JUNE 2015 £4.00
CQC shares best practice
Managing volunteers A new toolkit
Crowdfunding in social care
Internet job boards
Friend or foe?
Includes 4-page Skills Academy insert: Focus on learning and development support – how Skills for Care is helping the adult social care sector meet the challenges ahead
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In this issue 05
Is it just me…? Robert Chamberlain considers the challenges facing the Conservative Government in respect of social care and the Care Act.
Business Clinic The panel comments on the role of crowdfunding in social care.
From the Editor
A View from the Top 33 Ann Gibbons, Executive Director of Care and Support at Metropolitan. Resource Finder CMM profiles some of the leading names in building, design, construction and interiors.
Event preview 48 CMM previews the forthcoming CMM Insight Regional Conference and Exhibition in Derbyshire and Nottinghamshire.
What’s On? 49
Straight Talk 50 Hannah Pearce summarises the future of social care under the new Conservative Government.
Celebrating ‘Outstanding’ adult social care Andrea Sutcliffe shares the CQC’s understanding of ‘Outstanding’ care and gives examples for providers to follow.
Internet job boards – friend or foe? With a rise in the use of internet job boards to find new employees, Neil Eastwood challenges recruiters to find alternative methods to diversify their applicant sources.
Managing volunteers Rhidian Hughes and Des Kelly explore a new toolkit developed to help providers manage volunteers in social care.
Capital Allowances A year after the most significant change to this tax relief, Peter Mildenhall considers the impact and why providers should ensure they claim their Capital Allowances.
CMM June 2015 3
EDITORIAL firstname.lastname@example.org Editor in Chief: Robert Chamberlain Editor: Emma Morriss News Editor: Des Kelly Assistant Editor: Emma Cooper
PRODUCTION Lead Designer: Holly Cornell Director of Creative Operations: Lisa Werthmann Assistant Production Manager: Jamie Harvey Creative Artworker: Gemma Barker
ADVERTISING email@example.com 01223 207770 Advertising Manager: Daniel Carpenter firstname.lastname@example.org Director of Sales: David Werthmann email@example.com National Sales Manager: Paul Leahy firstname.lastname@example.org
Andrea Sutcliffe Chief Inspector of Adult Social Care, Care Quality Commission
Sharon Blackburn RGN RMN Policy and Communications Director, NCF
Sian Lockwood OBE Chief Executive, Community Catalysts CIC
Colin Angel Policy and Campaigns Director, UKHCA
Rhidian Hughes Chief Executive, Voluntary Organisations Disability Group
Des Kelly Executive Director, National Care Forum
SUBSCRIPTIONS Non-care and support providers may be required to pay £50 per year. email@example.com 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 2015 ISBN: 978-1-910362-48-8 CCL REF NO: CMM 12.4
Neil Eastwood Founder, Sticky People Ltd
Ann Gibbons Executive Director of Care and Support, Metropolitan
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4 CMM June 2015
Peter Mildenhall Director, CBRE Capital Allowances
Hannah Pearce Head of Public Affairs, Age UK
From the Editor Editor, Emma Morriss highlights the benefits that CMM can bring to providers in an increasingly difficult market. As I write this, the dust is just settling after the General Election and many are asking what the Conservative Government means for social care. Although I’m not in a position to make predictions, I’m sure we can all agree that continued austerity is likely to see ongoing cuts to local authority budgets. This means more of the same – fewer people will be eligible for support and local authorities are unlikely to have the budgets available to pay market rate fees. Providers will have to continue to do more, with less – although I’m not sure how long the market can sustain this continued tightening of the belt. The NHS and social care both face huge pressures within tight budgetary constraints. There is as much need now as there has ever been for integrated services and joined-up working to care for more people with higher needs. Although I don’t have a crystal ball to see what
the next five years will bring, CMM will continue to help you support the most vulnerable in society.
GET MORE FROM CMM CMM is working hard to help you operate in the current market. Since our re-launch in January, the CMM team has been developing a number of ways to help your business move forward. Have you subscribed yet? CMM subscribers via www. caremanagementmatters.co.uk receive a host of additional benefits to the printed magazine. We send out a daily news story and weekly news round-up. Subscribers also have access to the back catalogue of CMM’s best practice articles, an opportunity to access additional content to complement the magazine and join in the debate on subjects important to them. It’s a great way to get more
out of CMM, to enhance what the magazine delivers on a monthly basis, and for care providers – subscription is free.
CMM INSIGHT REGIONAL CONFERENCES In addition to those benefits, subscribers receive exclusive discounts to our events. We are currently in the process of finalising the agendas for our CMM Insight Regional Conferences and Exhibitions. If you operate in Derbyshire, Nottinghamshire, Berkshire, Lancashire or the
bordering counties – I’d highly recommend you attend the conference closest to you. CMM has built a reputation on high-quality content and delivering that in conference format, with carefully selected speakers and exhibitors, offers you the opportunity to hear first-hand what is happening in your region. Delegates will hear how to move forward in a difficult market and also have the opportunity to network with like-minded operators. CMM is here to help you through – all you need to do is make the most of what’s on offer.
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CMM June 2015 5
Is it just me...? Editor in Chief, Robert Chamberlain, looks at the challenges facing the newly-elected Conservative Government in respect of social care and the Care Act.
Whatever your political persuasion, you now have to accept that there will be a Conservative Government for (up to) the next five years. The majority of voters felt this best for our future, but will it be the best for social care? The Tories’ manifesto was worryingly silent on this issue.
CUTS AHEAD Whereas NHS funding is protected, social care funding remains at the mercy of cost-cutting exercises. The Institute for Fiscal Studies believes that there will need to be £30bn in real-terms cuts from ‘unprotected’ departments to keep pace with the planned budget deficit reduction. Having recognised the importance of social care in reducing hospital admissions and the further part it could play in working with the NHS, I struggle with the logic of leaving its funding unprotected. Our sector is a key player in the conundrum of how to ease pressures on the NHS, yet
it remains vulnerable to further cuts. Already a sector in crisis, I fear that social care will fall on even harder times and, to me, this seems counterproductive in the grand plans of an integrated system. It can, of course, be argued that social care will benefit from the pledged £8bn of extra funding for the NHS (by 2020) through the Better Care Fund and the integration of health and social care services. But I think the sector deserves more than a maybe.
FEASIBILITY The Care Act came into being pre-election, described as the ‘biggest shake-up for 60 years’. However, there are question marks surrounding a number of aspects of its delivery, including its affordability in times of increased austerity measures. The funding reforms will not take effect until next year but will, undoubtedly, fail if inadequately funded. Also,
there is the funding required by local authorities to set up the new systems to make the reforms work in practice, for example, to track the care cap for self-funders. Another concern relates to the increased responsibilities placed on local authorities by the Act and the policing of how well they deliver on requirements. For the Act to be as effective in
2015. This, of course, is technically not a ‘new’ responsibility; it is what councils were meant to have been doing since 2004 (as stated in LAC(2004)20), but they rarely did. The implementation of this duty under the Care Act was supported by the development of a ‘toolkit’, jointly produced by the Department of Health, Association of Directors of Adult Social Services and the Local Government Association. Beyond this, 1st April came and went but nothing seems to have changed. I am, as yet, unaware of councils approaching care providers to explain the procedure for top-ups or even to communicate a delay in its implementation. Not only is the current limbo state confusing for care seekers and providers alike, it is also concerning. If a third party contests the legitimacy of top-up payments made directly to a provider during this period, will the local authority be held to account - or the provider? Where are the Care Act police? What are the consequences for councils that miss a deadline?
‘Whereas NHS funding is protected, social care funding remains at the mercy of cost-cutting exercises.’ practice as it is on paper it must be enforced. Yet already it would appear that deadlines for the implementation of aspects of the Act have passed without action. Let me give you an example: My column in April’s edition of CMM highlighted that councils had a new statutory duty to manage third party top-ups from April 1st
NOT ENCOURAGING This is not an encouraging start to the ‘big shake-up’ and is more than a little concerning if this is how the rest of the Act will roll out. For some the Act fell short of what was needed, without its effective implementation it will fall even shorter.
Do you agree with Robert? Join the debate. Twitter: @CMM_Magazine Web: www.caremanagementmatters.co.uk CMM June 2015 7
APPOINTMENTS BOURNVILLE VILLAGE TRUST Bournville Village Trust has appointed Paul Hanley to oversee its development programme including the build of a £60 million care village.
CARE QUALITY COMMISSION CQC has appointed Stuart Dean as Director of Market Oversight and Corporate Providers and Sue Howard as Deputy Chief Inspector of Adult Social Care for the Central Region.
SHEFFCARE Bella Forsdike joins Sheffcare as a research assistant on the In Life Project looking at the use of technology as an aid to people with dementia.
DANSHELL Danshell has appointed Paul Bentham as Operations Director for its Child and Adolescent Mental Health Services.
NCPC The National Council of Palliative Care (NCPC) has appointed Baroness Ilora Finlay as its new Chair of Trustees.
CASTLEOAK Castleoak has created a new leadership team to drive forward growth and market expansion. Craig Currie is promoted to Chief Executive Officer. Dafydd John has been promoted to Chief Finance Officer. Mel Knight becomes Executive Chairman and Douglas Quinn steps down as Non-Executive Chairman.
SURECARE SureCare has appointed Christine Dilly and Clare Roberts as Business Development Managers for the North and South. 8 CMM June 2015
Improvement support for care providers A free online resource has been launched, aimed at care providers, so that they can drive up standards. Care Improvement Works, developed by the Social Care Institute for Excellence and Skills for Care, with support from the Think Local Act Personal consortium, maps a range of products to the Care Quality Commission’s inspection questions and ‘Key Lines of Enquiry’.
Providers should have the confidence to use it pre/postinspection and also to challenge practice. Managers of care services for adults can now find reliable resources to support improvement through an easy-to-use online resource. Care Improvement Works gives managers, owners and care staff the confidence to challenge and change practice.
Care providers can use the online resource before and after inspection, or at any time, to identify products that support improvement in areas where they may have concerns, or to review their current practice against recognised good practice. People who use services, and carers, can also use the resource to challenge the quality of care they receive.
Outcome-based commissioning Institute of Public Care, Associate Professor John Bolton has published a progress report on outcome-based commissioning. Emerging practice in outcomebased commissioning for social care explores the lessons learnt from a variety of approaches taken by councils to ‘outcome-based
commissioning’ in adult social care (sometimes called ‘payment by results’). It considers some of the opportunities and risks that arise from taking this approach. The paper puts the emerging practice in social care in a context with other developments within
the public sector; explores current practices in social care from a small number of councils and looks at the advantages and risks in taking this approach. It suggests that this approach could deliver better outcomes for people at a lower cost if the transaction costs can be limited.
Alistair Burt appointed Care Services Minister Following on from the General Election, the Prime Minister, David Cameron has appointed Alistair Burt MP as Minister of State for Care and Support. Taking over the role from Norman Lamb MP, Mr Burt is responsible for care and support at the Department of Health. His responsibilities include: • Older people. • Dementia. • Local Government. • Adult social care. • Carers.
• End of life care. • Mental health services. • Prison services. Mr Burt entered Parliament for the first time in 1983 and is the Conservative MP for north east Bedfordshire. Jeremy Hunt MP continues as Secretary of State for Health at the Department of Health in the Cabinet reshuffle. He was appointed Secretary of State for Health in September 2012 and was elected Conservative MP
for South West Surrey in May 2005. As Secretary of State for Health Mr Hunt has overall responsibility for the work of the Department of Health. The Department of Health provides strategic leadership for public health, the NHS and social care in England, focused around five key priorities: • Compassionate care. • Transparency. • Dementia. • Technology. • Better care.
CMM June 2015 9
10 CMM June 2015
NEWS / POLL
Dementia research project The Healthcare Management Trust (HMT) has announced a new partnership with the University of Stirling, embarking on a new dementia research project that will help improve the lives of those living with the condition.
