabilitation services. The hospital had been closed since October 2013.
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local authority & planning news
Hallmark in Rugby
Care UK plans approved
Hallmark Healthcare has been granted planning permission to a 70-bed home in Rugby.
Planning approval has been granted by St Edmundsbury Borough Council for the development in Haverhill of a new state-of-the-art care home for older people, and a wellbeing centre which will offer day care
Demolition of the existing building will start shortly with the home expected to open late in 2014.
£5.5m Devizes care home of St John Care Trust (OSJCT). The Stepnell team has just started building the new care home at Corn Croft Lane, off Horton Road. It is set to be completed in autumn 2014. It will provide nursing and specialist dementia care.
Construction company Stepnell has been appointed for a £5.5 million contract to build a new care home in Devizes, Wiltshire. The 80-bed care home is being developed by specialist developer Brackley Investments for The Orders
Dorset closures The residents will be moved into supported living on the basis of their individual assessed needs.
Dorset County Council has agreed to close two of its care homes in a move towards supported living in the county.
Extra care in Littleborough housing site. The site will comprise 43 extra care apartments and they will be completed in 2015.
A new extra care development will be built in Littleborough, Greater Manchester. Part of the land is a former sheltered
Seddon and Sanctuary National construction specialist Seddon has been chosen to build an £11 million housing project in Telford, Shropshire, for leading social housing and care provider Sanctuary Group. The development in Ketley, Telford, will create 86 extra care apartments for residents aged over-55 plus 12 apartments for people with learning difficulties. The Telford scheme is set to be finished in autumn 2014. It has been partly funded by the Homes and Communities
Agency and is being delivered in partnership with Telford and Wrekin Council. The new extra care scheme, set in landscaped gardens, will feature communal facilities including a restaurant, lounge, gym and hair salon. The project, designed by Brewster Bye Architects, is taking place as part of a £60 million four-year partnership between Seddon and Sanctuary which will see more than 700 new homes built across the Midlands.
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clubs and activities for older people who live independently in the wider community. The new care home which will be built by Care UK will accommodate 60 residents and provide nursing as well as residential care.
New Birmingham care home National construction specialist Seddon is starting work on a new £4.2 million luxury care home in Edgbaston, Birmingham, for Gracewell Healthcare. The 70-bed care home will be built at the former site of the Birmingham Central Synagogue. Architects Pozzoni have taken forward the earlier design by Gracewell to finalise the scheme. When complete, the new home will combine boutique hotel interior design with leading-edge dementia and
innovative specialist care facilities and services. Just like boutique hotels, which have become very popular in recent years, the home will be defined by its style, warmth, homely experience and intimacy. Amongst many innovative features the new home will include a hair and beauty spa, a nail bar, a chic cafe, a library and will have WiFi access throughout the home. Work is due to commence in August and the care home is set to be completed in October 2014.
ExtraCare Charitable Trust ExtraCare Charitable Trust has The site will include 262 been granted permission to build extra care apartments. It is a retirement village in Coventry. hoped to open late in 2015.
Stafford care home Plans have been approved to build a new 70-bed care home
in Stafford. The application was made by Medicx.
Housing 21 starts work Work has started on a new Housing 21 extra care scheme in Derby. The new scheme for older people will provide 70 two bedroom apartments for affordable rent or shared ownership.
The £8 million partnership scheme, which is funded by the Homes and Communities Agency, Derby City Council and Housing 21, will complete towards the end of 2014.
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Gainsborough Specialist Bathing launches new assisted showers Gainsborough Specialist Bathing, Europe’s leading choice in assistive powered baths, has launched a new range of modular shower units. These new showers deliver care providers, contractors and specifiers with several advantages and are ideally suited to long term care environments.
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Graphite sells Willowbrook Graphite Capital, a leading UK mid-market private equity specialist, has sold its majority shareholding in Willowbrook Healthcare, which develops, owns and manages premium quality care homes for the elderly. The company was acquired by the management team with the backing of Health Care REIT Inc., a large US healthcare property investor. Graphite has exited its investment in Willowbrook completely, generating a strong return from the transaction. Willowbrook’s founding management team, led by John Strowbridge and Ian Matthews, will continue to manage the homes and the company. Willowbrook was established in October 2008 following the success of Avery Healthcare and Optimum Care, two previous Graphite
investments backing the same management team. Graphite, the management team and a bank syndicate led by Royal Bank of Scotland provided funding of over £80 million to build the business. The banking syndicate also included Bank of Ireland and Allied Irish Bank. Since its inception Willowbrook has grown to 13 freehold homes with capacity for 880 residents. All of these homes were newly built, are amongst the highest quality care homes in the UK and trade under the Avery brand name. Willowbrook also has a pipeline of further sites ready for development. Willowbrook’s very high standards of care have enabled it to achieve high occupancy levels and a strong financial performance. The company now has 938 employees.
Seddon, Cinnamon and Barchester Seddon Construction has commenced construction on a new £5.1 million fully-fitted care home in Banks, Lancashire, for the owner Cinnamon Care Capital. The home will be operated by Barchester Healthcare. The 70bed, two-storey development, designed by Condy Lofthouse Architects, is due for completion in
August 2014. The contract was negotiated by Seddon who identified the site and obtained planning permission. This is Seddon’s second development for Barchester and follows the successful development of a 50-bed care home known as Cheshire Grange, in Lymm, Cheshire.
C-I-C’s 5-year plan Community Integrated Care (C-I-C) has published its 5-year plan which will see it pursue a highly ambitious programme of investment, development and change – aimed at delivering the highest standards of care to the people it supports, enhancing its workforce and growing by 30% over the period. The new strategy will see the charity make an investment of at least £23 million over five years into developing a number of brand new specialist care services across England
and Scotland. This will include creating several of its pioneering EachStep dementia care services – which deliver specialist integrated dementia support to assist people with the condition from diagnosis until the end of their lives; developing single person tenancies to support people with learning disabilities to live with greater independence in the community; and investing in high-quality, outcomefocused domiciliary care services.
Bondcare invests Bondcare is investing more than £1million in major refurbishments at four of its North East care homes. Allan Court, based in Benwell, Newcastle, Debaliol Care Home, which is located
in Newbiggin-by-the-Sea, Northumberland, Donwell House Care Home and Day Centre in Washington and Redworth House in Shildon, Co. Durham, will all benefit from the six-figure investment.
Clydesdale and Yorkshire Banks’ lending activity Clydesdale and Yorkshire Banks have underlined their commitment to the care sector with millions of pounds of funding for leading care businesses. Safehands Corporation run services from domiciliary care to a specialist hotel in Blackpool for people with disabilities and their carers. They received a £1.6million funding package from Yorkshire
Bank’s Business and Private Banking Centre in Preston to help develop the businesses further. Country Court Care, an East Midlands based provider of elderly care services, received a seven-figure funding package from Clydesdale Bank, Birmingham to assist with the purchase of Summer Lane Care Home in Weston-super-Mare.
Eden and HASS merge Eden Supported Living (Eden) and Housing & Support Solutions (HASS) are set to merge. The combined organisation will provide
support and housing solutions for people with a range of disabilities and support needs in the East Midlands and South Yorkshire.
Home Care Solutions expand into Lincolnshire Home care agency Home Care Solutions has expanded its operation into Lincolnshire. It will work in partnership with Lincolnshire County Council to deliver high quality domiciliary
care. The care provider operates services in Bedfordshire, Buckinghamshire, Cambridgeshire, Luton, Oxfordshire and Nottinghamshire.
New development for Methodist Homes A new retirement living development has been officially opened in Market Harborough by Methodist Homes (MHA). Welland Place has 100 one and two bedroom apartments for people over 60, with
individualised care and on-site support available 24 hours a day and options for sale, rent or shared ownership. Facilities for residents include a gym, spa, swimming pool and landscaped gardens.
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Nowhere to hide Corporate accountability in health and social care The Department of Health issued a consultation at the start of July to strengthen corporate accountability in health and social care. Peter Grose explores the detail of the consultation and its implications for the sector.
The recently published consultation Strengthening Corporate Accountability in Health and Social Care follows a commitment made by the Department of Health (DH) in its response to the events at Winterbourne View, Transforming Care: A National Response to Winterbourne View Hospital published in December 2012. In that response, the DH â€˜identified weaknesses and a system of accountability where leaders of organisations are not held to account for the delivery of poor quality services or for allowing a culture where neglect and abuse are rife.â€™
Being held to account Broadly, the consultation sets out proposals for how to hold providers of poor care to account. It proposes a new requirement that all directors of providers registered with CQC (including charitable trustees and NHS Boards) must meet a new fitness test. CQC will be able to insist on the removal of directors that fail this fitness test and will also be able to consider the role of the board, individual directors and trustees, in any cases where corporate providers fail to deliver adequate care, with the power to prosecute in the case of serious failure. The document also refers to the CQCâ€™s consultation, A New Start, setting out very preliminary proposals on a change to the regulations issued under the Health and Social Care Act 2008. As part of this new initiative, from July 2013, CQC is introducing a
new system for providers applying to register to provide care for people with learning disabilities. This includes a more robust test for providers whose ability to deliver high quality care is less clear; those who register must make a commitment to deliver safe and effective care; and named directors or leaders of organisations to be personally held to account for that commitment. This is in addition to making sure that providers and registered managers are held to account for the care they provide. The DH states that in developing changes to the regulations, it will explore whether it would be sensible to streamline the role of the Nominated Individual and the Named Individual at board level with oversight for quality and safety. The DH consultation makes it clear that some of the proposed changes will require amendments to the regulations, in that the response to the consultation will contribute to the development of those regulatory changes. It proposes to issue draft regulations quickly, in the autumn of 2013, with a view to making them law by the end of 2013 and operative from April 2014. A full impact assessment will be included with the new draft regulations in the autumn. This will look at both the direct cost in meeting compliance requirements and any other potential costs eg if there is a need to change governance structures to fit with the new approach. The DH consultation invites submission of any evidence about the likely costs and benefits of these proposals.
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nowhere to hide
The detail of the consultation needs to be examined in more depth to get a true understanding of proposals.