HMT St Hugh’s Hospital is dedicated to improving the lives of those living with dementia, which is why HMT has pledged £299,866 to fund a new research project. The new dementia project will develop, test and evaluate
Resources to prepare for CQC Skills for Care has developed a range of tools, resources and support that can help Registered Managers prepare and respond to Care Quality Commission (CQC)
inspections and regulations. They can help managers to demonstrate evidence around the CQC key lines of enquiry and meet the fundamental standards.
Poor homecare training A new survey reveals that staff are receiving inadequate homecare training putting elderly and disabled people at risk. The survey, conducted by UNISON, included more than 1,000 care workers employed by councils and private firms across the UK. More than two thirds (69%) said they cared for people with dementia. Despite this, more than a quarter (27%) had received no training in how to work with people with this illness. Additionally, homecare workers carry out many tasks such as: changing catheter
bags, peg feeding, stoma care and administering medication for which they receive little or no training. UNISON said that the survey suggests that homecare workers are feeling increasingly uncomfortable with a system that is sending them into the homes of people with complicated needs, with the bare minimum of training, or in some cases, no guidance at all. This lack of training is compounded by the fact that homecare workers are increasingly being forced to carry out their roles within shorter periods of time.
Shortage of care home places Healthcare Property Consultants Ltd (HPC) has published research into the national care home estate. Growth in the level of England’s elderly population over forthcoming decades is significant. Coupled with an ever-increasing awareness surrounding dementia, it might be reasonable to expect significant development of new facilities. Unfortunately, HPC’s research indicates otherwise with the number of beds in newly-registered homes all but mirroring the number simultaneously falling out of the market. Indeed several regions are showing a net bed reduction. The research (undertaken between 1st April 2011 and
30th September 2014) analyses registration data held by the Care Quality Commission. Bed numbers (in terms of closed facilities and new developments) are extremely consistent throughout the period. Net loss/gain has fluctuated, with the cumulative outcome being a marginal net bed gain. In terms of home (rather than bed) numbers, the annual number of newly-opened homes for the elderly is marginally in excess of 100 with the closure figure being approximately 200. With the capital being the notable exception, analysis of the data on a regional basis indicates a clear north/ south divide with net bed loss in the former and gain in the latter.
POLL an intervention to provide personalised physical activity for those living in dementia care homes. The project will focus on activities that can be incorporated into a person’s daily routine.
Volunteer Management toolkit The Voluntary Organisations Disability Group (VODG) and the National Care Forum (NCF) have launched a volunteer management toolkit. The development of the NCF/ VODG volunteer management toolkit has been supported by Volunteering Matters and Sue Ryder through the Department of Health’s voluntary sector strategic partner programme. The next steps for VODG and NCF are to run a series of regional workshops for care providers. For more information see the article on page 34.
What impact will the new Conservative Government have on social care? Positive Negative Don’t know You can vote via: www.caremanagementmatters.co.uk
May’s results Are you involved in working towards integration? No 56%
Source: www.caremanagementmatters.co.uk Figures correct at time of print.
Care Act information
The Department of Health and Public Health England have developed Care and Support & You to raise awareness of the Care Act Reforms introduced from April 2015. In addition campaign resources are also available to enable partner organisations to communicate the reforms simply and effectively. Resources include copy, creative, and briefing documents.
Skills for Care has launched a live National Apprenticeship Service (NAS) social care vacancies website. All the current social care Apprenticeship vacancies can be viewed on the NAS website. Clicking on a vacancy will take you through to the NAS website which will tell you more about the opportunity and how to apply.
Elizabeth Care Elizabeth Care, a revolutionary new career pathway designed to bring professionalism to those caring for older people, has announced that it is working in partnership with
The Prince’s Trust to create and implement a new pre-Apprenticeship programme to support disadvantaged young people into work within older people social care settings. CMM June 2015 11
£20m Welsh Intermediate Care Fund A new £20m-a-year Welsh Government fund will support people in their own homes and local communities, reducing pressure on hospitals, Health and Social Services Minister, Mark Drakeford has announced. The Welsh Government will invest a further £17.5m in the Intermediate Care Fund this year to continue projects which have proven to be successful in helping
older and vulnerable people remain in their own homes. The fund will support schemes which improve out-of-hospital care and helping people to return home from hospital. This helps reduce pressure on unscheduled care services and hospital admissions and adds vital new resources to care in the community. The remaining £2.5m in the Intermediate Care Fund will be
PrimeLife expansion PrimeLife has revealed plans for a 35-bed extension and addition of a new social centre to its Scunthorpe-based Phoenix Park Care Village. PrimeLife has also announced an extensive refurbishment programme and eight-bed extension at Little Acres in Nottinghamshire. PrimeLife intends to expand its ‘brand of high-quality care’ after
announcing major developments to two homes, costing almost £3 million, plus a new acquisition. The company, which runs more than 60 homes across England, has taken over the recently renamed care home, ‘The Fieldings’, in Nottinghamshire, where it has just completed an extensive overhaul of the environment, staff and processes to turn the home around.
used to identify those areas of good practice within the regional partnerships and ensure they are spread across Wales. The new funding builds on the £35m which was invested in 2014 to 15 in schemes to enhance integrated working by health and social care services. It will continue the focus on improved outcomes for older people and help address the pressures on unscheduled care.
Castleoak hands over to Cinnamon Castleoak has handed over a picturesque marina-facing care home on time and budget to specialist UK health investor, Cinnamon Care Capital. The home will be leased to Barchester Healthcare.
Danshell refocuses Danshell has revised the registration status of its Ducks Halt service in Kirby le Soken, North Essex. Following consultations Ducks Halt now offers a person-centred robust package of residential care with nursing and service users will benefit from support towards more independent lives.
Notts care home acquired Kames Target Healthcare Property Unit Trust has purchased the freehold interest of Clipstone Hall and Lodge from private investors for an undisclosed price. The Nottinghamshire-based 90-bed home is let to Orchard Care on the residue of a 35-year lease. Christie + Co represented the vendor.
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Alcohol and substance misuse in older people use screening into general health assessments to identify ‘at risk’ individuals. • The elimination of age barriers to treatment. • A joined-up approach from all sectors of primary and secondary health and social care providers in identifying and treating ‘at risk’ individuals.
New guidelines have been released by the Royal College of Psychiatrists that aim to reduce the current threat of alcohol related brain damage to older people and the rate of suicide among this age group. Alcohol-related brain damage includes alcohol-related brain injury and alcohol-related dementia. Currently, the highest prevalence of alcohol-related brain damage is found in the 50 to 60 age group. People with alcohol-related brain damage may already need support from health and social services and need this support for the rest of their lives. Recommendations in the new Royal College of Psychiatrists’ guidelines for the care of older people with alcohol and substance abuse problems include: • Incorporating substance/alcohol
Preventing problems from arising, and implementing effective local processes for dealing with them if they do, will give older people the support they need to recover from a drink or drug problem. Fewer older people will develop physical and mental illnesses related to alcohol or substance misuse and more will be cared for in community settings by a team dedicated to, and with an expert understanding of, their health and welfare needs.
Carers over 85 more than double in a decade Older people are struggling through their later years caring for a loved one in increasing numbers according to a new report. Figures show the number of carers aged 85 and over in England has risen by a staggering 128% in 10 years to over 87,000. The new analysis by charities Carers UK and Age UK also shows that over half (55%) of these over85s are caring for 50 or more hours each week. As our society ages, the number of carers aged 85 and over will continue to grow rapidly, with projections showing there will be over 200,000 carers in this age group by 2030. These older carers are making an immense contribution to the State – their care is estimated to be worth over £15bn each year. Yet, despite this rapid growth in older carers, fewer of them are
being offered support. The number of carers aged 75 and over being offered services to help them cope after an assessment of their needs has fallen by 9% since 2006/7 at the same time as demand is growing from people caring into old age. The figures are in the new report, Caring into Later Life which also found that nearly half (48%) of carers aged 85 and over who are providing 20 or more hours of care a week say that they feel anxious or depressed. Carers UK and Age UK are calling for immediate action to support the growing number of people caring in later life. The report reveals new insights into the make-up of older carers showing that 6 in 10 (59%) carers age 85 and over are men, in sharp contrast to the carer population as a whole (only 42% of all carers are men).
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CMM June 2015 13
NEWS / IN FOCUS
In focus A manifesto for residential care services WHAT’S THE STORY?
The charity, The Residential Forum, has produced a ‘manifesto’ for discussion with new Government about the priorities for the provision of residential care services for adults and older people.
WHY THE RESIDENTIAL FORUM?
The Residential Forum was established in 1994 by Dame Gillian Wagner following the publication of the Wagner Review of Residential Care and the subsequent improvement programme funded by the Department of Health Caring in Home Initiative. The charity has sought to champion the vital role of residential care services for children, adults and older people across the UK through good practice publications and policy events. In 2008, in partnership with CMM, the group published an edited book Residential Care: A Positive Future which revisited the original report and its recommendations after 20 years.
WHAT DOES THE MANIFESTO INCLUDE?
The manifesto sets seven priorities underpinned with a series of initial targets.
WHAT ARE THE PRIORITIES?
1. Residential shared living – a vital ingredient, a positive choice. 2. Respect for each resident and their relatives. 3. Real co-production for personalised care and support. 14 CMM June 2015
4. Reform the commissioning of residential services. 5. Regulate for better outcomes, quality and safeguards. 6. Resource the residential sector for a fair price and a fair wage. 7. Robust leadership at political, provider and professional levels.
…AND THE TARGETS?
Each priority is informed by a series of targets. In total they cover every aspect of residential care services, highlighting the overlapping and integrated nature of the best services and building to represent an ambitious and comprehensive agenda for change. For example they include: • A developing, diversifying and innovative residential care sector. • Training staff to work on equal terms with residents and relatives. • Residents to be active in setting the purpose, defining quality, planning delivery and monitoring complaints. • Promoting the use of a common commissioning framework. • Intervening in local markets to secure fair prices and wages. • A public campaign to counter the stigma carried by residential care. • Ministers and public figures to champion residential services. These targets will be used by The Residential Forum to review and evaluate progress once the new administration has been established and will be revisited over the next few years to determine how services develop and change.
Construction starts at £7.5m Care UK home Construction is now underway on a new £7.5m Care UK home in North Bar Place, Banbury. The purpose-built care home in Oxfordshire is expected to create up to 75 jobs when it opens in 2016. Representatives from Care UK’s construction partner, Healthcare Development Services Ltd, joined forces with the care provider
to mark the start of the home’s construction programme. The new three-storey care home, which will feature 73 en-suite bedrooms, has been sensitively designed to provide a high-quality environment for the provision of full-time residential care, specialist dementia care, nursing, and short-term respite care.
MHA refinances Derby-based Methodist Homes (MHA), a charity providing care homes and retirement living for older people and those suffering from dementia, has successfully completed a £70m refinancing exercise. The deal will enable continued focus on its mission to improve quality of life for some 16,000 older people across the UK, living
in MHA care homes or retirement apartments, or accessing care services within the community. KPMG advised the company on its refinancing, leading to MHA negotiating a 10-year nonamortising facility with Barclays. This financing has diversified MHA’s debt facilities and enables them to lock in favourable longer term rates.
Identifying pain in people with dementia New materials from the See Change - Think Pain campaign have been developed to help raise awareness about the signs of uncontrolled pain in people with dementia. Napp Pharmaceuticals and a group of experts in the fields of pain management and dementia care have launched the new training resource to help carers develop skills in identifying the signs and
symptoms of chronic pain in people who are less able to communicate due to dementia. The training material Recognising Pain in People with Dementia: A Carer’s Guide has been designed to advise carers and other healthcare professionals regarding how to recognise and assess pain in people who often have trouble communicating their discomfort.
Embrace Group sells home in Cornwall Trelana Nursing Home near Bude has been sold by Christie + Co on behalf of Embrace Group. The 50-bedroom care home has been purchased by Sharob Care, a family-run care operator, on an off-
market confidential basis. Sharob Care has two other homes in Cornwall; Eldon House in Liskeard and Caprera House in St Austell. Funding was provided by Christie Finance.
CMM June 2015 15
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Work starts in Surrey Work has started on a major building project at a Surrey retirement village. Plans for a multi-million pound retirement development were unveiled at a special ceremony. Representatives from operators Retirement Villages Group Ltd and its specialist construction partner, Castleoak were joined by residents from Elmbridge Retirement Village
in Cranleigh. The multi-million pound project includes the provision of a new clubhouse, complete with auditorium, restaurant, library, bar and doctor’s surgery. Built above, and available to purchase, will be 18 one and twobedroom apartments overlooking the village’s established leafy grounds.
Building underway for Abbeyfield Building work has started on-site at Tudeley Lane in Tonbridge, where The Abbeyfield Kent Society is developing a new care home and extra care scheme for older people. Work has commenced on the site adjacent to Woodgate residential home, where an £18.3m care home
and extra care scheme are to be built. The project will comprise two new builds, a three-storey 101-bedroom care home and an extra care scheme, which will consist of 52 one and two bedroom apartments. The first phase of the build is due for completion in 2016.
Changes to eligibility in Wales
Gloucestershire care home sold
Major changes to the way people’s needs are assessed to decide if they need a package of care and support in Wales have been unveiled by Health and Social Services Minister, Mark Drakeford. Under the changes to the eligibility criteria for social care, which have been laid before the National Assembly for Wales, the rules will be simplified so that people receive the right care, in the right place, at the right time, that’s appropriate to their circumstances and needs. The new model is designed to bring processes under one framework while recognising the different needs of children and adults. The new eligibility model will remove the current cliff-edge decisions where people receive care and support services only when their
Acting on behalf of outgoing owners, Paul and Helen Hutson, Christie + Co has sold Stinchcombe Manor Nursing Home in rural Gloucestershire. The care home has been acquired by local operator Stroud Care Services, who plan to develop the Grade II listed former Manor
needs are at or near crisis point. This will be replaced with a more individualised approach that will require local authorities to put in place an appropriate and, wherever possible, preventive response for each individual. The new arrangements will focus on local authorities working with people and their carers and families to identify strengths, capacity and capability to maximise an individual’s wellbeing and independence. This approach will ensure that people can stay in control of decisions made about their care and support. The changes are being introduced as part of the most wideranging reforms to social care law in Wales in 60 years, when the Social Services and Well-being (Wales) Act 2014 comes into force in April 2016.
Voyage opens supported living A new purpose-built supported living scheme for adults with learning disabilities and complex needs has opened in Nuneaton. Operated by Voyage Care, Savoy Gardens comprises 17 selfcontained one and two bedroom apartments. The scheme was built by health
and social care construction specialists Pacy & Wheatley Construction, properties will be allocated via Westmoreland Supported Housing Association and ,in addition to meeting a specific local housing requirement, the development is expected to create up to 50 care-related jobs.
House into their flagship facility. Stinchcombe Manor is registered to accommodate a maximum of 36 clients in 28 bedrooms, 18 of which have their own en-suite facilities. The freehold interest in Stinchcombe Manor was sold for an undisclosed sum off a guide price of £1.75m.
New £9m Chester mental health facility A £9m project to construct a new Children and Adolescent Mental Health services facility for Cheshire and Wirral Partnership NHS Foundation Trust (CWP) is underway. Work is being undertaken by Eric Wright Construction, a division of the Eric Wright Group and completion is scheduled for May 2016. The two-storey facility will be built within the grounds of the Countess of Chester Health Park on a site owned by CWP. It will provide 26 beds in two wards of 12 and 14 beds, each of which will be subdivided into two smaller areas with beds and day spaces, a central nurses’ station and a seclusion suite and a four-
bed psychiatric intensive care unit (PICU). The new unit will be a ‘Tier 4’ facility, providing in-patient and day-patient care for children and young people with severe and/or complex mental health conditions that are beyond the remit of community Children and Adolescent Mental Health services. The new facility has been designed by mental health specialists, Gilling Dod Architects. The contract has been awarded on behalf of the Trust by Villicare, Ryhurst’s joint venture with CWP. The joint venture was formed to assist the Trust with its capital investment programme, and will be managing the delivery of the project.
HPC sells former residential school The former Tregynon Hall School in Powys has been acquired by a private purchaser in a sale handled by HPC.
The property occupies a rural location in mid-Wales and had previously been run by a corporate operator providing day and
residential education for children with special educational needs. The purchaser acquired the 14-acre site including a substantial
period building, together with a modern classroom and administration blocks, sports court and a variety of outbuildings. CMM June 2015 17
Experiences of inpatients with learning disabilities Alphington self-harm; accidents; physical A new report gives a snapshot 2014 Learning Disability Census Lodge in in January 2015. The census assault; restraint and seclusion. of the experiences of people with learning disabilities who considers inpatients with learning It also reports on the length of Exeter sold disabilities, autistic spectrum stay and distance from home; are inpatients in either NHS or independent services, and provides a new insight into regional variations of care. The Learning Disability Census: Further Analysis Report is published by the Health and Social Care Information Centre and provides regional breakdowns of national information that was published as part of the
disorder and/or behaviour that challenges, giving information about their characteristics and their experiences of care in NHS and independent facilities in England on September 30th 2014. The publication includes information about the use of antipsychotic medication, and the frequency of experiences of
the number of patients with an agreed care plan; the reason for the patient being in inpatient care; and how many patients have been receiving continuous inpatient care since the Census in 2013. This information was published at a national level in January 2015, but is broken down to NHS Area Team level for the first time.
Christie + Co has sold Alphington Lodge residential home in the Alphington area of Exeter following a competitive bidding process. The Grade II listed property, which is registered for 28 residents and has been in the same family hands for over thirty years, has been acquired by Nery Holdings Ltd.
is currently undergoing significant investment and will re-open as a specialist Clinical Commissioning Group funded service, which Glen Care has identified as an area of need. The final stage of the company’s plans to re-position itself as a community-based provider will see the London Autistic Spectrum
Centre (LASC) in Anerly close and the small number of patients moved to alternative placements. The LASC was originally built as a young offender’s service and is not an appropriate environment to deliver community-based care. The area will be re-developed to help address the acute shortage of housing in London.
Glen Care to reconfigure business Glen Care is reconfiguring its business to meet the changing needs of the sector. NHS England ‘commissioning intentions’ clearly identifies that part of the strategy is to reduce the number of forensic beds across England and Glen Care is positively reacting to the needs of commissioners. A strategic decision has been
taken to move away from low secure forensic services in London to focus on existing services and developing further residential communitybased and non-secure services, into which the company will make a considerable investment. As part of this strategy, the London Treatment and Rehabilitation Centre in Croydon
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18 CMM June 2015
Care UK sells mental health services
Former care centre in Dorset sold
Care UK has confirmed that its mental health services are to be acquired by Partnerships in Care, the specialist mental health provider, on 1st June. Care UK currently operates 20 services supporting NHS commissioners to meet mental health needs. Care UK is progressing its strategic review process regarding the potential acquisition of its domiciliary care and learning disabilities services.
Following its closure in October 2013, the former Cerne Abbas Care Centre in Dorset has been sold by Christie + Co following strong interest and multiple offers. The property has been acquired by Casterbridge Manor, who plan to extensively refurbish the building and reopen as a care facility later this year. The former Cerne Abbas Care Centre was previously registered to
The anticipated refocusing of the Care UK portfolio is part of a strategic programme to enable the organisation to focus on the development of its market-leading provision of primary and secondary NHS health services and on its development of residential care services. This includes its previously announced investment programme in newly-built residential and nursing facilities, the largest such programme in the UK.
New £8m Shrewsbury care home Work has started on Shrewsbury’s new £8m care home. The 90-room residential and nursing home is being built on the site of the former TA centre, on Sundorne Road, by
Coverage Care Services. Once in full operation, before the end of 2016, the site is expected to employ around 130 people, creating new jobs in the area.
accommodate 57 clients and boasted 57 bedrooms, 52 of which had en-suite facilities. The accommodation was arranged over three floors, with two lifts and five self-contained flats on the top floor. The freehold interest in the property was sold for an undisclosed sum having been marketed at a guide price in the region of £750,000.
Construction begins in Tunbridge Wells Work has begun on the construction of a 72-bed care home which will provide residential, nursing and dementia care and create 60 jobs. Chamberlain Court is being built at a cost of £5.9m on a one
acre site on Mount Ephrain Road in Tunbridge Wells by Hallmark Care Homes. Chamberlain Court is scheduled to open its doors to its first residents at the end of April next year.
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CMM June 2015 19
With the roll out of the new inspection regime, what can providers to do ensure they are delivering ‘Good’ or ‘Outstanding’ care? How and where can providers identify improvements to take them to the next level?
Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission responds.
Anyone who is receiving health and adult social care services has a right to receive really great care. It has to be good enough for my mum, your mum or anyone’s loved one and – for the past seven months – we have been rating every adult social care service so that people can be clear about whether we think the care they receive deserves that description. Much attention is rightly focused on the occasions where people experience poor-quality care. On a daily basis, my inspection teams across the country find and report on services failing the people they are meant to support. Sometimes this is as a result of routine, unannounced inspections and sometimes the result of information shared with us by staff, relatives or other agencies. We know that’s what makes the headlines and tackling poor care to encourage services to improve, change or close is a vital role for us at the CQC. But we also know that behind the headlines of poor care, there are thousands of services that we would be happy for anyone we love and care for to use. Our new style inspection process and ratings system is helping to highlight this and I am really pleased to celebrate those services that are getting it right.
ENCOURAGING IMPROVEMENT As well as shining a spotlight on all of the great care we find, another vital role for the CQC is about being a driving force for change that improves the quality of care that people simply deserve. We do this not only by encouraging improvement where care is poor, but by identifying excellence and finding ways to share practice that we have identified as ‘Good’ or ‘Outstanding’ so that other providers can learn from the best.
IDENTIFYING EXCELLENCE Examples of some of the ‘Outstanding’ adult social care I have had the pleasure of celebrating, from our inspection work so far, includes: • Home Instead Senior Care in West Lancashire – one of the first adult social care services to be rated as ‘Outstanding’ for how it cares for and supports people with physical disabilities and mental health needs. In particular, the CQC highlighted the service’s person-centred approach, including the emotional support that it factors into care plans and its principles of kindness, respect, dignity and compassion. • St Cuthbert’s Hospice in Durham – an ‘Outstanding’ care provider that puts individuals and their personal needs at the heart of its effectiveness and was found to follow palliative care principles that promote autonomy and independence for as long as possible. Reporting in January 2015, the CQC heard comments, including, ‘The staff and volunteers are just brilliant’. • Robert Owen Communities – Domiciliary Care East Devon – an ‘Outstanding’ homecare service providing support with personal care for 30 people with learning disabilities, sensory impairments and physical disabilities. The CQC’s inspection report commends the service for its person-centred approach with residents enjoying as much independence and freedom of choice as possible and staff encouraging them to become active members of their local communities.
20 CMM June 2015
â&#x20AC;&#x2DC;Outstandingâ&#x20AC;&#x2122; adult social care
CMM June 2015 21
CELEBRATING ‘OUTSTANDING’ ADULT SOCIAL CARE
• Prince of Wales House in Ipswich – an ‘Outstanding’ care home that has been praised for the innovative and creative practice used by staff and a clear commitment by managers to continually improve. Residents, their relatives and health professionals told inspectors that care at the service was excellent and that staff were kind, caring and always went the extra mile.