1. Fit and Proper Person Test for Directors The DH is concerned that currently there is no registration requirement specifying that all board directors, trustees or members of the governing body of non-corporate associations have to be fit and proper persons. It, therefore, proposes that CQC registration requirements are amended to place a clear duty on corporate service providers to make sure that all directors who are appointed to the board are suitable for the job (ie are fit and proper persons). It states that the regulations will define which appointments the test applies to – should it only apply to main board directors or should it apply to ‘other principal officers’ who might not be part of the board, particularly as the major national care providers rely on a system of ‘Regional Directors’ or similar who are usually not board directors but who play a fundamental role in the organisation and supervision of the company’s operations. The consultation also invites comments on how the new regulations and guidance should define what is meant by a ‘fit and proper person’. This could include identifying if there are any concerns arising from general or financial background checks about the individual’s honesty and integrity, competence and capability, and previous history as a director. The Consultation is clear that the responsibility of ensuring that directors are fit and proper should rest very firmly with the company, charity or NHS organisation concerned. It states that CQC could take action against a corporate provider that appoints a director who is not fit and proper by means of a condition of registration ie CQC would be able to insist on the removal of the director by placing a condition on the provider’s registration. If the provider did not remove the director concerned, that would be an offence for breach of the condition and the provider would be liable to prosecution. Additionally, CQC would be enabled to take action against board members where the quality of care is poor and it can be established that the governance provided by the board had not been adequate. CQC could then consider the actions of the directors and reach a judgement about whether they were still fit. The consultation states that the provider would have a right of appeal to the FirstTier Tribunal against any condition imposed by CQC in relation to the fit and proper person test for directors.
2. Other actions to address the issue of corporate accountability The DH states that it plans to put in place a barring scheme that will apply to all senior NHS managers and leaders across NHS Trusts and Foundation Trusts. The consultation states that it is looking at who else the scheme will apply to. This will require primary legislation but the consultation will be used to explore the relationship between a fit and proper person test and a barring scheme that will cover the appointment of all senior NHS managers and leaders. Additionally, it is stated that the Government plans to abolish the limit on certain fines on conviction by Magistrates Courts (currently £5,000) and that this will apply to the failure to meet
the revised registration requirements. The final major question posed by the DH in the consultation is whether CQC’s proposed introduction of Fundamental Standards outlined in its own consultation and a new fit and proper person test, together with existing legislation are adequate for holding providers to account for unsafe care. The consultation states that CQC is already able to prosecute providers, directors and unincorporated associations under the Health and Social Care Act. However it notes that, in practice, there have been no prosecutions and CQC has only issued four fixed penalty notices in lieu of prosecution for failing to meet registrations requirements. This is because CQC is currently required to issue a warning notice in advance of any prosecution, ‘so, however appalling the failure, if the provider complies with the warning notice, then there can be no prosecution. This needs to change.’ The DH states that the introduction of Fundamental Standards as set out above would make it easier for CQC to prosecute both corporate bodies and individual directors for providing poor and harmful levels of care, in effect giving CQC the power to prosecute for criminal neglect. The DH notes that there are a number of criminal offences for which a board director can currently be prosecuted including offences under general criminal law (eg aiding and abetting the commission of any offence such as an assault; manslaughter as a result of death caused by gross negligence; and numerous offences under the Health and Safety At Work Act). It proposes that the introduction of Fundamental Standards and clear guidance, together with an enhanced role for the HSE, will ensure that it is easier for directors and managers to understand their duty to provide safe care and their potential liabilities when they fail to do so. It will also improve the way that existing sanctions are used to prosecute providers for failings in the quality and safety of care.
have your say Responses to the consultation are required by 6th September 2013. It should be noted that the consultation falls short of one of the proposals in Transforming Care which mooted the possibility that banks and investors in corporate care providers might be held responsible for failings in care delivered. This is clearly regarded as a step too far but, of course, it is possible that this may be raised during the consultation by hardliners such as the Labour ex-Health Minister Paul Burstow MP who has raised concerns about the liability of directors, not least financial liability. Mr Burstow notes that the huge cost of the Winterbourne enquiries, particularly that of the Local Authority Safeguarding Investigation and Serious Case Review, was borne by taxpayers and the fault was due to lack of adequate oversight by board members of Winterbourne View’s corporate owner. It will be interesting to see whether this issue will be raised in responses to the consultation. cmm For a copy of the consultation and how to respond, visit: https://www. gov.uk/government/consultations/improving-corporate-accountabilityin-health-and-social-care or search online for Strengthening Corporate Accountability in Health and Social Care. Peter Grose is Partner at Lester Aldridge LLP Solicitors. Peter.Grose@LA-Law.com
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Chris White MP Chris White MP is the Member of Parliament for Warwick and Leamington. He has been appointed the Governmentâ€™s new Social Value Ambassador.
Tell us about social value Formally, social value is the additional social, environment and economic benefit that we can create through smarter commissioning and procurement of public goods and services. More generally, social value is the added value that we can create in our communities.
How does it fit with social care? Social value has the potential to ensure that we get the best outcome from spending on social care and help charities and voluntary organisations who can deliver high quality social care and support wider social, environmental and economic objectives through their work. Social care is becoming an ever-increasing part of public spending and if we are smart in the way that we commission services and the partners that we deliver them through, then I believe we can deliver better outcomes and increase the impact that these services have on our communities.
What are your aims for your new role? As the new Social Value Ambassador my job is to go around the country raising the profile of the Social Value Act and the wider social value agenda, as well as trying to gather case studies on the successful implementation of the Act. I will also be advising the Government on how the Act and social value is being deployed across the public sector and how we can remove barriers to its widespread integration.
How do you like to switch off (if you ever get the chance)? Representing Warwick and Leamington is a fabulous privilege and I devote as much as possible in doing this job to the best of my ability. However, if I do have spare time generally I like to spend it catching up with friends and enjoying the many festivals and events that take place locally. To find out more about social value, the Social Value Act can be found at: http:// www.legislation.gov.uk/ ukpga/2012/3/enacted CMm
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Quality in a time of budget cuts
Great quality care is possible for many, even during current cuts in social care budgets. Sharon Wood shares her experience at Meridian Healthcare of maintaining quality in care homes when budgets are squeezed.
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It certainly isn’t easy to keep quality of care high when facing rises in the minimum wage and higher utilities bills alongside reduced or static fees and rapid changes in placement activity. To balance the books, many local authorities reduce the number of placements into long-term care, raise the eligibility criteria, slow down the funding panel process and make short-term ‘respite’ placements instead of permanent placements. These combined factors place enormous practical pressures on the day-to-day operation of a care home and its ability to offer a good quality, safe, caring service to residents. The Meridian ethos has always been to provide quality care and high quality accommodation whether an individual is local authority funded or not. We have deliberately, over time, re-focused our accommodation so that we only offer single rooms and, where possible, we have added en-suite facilities. When times get tough, how is it possible to continue offering a person-centred, well-staffed and welcoming service? There is no single quick fix or solution but there are some tips which can help to manage service quality and reduce cost pressures on a care home. Many of these will be familiar to care home managers around the country trying to balance the books and keep their residents at the forefront of their service.
Staff are your biggest asset. They determine whether a resident has a positive experience and whether your care home operates successfully. As a result, continued investment in their development is essential. Of course staff training is an expense; however there are ways of mitigating the cost to get maximum benefit with minimum cost.
Accessing funding for training Establishing good relationships with workforce development organisations such as Skills for Care can reap benefits. They are a valuable source of up–to-date information about available funding for courses. Developing partnerships enables you to draw down funding against accredited training for staff. This applies to health and safety training right through to end of life courses. Meridian most recently accessed the fully-funded NHS Six Steps to Success programme via a local Clinical Commissioning Group’s funding scheme. However, without the relationship in the first instance this would not have been possible. Courses can sometimes be expedited if you have a good relationship with a training provider – a speedier completion can mean a care home can attract higher fees from a local authority.
Training staff as trainers Spending £500 to £800 to train someone as a trainer can mean that tens of other staff can be trained without the cost of external training. This is a cost saving that offers flexibility as training can be arranged at a time to suit you.
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quality in a time of budget cuts
Using staff supervision time effectively
Every care home is only as good as its weakest carer. Alongside regular training, active promotion of supervision sessions, which include mixed job role groups, can help staff gain a broader view of what’s going on. Meridian has had examples in the past where kitchen staff never met with other carers in the home. Service and delivery was poorer as a result with staff not understanding the issues and pressures of their co-workers. Seeing supervision sessions as development not a disciplinary tool is the key to an open and transparent dialogue with staff about service levels.
Management of sickness and absence Cuts to fees means that staffing budgets have to be managed carefully. Tightening up on sickness and absence procedures is a low cost and high impact area for managers which, in turn, improves the consistency of your service and reduces the overall cost to the business. Return to work interviews and an accurate process for recording holidays and absence are a vital part of this process. Difficulties in managing with sickness, holiday and absence can result in the use of agency staff to provide cover. Agency staff don’t know about individual client’s needs and organisation processes so quality standards can drop. Meridian managers are advised to use agency staff as an absolute last resort for this reason. The safety of your residents and the service provided to them always has to come first, but shouldn’t always mean the use of unknown agency workers.
Remove artificial pressures Part of managing quality when budgets are tight is about focusing on the essentials. Don’t impose artificial deadlines or pressures on staff.
The manager’s role When times are hard, the hands-on involvement of managers becomes critical. ‘Half an hour saved now, saves two hours later on’. Timely intervention to avoid future problems. Arrive early and get a good handover from your night team by walking around the building with them. Ensuring that all necessary actions have been taken whilst you have the staff in the building can save hours of chasing and query later on. Walk the floor regularly so you know what’s happening. Listen to how staff are interacting with residents Speak to families as they come in – take the time to understand their experience of your service. Half an hour spent with a family soon after a resident has moved in, for example to get life story background and materials, can save two hours down the line. Ask for feedback from residents, visitors and staff – it’s essential information to help you improve your service. Identify high risk areas in the home - map indicators for food, complaints, accidents and incidents to get a wider picture. Reduce the workload by bringing down accidents and incidents – do this through training and identification of risk points.
Monitoring quality It is essential under any circumstances for managers to carry out regular audits and not be complacent. Take an ‘auditing with eyes wide open’ approach. This is about looking at the facts rather than how hard someone has worked. Being able to stand back and take a holistic and objective view of the service, including any feedback
received, is the only way to ensure issues are picked up and addressed promptly. Understand that ‘quality’ isn’t just about meeting standards for CQC or the local authority. It’s about the attitude of staff, their care, compassion and knowledge of their residents. Feedback and comments from families, staff and residents provide insight into whether these aspects are working. Clearly, things don’t always go right as human error is always a factor. The key is to learn from each issue or incident, to share this knowledge amongst colleagues so that they might also learn, and to create processes to stop it happening again.
Budgeting If struggling with fee and placement cuts, something has to give. This is where the canny manager comes into their own. Understanding the budget in detail means you can manage costs, without cutting into quality. Keep costs in line with occupancy without compromising service levels. If you have 40 beds but only 25 residents, ensure the kitchen isn’t still ordering food for 40. Appropriate staffing and using annual leave allowances wisely can make a big difference to operating to your staffing budget. Are you staffing for 100 per cent occupancy or your current 87 per cent? Agency staff can quickly eat into valuable staff budgets.