WHAT UNDERPINS ‘GOOD’ AND ‘OUTSTANDING’ CARE? In our new approach to inspection, we assess the quality of care that providers are delivering on the basis of five key questions: asking whether a service is safe, effective, caring, responsive to people’s needs and well-led. We know these questions are what matter most to people. They identify shortcomings and where we can take action if providers are failing people who use their services. But importantly, our system also finds ‘Good’ and ‘Outstanding’ care that we can shout about and share. To help people who use services, their families and carers as well as providers and staff to see our inspection judgements as robust and reliable – and to help them make better choices about their care – we have also set out what ‘Outstanding’, ‘Good’, ‘Requires Improvement’ and ‘Inadequate’ care should look like. This really allows our inspection teams to get under the skin of adult social care services so that providers know what we are expecting and families know how we will consistently rate their services. A summary of the CQC’s characteristics for each rating level looks like this: ‘Outstanding’: Innovative, creative, constantly striving to improve, additional key characteristics that make the service exceptional and distinctive. ‘Good’: Consistent level of service people have a right to expect, robust arrangements in place for when things do go wrong, open and transparent. ‘Requires Improvement’: May have elements of good practice but inconsistent, potential or actual risk, inconsistent responses when things go wrong. ‘Inadequate’: Significant harm is likely to occur, shortfalls in practice, ineffective or no action taken to put things right or improve.
COMMON THEMES Based on sample inspections so far, there are three emerging themes that ‘Good’ and ‘Outstanding’ services share: 1. They provide care that is person-centred – designed around the individual and with their involvement. 2. They have a clear ‘line-of-sight’ from senior leadership to the frontline staff and services. 3. They check how well they are doing and seek ways to improve. Our annual report on the state of health care and adult social care has also shown that there is considerable variety in the quality of care provided in England. Among the best care we have found is in services that acknowledge there is always room for improvement – they are proactive about seeking feedback and learning from concerns and complaints.
IT CAN BE DONE There are many ‘Good’ services, but what is it that pushes these services across that boundary into ‘Outstanding’? I encourage you to take the time to read some of our reports to see for yourself, but here are some of my initial thoughts. • They go the extra mile – one quote from a community professional about Home Instead, ‘it is very refreshing to work with an agency who really do care and provide an excellent service above and beyond their role’. • They really focus on supporting their staff through induction, ongoing training and support and by involving them in the development of the service. Staff at Robert Owen Communities spoke with pride about the people they supported, one said, ‘It’s a privilege’ and another said, ‘I feel I make a difference’. • The care is person-centred. Paul Marriott, Chief Executive at St Cuthbert’s Hospice, said the heart of what makes the hospice ‘Outstanding’ is its ‘shared culture and values among staff’. Our CQC inspection heard people being asked whether they would like a bath that day and individual care was planned to support the ‘total wellbeing’ of each person. This included physical, psychological, social and spiritual needs. • They pay attention to the details that make all the difference to people – for example, garden furniture at the Prince of Wales is engraved in memory of previous residents and located in what was their favourite place in the garden. I could go on with many more examples, but the stand-out theme for me in all of our ‘Outstanding’ and ‘Good’ rated reports is the focus on care that embraces the individual and those around them. Some more examples from our findings so far include: • ‘People and staff had high expectations of what each person could achieve and showed determination to succeed.’ • ‘Staff, skills, hobbies and interests were matched with the interests of the people they supported.’ • ‘The management team provided strong leadership and led by example.’ • ‘Staff were encouraged to challenge and question practice and supported to change things.’ • ‘The environment had been arranged to promote people’s wellbeing. Staff worked creatively to best use the space to support people’s independence and personal identity.’
MAKING A DIFFERENCE While we may despair at the poor services that exist, the joy of seeing and hearing about ‘Good’ and ‘Outstanding’ services is that it demonstrates truly excellent care can be provided and does make a real difference to people’s lives. The message from our inspection findings so far seems to be: focus on the person, support your staff, pay attention to detail and always try to improve. Of course there’s a lot more to it than that but I hope I have given you enough of a taster to read through some of our reports and see what can be done so that people can get the best care they deserve. CMM
Andrea Sutcliffe is Chief Inspector of Adult Social Care at the Care Quality Commission. Twitter: @CrouchEndTiger7 What are your thoughts on what makes ‘Good’ and ‘Outstanding’ care? Join the debate at www.caremanagementmatters.co.uk If you would like to put your question to senior decision-makers, email email@example.com 22 CMM June 2015
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CROWDFUNDING IN SOCIAL CARE Crowdfunding is a relatively new approach to sourcing funding for projects. It has grown steadily in recent years, with a number of online sites offering people a platform to promote their projects amongst potential investors and get them off the ground. However, is it a model that could work for social care? One potentially new community care company is trying it out. According to the UK Crowdfunding Association (UKCFA), ‘Crowdfunding is a way of raising finance by asking a large number of people each for a small amount of money. Until recently, financing a business, project or venture involved asking a few people for large sums of money. Crowdfunding switches this idea around, using the internet to talk to thousands – if not millions – of potential funders. Typically, those seeking funds will set up a profile of their project on a website. They can then use social media, alongside traditional networks of friends, family and work acquaintances, to raise money.’ Initially developed in 1997, crowdfunding has grown steadily ever since. There are three ways for people to invest or receive investment. These are donation or reward crowdfunding, debt crowdfunding and equity crowdfunding.
DONATION/REWARD CROWDFUNDING People invest in projects because they believe in the cause or want to make a difference without receiving a financial return. Some projects offer rewards or gifts to investors which can be anything from a ‘thank you’ on their website, to a month’s trial of their service if successfully funded. Rewards can vary and can be intangible.
DEBT CROWDFUNDING This is also known as peer-to-peer lending and sees investors get a return on their investment with 24 CMM June 2015
interest. It is explained by UKCFA as allowing ‘for the lending of money while bypassing traditional banks’.
EQUITY CROWDFUNDING The final crowdfunding option, equity funding, as the name suggests, enables investors to purchase a stake in a company in return for their investment.
RAISING AWARENESS Crowdfunding, in theory, has potential. It could be assumed that those projects with social value are more likely to find funding in an increasingly socially aware society. However, it’s only likely to be as successful as its promotion. Just setting up a project on a website isn’t enough, it’s important to raise awareness. Social media is the most logical platform to do this, with associated Facebook, Twitter, LinkedIn and other accounts being used to raise awareness and push the project.
CROWDFUNDING IN SOCIAL CARE Given the social interest of social care, it might be felt that there would be a plethora of social care projects being funded by crowdfunding. However, they seem to be severely lacking. CMM sent out a number of requests to identify crowdfunding in social care and only one live project came to light. A community care project seeking funding in Stafford. Affexa has set up a crowdfunding site to raise start-up capital for a home care service for adults and
older people in Stafford and the surrounding areas. Under the title of Helping to transform social care locally, it is looking to raise £7,500, however it says that the crowdfunding site is only one of the methods being used to raise capital. Initially set up in March, the crowdfunding project runs until 26th May. The project aims to offer high standards of care and an opportunity to drive change in the sector. Affexa aims to change the way community care is regarded as a sector as well as offering careers in social care by working with local jobcentres and careers coaches to help people get back into employment. Investors are able to pledge from as little £1, for which they would receive a ‘thank you’. Investors of £5 or more, would receive a ‘thank you’ on social media including Facebook and Twitter. Those pledging £10 or more would be listed on the organisation’s ‘Wall of Fame’ on its website, receive a personalised thank you letter and also a mention on social media. Investors of £25 or more receive the same as those pledging £10 plus a free goody bag. As the pledges increase so do the rewards, for £50 or more investors would be invited to a community coffee morning and be entered into a prize draw to win an iPad mini as well as receiving all the other rewards mentioned so far. Finally, if anyone was to invest £100 or more in the project they would be able to try Affexa’s services for free, if they live in the local community. The trial would be limited to 10 hours and could be used as the individual wished. They would also receive a handy bag and all of the other rewards mentioned
above. CMM will be published as the project closes but at time of print it has only raised £215.
CROWDFUNDING OVERSEAS In the Netherlands, a recent, innovative social care project exceeded its crowdfunding target by 336%, raising €167,750. The aim of the project is to connect older people needing support with medical students living nearby, who will support the individuals with anything from companionship to household or social care tasks, whilst updating family and friends with a ‘digital diary’. In the US, there have been crowdfunding projects for assistive technology and community care services, with varying degrees of success. Is it time for UK-based social care to push crowdfunding as an alternative source of financing? CMM
OVER TO THE EXPERTS... Given the rise in crowdfunding and the associated websites, is there a place for it in social care? Given that social care is highly-regulated, is there a risk that the interest of parties in debt or equity crowdfunding would be limited to those organisations with a track record of quality care and compliance? Could crowdfunding help to boost the ability of social care start-ups to become a reality in what is still a tight lending landscape for smaller providers? Is social care slow on the uptake of this investment model?
DEFINITELY AN ADDITIONAL FORM OF FUNDING In theory this form of innovation in funding ought not to be any less important for the social care sector than any other form of investment through a bank, organisation or individual. As yet crowdfunding is not common in social care in the UK and, therefore, is untested as a method of funding. In that respect it is a less familiar way of generating income to fund social care initiatives. There is a tendency within the current mode of operation to seek out certain, not speculative, funding as opposed to other areas of income. Crowdfunding could be another form or source of funding for social care, especially with community and people-led initiatives. These approaches to social care add greater variety of provision. It would seem that only one live example of crowdfunding in this sector has been identified to date.
It is therefore, difficult to comment on that specific site or initiative per se. As services become more diverse and the value of community-led initiatives are recognised, then more examples of innovative funding streams, such as crowdfunding, may occur in line with the spirit of person-centred and co-produced ideas and practice. Initiatives led by the people for the people. Indeed this may enhance how social care is perceived. It is definitely an additional form of funding within the sector, I would suggest that it has great potential within the context of charities and not-for-profit organisations. In these sectors of social care it can play a part in furthering innovation to bring about a wider range of provision.
Sharon Blackburn RGN RMN Policy and Communications Director, NCF
HAS GREAT POTENTIAL FOR COMMUNITY ENTERPRISE We think that crowdfunding has great potential for community enterprise. There are a number of possible platforms including, of course, the well-established Kiva; a peer-to-peer investment with an expectation that loans are repaid and then reinvested in another project. Kiva works through microfinance institutions and its mission is to eradicate poverty by helping people to set up businesses. It encourages lenders to look for projects that connect with issues that they care about and whose story touches them in some way. Kiva’s peer lenders seem less concerned about regulation and more interested in the person and the project. This is an approach that could connect well with the social care sector. Another interesting development in peer-lending is Funding Circle. Created with a big idea to
revolutionise the outdated banking system and secure a better deal for everyone. It operates as a bank (and is the fastest growing bank in the UK). It offers businesses the opportunity to borrow directly from a wide range of investors, including more than 40,000 people, the UK Government, local councils, a university and a number of financial organisations. Currently we are exploring a number of platforms with the aim of linking our own web platform for community enterprise, Small Good Stuff, with an appropriate crowdfunding platform. The Small Good Stuff directory offers providers of very small scale services and supports a chance to tell people what they can offer. We find the stories of our community entrepreneurs inspirational and we think peer lenders will as well.
Sian Lockwood OBE Chief Executive, Community Catalysts CIC
MAY OFFER INTERESTING POSSIBILITIES Crowdfunding may offer interesting possibilities for social care projects. Homecare services generally have extremely low financial barriers to entry - little capital spend is required - the biggest costs are probably preparing for registration (including developing suitable policies and procedures), the recruitment of staff and attracting customers. However, in a UK market with over 9,800 locations already delivering regulated care, funding the set-up costs of more micro-providers may not be an attractive position for prospective investors unless the service offers something genuinely innovative, or which can be shown to be missing in the local area. In deciding whether crowdfunding could be an effective option, people should consider precisely what they can offer investors in terms of vision, knowledge and skills. Previous experience in a front-
line social care role is valuable, but running a homecare service requires a range of business skills, not least of which include being an employer, meeting regulatory requirements and managing what can be a financially fragile organisation, where workers rightly expect to be trained, supported and paid. Maintaining cash-flow is even more crucial to success than simply securing set-up costs. Adult social care services are not well-understood by the public, and what awareness exists is often coloured by media reporting of inadequate, under-resourced statefunded care. Where crowdfunding may be particularly successful in social care could be in supporting the development of co-operatives of personal assistants or developing services which are highly-differentiated from what is already widely available.