Challenges going forward The Government plans for changes in eligibility criteria, with only those with ‘substantial’ or ‘critical’ needs being funded for respite or long-term care. Clients are substantially frailer and, in many cases, have behaviour that challenges. Admissions regularly follow a crisis. Funding is also usually only available for a short stay. This means that whereas a few years ago, a home might have four or five new admissions a month, this is now the norm for a week. The nature of these admissions, often the result of a family crisis, means that the information which comes with the client is poor. The home is also coping with increasing admissions, many of which are late at night. Management of this and the accompanying paperwork and administration are on-going challenges. Meridian has reduced the amount of initial paperwork required in the early stages for short stay residents but there is still some way to go. Families tend to be busier than ever before with many members working full time. Sadly, many families are unable or unwilling to support residents with the basics. Managers have had to rush out to buy basic underwear and toiletries for a newly-admitted resident. Families were once an integral part of ensuring residents’ likes and dislikes were known and documented, which is becoming harder to achieve. The result of these changes in commissioning practice is a huge pressure on time and resources. If cuts continue to be made, there is a real risk that good quality homes in areas where local authority funding dominates, will be lost as operators seek more stable areas to develop homes. In the meantime, we continue to refine and improve our processes to support our managers in the delivery of really excellent care for all. cmm Sharon Wood is Quality Assurance Manager for Meridian Healthcare www.meridiancare.co.uk.
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Focus on Leadership and Recruitment: introducing Values-Based Approaches in Social Care Welcome to the National Skills Academy for Social Care’s Leadership Section Welcome to our latest issue. As Camilla Cavendish noted in her independent Review into training and support of front-line social care workers, published in July: “To get the right quality of care, it is vital that the right people are recruited to caring roles.” If we’re really going to transform social care, we all – employers, people using services, relatives, unpaid carers and commissioners – need to have faith that we have the right people in post, doing the right thing in the right way. And recruiting people with the right values and behaviours in sufficient numbers to support a growing sector is a real issue in social care. According to Skills for Care, the number of adult social care jobs is projected to grow from just under 2 million at present to over 3 million by 2025. At the moment, there are shortfalls in filling vacancies and high levels of staff turnover in some areas. This has implications for care quality. Shortfalls in the workforce are an expression of unmet social care need. High turnover rates, particularly in the first few weeks following appointment are often an indication that people have come into care and support roles but do not have the right values to sustain them in these roles. High turnover and churn rates lead to lack of continuity – a factor that counts highly with service users. And there is a risk (fear?) that employers will take on candidates without the right social care values, with potentially profound implications for the care of vulnerable people. So what to do? Well, one way is to make it easier for employers to recruit for social care values like empathy, a sense of how to treat people with dignity and respect, commitment to care and the courage to stand up for quality and safety. In other words, you can recruit for leadership behaviours which indicate the values you’re looking for. And there are practical ways to do this. There are tools, widely used in other sectors and already used by some larger social care employers with HR Departments, that help them recruit for values, especially at senior level. These approaches have been shown to bring clear benefits. Apart
Debbie Sorkin, Chief Executive of the National Skills Academy for Social Care, writes about a new leadership initiative from the Academy to make it easier for all employers to recruit staff with the right social care values. from anything else, they are an excellent way for a provider to demonstrate the quality of their service. But most social care employers are relatively small. They won’t always be familiar with, or have the resources to support, values-based approaches to recruitment. Most staff, whether they work in residential or in home care, work at front-line, not senior, level. And there are increasing numbers of Personal Employers looking to employ Personal Assistants. To support them, the National Skills Academy for Social Care, together with Skills for Care and MacIntyre, has developed a Values-Based Recruitment Model for adult social care. We’ve brought together different aspects of values-based recruitment in an online toolkit that has now been launched. The toolkit, available at: https://www.nsasocialcare. co.uk, aims to bring values-based approaches within everyone’s reach. It includes guidance in plain English on how employers can recruit and select for social care values; examples of draft job advertisements and interview questions; a simple online Personality Profiling tool which employers can use with candidates; links to the Skills Academy’s Leadership Qualities Framework with an explanation of how it can help in recruiting for values; and signposting to other sources of information, such as Finders, Keepers: Skills for Care’s recruitment toolkit for employers. We believe this is a really important step for the sector – a workable model in support of values-based recruitment, especially of front-line staff and first-line managers. Fundamentally, it’s about better leadership in social care. If it works, it will mean better outcomes for people being supported and for workforce retention. And with Camilla Cavendish’s renewed call for values to be put back at the heart of social care, it couldn’t be more timely. For more information, please contact debbie.sorkin@ nsasocialcare.co.uk or go to www.nsasocialcare.co.uk.
Values are the key to great social care: the view of the Department of Health Dr Glen Mason, Director of People, Communities and Local Government, Department of Health People in our country deserve the very best high quality social care and we believe that staff with the right values are at the very heart of excellent social care. Quality care requires quality people and values such as dignity, respect and compassion are the hallmark of safe, outcomes-focused and responsive services. This is why the Department of Health has so strongly supported the work of the National Skills Academy, working in partnership with Skills for Care and MacIntyre in developing and promoting a values-based recruitment toolkit. Ministers are determined to put values at the heart of all in the social care sector and Norman Lamb, the Minister of State for Care and Support, spoke at the recent launch of the Values-Based Recruitment Toolkit to reinforce this point. We often hear of the catastrophic failures when Health and Social Care leaders and staff don’t have the right values. Winterbourne View and Mid-Staffs are the most recent shocking examples of this. However, as unacceptable as these failures are, as I get out and about in the sector’s care homes, home care services and social work teams I am constantly reminded of the excellent
care that is provided day in and day out by staff with exactly the right values. Staff who do everything they can to promote and respect dignity, to provide choice, to be compassionate and always to seek to go the extra mile, sometimes in difficult circumstances. However, we accept it isn’t always easy to put in place systems and processes to ensure people with the right values are recruited. Social care is primarily made up of an army of dedicated small and medium-sized providers. What the toolkit does is put into the hands of all providers a set of resources, from example job adverts and interview questions through to an online profiling tool. We are piloting these resources for a twelve-month period and will look to evaluate their success. If you are an employer in social care I urge to you have a look at the toolkit and try it out. If you are a member of staff ask your employer if he or she is using the toolkit to recruit your next new colleague. Values are key to great care and we in the Department of Health believe this toolkit is a significant step forward in supporting employers to recruit the right people.
Values-based approaches to recruitment: the benefits across the social care workforce Sharon Allen, Chief Executive Officer, Skills for Care One of the most sobering statistics for all of us is that by 2025, our National Minimum Data Set for social care calculates our sector will need at least 350,000 new workers and that figure could go as high as one million. So in a little over a decade we have to find a lot of new people - but in doing so, we must not sacrifice quality for quantity. Every person we recruit must have the right behaviours and values to deliver the sort of high quality care people have a right to expect. I know from my own experience as an employer there is no exact science to recruiting the right people; we can’t see into people’s souls. But what we can do is be much smarter about how we find and retain the right people by using proven techniques that other sectors routinely use. That is why we have worked with the National Skills Academy for Social Care and major service provider MacIntyre to pilot a values-based recruitment toolkit that uses intelligent personality profiling - in tandem with other recruitment techniques - to help establish if people have the sort of values we need. This toolkit will help employers find people who understand that values like compassion, dignity, integrity, respect and responsibility are not options but essential qualities needed to become a good care worker.
The toolkit includes a personality profiling questionnaire for candidates, The Leadership Qualities Framework as a guide to behaviours and values, our Finders Keepers resource to help recruit and retain staff plus examples of job adverts and interview questions. The model brings together different aspects of valuesbased recruitment into an online toolkit which will be piloted by employers across the sector over the next 12 months. It is critical we get employers to road test this model so we can make sure it is fit for purpose. Using the toolkit will help employers find workers who will quickly pick up the emphasis on values and behaviours in the Common Induction Standards and through to levels 2, 3, and 5 qualifications as they progress their careers. The toolkit also has logical and signposted links to the Skills Academy’s Leadership Starts With Me. It is designed to give proprietors, Registered Managers, HR teams and individual employers a better idea of what sort of person has applied for a job - before an interview. But the real winners are people who need care and support because their care will be delivered by people who consistently model those behaviours and values that are critical to quality care delivery in our communities.
Realising the benefits of Values-based recruitment: MacIntyre’s experience Bill Mumford, Chief Executive Officer, MacIntyre There is a perfect storm raging in social care: increasing demand from an ageing population coupled at the same time with sustained reductions in government spending. There is no prospect of this storm passing any time soon and so organisations need to adapt to what is being termed as the “new normal”. Adaptation meaning being resilient - getting the basics right, and being innovative - looking to do things differently. When a new idea ends up improving the resilience of my organisation, I implement that idea, and fast. When a new idea ends up improving the experience of service users, I implement that idea, and fast. And when a new idea achieves both these things, instantly adding value to a process I assumed was set in stone, I wish I’d made the change the day before yesterday. The idea I want to introduce is the new Values-Based Recruitment Toolkit for employers in adult social care. The toolkit is an online resource, with everything from example job adverts to interview questions – all designed to highlight candidates with the right values; the personal attributes we want to see in our profession. We’ve been working with partner organisations The National Skills Academy for Social Care, and Skills for Care, and with the support of the Department of Health, on the toolkit. It will help employers recruit the right staff. People that care. People with values of compassion and integrity. People you can
trust to do the right thing. I urge you to engage with this. At MacIntyre, where we provide services for people with learning disabilities, we have been using this approach for four years. It works. There are multiple benefits. The metrics are great: first-line managers are more confident making recruitment decisions, staff teams are engaged more than ever, we have lower levels of sickness and absence, lower staff turnover, fewer low-level disciplinary issues and greater take-up on training. We are also saving money. Embedding values-based recruitment within our routines has enabled us to overcome long-standing logistical issues. We’re recruiting smarter. The candidates we hire are more likely to be the right ones. They stay, and contribute. So we’re spending less on ongoing rounds of recruitment, each designed to solve the problem the last round didn’t get to. The experience is better for candidates too – a clear articulation of care values helps the right people to self-select into the process. More satisfying than anything, we’re improving service outcomes and individuals and families are constantly making comment. Our last Investor in People assessment also agreedupgrading us to “gold” standard. Any organisation that aims to improve the quality of care they are providing – and that’s all of us, isn’t it? – should use every advantage available in making that happen.
Values-based approaches to recruitment: the benefits for smaller providers Sheila Scott OBE, Chief Executive, National Care Association My organisation, the National Care Association, represents SMEs who actually provide most of the residential care around the country. Wearing another hat, I chair the Department of Health Working Group on Recruitment and Retention for Skills for Care, so I have an especial interest in seeing better recruitment and retention of social care staff. Finding good staff is a particularly important issue for smaller providers - they really form the bedrock of quality care. Many of my members have one or two care homes. Often they will be family businesses, established for many years, with owners who are deeply involved in the management of the service. They want to provide an excellent service to people - often frail, elderly people - who need their care and support. But they’re under a lot of pressure - from commissioners, from relatives and from regulators. More pressure than ever before. And this means that more than ever, they need to recruit - and retain - the right people with the right values, so that they can rely on them to do not just the right thing, but the ‘thing’ right.
Quite often, though, smaller employers won’t have easy access to guidance and advice on how to select the right kind of people. Or they won’t have in-house HR Departments to call on. This is where this Values-Based Toolkit comes in, and why I so welcome this initiative. I must admit, I was very sceptical at first. I thought it might turn into yet another burden on small employers. But it’s not - it’s the opposite, in fact, because it makes their job easier. The toolkit gives organisations like my members, who wouldn’t always be familiar with values-based approaches, easy access to everything they need. It’s SME providers like my members who will actually be the main beneficiaries of this approach. The National Care Association will be promoting the toolkit to all its Members, linking in to the toolkit via its own website. We have the makings, in this toolkit, of something that could be a watershed for the sector – bringing values-based approaches within the reach of all providers and embedding values at the heart of care.
The Value of Values Professor Martin Green OBE, Chief Executive, English Community Care Association The social care sector is one of the most difficult and complex sectors in any part of the economy. We face the challenges of increased need, rising expectations and reducing resources. As well as these competing pressures, our sector is unlike any other because it has at its heart the need support people who have complex and multiple conditions and, to do this in a way that holds true to the values of social care and respects the citizen’s dignity and individuality. In recent months we have seen graphic illustrations of what can happen when social care and health services lose touch with their core values, and move to a position where individuals are treated as commodities and services are run on process, not on outcomes. The evidence is clear: high quality, successful social care services have to be run on the values of social care. The enormous challenge for employers is to understand how to recruit their staff on values, as well as on competencies and experience. Up until now there has been very little support for employers to understand how to do this, but the launch of this new resource by The National Skills Academy for Social Care is set to give employers an easy and accessible toolkit, which they can use in their recruitment processes.
Values-based recruitment delivers not only better quality care services, but it also reduces the amount of turnover and leads to a much more stable, harmonious and committed workforce who understand the essence of social care, and deliver it in ways that respect the human rights and dignity of the person receiving the service. The new toolkit is remarkably easy to use and accessible for employers of all sizes within the sector. It clarifies what people should look for in their staff and gives them clear and accountable ways to measure it. In the short time since this toolkit has been launched, it is already becoming a recognised and highly-valued resource within the social care sector. As the toolkit cascades out to more employers, it will become an essential element in developing recruitment strategies in a highly competitive and pressured sector. The new Care Bill will give more and more power to the individual service user and it will be the people who use services who will be making informed choices about which services they want to deliver their support. The businesses that understand the values of social care and respect the rights of the individual will be the ones who are successful, because they will be differentiated in the market on quality and outcomes and judged upon their values.
Values are vital after all! Des Kelly OBE, Executive Director, National Care Forum Time and again the issues of recruitment and retention are highlighted as being crucial to the delivery of good quality care and support services. They represent a major challenge for care providers. At the National Care Forum (NCF) we administer an annual survey of the workforce across our membership of not-forprofit care providers. We have done so for 10 years and we use this information to track developments and benchmark such key indicators as staff turnover and qualification rates. We know that measured against such quality criteria notfor-profit providers perform better than the average in the sector – I like to call this the “not-for-profit dividend” because I believe it is related to pay and terms and how people are treated. Arguably, all good employers share a desire to demonstrate that they value their staff and generally this will be reflected in staff retention and stability. In recent years, the NCF has become interested particularly in the ‘churn’ of staff rather than simply ‘turnover’. Our data shows that 21.9% of people recruited leave within the first 6 months and 32.4% within 12 months. This is clearly a huge waste of time and cost.
The NCF welcomes the launch of the Values-Based Toolkit for social care recruitment by the National Skills Academy for Social Care (working with Skills for Care and MacIntyre). We believe it has the potential to make a significant difference to reducing this loss of people and talent. Recruiting the right person with the right values at the outset has to be part of the answer to improving staff stability in the care sector. Values such as respect, compassion, responsibility, commitment, empathy and imagination are crucial to ensuring that training can build appropriate skills and competence onto firm foundations. Together with professional supervision and support and the opportunity to reflect and learn, they are key to demonstrating commitment to quality. The toolkit brings together a range of ideas and practical resources for employers including an online personality profile test and a quick and easy-to-complete questionnaire. There are also suggested interview questions that can be used by new managers. The Skills Academy will be testing the toolkit and assessing its use for providers. NCF is encouraging its members to make full use of this new resource and to engage in offering feedback on how it is used. Values are vital after all!
The Future of Learning Disability Care The Renaissance Hotel, Manchester M3 2EQ 25th February 2014 Now in its 6th year, this national conference will once again bring together the most influential organisations to explore current and future developments in the specialist sector. Our stimulating conference programme will: • Have speakers focused on helping your organisation • Motivate you to see Learning Disability Care differently • Be a great networking opportunity • Include a range of useful workshops • Include an exhibition aimed at providing you with products and services to help your organisation • Include a live Business Clinic where you can ask questions to a panel of industry experts.
Delegate summary: • Major Providers • Independent Specialist Providers • Providers of Supported Living • Local Authorities • Major Lenders • Insurers • Property Consultants • Solicitors • Suppliers to the sector
For more information please email email@example.com or call 01223 207770
www.caremanagementmatters.co.uk/events.asp • Keynote Presentations • Workshops • • Exhibition • ‘Live’ Business Clinic • • Panel Discussions •
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How do you solve a problem like homecare?
Leonard Cheshire Disability has announced it is no longer bidding for 15 minute homecare contracts. Added to this, Care Services Minister Norman Lamb MP has declared homecare is in crisis. What’s got to give? How do you solve a problem like homecare? The sector is aware of the pressures on the system, especially homecare. We know that the system is at breaking point and 15 minute visits, although not ideal are, in some cases, the only way to get contracts and achieve what’s needed on available funding. When Norman Lamb MP announced that homecare was in crisis it was acknowledgement from the top that something has to change. Leonard Cheshire Disability has now waded into the debate by announcing that it will stop bidding for 15 minute homecare contracts. But, is there another way to meet demand on an ever-decreasing budget?
Current situation There’s less money in the pot in these times of austerity and local authority funding from central Government is continually being
squeezed. According to ADASS, over the last three years, net spending by adult social care departments has been cut by 20 per cent. With more people requiring care, a Government drive to support people at home rather than in care homes but less money coming through the system to provide that care; it’s no wonder that homecare visits are becoming shorter. The United Kingdom Homecare Association’s (UKHCA) report Care is not a Commodity revealed the ‘very short visit times that councils are commissioning.’ Stating that ‘73% of homecare visits in England appear to be 30 minutes or shorter.’ It goes on to report that 1 in 10 administrations limited visits to no more than 15 minutes.
Government’s approach To address the growing homecare issues,
the Government has launched a Homecare Innovation Challenge to improve homecare through the sharing of ideas and experiences. At the launch, Norman Lamb MP announced, ‘I am very serious about the quality of homecare – of care that happens behind closed doors. I have warned that the next big scandal – as serious as MidStaffordshire could happen in homecare. ‘Whilst most homecare is good, and a lot is excellent, care in a person’s home is too often delivered in 15 minute or 30 minute rushed visits that fail to treat people with dignity and respect. I believe that the way these services are commissioned by councils too often incentivises a system of low-wages, poor care and neglect.’ Despite this, Mr Lamb made it clear that there’s no extra money.‘You all know the huge challenges we face. On public spending;
A valuable tool in the overall kit
Providers must consider costs and quality
Sandie Keene President Association of Directors of Adult Social Services
Colin Angel Policy and Campaigns Director United Kingdom Homecare Association
As President of the Association of Directors of Adult Social Services I would caution against people taking a broad-brush stance against all 15-minute homecare visits that are commissioned by local authorities. Homecare these days has evolved. It is so much more than the traditional tasks of getting people up and dressed in the morning and putting them to bed at night. These homecare tasks also now include prompting people to take their medications on time, ‘just checking’ visits throughout the day to make sure people are all right, and offering support to fulltime family carers for tasks that need two people for just a short length of time. With tightening budgets and less money coming from central Government, local authorities have to spend every penny they have wisely. Why would they schedule an hour’s visit for something that only takes a few minutes? This doesn’t make
economic sense and isn’t a good use of budgets. I would agree with Leonard Cheshire Disability’s suggestion that fifteen minutes isn’t long enough to allow some homecare tasks to be done properly and to maintain people’s dignity. But I disagree that there is no place at all for the fifteen minute visit as long as it is not abused. It can be a valuable tool in the overall ‘kit’ for delivering excellent outcomes for people. This is obviously an issue that needs further consideration and the Association of Directors of Adult Social Services proposes to join with citizens and providers to develop standards for commissioning for excellent outcomes. We want to see how flexible and truly personal approaches can fit into the overall picture of delivering quality care that meets a wide variety of needs and enhances people’s quality of life.
While some larger homecare providers have a degree of choice about where they tender for local authority business, it’s not necessarily an option available to all. Councils effectively operate a ‘monopsony’, using their dominant purchasing power to drive prices and costs down. For many providers there’s a stark choice between accepting the terms that a local authority imposes under contract; reorganising the business to cater solely for self-funders (where there is a market), or ceasing to trade. The decision to tender with a local authority is a commercial one. Providers must consider whether visit times allow sufficient quality of care to be delivered, whether the price is viable to sustain regulatory requirements, and whether the council will pay a sufficient rate to enable the provider to recruit and retain a workforce at market rates. UKHCA’s free Costing Model helps providers and local authorities to identify the necessary rate to cover legal and contractual
obligations and determine whether any maximum price imposed by the council in tenders is sustainable. We encourage providers to share their use of the Costing Model with their commissioners and highlight the inadequacy of funding at a local level, where this is the case. We also suggest providers who are considering moving away from council-funded care make their reasons known in advance, to help authorities understand the implications of their commissioning on their local care market. In the meantime, councils who actively discourage providers from accepting privately purchased care to ‘top-up’ the services available from allocated budgets should cease to do so. Councils should also consider developing Individual Service Funds, which allow the user and provider to negotiate the ‘best fit’ of visit times and services within the allocated budget - giving users greater choice over whether a 15-minute visit is adequate.
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business clinic let’s be clear that no Government of any political persuasion can escape tough financial constraints – that is just the reality. The numbers of over 85s is to more than double by 2035 and the ratio of working age people to older people will change from around four working age to every older person to around two working age people to every one older person. This has profound consequences and we need to be creative with what we have.’