Colin Angel Policy and Campaigns Director, UKHCA
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Internet job boards
FRIEND OR FOE?
When I ask care providers about how they source their frontline care applicants, the most common answer I hear now is ‘Internet job boards’. They may run an open day every so often, offer an employee referral scheme, occasionally place a local newspaper advert or two or even have a ‘We’re hiring!’ banner outside their care setting, but internet job boards now seem to be the go-to option for most social
Neil Eastwood challenges recruiters in social care to diversify their applicant sources and reap the rewards.
> CMM June 2015 27
INTERNET JOB BOARDS – FRIEND OR FOE?
care recruiters. I think this is a mistake. There is no denying the power of the leading job boards to deliver a relentless flow of applicants to your inbox, but they, like all ‘broadcast’ recruitment advertising, have one big overriding flaw. They only attract active job seekers – people consciously looking for a new job – and a certain kind of active job seeker at that.
ACTIVE VERSUS PASSIVE JOB SEEKERS I think it is important to look more closely at who is an active job seeker and see how this fits with social care’s requirements. What makes people look for a new job? There can be benign reasons – recently moved to the area, returning to work after children, seeking promotion and so on, but I am going to propose there are also a lot of potentially negative reasons too. Are they job-hoppers? Are they unemployable? Perhaps they feel underpaid? Could they be in dispute with their current employer or recently dismissed? Certainly a qualified frontline care or support worker who can’t readily find employment in the sector raises questions for me. In my years of studying how the world’s best care organisations find new staff, I have found that the recruitment practice of these exemplar companies are weighted towards seeking out candidates using their clients, staff and local networks as well as specific referral methods. Their tentacles run much deeper into the community than most care providers. They exploit these vibrant connections to find candidates that are unlikely to respond to their posted job ads. They are prioritising passive job seekers – people not actively looking for a job. Passive job seekers are those that would make high potential frontline staff but need to be approached. They probably do not have an up-to-date CV and are blissfully unaware of your job advert. 28 CMM June 2015
WHO IS SEARCHING FOR A JOB ONLINE? Let’s return for a minute to the competitive and crowded world of online job searches, where our active job seekers can be mostly be found. According to the Department of Work and Pensions (DWP) about 12% of the working population is looking for a job at any one time; females slightly less so. By only advertising to those actively looking for a job we are excluding around 90% of our female-weighted potential candidates. Of these job seekers the DWP says the majority, about 80%, will be searching internet job boards. There is still a heavy bias towards younger job seekers on job boards, so in recently available Government data,
‘What makes people look for a new job? There can be benign reasons – recently moved to the area, returning to work after children, seeking promotion and so on, but I am going to propose there are also a lot of potentially negative reasons too.’ 85% of 16 to 34 year olds used internet job search versus 59% of the 55 to 69 age range. Where this leaves us is that an overreliance on online job posting is reaching a) a small section of potential future staff, b) a younger demographic and c) potentially the least suitable candidates. Anecdotally, I regularly hear of fake contact phone numbers on online applications used by benefits-recipients needing to demonstrate some jobhunting effort, out-of-territory and even out-of-country applicants and a high percentage of interview ‘no-shows’. The return on investment with online job board spend seems to be rarely measured but I would ask readers to gauge the success of their job board spend not by how many CVs fill their
inboxes each day but by how many of these applicants have made it to be successful and loyal employees. US research from Jobvite has found that after three years, only 14% of job board applicants will still be with your company, compared to 47% who were referred by a member of staff, for example.
A BLENDED APPROACH Despite this I am not advocating to cease job board advertising in social care, rather I propose three actions that recruiters could take to improve their candidate intake for frontline care roles: 1) Augment your ‘broadcast’ candidate attraction effort with proven
Derbyshire & Nottinghamshire Care Conference The Nottingham Belfry, 15th July 2015
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CMM June 2015 29
Are you ready for the new changes? From April 2015 social care providers are required to implement the new Care Certiﬁcate framework to ensure employees delivering care are compassionate, caring and provide quality care. Care Certiﬁcate will replace both the National Minimum Training Standards and the Common Induction Standards. CQC have also introduced new ratings and KLOE inspection guidelines to encourage care providers to improve.
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INTERNET JOB BOARDS – FRIEND OR FOE?
community-centric referral methods as described below. 2) Review and refine your online job advertisement wording to target the most suitable online job seekers. 3) Ensure you are effectively prescreening candidates as early as possible to reduce the dual burden of interview no-shows and clearly unsuitable candidates. Here, I intend to focus on the first action as by doing that there will be less need to use online job boards.
BUILDING YOUR COMMUNITY REFERRAL NETWORK One of the bad habits that the growth in Internet job boards has encouraged is what I term ‘armchair-recruiting’. Given the competing demands on a Registered Manager’s or recruiter’s time, it is enticing to click a button from the comfort of your desk and post jobs to an eager global audience of those seeking work. But we know from extensive research that there are groups living around your care setting that have a high potential in a paid caring role, if only you reach out to them. These include the retired, those who are actively practising a faith, those who have experience caring for a loved one or have a family member or friend with a disability and those who volunteer. From my studies, it seems that the quality of those recommended to you by another person or organisation usually trumps the active job seeker who responds to your advertisement directly.
THE THREE REFERRAL SOURCES YOU MUST PRIORITISE As the Jobvite statistics above indicate, your employee referral scheme can be a very powerful recruiting ally if
operated properly. This method is always most effective at the commencement of employment or even earlier, at application stage. This is when the employee or candidate is the most eager to please and when you first get access to their network. I recommend enquiring about the names of other suitable friends and contacts of every applicant as a matter of course. You can also ask their employment references for recommendations in some cases. Secondly, the huge latent goodwill that you have generated amongst clients and their families over years of compassionate and reliable care delivery is all too often left to go fallow. Simply asking this group if they know anyone who would meet the standards you seek will generate recommendations. Referrals from this source are particularly valuable as they have direct or indirect experience of care and an insight into the requirements of the role. Thirdly, do not turn your back on ‘good’ leavers. In US tests, up to 30% of this group have been found to return to work for their previous care employer within six months when approached systematically. This is because in many cases they are leaving for reasons that do not reflect a lack of loyalty or a rejection of frontline care. An example can be pressure from family members, particularly a spouse or partner, to find a job with more sociable hours. Or a mistaken belief that the social care grass is greener elsewhere. Either way you often have a leaver, who after a few weeks, regrets their decision and wants to return but is too embarrassed or coy to make contact with you, their recently ex-employer. By staying in touch with good leavers by regular text message, social media or a note posted home (or preferably all three), a surprising number will actually gladly take up your offer to return. In
many cases these are great care staff who would have otherwise been lost from our sector. One obvious group of passive job seekers that we have yet to address are the loyal and happy staff of other care providers in your area. Whilst I know enticing the best staff away from other providers is commonplace and highly appealing, ultimately it is a zero sum game. Trading social care staff between providers is not growing the workforce.
DIVERSIFYING YOUR RECRUITMENT APPROACH IS NOW CRITICAL Given the growing demand for committed and compassionate frontline staff, we simply must bring fresh sources of high potential staff into our sector. It is my strong view that the evidence points to the most suitable of these new recruits being found from the ranks of targeted, passive candidates around your care setting and less from the speeddating world of internet job boards. By consciously widening your recruitment channels you can only improve your opportunities to build a strong and loyal workforce for the future. CMM
Neil Eastwood is Founder of Sticky People Ltd. firstname.lastname@example.org Twitter: @StickyNeil How do you find new recruits? Let CMM know. Web: www.caremanagementmatters.co.uk Twitter: @CMM_Magazine CMM June 2015 31
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A VIEW FROM THE TOP
A N N
G I B B O N S
Ann Gibbons is Executive Director of Care and Support at Metropolitan.
REFLECTIONS ON THE LAST DECADE The reality of the last decade is that the demand for services has risen while public spending has fallen. The sector has seen a seemingly endless commissioning cycle of increasingly competitive tenders which have confused and unsettled service users and put support staff through the experience of TUPE again and again. Many local authorities raised their eligibility criteria, arranging support only for adults with substantial or critical needs. The Care Act 2014 has introduced a single eligibility threshold, but it remains to be seen how this will work in practice. I think this legislation is as much about culture as it is about process and rules. For example, it defines the primary responsibility of local authorities as the promotion of wellbeing centred on the needs of the individual. It also makes prevention a statutory duty which is good news – we know that prevention at any early stage is far better than letting things reach a crisis point. PROJECTIONS FOR THE NEXT DECADE One thing is for sure, there will be a huge increase in the number of people who will need some form of care and support. The Care Act clearly puts housing back into the picture which is welcome as we have long-recognised that environment plays a vital part in recovery. The legislation should improve the integration of health, social care and housing; but
its implementation will not be without challenges. Local authorities need innovative providers to help find solutions to the burdens of assessment and support provision with increasingly limited budgets. Metropolitan is an advocate of collaboration in social care. We have established partnerships with NHS trusts and local authorities, particularly in mental health, to develop supported housing as an alternative to hospital and residential care. The shared goal is to provide cost-effective care pathways which foster enablement and independent living wherever possible. Having successfully completed a twoyear turnaround plan, we have the firm foundations to further build and develop services to deliver these positive outcomes. INSIGHT I have been involved in many change initiatives during my career. Far too often consultants and interims are brought in to ‘manage’ transformation through process change and endless workshops. In my experience this simply doesn’t work. I believe change has to be led, not managed. Good leadership should be measured by the ‘followship’ of those who work with you. If people aren’t coming with you, you aren’t changing anything. INFLUENCES Before I joined social care, I worked in hospitality and financial services. Ian
Webster, a managing director at Whitbread when I worked there, inspired me simply because he was honest – sometimes really brutally honest. He talked about organisations putting their money where their mouths are – and that really stuck with me. For instance, in this sector, if we want to attract and retain bright, committed and skilled people, we have to invest in them. LESSONS I attended a Disney Institute leadership course while I worked at Whitbread. The focus on creating a customer experience that will be remembered and valued, those ‘magic’ Disney moments, was a valuable lesson for me. The way they treated their colleagues also really taught me the importance of respect, because you can’t deliver an exceptional customer experience without delivering an exceptional experience for those who deliver it. ADVICE The only limitations on your career are your beliefs about them. This is an amazing sector to work in because it’s so diverse and challenging – nobody’s barred. You don’t have to have a degree in social care to be an executive director of care and support – you just need to have demonstrated through your work and achievements that you’re capable. If you’re a creative, passionate and organised person, you can bring a lot to an organisation and the people it serves. CMM
An extended version of this interview can be found at www.caremanagementmatters.co.uk CMM June 2015 33
Rhidian Hughes and Des Kelly discuss approaches to managing volunteers in care services and a new toolkit to help providers.
34 CMM June 2015
At a time when frontline services are under extreme financial pressures, the role and value of volunteering has never been more important. Volunteers are no substitute for the right configuration of staff. Nevertheless, the estimated three million volunteers across the health and social care sectors in England are making a real difference to the lives of people using care services. In a review of volunteers across the health and social care sectors, the King’s Fund identified a number of benefits: • To people using services, support from volunteers is associated with higher levels of wellbeing and lower levels of social exclusion, including loneliness. • Volunteers themselves, especially older people, benefit from improved self-esteem, wellbeing and social engagement. • Providers benefit from services that are better interconnected, responsive to local need and engaged within their communities. When demand for care services is increasing, volunteers have an important role to play but this is not, and should never be, a substitute for the right funding and fees for providers.