Pressure on the system The Government’s Innovation Challenge is admirable but it won’t ease the immediate pressure on the system, and given it isn’t likely to report until the autumn, it won’t be fastmoving action. Although some organisations are able to cope with increased demand, disability charity Leonard Cheshire Disability has declared that it is putting an end ‘to bidding for future contracts providing 15 minute homecare visits for disabled people… exactly three weeks after the Government called for an end to care workers being limited to 15 minute care slots.’ Leonard Cheshire Disability is the UK’s largest voluntary sector provider of social care services to disabled people. With over 7,000 staff, it supports over 4,600 disabled people either in their own homes or in residential services. Announcing the charity’s policy change in a
speech to the National Disabilities Conference in London, Chief Executive Clare Pelham told delegates, ‘As pressure on council budgets grows, the time allowed for care visits is decreasing…we know that 15 minutes is insufficient time to give disabled people high quality personal care and support. To put it clearly – it’s not care if the support worker does not have time to take their coat off. Let alone have a proper conversation. ‘Care workers are telling us that they cannot properly support disabled people to get up, to bathe, get dressed and to have breakfast in 15 minutes. This is not care. It is boxticking. The situation has become critical. This is why we are going to stop bidding for 15 minute homecare contracts, unless the person specifically requests a short visit, for example to receive an injection.’
Extreme cases Ms Pelham went on to explain just how restrictive some contracts have become. ‘In the most extreme cases we have seen a tender for visits of only 10 minutes. This is entirely unacceptable. ‘We understand the pressures on council spending. But there comes a time when it is right to draw the line. And to say so. We urge the Government to act now and use the Care Bill which is currently in Parliament to
actually stop inappropriate and indecent care visits from being commissioned.’
The rest of the sector Although Leonard Cheshire has withdrawn from bidding for these contracts, many private homecare providers are able to deliver acceptable care under local authority contracts and turn a profit. Many are able to make good investment in staffing, technology and processes to streamline the ability to deliver care quickly and efficiently. However, there has also been a rise in zero-hours contracts in the care sector, which according to the Office of National Statistics, have risen to over 300,000 from previously estimated figure of 200,000. Are these contracts and the flexibility they provide employers and employees helping to reduce costs? cmm
Over to the experts... Many could say that Leonard Cheshire’s approach is admirable and in the best interests of those it supports. But is it good business sense if these contracts are all that local authorities are commissioning? Will others follow suit and refuse to bid for 15 minute contracts to force a resolution to the problem? How do you solve a problem like homecare?
Their stance is exemplary Paul Tarsey Group Managing Director Bluebird Care All credit to Leonard Cheshire Disability for showing the courage in the 21st century that Group Captain Cheshire himself displayed to win his Victoria Cross in 1944. It is strange how so many care providers are happy to put themselves in the firing line whilst at the same time complaining about the risks to people who use their services. The reality is that, if a provider accepts an instruction to provide care (even at an utterly unrealistic price and with myriad tasks stacked into a 15 or 30 minute visit) from a local authority, they are immediately complicit in any shortfall in service or quality. For providers to say ‘it is not our fault’ is clearly, legally at least, naive. In stating that they will not provide an inferior service, even though refusal to do so may impact on their operational strength, Leonard Cheshire Disability’s stance is exemplary. Too many providers seem to believe that they will not be held responsible if things go
wrong and that they will simply blame the local authority and their funding regime. Until more providers take a stance like Leonard Cheshire Disability the practice will go on. The funding of care is, of course, a much bigger issue than simply the provision of 15 minute visits. Local authorities are being set up to fail and are in an impossible situation. It seems that no central government, of any political persuasion, will take the unpalatable decisions which would undoubtedly cost votes and, with the ratio of 3.2 people of working age to every person over 65 getting tighter and tighter every day, the current financial architecture is probably untenable anyway. So, how do we solve a problem like homecare? We have to start with the very biggest of issues and push the whole care, health and pensions questions to the very top of the political agenda, rather than tinkering with 15 minute visits. cmm september 2013 | 27
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FINANCE AND FINANCIAL SERVICES In the current financial climate, financing can be hard to come by. If you’re looking to finance or refinance your business knowing where to start is half the battle. Despite times of austerity and key lenders exiting the sector, there are still sector-specific financiers and financial services available to assist you and your business. Whether looking for funding for expansion, refinancing, financial advice or other financial services, CMM tells you who’s who. BARCLAYS
Paul Birley is Head of Corporate Banking Healthcare at Barclays, and manages a large team of Relationship Directors based across the UK and Ireland. Paul has worked for Barclays for 32 years and has been involved in the Healthcare sector for the last 15 years. Barclays is committed to supporting the healthcare industry and building relationships with the range of providers and organisations that operate within it. Sector specialist propositions covered include care providers both large and small, NHS and Third Sector. Barclays also supports the sector by facilitating networking events and industry sponsorships, and has won HealthInvestor’s Bank/Lender of the Year from 2009-2012.
PAUL BIRLEY Head of Corporate Banking Healthcare Telephone: 07775 546435 • Email: firstname.lastname@example.org • www.barclays.com
CHANDLER AND CO
John Read helped set up Chandler and Co back in 1995. After years of working in the healthcare sector he realised the importance of providing a truly independent service within the healthcare finance market. He has over 30 years of specialist experience in the healthcare sector. Over this time he has built up many close relationships with a wide range of lenders and professional contacts in the industry. He also has first-hand experience in operating care businesses; this experience has proved invaluable in being able to assist other investors.
JOHN READ Partner
He says, ‘I am proud to have created a dedicated team at Chandler and Co who provide a bespoke service to meet our clients’ requirements up to completion and beyond. The care sector has a ‘green light’ from major lenders and many competitive finance terms are now available. I am very optimistic about the remainder of 2013 and the potential for 2014.’
Telephone: 01622 817484 • Email: email@example.com • www.chandlerandco.co.uk
David Grant has been arranging intelligent financial solutions on behalf of a variety of clients for many years. He started his career in accountancy before moving to Christie Finance in 2000. He was fundamental in the development of Christie Finance as the leading business mortgage broker in Scotland. Having previously covered our Edinburgh, Newcastle and Manchester offices, David now heads up our UK mortgage operation. As a Director of Christie Finance with many years’ experience in the commercial finance markets, David’s advisory services are widely sought-after by first-time buyers and existing business operators alike, for business purchase, expansion or re-finance. In 2012, Christie Finance secured £50 million of exclusive funding for clients seeking to invest in the care home, pharmacy and children’s day nursery sectors
DAVID GRANT Director and Head of UK Business Mortgages Telephone: 0141 352 7300 • Email: firstname.lastname@example.org • www.christiefinance.com
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who’s who…finance and financial services CLYDESDALE AND YORKSHIRE BANKS
Derek Breingan has more than 25 years’ banking experience, ten of which working directly with a wide variety of healthcare businesses; care home operators, dentists, nurseries, pharmacists and general practitioners. His role as Head of Healthcare at Clydesdale and Yorkshire Banks is to support healthcare businesses to identify and execute strategic growth opportunities, while co-ordinating the Bank’s national approach to the sector. Derek is a panel member of Developing Strathclyde, a charitable organisation which provides business loans to the third sector and SMEs which may not qualify for traditional bank support. He also lectures business studies to final year dentistry students at the University of Dundee.
DEREK BREINGAN In 2012 the Bank was nominated for the first time as HealthInvestor Healthcare Lender of the Year. Head of Healthcare Telephone: 07818 454674 • Email: Derek.email@example.com • www.cbonline.co.uk • www.ybonline.co.uk
David Jones leads the dedicated Deloitte Healthcare and Life Sciences Corporate Finance practice. For over a decade, he has advised on M&A in the healthcare sector including buy-side and sell-side transactions, joint ventures and public sector partnerships. He has been at the forefront of high profile and innovative deals, including Terra Firma’s acquisition of Four Seasons Health Care and Mitie’s strategic entry into home healthcare. Most recent deals include the sale of Health Management (occupational health), Curocare (specialist care) and Medica (teleradiology). With a track record of success driven by strong industry knowledge, David’s team works closely with corporates, management teams, founder shareholders and private equity houses across a range of sub-industries including healthcare services, consumer healthcare, medical devices, biotechnology and pharmaceuticals.
DAVID JONES Partner
Deloitte’s global network of Healthcare and Life Science professionals allows the team to operate at the forefront of the industry and maintain strong relationships with corporates and financial investors on a global scale.
Telephone: 0207 007 2259 • Email: firstname.lastname@example.org • www.deloitte.com
GLOBAL BUSINESS FINANCE WWW.GLOBALBUSINESSFINANCE.COM
Mark Widdows founded Global Business Finance in 1989. He originally trained as an accountant and was later headhunted to run a financial services firm, before leaving this position to establish Global Business Finance. He and his team assist clients throughout the UK who specialise in the healthcare sector to achieve their objectives in refinancing, purchasing further businesses or developing new care homes. Mark can offer, not just a finance broker’s or accountant’s approach to the task, but also that of a care home operator. For the past 10 years, Mark has operated care homes specialising in dementia care of the elderly, which brings a wealth of additional knowledge and an insight that most brokers cannot offer their clients.
Telephone: 01242 227172 • Email: email@example.com
Senior Partner Global Business Finance only works with clients in the care sector and has completed over £1bn in loan facilities for customers to achieve their goals. They have extensive banking contacts and a reputation and ‘buying power’ that allows them to source highly-competitive funding facilities, with not just exceptional interest rates but excellent overall borrowing terms and repayment periods of 5 to 25 years and even interest only periods where the transaction justifies this facility, such as refurbishment, new build, extension or the taking over of a failing care business. Credit facilities commence at a few hundred thousand but run into multi-millions for some clients and all manner of projects are handled by the firm. Recent successful
loan placements have included a new 64-bed dementia home, a Georgian renovation, an eco-build extension, a refinance of over 200 beds to release funds for an unrelated business and the purchase of a further care home via off-shore company. However, everyday facilities have also included a new buyer seeking to purchase two care homes, a family investing in the next generation though a parental ‘gifting’ scheme as the children had no deposit funds plus a ‘deferred-payment scheme’ to help a buyer with limited funds buy a home that required immediate capital investment along with many other upgrading and extension funding transactions. Mark and his team are ready for your enquiry so please email or call them.
HAZLEWOODS - WWW.HAZLEWOODS.CO.UK
Andrew has a wealth of experience gained over 20 years of advising in the social care sector providing proactive accounting, tax, business and corporate finance advice to many care operators. Andrew is nationally-recognised for his knowledge of the sector, having qualified as a Chartered Accountant in 1989 and then specialising in Corporate Finance in the early 1990s. Andrew has a wide range of experience on mid-market transactions, which he shares with his many clients.
ANDREW BROOKES FCA CF Partner and Head of Health and Care
Telephone: 01242 246670 • Email: firstname.lastname@example.org
Hazlewoods is a long established accounting firm based in Gloucestershire, ranked 36th by size in the UK (the Corporate Finance team is ranked in the top 20). We are specialists in the healthcare sector, operating throughout the whole of the UK, and have a longestablished reputation for innovation and service.
‘Due Diligence Specialist of the Year’ at the M&A Awards in May 2012.
We have developed an enviable knowledge and understanding of healthcare over the past 25 years, which is used to help clients understand not only the financial impact of strategic decisions, but also the operational and commercial implications.