KEY QUESTIONS FROM THE FRONTLINE Members of the Voluntary Organisations Disability Group and the National Care Forum were consulted as providers to identify some of the key issues and ideas for good practice in managing volunteers. Whilst the business case, as illustrated above, is clear, frontline managers raised a number of questions relating to utilising volunteers within their services: • Where and how can we find volunteers with the right skills and values? • What support do volunteers require? • How do we go about demonstrating the impact and value of volunteering within our services? We explored these questions and developed the VODG and NCF
Volunteer Management Toolkit in response. Some of the main areas of best practice are explored within this article.
RECRUITING VOLUNTEERS The single most important factor in successfully managing volunteers is the development of interesting roles that match the needs of the people using the service and those willing to offer their time. There are any number of ways to source volunteers, and many providers find that a blend of methods yields the best results. Figure 1 is a collection of top tips collated after conversations with managers. Here are just some of the approaches used: • Word of mouth. • Community groups. • Timebanks. • Students. • Employer supported volunteering. • Pro-bono professional advice. • Brokered volunteers. All these have strengths and weaknesses which are explored in more detail in the toolkit. Application packs and selection tend to follow a similar process to the paid workforce, but there are some important differences. For example, interviewing for volunteers tends to explore the fit between the organisation and volunteers rather than suitability for a particular role. Interviews that involve people using services should be kept relatively short or conducted in different parts with breaks in between.
SUPPORT AND SUPERVISION
Figure 1. Top tips for recruiting volunteers
TOP TIPS FOR RECRUITING VOLUNTEERS 1. Make sure your volunteering roles are interesting. Would you do them? Remember that for many people volunteering is an alternative to leisure, so mix up uninteresting tasks with others that make roles enjoyable.
2. Give great customer service. People expect a responsive service as the norm, so make sure you get back to potential volunteers quickly. You are more likely to attract volunteers by providing an efficient, friendly service.
3. Be open to offers. Volunteers may bring talents that you had not considered but could add value to your service. Be prepared to adapt or create a role around specific skills and make sure volunteers know you are open to offers.
4. Be flexible Some people like to suggest what they could do while others like to see clearly what is on offer, in terms of the tasks, skills required and time commitment up front.
5. Provide a wide range of ways to volunteer. Successful recruitment, and matching, of volunteers requires the widest range of different opportunities – be flexible, adaptable and consider how best to use all skills.
6. Can you accommodate teams or group opportunities? If you have tasks that are suitable for a team, make sure you promote these as they can be difficult to find. Offering the opportunity to volunteer as a family, a couple or a group of friends can also attract people and this type of volunteering can be a great way of preventing loneliness and isolation.
7. Highlight the difference volunteers make. People are more likely to be motivated if they see the difference they could make through volunteering. Be clear on what impact volunteering will have to people lives and the local community.
8. Promote the positive impact volunteering can have on volunteers. Promote the benefits of volunteering, such as making friends, learning new skills and gaining experience. What can volunteers expect from you? If you offer training or other opportunities, make sure you promote these too.
Everyone needs support to give their best and a lack of this can be a significant barrier to volunteering. Some people may need to be supported, especially at the beginning of the volunteer arrangement. Assistance from other volunteers can help. An important part of volunteer management is regular
9. Allow volunteers to try before they commit. Offer taster sessions to appeal to people who may be unsure about what’s involved.
10. Engage volunteers in recruitment. A lead member of paid staff will help to ensure that someone in your service is championing volunteer recruitment. In addition you might ask volunteers to help by writing recruitment messages and promoting volunteering at recruitment presentations. CMM June 2015 35
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supervision – at least once a month is good practice. Feedback helps people to develop and fulfil their roles as volunteers. They need to understand what is working well and what could be improved.
PEOPLE WHO USE SERVICES AS VOLUNTEERS Many people who use care services are uniquely placed to undertake certain volunteer roles. Opening up volunteer opportunities to these groups taps into a level of insight which can only be gained through lived experience. Volunteering offers people a valued role and can lead to the development of friendships as well as experience, skills and confidence. Opportunities include: • Befriending – connecting with communities through support and one-to-one relationships. • Providing additional support – such
as leisure activities or gardening. • Peer support – empowering people to use their own experiences to help others. People who use services should be able to expect the same high standard of services whether it is delivered by staff or volunteers. Whilst, as figure 2 illustrates, many common concerns can be mitigated, providers are responsible for ensuring that their services are safe, effective, caring, responsive and well-led.
MEASURING THE VALUE AND IMPACT OF VOLUNTEERING Providers tend to embark on using volunteers because they want to make a positive difference to the people they support. For some their goal will have been achieved through the effective delivery of volunteers
in their services. The challenge for providers in the difficult operating climate is to go the extra mile and also measure the value and impact that volunteering makes. Although a challenge, doing so helps to: • Demonstrate what has changed as a result of volunteers. • Understand what has worked well and areas for improvement. • Provide feedback to volunteers. • Provide evidence to inform future business and workforce strategy, as well as funders, on the benefits of using volunteers. What to measure, when to measure and how to measure are just some of the considerations discussed further in the toolkit. It also includes different approaches and tools available to support providers to gather and use evidence in the right way to demonstrate impact. Volunteers can bring a wealth
of skills, experience and support to a care setting. With the right recruitment, management and support they can have a real impact on care services. CMM Volunteer Management Toolkit The VODG and NCF Volunteer Management Toolkit brings together a wide range of resources and is free to download from www.vodg.org.uk or www.nationalcareforum.org.uk. The development of the toolkit was also supported by Volunteering Matters and Sue Ryder through the Department of Health’s voluntary sector strategic partner programme. In the coming months there will be a series of regional workshops for third sector providers to come together and discuss managing volunteers in care services.
Figure 2. Managing quality and risk
Will quality be consistently high?
• Match volunteers with suitable roles. • Put in additional support for the volunteer according to their needs. • Ensure the volunteer and their supporter (if they have one) have a manager to refer to. • Provide regular supervision. • Review the arrangement regularly. • Have adequate monitoring systems in place for all care and support delivery.
Will there be increased risk to people who use services?
• Only ask volunteers to undertake tasks that are within their capability. • Risk assess the task, if appropriate, and put additional controls in place. • As part of the induction process talk to the volunteer about how to respond if they encounter a problem or have a concern. • Provide volunteers with relevant training.
Will the boundaries of relationships between volunteers and people using the service be clear?
• Ensure this is covered in the volunteer induction. • Where a volunteer is matched with an individual, talk to the service user and volunteer about the boundaries of the relationship. • If the arrangement is for a fixed period of time, make this clear from the start and include information about dealing with endings.
Will people who use services have the confidence that volunteers are competent in their roles?
• Start by introducing volunteering for activities that are not crucial to the user’s wellbeing. • Only match individual users and volunteers when both people are happy with the arrangement. • Broker a trial period with both people. • Provide opportunities for both to feed back. • Review the match on a regular basis.
Will there be an increased risk of breaches of confidentiality?
• Ensure confidentiality is covered in the volunteer induction. • If people raise this as a concern, check out why they feel this way; people living in vulnerable circumstances can maintain confidentiality as well as anyone else. • In the event of a breach of confidentiality, address this in exactly the same way as you would with any other volunteer.
Rhidian Hughes is Chief Executive of the Voluntary Organisations Disability Group. email@example.com Twitter: @RhidianHughes Des Kelly is Executive Director of the National Care Forum. des.kelly@national careforum.org.uk Twitter: @DesKellyOBE To read the Volunteer Management Toolkit and the King’s Fund report Volunteering in health and care: Securing a sustainable future visit www.caremanagementmatters.co.uk CMM June 2015 37
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RESOURCE FINDER: BUILDING, DESIGN, CONSTRUCTION AND INTERIORS
Building Construction Partnership
Axess 4 All Tel: 0116 274 4040 Email: email@example.com Website: www.axess4all.com
SECTORS • Care homes; • Nursing homes; • Dementia care; • Specialist care; • Care villages; • Healthcare; • Education; • Offices; • Commercial.
SERVICES • Mobility access solutions; • Platform lifts; • Stair lifts; • Step lifts; • Lift training.
COMPANY INFORMATION Axess 4 All is recognised today, not only as the UK’s leading supplier of platform lifts, but also as an authority in the field of access for people with impaired mobility. We provide a range of mobility access solutions to suit your specific needs. We believe you will find we offer an exceptional level of customer service and a refreshingly pragmatic approach to finding aesthetic and costeffective access solutions. As part of the Cibes Lift Group, the largest platform lift company in Europe, Axess 4 All also has considerable resources in service and development. With 10 years’ experience of
40 CMM June 2015
specialising in access platform lifts for people with impaired mobility, Axess 4 All offers a market leading range of options from short rise lifts to units that travel up to 13 metres. Our extensive experience and comprehensive knowledge of legal and regulatory issues and the most cost-efficient access solutions, that take into account the needs of all concerned, architects, developers, owners and, most importantly of course, the users. Axess 4 All’s head office is based in Leicester and includes our new showroom with a fully working A5000 demonstration unit, complete with a unique glazed machine side wall displaying the working mechanism of the lift. Any visitors are welcome to come to our showroom and view the lift and discuss the options available. Also, we now have our own purpose-built warehouse and storage facility, giving us full control of the supply process. All our platform lifts come with a 12 month warranty and a 24-hour customer care line. At Axess 4 All we understand that not every installation is the same and our installation engineers are trained to not only install products to the high standard expected from Axess 4 All but to understand and co-operate with the client to ensure the installation goes ahead with minimum disruption and inconvenience.
Tel: 0800 019 9750 Email: firstname.lastname@example.org Website: www.building-construction-partnership.co.uk
SECTORS • Nursing homes; • Specialist care; • Mental health; • Residential homes; • Dementia care; • Care villages.
SERVICES • Land sourcing; • Care home design and construction; • Care home refurbishment.
COMPANY INFORMATION Established in 2001, Building Construction Partnership Ltd (BCP) is a West Yorkshire-based care home construction specialist. Specialising in nursing and residential care homes, BCP prides itself on having the knowledge to interpret what the client is looking for and the expertise to provide the solutions to their individual needs. BCP has a large and dynamic portfolio of completed projects across the UK. Working in partnership from the drawing board through to handing over the keys, clients of BCP enjoy total customer satisfaction, with completion to the agreed quotation and deadline. Ranging from specialist bariatric to dementia, clients can relax
in the confidence that whatever their request, BCP will have dealt with parallel issues previously and successfully. Managing Director, Brian Bullock is a Chartered Builder who has been in a management role within the building industry for 30 years and over 20 of those exclusively specialising in nursing homes and the healthcare industry, instrumental in developing designs seen in many of our modern homes. One of the strengths Brian brings to BCP is his use of those years of experience to work with clients’ specific needs to advise, design and build homes that meet all the requirements of a modern home, fit for the future but within the budget constraints necessary to bring a project to fruition. Lee Brough, also a Chartered Builder, holds the role of Commercial Director at BCP. Lee has had senior management positions within the construction industry for the last 20 years and joined BCP as a specialist Healthcare and Nursing Home contractor in 2002. As a major part of the BCP team, Lee has been involved in the development and construction of over 40 newbuild care home projects and is responsible for the financial control of the company and its developments.
RESOURCE FINDER: BUILDING, DESIGN, CONSTRUCTION AND INTERIORS
Access 21 Interiors
Castleoak Tel: 029 2054 8800 Email: email@example.com Website: www.castleoak.co.uk
Tel: 0208 399 3091 Email: firstname.lastname@example.org Website: www.access21interiors.com
SECTORS • Residential; • Nursing; • Mental health; • Learning disabilities; • Dementia design.