• • • • • •
For a number of years we have been the UK’s number one corporate finance advisers in the sub £50 million market. Our Corporate Finance team won the Laing and Buisson Independent Healthcare Award as ‘Corporate Finance Adviser of the Year’ in 2011 and
Our Healthcare Team advises healthcare operators covering a wide range of care throughout the UK, including the following sub-sectors: Nursing homes for the elderly. • Residential homes for the elderly. Domiciliary care. • Learning disabilities. • Supported living. Mental health. • Children’s homes. • Foster care. Children special needs schools. • Specialist needs education colleges. Eating disorders, drug & alcohol units. • Secure units. Independent hospitals. • Acquired brain injuries.
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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: email@example.com Web: www.hazlewoods.co.uk @HazlewoodsCare
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CMM SEPTEMBER 2013 ÂŚ 31
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who’s who…finance and financial services
LLOYDS TSB BANKING PLC.
Mark Ellis is Head of Social Care Banking Services for Lloyds TSB Commercial – which provides tailored banking services to care home businesses with a turnover up to £25 million. Mark joined Lloyds TSB Group in June 2007 with a brief to develop a social care proposition to operate alongside the bank’s established primary care offering. Mark has also held key positions in a number of high street and merchant banks working in both commercial and corporate banking and has extensive experience of the healthcare market, having been involved in the care sector for many years. The bank has made significant investment in building a 100-stong specialist team that understand the specific challenges firms face and can develop MARK D ELLIS ACIB Head of Social Care appropriate tailored banking solutions. The Social Care Banking Team that Mark leads is targeting further lending increases in the sector during 2013 and is focused on growing its customer base in England, Wales and Scotland. Banking Services, SME Banking Telephone: 07912 099125 • Email: firstname.lastname@example.org • www.lloydstsb.com/healthcare
SAVILLS - WWW.SAVILLS.CO.UK
David has been active in the healthcare sector for over 25 years and has arranged debt/financial solutions in the following areas: • PCT / primary healthcare investment and development. • Nursing and residential care - trading and development. • Specialist learning disability care. • Assisted living villages - development. David has worked on behalf of a number of the country’s top 10 nursing and residential home providers and also some of the most high profile operators and developers in the assisted living sector. The main focus has been providing ‘senior debt’ solutions, but the specialist team has successfully arranged additional mezzanine and equity funding. The SPF team continues to develop relationships with numerous lenders including banks, insurance companies and specialist debt funds, to ensure that an optimum financial solution is available for their many clients. The team operates on a national basis.
Director - SPF Private Clients
Telephone: 0207 409 9991 • Email: email@example.com • www.spf.co.uk
Neil Farquhar founded Savills Capital Allowances Consultancy in 1996 which has become one of the largest, leading national practices in this specialist field covering all areas of the UK. We advise a wide range of healthcare clients including care homes, specialist centres, clinics and treatment centres, and have a proven track record of establishing maximum value and greater tax savings. Our team comprises both specialist surveyors and tax advisers with significant experience together with a well-established working relationship with HMRC and the Valuation Office, based on our fully disclosed, forensic approach. Services include: • All aspects of Capital Allowances consultancy and compliance. • Due diligence and valuation on property acquisition and disposals. • Valuation on all aspects of capital expenditure projects (new build, extension, refurbishment and fit out). • Capital allowances structuring and planning. • All aspects of HMRC / Valuation Office negotiations.
National Director Head of Savills Capital Allowances Consultancy
Telephone: 0207 409 8968 • Email: Nfarquhar@savills.com • www.savills.com/capitalallowances
Dominic has been a partner at Sovereign Capital since 2008 and leads the firm’s healthcare services team. He is known as one of the most prolific dealmakers in the mid-cap market, having worked on over 40 healthcare acquisitions at Sovereign, which cover the spectrum from acquired brain injury care through to fostering services and domiciliary care.
DOMINIC DALLI Partner
Dominic’s investments include: National Fostering Agency, which more than doubled the number of foster children placements during Sovereign’s investment; acquired brain injury and spinal injuries specialist Christchurch Group, which has opened four new locations in the past
two years; specialist residential home operator Tracscare, which now comprises more than 75 homes; and domiciliary care group City & County Healthcare, which has become the fourth largest domiciliary care business in the UK since Sovereign’s investment. Recent investments include Partnerships in Children’s Services, which currently comprises fostering agencies Fosterplus and ISP, and Hillcrest Care, one of the UK’s largest providers of services for looked after and autistic children and individuals with learning disabilities.
Telephone: 0207 340 8800 • Email: firstname.lastname@example.org • www.sovereigncapital.co.uk
Next issue: Spotlight on infection control. If you would like to feature in the next Spotlight on please email email@example.com or tweet us @CMM_Magazine
32 | cmm september 2013
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Specialist dementia training DVD packages • Improve care outcomes for people with dementia. • Enhance your reputation as a provider of excellence in dementia care. • Equip staff with the skills and conﬁdence to provide compassionate, person-centred care. • Provide staff with specialist training tailored to their own work setting. For staff in a residential care setting, Tomorrow is another day covers dementia awareness and person-centred approaches. Already popular with many care providers, it is a key addition to your training library. For staff caring for people at home we have a new dementia awareness package, Supporting people with dementia at home. Two thirds of people with dementia live in the community, so this is an essential training tool for any care agency.
Alzheimer’s Society’s specialist training DVDs cost just £249 + VAT each Order your copy today, or contact us for more information T 01904 633581 E: firstname.lastname@example.org Both packages include a DVD with ﬁlm footage as well as a CD Rom with all notes and training exercises. They are designed to be delivered by you, direct to your staff, and cover the basics in dementia awareness, communication, well-being and person-centred approaches. On completion of the training learners can take a short certiﬁcated assessment which provides successful candidates with an Alzheimer’s Society certiﬁcate and badge – contact us for more details. Alzheimer’s Society also offers a range of products to assist people with dementia in their daily lives – please visit our online shop at alzheimers.org.uk to view the full range, and for details of how to place an order. Alzheimer’s Trading Ltd (registered company no: 02737333) is a wholly owned subsidiary of Alzheimer’s Society (registered charity no: 296645) to which it Gift Aids all taxable proﬁts at the end of the ﬁnancial year.
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Coming soon to your local area! North West Care Conference 17th October 2013 De Vere Venues Whites, Bolton www.mcculloughmoore.co.uk/northwestcare
Berkshire Care Conference 7th November 2013 The Hilton Hotel, Reading www.mcculloughmoore.co.uk/berkshirecare
Interested in exhibiting? Organised in partnership with the Lancashire Care Association and the Berkshire Care Association, these two events represent the perfect opportunity to get your business in front of the key care decision makers and purchasers in Berkshire and Lancashire and beneﬁt from an array of additional promotional beneﬁts with Care Management Matters Magazine.
Interested in attending? Topics covered during the day will include: Interpretation of the Care Bill • Providers’ guide to safeguarding • Rebuilding public & provider conﬁdence in the care sector • Bank ﬁnance – what’s happening in reality? • Sharing sector experiences • Plus Workshops!
All delegates entered to W will be IN including a 3 prizes dinner for tw course o month’s healt and a h clu membership b
What to expect from the events • Agendas that have been put together in partnership with providers in the region, reﬂecting their needs and ensuring the highest quality debate • The highest level decision makers from within the independent sector • Content led sessions from the best quality speakers, designed to inform delegates of ideas and opportunities to improve their business and strengthen their position in the region’s care market • Networking opportunities of the highest quality facilitated • Events worthy of your marketing budget and the time of your team
Supported and organised by Care Management Matters
For exhibitor enquiries please call Paul Leahy on 01223 206965 For delegate enquiries please call Denise Woodhatch on 01293 854401 SUA1332 NW and Berkshire Conference Coming Soon A4 Ad_FINAL.indd 1
Investing In Ordinary Lives
The Housing and Support Alliance (H&SA) has worked with the Cameron Trust and the Centre for Welfare Reform to develop Investing in Ordinary Lives, a joint initiative which explores new ways to increase investment into ordinary housing for people with learning disabilities by working with business and entrepreneurs. Alicia Wood breaks down the initiative and opportunities for providers.
What is Investing in Ordinary Lives? Launched earlier this year, the first stage of Investing in Ordinary Lives has been to understand how various forms of finance from the private and charitable sector can be used to get people with learning disabilities the housing they need. This has been written up in a series of briefings to inspire conversations and action. Now, we are working directly with landlords, investors and charitable trusts to deliver more housing for people with learning disabilities. This will involve matching people with learning disabilities who need housing (through the H&SA
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investing in ordinary lives
membership) to investors or landlords who can rent housing to them. Some of these landlords will work with the Cameron Trust, which will support them to set up the right tenancy arrangements. In some cases, the Cameron Trust will set up lease arrangements with the landlord or investor and manage the tenancy arrangements on their behalf (see case study). The Cameron Trust has negotiated with a lender to provide low interest loans to match the funding of an investor or landlord just for housing for people with learning disabilities. These loans will help keep rents as low as possible as well as attract investors into this market.
HOW IT DIFFERS As well as accessing alternative sources of finance, the big difference with this initiative, compared to other private finance initiatives, is that the housing will always be based on an individual and their needs, or a group of people who are choosing to live together. We will never start with a property and then try to fill it. The expectations of people with learning disabilities and their families are changing. People want more control over where they live and who they live with, if anyone. We now know that the right housing and the right care and support do not necessarily come as a package. Some commissioners have stopped placing people in care homes to meet their housing needs. Models of housing tied in with care are not the future for everyone. More people are opting for choice and control with bespoke approaches to personal budgets or individual service funds.
IS THERE A ROLE FOR PROVIDERS? Residential and specialist healthcare providers need to think about if and how they can respond to these changes. Now is the time to think about what people with learning disabilities and their families want and consider adapting to the changing world. There are opportunities to develop expertise in supporting people in their own homes and enabling people with learning disabilities to be full citizens. There are possibilities around working with local communities and providing bespoke care or housing solutions. So here’s a challenge for residential and specialist healthcare providers. There are some who say that there is no place
for making a profit in care and the public sector. After the scandal of Castlebeck, it is easy to understand why people take that stance. Yet there are good quality, commercial and private sector, ethical housing and/or care providers out there. Organisations are enabling people with learning disabilities to live equal lives, in ordinary housing, with good quality care and support for a reasonable cost. They make their money because they are good at what they do and people want their services. So it is possible for the private sector to deliver what people want? Can you do the same? For more information on Investing in Ordinary Lives, including free download of brieﬁng papers visit: www.housingandsupport.org.uk/ investing-in-ordinary-lives Alicia Wood is Chief Executive of the Housing and Support Alliance.
The Cameron Trust The Cameron Trust has developed a model where investors and landlords can either rent directly to people with learning disabilities with advice and support from the Trust or where the Trust leases the property and rents it out to the individual tenant/s. Through the Cameron Trust a high net-worth individual – that is, someone with more than £620,000 free cash to invest - has invested more than £2 million in property speciﬁcally for people with learning disabilities in the south west of England. The Cameron Trust manages these properties, which consist of one block of nine 1-bedroom ﬂats and one block of seven 1-bedroom and two 2-bedroom ﬂats. The approach involves a partnership with a small local support provider that delivers the support services that each tenant requires to live independently. All the tenants are eligible for housing beneﬁt to meet the cost of the rent and service charges. The investment of £2.6 million provides an annual return of 4.43 per cent as well as high quality housing for people with learning disabilities. This arrangement has been running for approximately two years and, although the yield may not be as high as some other property rental, the landlord gets a long-term, stable income because people tend not to move and they always pay their rent.
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Thursday 22nd May 2014 at the National Motorcycle Museum in Birmingham. (Coventry Road, Bickenhill, Solihull B92 0EJ) In association with
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.
Our exhibition comprises 50 local, regional and national service providers, products and services. For more information on how to become involved contact Paul Leahy on 01223 206 965 or email: email@example.com Solihull Life Opportunities (SoLO)
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AquaCert is part of the EMS group, which also carries out Air & Water Hygiene Surveys and Tank Repairs and Replacements
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Changes to employment law In conjunction with Care Show Birmingham, CMM brings you a round-up of employment law changes.
he changes to employment law this year see significant reforms to basic employment rights. These changes will require a need to understand the new processes and no doubt occupy lawyers’ and HR professionals’ time. While the worst excesses of the initial proposals may have been tempered, it is questionable as to whether the changes will improve employment relations or support business.
New employment tribunal rules Changes to employment tribunal rules include giving judges the discretion to combine pre-hearing reviews and case management discussions, revised powers for judges to strike out weak cases and a requirement that an employment tribunal must, where appropriate, encourage parties to use alternative dispute resolution. The tribunal rules make several important changes to the procedure applicable in employment tribunals. Key changes include: • A tribunal will reject a claim form if it isn’t accompanied by the fee (or a remission application). See opposite for information on new costs. • A claim will be rejected if it ‘cannot sensibly be responded to or is otherwise an abuse of process’. • Once an employer’s response has been accepted by the tribunal, the claim and response will be reviewed by an employment judge to decide what case management orders are necessary to get the case ready for a hearing. • Relaxation of the rules in relation to making an 38 | cmm september 2013
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application to extend the deadline to submit a response. • Costs awarded in excess of £20,000 may be made by the employment judge rather than being referred to the Sheriff Court (Scotland) or the County Court (England and Wales).
New employment tribunal costs New employment tribunal costs will be payable by individuals and groups making a claim against an employer. The fees have been introduced to: • Place employment tribunals on a similar footing as civil courts who have been charging fees for many years; • Transfer the significant cost of running the employment tribunals (estimated at £84 million) from the taxpayer to the people using the system; and • Encourage the parties involved to try and resolve their differences through other means (such as workplace mediation) and support early settlement. Individuals bringing a Type A claim (eg unlawful deductions, redundancy pay, notice pay) will pay £160 to submit a claim and £250 hearing fee. Individuals bringing a Type B claim (eg unfair dismissal, discrimination, whistleblowing) will pay £230 to submit a claim and £950 hearing fee. There is only one fee to pay per case, which will be the fee for the highest level claim, for example, if the claimant claims for both unfair dismissal (Type B claim) and unlawful deductions (Type A claim), they will pay the fees for one Type B claim only. Group claims will cost more: • 2 to 10 claimants – single fee multiplied by 2. • 11 to 200 claimants – single fee multiplied by 4. • 201 + claimants – single fee multiplied by 6. Her Majesty’s Courts and Tribunal Service remissions scheme will be extended to protect access to a tribunal for those who cannot afford to pay a fee. In these cases, claimants may pay reduced fees or no fees, depending on their income, savings and capital. If the claimant loses, there is no automatic rule to say they have to pay the respondent’s costs. This will be decided on a case-by-case basis, which may lead to employers paying costs even if they win the case. There will also be additional fees of £400 to submit a claim and £1,200 hearing fee for appealing to the Employment Appeal Tribunal.
Concerns around fee introduction The introduction of expensive fees to make a claim to an employment tribunal raises concerns for those on the lowest incomes seeking justice and fair treatment and costly delays to the process. Concern has prompted a judicial review as to whether the introduction
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changes to employment law
of fees will be indirectly discriminatory by having a disproportionate effect on women. While it is anticipated that costs will deter claims and the numbers may drop, the introduction of the hearing fee is likely to deter claimants agreeing an early financial settlement and, ultimately, push up the cost of tribunals. The disproportionally high cost of fees relative to the small value of many claims, perversely, may push these claims to the county court where judges don’t have the same level of expertise to hear and decide specialist employment disputes. It will certainly be interesting to see what effect these changes have on the number of claims, and the effectiveness of early resolution via processes such as ACAS conciliation and workplace mediation.
Settlement agreements Legislation to change the name of ‘compromise agreements’ to ‘settlement agreements’ also came into force on 29th July 2013. The ACAS Code of Practice sets out compromise agreements as, ‘legally binding agreements that can be used to resolve all possible employment claims that an employee could bring to a court or tribunal, usually in return for a severance payment to the individual by the employer. The use of these will be facilitated by new rules in relation to pretermination negotiations.’ The name is being changed to settlement agreements as it is, ‘a term which is felt to more accurately describe their purpose and content’. Although the introduction of new settlement agreements and protected conversation includes a replacement of the compromise agreements, it is limited in scope, only applying to unfair dismissal claims. It is important that employers understand these new provisions and the concept of ‘without prejudice’ conversations. As has previously existed, employers can always have conversations of this nature with staff as long as it does not pre-determine or compromise proper process. It is necessary for employers to appreciate the limitations of this protection and also think about what they will need to do thereafter, if the discussion doesn’t result in the employee signing a binding settlement agreement. While views may differ as to whether these changes bring new challenges to employment relations or opportunities for employers, it remains fundamental to good business to agree and follow robust employment policies that will offer fair process to staff and protect the employer from unnecessary employment disputes or expensive tribunal claims. To that end many employers work with trained, experienced trade union representatives, who provide free employment expertise, advice and representation, and as a result employers report significant improvements in retention; and reduction in sickness absence, accidents and employment tribunal claims.
evidence of ‘pre-termination negotiations’ between an employer and employee won’t be admissible as evidence in unfair dismissal proceedings only. This goes further than the ‘without prejudice’ principle as it will apply even where no formal dispute has yet arisen. The legislation applies to negotiations held with a view to terminating employment under a settlement agreement. However, there are a number of exceptions and rules which must be followed so it is advised to get proper employment law advice on this matter before proceeding.
Reduced cap for unfair dismissal An individual cap of 12 months’ pay in relation to the compensatory award for unfair dismissal has been introduced. The individual cap will apply where this amount is less than the overall cap, currently £74,200. However, there are some considerations, for employees on low salaries; this will drastically reduce the amount they can recover. Any other awards such as discrimination are not capped, giving more scope for manipulation of claims.
Whistleblowing With effect from 25th June 2013 there have been changes to the whistleblowing legislation. There is no longer a requirement for employees and workers to make disclosures ‘in good faith’ although in cases where good faith is not present the tribunal can reduce compensation. Also, disclosures are now required to be in the ‘public interest’ and, therefore, cannot be limited to complaints simply about breaches of the employee or worker’s contract alone.
Get professional advice It’s important to be aware of these recent changes to employment law and make sure that you’re fully advised by a HR professional or employment lawyer in matters of this nature. cmm With thanks to Liz Strama, Chief Executive of HR Protected, Allan Fernie, Manager - Employment Law at Wirehouse Employment Services, Clare Jacobs, RCN Employment Relations Adviser at Royal College of Nursing and Nick Jones, Partner, Employment Law Group, Lyons Davidson. For more information on the changes to employment law, and to see Liz, Clare, Allan and Nick explore these changes in more detail visit the Care Show, Birmingham’s Keynote Seminar Theatre on 12th and 13th November. www.careshow.co.uk.
Pre-termination negotiations Also coming into force on 29th July is the change that 40 | cmm september 2013
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Healthcall has a new home It’s now part of the Specsavers Group
Healthcall is now owned by Specsavers, the UK’s most trusted optician*. However, there will be no immediate change to its service – it is very much business as usual for all Healthcall customers and staff. But we believe that in the future, the combination of Healthcall’s 20 years of experience in the domiciliary eyecare sector and Specsavers’ focus on choice, value and service will be of enormous benefit to all those who are unable to visit a high street optician unaided.
For more information call 0800 198 1132
*Source Readers’ Digest Trusted Brands surveys 2002-2012 ©2013 Specsavers. All rights reserved.
12082_Announce_A4_Mag ad FINAL.indd 1
The importance of eye health in falls prevention Did you know that a third of people over 65 and up to half of those over 80 will suffer a fall this year? Or that in England more than 220,000 people over 60 will suffer a fracture as a result of a fall? Kamlesh Chauhan explores the link between eye health and falling in older people and offers advice on how you can help your residents. These numbers alone show that falling over among older people is a very serious issue and, when you consider that Age UK has estimated that treating people who have fallen costs the NHS up to £4.6 million a day, it is clear that more needs to be done to reduce significantly the number of falls. Furthermore, new research commissioned by the College of Optometrists has revealed a shocking lack of awareness about the link between vision and falls among older people. This is why the College launched Watch Your Step – a campaign to encourage older people and those caring for them to pay closer attention to their eye health and ensure that older people have regular eye examinations.
Who is most at risk?
Why we need to raise awareness of the link between vision and falls
The importance of good eye health
Worryingly, nearly half of those who took part in the College’s research said they had an older friend, parent or relative who had fallen, but fewer than three per cent of people questioned said their parents’ deteriorating eyesight was a cause for concern. These findings show that we need to raise awareness of the importance of looking after older people’s eye health to reduce the numbers of people who are left physically or mentally harmed by a fall that could have been prevented. Many people working in the care sector will have experience of helping an older person recover after a fall and will be aware of the effects that falls can have on an individual’s health, quality of life and of the tragic reality that some people never recover. While not all falls result in serious injury, they can still have a psychological impact, reducing a person’s confidence and their independence.
Those most at risk of falling include those aged over 75, particularly women, those who have fallen before and people with conditions including Parkinson’s disease, arthritis and dementia – all conditions that are more prevalent among older people. Other people at a higher risk of falling are those taking sedatives, antidepressants and people taking more than four different types of medication a day. So whilst poor vision may not be the sole cause of a fall, we know it can be a major factor and it is vital that care professionals working with older people do everything they can to reduce the risk of a fall due to poor vision.