SECTORS • Project management and fit out; • Furniture; • Curtains and blinds; • Carpet and other flooring; • Lighting; • Artwork; • Towels and bedding; • Tableware; • Commercial laundry and kitchen.
• Interior design and procurement services;
• Care homes; • Assisted living; • Retirement living; • Care villages; • Specialist care.
SERVICES • Development; • Funding; • Design; • Construction.
Bright Bay Design Tel: 01525 221395 Email: email@example.com Website: www.brightbaydesign.co.uk
SECTORS • Residential homes; • Nursing homes; • Specialist dementia homes; • Care villages; • Assisted living; • Retirement homes.
SERVICES • Interior design; • Brief development; • Space planning; • Concept design;
• Visualisations; • Furniture and fittings specification; • Bespoke furniture design and detailing; • Soft furnishings design and specification; • AutoCAD working drawings; • Bespoke joinery design and detailing; • Lighting scheme design and layouts; • Project planning, management and programming; • Procurement.
Castleoak has specialised in care accommodation and retirement housing since 1996, delivering 200 care homes and 3,000 apartments across the UK. The £60 million turnover group is the leading name in the development, design and construction of quality care homes, assisted living and extra care apartments, retirement living, care villages and specialist care. Castleoak provides a flexible and bespoke design and construction service for small and large operators as well as specialist developers and funders across the UK. It leads the
care sector in modern, sustainable methods of construction, including the adoption of standards including BRE Environmental Assessment Method (BREEAM) and Passivhaus. Castleoak’s comprehensive and multi-award winning property development solution encompasses land sourcing and acquisition, demographics and project feasibility analysis, securing planning permission together with tailored funding solutions. Castleoak develops long-term partnerships and many customers have chosen to work with the business for over 10 years. Today, 84% of projects are from returning customers. Castleoak’s customers include Barchester Healthcare, Care UK, Anchor, Methodist Homes, Fortis Living, The Abbeyfield Society, Lexicon Healthcare, Cinnamon Care Capital and many more. Castleoak is committed to improving the image of the care sector and enjoys strong working relationships with key sector bodies, including the National Care Forum, Care England, Housing LIN and ARCO. In 2014, Castleoak was named HealthInvestor’s Property Developer of the Year for the second time.
CMM June 2015 41
RESOURCE FINDER: BUILDING, DESIGN, CONSTRUCTION AND INTERIORS
Tel: 0333 014 3132 Email: firstname.lastname@example.org Website: www.danfloor.co.uk
Tel: 01789 298006 Email: email@example.com Website: www.dobson-grey.co.uk
SECTORS • Healthcare; • Care homes; • Supported living; • Specialist care; • Hospitals; • Mental health; • Commercial; • Leisure; • Education.
SERVICES • Specialist manufacturer and supplier of commercial carpets.
COMPANY INFORMATION Danfloor UK Ltd is a specialist manufacturer of broadloom carpets, producing ranges that are suitable for demanding environments such as the healthcare sector. Danfloor’s manufacturing history is underpinned by continued research and development. This enables us to deliver carpets that not only achieve the highest standards in performance, but more importantly for you, the customer, includes advancement in yarn and manufacturing technologies, resulting in a superior flooring finish. Carpets are manufactured in our Danish tufting plant then backed in one of Europe’s most technically advanced backing facilities before being shipped into our UK distribution and warehousing facility. Our area representatives
42 CMM June 2015
cover the whole of the UK and are supported by our sales and logistical support team who are based in the UK distribution centre in Bristol. We call ourselves innovative as our carpet ranges include impervious backed carpets, antimicrobial carpets and carpets which are resistant to soiling and stains. As a result, the readers of the Contract Flooring Journal have acknowledged the quality, choice and performance of our products by honouring us with the best broadloom carpet provider award for six consecutive years. In addition, our Green Guide Ratings reflect how carefully we monitor the environmental impact of our business and our products. BREEAM (BRE Environmental Assessment Method) is Europe’s foremost environmental assessment method and rating system for buildings. It sets the standard for best practice in sustainable design and has become the ultimate measure used to describe a building’s environmental performance. Our Equinox Collection comes with full BRE certification offering Green Guide Ratings ranging from A to A+. BRE ensures we meet and continue to meet appropriate standards through a combination of regular company audits and a schedule of ongoing tests, whilst providing independent verification for the work undertaken to enhance the environmental credentials of our products.
SECTORS • Local authorities; • Social care; • Healthcare; • Housing; • Independent schools.
SERVICES • CDM 2015 compliance assistance for clients; • Health and safety inspections and surveys;
• Sub-contractor audits and safety support; • Health and safety training; • Institute of Occupational Safety and Health Managing Safely;
Pozzoni Architecture Ltd Tel: 0161 928 7848 Email: firstname.lastname@example.org Website: www.pozzoni.co.uk
• Residential, nursing and dementia care homes; • Close care; • Extra care; • Assisted living; • Independent living; • Retirement housing, retirement villages and care villages; • Learning and physical disabilities; • Autism; • Supported housing; • New build and refurbishment; • Not-for-profit and private sectors;
• Full architectural design and construction services; • Feasibility and concept design; • Planning applications and advice; • Building regulation applications and advice; • Detail design and construction services; • Client design adviser; • Design audits and appraisals; • Post-occupancy evaluations.
RESOURCE FINDER: BUILDING, DESIGN, CONSTRUCTION AND INTERIORS
LNT Care Home Developments Tel: 0113 385 3866 Email: Emily.email@example.com Website: www.lntcarehomedevelopments.co.uk www.turnkeyplus.co.uk
SECTORS • Care homes; • Close care apartments; • Assisted living; • Special projects by arrangement.
SERVICES • Complete ‘Turn of Key’ development; • Business support for ‘Turn of Key’ schemes covering: > Recruitment; > Marketing; > Commissioning – ‘Turn of Key Plus’; • Funding; • Design and Build.
COMPANY INFORMATION LNT Group is the single largest developer of purpose-built care homes in the UK. LNT Group has specialised in the development, operation and turn-key sale of purpose-built care homes since 1995. The Group has built over 60 care homes since mid-2009, commissioning homes for its own operating company, Ideal Care Homes as well as ‘Turn of Key’ schemes for Anchor, Avery Healthcare, Sanctuary, MHA, Priory Group and a host of private
operators and not-for-profit companies. LNT Group’s schemes are recognised and accepted widely by lenders, and sale and leaseback providers. LNT Group’s unique combination of wholly-owned construction business, LNT Construction – including in-house mechanical and electrical divisions, and care home business, and Ideal Care Homes means that the company can deliver ‘Turn of Key’ and business support based on direct operational experience. This ensures a deep understanding of care delivery, service standards and cost management resulting in the smooth delivery of new homes to the customer. Project management and simple price structure ensures completion on schedule and certainty for the buyer with no cost over-runs. LNT Care Home Developments is the front-end business that specialises in the acquisition of land and ‘Turn of Key’ sales and investment sales. Following Group funding with Legal & General and development funding with Omni Capital, the Group – LNT Care Home Developments – is seeking to acquire 40 new sites over the next two years.
Red Room Interiors Tel: 08445 048 047 Email: firstname.lastname@example.org Website: www.redroominteriors.co.uk
SECTORS • Care homes; • Nursing homes; • Dementia care; • Specialist care; • Mental health; • Independent living.
SERVICES • Contract furniture; • Contract lighting and accessories; • Re-upholstery; • Carpets; • Curtains and blinds; • Interior design; • Space planning; • CAD drawings; • Finance packages.
COMPANY INFORMATION Red Room Interiors offers a service which is bespoke to our clients’ requirements. Whether you are investing in a full refurbishment
Red Room I n t e r i o r s
or wanting to replace items of furniture, carpets and curtains we can help. Whether you are looking to keep a traditional feel or are wishing to create contemporary surroundings with our diverse product range and huge choice of fabrics we can cater for all. We offer a personalised service adapting ourselves to each and every project individually. Giving the care and attention that we know our clients expect and deserve, we lead the way from concept to completion. We at Red Room Interiors pride ourselves on getting things right first time, every time. With our experienced team we can undertake any building work required with the minimum disruption to your venue. We have a strong understanding of the obstacles that may arise with refurbishments. We can also offer our clients a tailor-made finance package.
CMM June 2015 43
WHAT ARE CAPITAL ALLOWANCES? Capital Allowances are the main form of tax relief on UK real estate. They are used to reduce taxable profits in the UK. The more Capital Allowances that are identified, the less tax is payable to HM Revenue and Customs due to the tax relief that Capital Allowances bring. In light of so many intricate structured tax planning schemes (such as those adopted by many multi-national companies currently in the news), it is worth noting that claiming Capital Allowances is not in any way ‘tax avoidance’; it is however, an area of relief that is often forgotten about when buying, refurbishing or selling property in the UK. There are many forms of Capital Allowances, but for the purposes of this article, we will be considering ‘plant and machinery allowances’ (PMAs) only. PMAs, whilst not defined in legislation, are broadly ‘apparatus with which an entity carries on its trade’. Obvious examples of PMAs in the healthcare and the social care sectors might include beds, nurse call points and security installations. Less obvious examples include numerous electrical, air conditioning, sanitary and recreational installations. Such qualifying business expenditure is treated differently from immediate ‘tax write offs’ that are normally available, for items such as rent, salaries and repairs. The Capital Allowances Act sought to recognise and grant relief for this disparity on equally business-related expenditure. The relief however, was granted over longer periods of time (rather than instantly in the year it was incurred).
LEGISLATIVE CHANGES April 2014 saw the most recent and significant change to Capital Allowances legislation. To put the
44 CMM June 2015
changes into context this hypothetical case study will help. Company (A) acquired a nursing home 30 years ago for £100,000. At the time of acquisition, there were qualifying Capital Allowances of 20%. Therefore, over time £20,000 of tax relief was available to A. A then sold the property 10 years later to B for £500,000. Assuming no capital expenditure had been incurred in the interim, company B might have expected to also make a claim for 20% of £500,000. In this way, £100,000 of tax relief would have been available to B on the same assets used within the course of its trade as well as when A was running the home. This ‘double relief’ situation was clearly a loss in revenue to the Exchequer and was not the intention of the legislation at the time. For this reason, various amendments to legislation were introduced over time, most notably to the Finance Act in 1996. These were introduced to restrict Capital Allowances to the original cost of the asset (in this example, £20,000 as established by A). However, the most recent change in April 2014 has had the biggest impact on rules around Capital Allowances. The change in the law required most vendors, when selling a property, to ‘pool’ their qualifying Capital Allowances - that is, to quantify and enter it into their tax records. They would then agree the appropriate figure to pass onto the purchaser in an irrevocable document called an Election. This document is appended to the tax
Capital Allowances In April 2014, significant changes to the Capital Allowances legislation were introduced. With over a year to bed-in, Peter Mildenhall considers the impact these changes have had. CMM June 2015 45
New categories for 2015 • Beyond Governance • End of Life • Technology • Making a Diﬀerence
Nominations opening soon Follow us on Twitter @3rdsectorcare to keep up to date with developments.
For more information on sponsoring or attending our event please contact: David Werthmann T: 01223 207770 E: email@example.com The London Marriott Hotel - Grosvenor Square, Grosvenor Square, London W1K 6JP Wednesday 9th December 2015 • 11.00 - 16.30 Organised by:
www.3rdsectorcareawards.co.uk 46 CMM June 2015
return of both parties. Most importantly, failure to do both elements of this process would result in Capital Allowances being denied to the purchaser and every future owner of the property thereafter. The intention was to establish a link between buyer and seller, and to restrict the relief to the original cost of the Capital Allowances over the life of the assets concerned. Its, perhaps unintended, consequence in practice was to increase the burden of due diligence when buying and selling properties, particularly when one or more of the parties involved has not sought, or known to seek specialist tax advice.
As a result, additional expenditure previously missed by the vendor was identified in excess of £500,000. This was added to the vendor’s ‘pool’, enabling them to make the appropriate claim going forward. It is important to note that failure to act at this stage would have resulted in a complete loss of the £500,000 of tax relief forever. In many cases, it takes a qualified tax consultant to have the expertise to know what sorts of assets would qualify within the boundaries of the legislation. Chartered quantity surveyors would then be qualified to estimate the cost of these assets when the original cost information is not available.
WHY CLAIM CAPITAL ALLOWANCES?
IMPACT OVER THE LAST YEAR
It has never been more important to consider what relief may be available when buying a property. It’s imperative to track and record qualifying expenditure (‘pooling’) during the period of ownership and to enter into the appropriate Election when selling, to ensure the relief is fully utilised. Considering that over 40% of the purchase price of care home typically qualifies for Capital Allowances, it is a lot of money that could be thrown away. Many organisations in the care sector are not claiming the level of Capital Allowances that they could be. This is most often because the legal documentation is not substantiated during the purchase process, and because items qualifying for potential relief do not get identified during the subsequent period of ownership. This is not surprising given the skill sets required to identify and track this expenditure accurately. Our team recently reviewed the potential acquisition of a nursing home in North West London for an operator. An initial review of the legal documentation revealed a suspiciously low claim for Capital Allowances had been made, especially for a building that was almost new. A site investigation revealed the Capital Allowances identified had only allowed for the chattels in the property (ie the loose items of plant and equipment); no account had been made for the items fixed to the property. This is quite commonplace, as a vendor’s accountant or lawyer will simply not have (nor be expected to have) the knowledge necessary to break down a property into its constituent qualifying components. This task is made even more difficult if the property has changed hands many times over the years and documentation is lost.
The legislative changes have necessitated a clear need to identify and document capital expenditure through the lifecycle of a property. The default situation has shifted from ‘it can wait’ to ‘zero allowances’ almost overnight. As public funding for care homes tightens and profit margins are squeezed, it has never been more important to ensure this process is carried out thoroughly. As mentioned above, a care home being sold for £5m might have £2m of Capital Allowances available on it. The inability of a vendor (or purchaser) to identify and carry out the correct due diligence can result in the loss of these Capital Allowances forever. When considering £2m of Capital Allowances can be worth £900,000 in cash, over time, to higher rate tax payers, this can result in a significant drop in the potential re-sale value of a care home. Even if you think there is no relief available, it is worth engaging a specialist to assess the potential relief, as failure to act will default to ‘zero allowances’ in future.
POINT TO NOTE Although these legislative changes have been significant, the legislation and supporting case law will continue to evolve. Only recently, the First Tier Tax Tribunal heard the case of Bowerswood House Retirement home in Preston, which sought to make a claim for tax relief on a conservatory and a swimming pool for Capital Allowances purposes. Whilst the details of this case are outside the scope of this article, the fact that a care provider is having a case heard at the First Tier Tax Tribunal reinforces the need to seek professional advice in the assessment and methodology adopted in quantifying the tax relief potentially available in this sector. CMM
Peter Mildenhall is Director at CBRE Capital Allowances. Peter.Mildenhall@cbre.com Have you claimed Capital Allowances? Let CMM know. Web: www.caremanagementmatters.co.uk Twitter: @CMM_Magazine CMM June 2015 47
DERBYSHIRE AND NOTTINGHAMSHIRE CARE CONFERENCE 2015
CONFERENCES • EXHIBITIONS Derbyshire & Nottinghamshire Care Conference 15 July 2015
15th July, The Nottingham Belfry In a changing social care landscape, the sector is facing pressure from all sides. It is with this in mind that CMM Insight is returning in 2015 with its Derbyshire and Nottinghamshire Care Conference. Bringing the quality of a national conference to a local stage the event focuses on the issues that matter to providers in the region. Current pressures facing those delivering care and support include phase one of the Care Act with phase two on the horizon, changes to CQC inspection and regulation, integration of health and social care. Added to this are tightening local authority fees, increasing running costs and ongoing staffing issues. Being able to manage all of this whilst operating a successful business and supporting vulnerable people can be a delicate balance.
The Derbyshire and Nottinghamshire Care Conference aims to address all these points and more. Delving into the specific needs of the local care market, the agenda has been developed in conjunction with Derbyshire Care Homes Association and Nottinghamshire Care Association. Presentations will be delivered by leading sector representatives and offer expert insight into the local landscape. They will explore policy, regulation, the market, training and much more, whilst keeping a focus on the future of care and commissioning. Delegates will have an opportunity to network with like-minded providers and learn more about delivering best practice in a changing social care environment, whilst being able to attend an exhibition of carefully selected
services and products. Practical workshops also offer attendees a chance to delve into a subject further. Run in association with Derbyshire Care Homes Association and Nottinghamshire Care Association, delegates can be assured that the event will hit the mark in helping them to navigate the current social care landscape. For more information on the agenda, speakers and how to book or sponsor, visit www.caremanagementmatters.co.uk
100% of delegates at last year’s conference said they would attend again. Don’t miss out on your chance to stay ahead of the changes.
CMM subscribers receive a 10% discount from the price of their ticket In association with
48 CMM June 2015
WHAT’S ON? Event: All Together Now! Breaking the Boundaries of Care Date/Location: 29th May, London Contact: Care England and Royal College of Nursing, Tel: 0207 492 4840 Event:
Delivering the Care Certificate in Health and Social Care Date/Location: 24th June, Manchester Contact: Capita Conferences, Tel: 0870 400 1020 Event: Health+Care 2015 Date/Location: 24th/25th June, London Contact: CloserStill Media, Tel: 0207 348 5261 Event:
Enhanced Health in Care Homes: Implementing New Models of Care Date/Location: 2nd July, London Contact: The King’s Fund, Tel: 0207 307 2596 Event: CQC Inspections in Adult Social Care Date/Location: 7th July, London Contact: Healthcare Conferences UK, Tel: 01932 429933 Event: Commissioning for Health and Care Transformation Date/Location: 10th July, London Contact: Capita Conferences, Tel: 0870 400 1020
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What’s New? A year of change? Care England 2015 conference and exhibition Date/Location: 12th November, London Care England, Tel: 0207 492 4840 Contact:
CMM EVENTS Event: Date/Location: Contact:
Derbyshire and Nottinghamshire Regional Care Conference 2015 15th July, Nottingham Care Choices, Tel: 01223 207770
Event: Date/Location: Contact:
Lancashire Regional Care Conference 2015 23rd September, Clayton Le Moors Care Choices, Tel: 01223 207770
Event: Date/Location: Contact:
Berkshire Regional Care Conference 2015 15th October, Reading Care Choices, Tel: 01223 207770
Event: Date/Location: Contact:
3rd Sector Care Awards 9th December, London Care Choices, Tel: 01223 207770
Please mention CMM when booking your place. CMM June 2015 49
HANNAH PEARCE • HEAD OF PUBLIC AFFAIRS • AGE UK
Hannah Pearce considers the caring crisis and asks the new Government not to think of social care as ‘too difficult’.
In the division of jobs following the Coalition agreement in May 2010 it’s probably a fairly safe bet that there wasn’t a long queue of budding Ministers putting their hands up for the job of sorting out social care. The headache of how to deliver high-quality social care fairly, to an increasing ageing society with ever-complex needs is an intellectual assault course. Working out how to pay for it is ten times as difficult. Tribute should now be paid to Paul Burstow MP and Norman Lamb MP as the successive coalition Ministers for Social Care who grappled hard with the
issues and wrestled out a Care Act which contains much to welcome, including a cap on care costs, national eligibility criteria, a duty to promote well being and improved provision of information and advice. They also both engaged seriously with those of us, statutory and nonstatutory organisations, who support individuals and deliver care. The argument that we failed to win under the last Government was the promise of adequate funding for a service that is on its knees. That is a huge pity and a daily disaster for hundreds of thousands of older people and their families across the country, struggling to manage without formal support. The question of funding for social care remains the challenge for us under the new Conservative-led Government. Age UK’s most recent assessment of the shambolic system of social care found over 900,000 older people going without necessary care. The amount spent on social care services for older people has shrunk by over £1bn since 2010/11. Preventative services like meals on wheels and day care have plummeted by over two thirds, and the number of older people receiving homecare has fallen by a third. In 2010/11, 12.4% of all people aged 65 and over received social care but today just 9.1% of older people (849,280) receive any support. This comes as the number of people over 65 has grown by well over a million in the last decade and those aged 85 and over, the fastest growing age group and those most likely to live with multiple long-term conditions, including dementia, are most likely to need care. The result is care being severely rationed, and both paid and unpaid carers being stretched to breaking point. There is precious little detail in the Conservative manifesto about the Party’s plans for social care. They confirm they will implement the care cap and the deferred payments systems which will be
in place by 2016. The manifesto makes further commitments to the Better Care Fund, which is a valuable initiative to encourage local health and care services to work together. But there is no mention of increased investment in social care services. Let alone the additional £4.3bn estimated by the Association of Directors of Adult Social Services which will need to be found by 2020 just to keep services at current levels. The Conservatives weren’t alone in this lack of manifesto detail, all the parties were complicit in trying to ignore the problem of social care, instead relying on people to muddle through. This is particularly frustrating at the same time as a sort of bidding war took place on the NHS where parties competed on how many billions of pounds of investment they would promise. But without the accompanying increase in funding for social care, we will continue to see increased demand for expensive hospital care as people are unable to manage at home. We’re all too familiar with the stories of people bouncing in or out of hospital, or hospitals unable to discharge older patients because there isn’t the support they need at home or in care homes to allow them to leave, contributing to the costs and pressures on the health service. The danger is that Government once again puts social care in the ‘too difficult’ box or convince themselves that more thinking is needed. The three very authoritative commissions on long-term care by Sutherland (1997), Wanless (2006), and Dilnot (2011) have laid out the theory. We don’t need more analysis, we need more investment. Our priority for the next five years will be to ensure that more and more people don’t slip into the hole which has opened up between need and supply of care, that social care is a political priority and to convince the new Minister for Social Care that increased funding is unavoidable. CMM
Do you agree with Hannah? Join the debate at www.caremanagementmatters.co.uk Twitter: @CMM_Magazine 50 CMM June 2015
Design The Touch Series is a UK manufactured and designed care system, using hospital grade materials that house Intercall technical excellence.
Location RFID technology is used to identify staďŹ&#x20AC;, record actions and control user access.
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Integration Industry standard connectivity via TCP/IP, the Touch Series is a modern nurse call system oďŹ&#x20AC;ering easy communication and management of patient care.
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Sky TV packages for heightened well-being
vouchers with your first lounge package†
With the over-65s watching more Sky TV^ than any other age group, our TV packages offer all kinds of ways to keep your residents entertained. Great value in-room packages cost under £10* a week, with lounge packages at less than £70* a week.
To find the right Sky TV package for your care home, call 08442 414 645
Believe in better
^Over 65s Sky TV viewing statistics based on Sky IQ data, April 2014. *Pricing shown is ex VAT. Customers will be billed monthly and installation costs apply. Installation of equipment is not included, please call for more information. Charge of £50 per box (plus VAT) if Sky does not install your equipment. Sky TV minimum term is 12 months. Channels available dependant on chosen package and scheduling may be subject to change. Some content/channels unavailable in communal areas. As at the date of print, channels not available in communal areas are: Alibi, G.O.L.D., Watch, Star Gold, Star Life OK and Star Plus. Calls cost 5.1p per minute (plus 15.97p connection fee) for BT customers. Calls from other providers may vary. Correct at the time of supply 11.05.2015. †Oomph voucher: £500 discount voucher off “Oomph! Training” or “Oomph! Monthly Activity Packs” to care homes purchasing their first Sky Home TV lounge. No cash alternative available. Voucher cannot be used in conjunction with any other offer and expires 6 months after date of issue. Voucher is issued by Oomph Wellness Training Limited. Further terms apply [www.oomph-wellness.org/sky].
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