A simple eye test can greatly reduce the risk of poor vision becoming a serious problem. People over 60 are entitled to free eye tests on the NHS and many older people are entitled to have their eyes tested in the comfort of their own home or care home. We urge care providers to ensure their residents are not only aware of this but actually have regular tests. There are a host of eye conditions that older people are more at risk of, including cataracts, glaucoma and Age-related Macular Degeneration (AMD). As is often the case, early detection is the key to ensuring appropriate treatment can start at the earliest possible stage, minimising the risk of long-term damage. The Watch Your Step campaign is being supported by Anchor Care Homes. Chief Executive, Jane Ashcroft, agrees it’s important that older people have regular check-ups, saying, ‘We are keen to lend our support to any campaign which encourages greater
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understanding about what causes falls and how to prevent them.’ We also recommend that care professionals pay close attention to their residents’ eye health so they can monitor for any obvious changes, which could increase their risk of a fall. They should also be aware of any major changes to a resident’s glasses or contact lenses – for example, a significant change in the strength of new glasses can have a disorientating effect, increasing the risk of an individual falling - so staff may want to offer more support when that person is walking. This risk can also be lessened by staff discussing with the optometrist the option of dispensing a new prescription in stages so that the patient can get used to changes more gradually. Staff should also be aware that wearing bifocals or varifocals can make it more difficult to walk up and down stairs or kerbs, so residents should be advised to wear distance spectacles for outdoors or unfamiliar places.
Practical tips As well as regular sight tests, there are a number of practical steps that care professionals can take to help reduce the risk of their residents falling. Certain eye conditions can reduce the ability to perceive depth, increasing the chances of tripping when going up stairs, so using contrasting colours or textures on stairs can help, as can making sure homes are well lit. It’s also important to make sure that all carpets are well-fitted and there aren’t any trip hazards on the floor, such as slippery rugs or stray wires. Finally, and it may seem obvious but, it’s important to ensure residents are wearing appropriate footwear when walking inside and outside.
How to find out more I hope that care providers across the country will support our campaign and encourage their residents to look after their eye health. More information about the College’s campaign, top tips for preventing falls and more details about eye conditions that are common among older people, can be found at www.lookafteryoureyes.org. cmm Kamlesh Chauhan is President of the College of Optometrists.
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Health+Care 12/13 June, London
he first Health+Care conference and exhibition was created for GPs and healthcare professionals by CloserStill Media to become a forum for debate and learning around the ongoing issues of healthcare integration and NHS reform. Incorporating commissioning, integrated care, home care and residential care, the packed conference programme, wide variety of exhibitors, learning zones and networking saw nearly 6,500 visitors attend the new show.
Ringing endorsement from the Minister The event was given a ringing endorsement from the Minister of State for Care and Support Norman Lamb MP who said it was ‘something people should go to’. Mr Lamb was one of the show’s keynote speakers and made an impassioned speech on the merits of healthcare integration. The Rt Hon Norman Lamb MP, Minister of State for Care and Support said: ‘To have this opportunity talking to so many hundreds of people is fantastic from my point of view. ‘It’s just an amazing opportunity away from the frontline to just have some thinking time, to learn what’s going on, and find out what you can do yourself to make your operation better.’
keynote speakers Other keynote speakers at Health+Care included Labour Party Shadow Health Secretary the Rt Hon Andy Burnham MP, Dementia Tsar Professor Alistair Burns and Andrea Sutcliffe, Chief Executive of the Social Care Institute for Excellence. Overall more than 300 speakers took part in the show in conference streams ranging from clinical commissioning support, technology, facilitate learning and integrated care to long-term conditions, personalisation, the dementia challenge, home care opportunities and residential care.
event partners The event was backed by leading associations including the National Association of Primary Care, the NHS Alliance, the UK Home Care Association and the English Community Care Association. CMM was proud to be media partner for the event. Ralph Collett, Director of Medical at CloserStill Media said: ‘We set out to create a unique event that brought together our already successful Commissioning Show, with the other areas of care that are so important if we are to create a truly integrated healthcare system for the future in this country. ‘I believe the team has achieved that and I am absolutely delighted with the results. In particular I was pleased with the growth in exhibitors and delegates, at what was a hugely successful two days at the Excel.’ Tom Vine, Event Director of Health+Care, said: ‘After a fantastic first year, we are already looking forward to Health+Care 2014. The debates around healthcare integration will only grow louder over the coming years, so we are delighted that Health+Care is now the forum for them to be heard. ‘We will make Health+Care 2014 even bigger with even more expert speakers and exhibitors. It will once again provide the stage for the most senior professionals from all the disciplines, backgrounds and organisations involved in both health and care in 2014 to come together to give a 360° approach to delivery.’
looking to the future Health+Care 2014 will be held over 25th and 26th June at Excel, London. 10% of this year’s delegates have already reserved their passes for next year’s event.
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E-book Now Available Online Website also contains... • Catalogue of back articles • Readers’ letters • What’s on?
WHAT S ON? Event:
Falls and Postural Instability Conference
9th September, Bristol
British Geriatric Society, Tel: 020 7608 1369
Annual Mental Health Law Conference
12th September, London
RadcliffesLeBrasseur, Tel: 020 7222 7040
25-28 September, Dusseldorf, Germany
Messe Düsseldorf, Web: www.rehacare.com
Integrating Health and Social Care: Next Steps for Delivery
JULY 2013 £4.00
CARE IN 2023 What do you see?
8th October, London
Westminster Health Forum, Tel: 01344 864796
Financial scrutiny Is CQC best placed for this?
Health hotels, why not care homes?
Spotlight on… Care sector software
Includes 4-page Skills Academy insert: Focus on Leadership in the Front line: The Front Line Leaders Programme FC June 20113.indd 1
The LCS 14th Annual Conference
15th October, London
LCS, Tel: 0207 387 6828
Making Health and Care Services Fit for an
14/06/2013 12:36 pm
PLEASE Lost your keys? No Problem!
22nd October, London
The King s Fund, Tel: 020 7307 2584
23rd October, London
Capita Conferences, Tel: 0207 202 0593
Safe and Sound - ECCA 2013 Conference and Exhibition
Just tell us the number on the lockface and we’ll post the keys to you today!
6th November, London
ECCA, Tel: 020 7492 4846
We have a loyal customer base ranging from the largest hospitals to the smallest care home, actually anywhere that has things which need to be kept locked.
Visit our website for more details and to order your keys securely online:
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The Key Replacement Service
North West Regional Care Conference
17th October, Bolton
McCullough Moore Ltd, Tel: 01293 854401
Berkshire Regional Care Conference
7th November, Reading
McCullough Moore Ltd, Tel: 01293 854401
The Future of Learning Disability Care
Tel: 020 8343 2943 Fax: 020 8343 2994 Email: firstname.lastname@example.org Colton House • Princes Avenue • Finchley • London • N3 2DB
Conference 2014 Date/Location:
25th February 2014, Manchester
CMM, Tel: 01223 207770
Please mention CMM when booking your place. CMM SEPTEMBER 2013 ¦ 45
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straight talk With the Liverpool Care Pathway rarely out of the news and now to be replaced with personalised plans, Joe Levenson explores why change is essential to ensuring better end of life care for all. JOE LEVENSON DIRECTOR OF COMMUNICATIONS NATIONAL COUNCIL FOR PALLIATIVE CARE For a few weeks last autumn barely a day went by without the Liverpool Care Pathway (LCP) making headlines with a wide range of concerns raised including, most worryingly, that patients and their family members were not always being consulted before it was used and that staﬀ in some hospitals were apparently failing to implement it properly. Concerns of this kind were also raised directly with Dying Matters as part of work we were asked to do by the National End of Life Care programme, looking into people s own family experiences of the LCP, both good and bad. This work conﬁrmed that whilst the LCP appeared to be being implemented well in parts of the country, many people either felt that it had not been explained properly to them or that it had not been used appropriately. That s why we welcomed the appointment of Baroness Neuberger to chair an independent review of the LCP. It s also why we, subsequently, welcomed the ﬁndings of the review when they were published in July, and believe that its recommendations have the potential to make a real and much needed diﬀerence to the quality of care that people receive in the last days of their life.
All those involved in end of life care must see the care of the dying and improved communication as a priority and provide ongoing training and support for staﬀ to make this a reality ‒ something the review is rightly very strong on. It s also clear that a great deal more must happen to provide the right end of life care for people, wherever they are and at whatever time of day or night they need it ‒ something which the review of the LCP raises concerns about. We also welcome the review s conclusion that there needs to be a proper national conversation about dying, something that the Dying Matters Coalition, which the National Council for Palliative Care leads, is uniquely placed to be a key part of. All of us, whether we work in health or care or not, need to be
There can be no excuse for not treating people with dignity, compassion and respect when they are dying, at the very time that they most need this.
If further evidence were needed that the current state of care for the dying needs to be dramatically overhauled - after a series of critical reports ranging from the Francis Inquiry to the National Bereavement Survey (VOICES) which came out a week before the LCP review - then the LCP independent review report undoubtedly provides it.
supported to become more comfortable talking about dying and end of life issues ‒ so that we can talk about our wishes before it s too late and help others to get theirs met.
There can be no excuse for not treating people with dignity, compassion and respect when they are dying, at the very time that they most need this. It is, therefore, essential that whatever follows the LCP must be developed in partnership with patients, carers and staﬀ to ensure better outcomes for people who are dying and their families ‒ and that patients and carers are fully involved in the work of the new Chief Inspector of Hospitals, something that Professor Sir Mike Richards has already indicated he plans to take forward.
We only have one chance to get it right for people who are dying, which is why it is so important that whatever follows from the LCP is well thought through and implemented consistently to a high standard. Five years on from the End of Life Care Strategy, NHS England now has an important opportunity to set out plans for priority actions in end of life care, including arrangements to make sure that no one is left in limbo during the transition from the LCP to personalised end of life care plans.
WHAT DO YOU THINK ABOUT LCP? DO YOU AGREE WITH JOE? PLEASE EMAIL YOUR THOUGHTS TO EDITOR@CAREMANAGEMENTMATTERS.CO.UK.
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Will you be a winner in 2013/14? Nominations are now open for Accolades 2013/14 The annual Skills for Care Accolades celebrate the very best practice in social care and reward employers and organisations for commitment to workforce development and innovation. Achieving an Accolade proves you are improving the lives of people using social care services through workforce development.
Does this sound like you or your organisation?
If you provide a high quality service and invest in developing your staff we want to hear from you. You can also nominate yourself, another organisation or employer that you think would be a worthy winner of an Accolade.
There are eight categories all applicable to the adult social care sector:
Best employer of under 250 staff Best employer of over 250 staff Best individual employer who employs their own staff Best provider of learning and development Best employer support for Apprenticeships Best employer support for the assessed and supported year in employment (ASYE) Best recruitment initiatives Most effective new approach to service delivery
To enter Accolades 2013/14 or for more information visit www.skillsforcare.org.uk/accolades. The closing date for nominations is Thursday 5 September 2013.
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