Care Management Matters March 2018

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MARCH 2018 ÂŁ4.00

THE RISE OF TECHNOLOGY Software, surveillance and more

Mixing matters

Shared sites for young and old

Business Clinic

Virtual care home pilot

Resource Finder Care sector software

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Improve your quality of care

In this issue 05

Is It Just Me…? Rhidian Hughes shares recent action on the sleep-ins back pay crisis.


CMM News


Business Clinic A Surrey care provider is piloting a virtual care home to help with the cost-effective integration of health and social care for older people. What does our panel think?


A View from the Top Richard McKenzie, Chief Executive at Christchurch Group answers our interview questions.


Rising Stars Julie Harwood, Registered Manager for Accord Housing Association is our Rising Star.


Event Review CMM reviews the Dorset Care Conference 2018.


What’s On?


Straight Talk Sally Bowell discusses ILC-UK’s new report on dementia and music which outlines a blueprint for positive change.







From the Editor



Mixing Matters: Shared sites for young and old Stephen Burke explores the benefits of intergenerational sites and why you should consider the approach.


Hand in hand: Digital transformation and change management Luis Zenha Rela explains how change management is integral to the digital transformation of care.


Beyond Big Brother: The use of surveillance and monitoring in care Philip Scott shares his thoughts on the rise of surveillance and monitoring technology in social care.


Resource Finder: Care sector software CMM brings you a selection of software providers to help you in your daily business.

CMM Insight 2018 • 21st June 2018 • The Renaissance Hotel, Manchester CMM March 2018


EDITORIAL Editor in Chief: Robert Chamberlain Editor: Emma Morriss Content Editor: Emma Cooper


PRODUCTION Lead Designer: Holly Cornell Director of Creative Operations: Lisa Werthmann Studio Manager: Jamie Harvey

ADVERTISING 01223 207770 Advertising Manager: Daniel Carpenter Director of Sales: David Werthmann Senior Sales Executive: Aaron Barber





Rhidian Hughes Chief Executive, VODG

Stephen Burke Director, United for All Ages

Luis Zenha Rela Head of Digital Transformation, Nourish

Debbie Sorkin National Director of Systems Leadership, The Leadership Centre





Raina Summerson Group Chief Executive, Agincare

Ewan King Director of Business Development and Delivery, Social Care Institute for Excellence

Richard McKenzie Chief Executive, Christchurch Group

Julie Harwood Registered Manager, Accord Housing Association

SUBSCRIPTIONS Non-care and support providers may be required to pay £50 per year. 01223 207770 Care Management Matters is published by Care Choices Ltd who cannot be held responsible for views expressed by contributors. Care Management Matters © Care Choices Ltd 2018 ISBN: 978-1-911437-80-2 CCL REF NO: CMM 15.1

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CMM March 2018



Philip Scott Founder, Care Protect

Sally Bowell Research Fellow, International Longevity Centre – UK

Sign up today to start getting more from CMM. It’s FREE for care providers.

From the Editor Editor, Emma Morriss explores this month’s focus on technology, plus the benefits of intergenerational care. This month, CMM has a focus on technology. Wherever you look in the sector, technology is there, and the way it is used across social care varies enormously. With the need to improve quality, drive efficiencies and streamline processes, you can’t deny that there is a place for technology and software in the modern age of care delivery. However, with this comes many considerations, not just from the type of technology you want to implement, but also staff ability and adoption, security, ethics and more.


CCTV Also this month, Philip Scott explores the growing use of CCTV in the sector. Many consider it to be an intrusion of privacy and there are consent issues to be considered. However, Philip argues that it can help to improve quality and deliver trust, confidence, reassurance and transparency in what is a very stretched sector. What do you think? Read his article, starting on page 36 and let us know.


INTERGENERATIONAL Also in this issue, we have a really interesting article on intergenerational settings. We first covered the subject in CMM last year, when we ran our Business Clinic on Channel 4’s Old People’s Home for 4 Year Olds programme which featured St Monica’s Trust. This month’s feature is based on a new report summarising the benefits of intergenerational settings throughout the community. I think there’s a lot to gain from the mixing of generations in different settings and it’s interesting to read how it’s being approached in different

ways. Stephen Burke’s article starts on page 22, I hope it inspires you to explore intergenerational opportunities for your organisation and clients.


Finally, I would like to encourage We also bring you a Resource you to sign-up to the CMM website. Finder on care sector software. As a care provider, subscription In an article on digital If you’ve not yet embraced is free, and benefits include CMM transformation in social care, Luis technology or you are looking for News delivered to your inbox Zenha Rela argues that change the right software to support your every weekday morning, exclusive management and culture change business, our Resource Finder, discounts and bonus content. are essential to the smooth starting on page 40, details a Added to that, you can access integration of technology and number of leading providers who our archive of features and share buy-in from staff. Do you agree? might have the product you’re your thoughts on any of our Take a read of his article, starting looking for. Let them know you articles. on page 26. saw them in CMM. R075 CMM_reports_ad_Layout 1 04/09/2017 15:25 Page 4 Email: Twitter: @CMM_Magazine Web:

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Is it just me...?

tax and back pay calculations. Providers have a year to self-assess the back pay owed and then three months to pay it. Another challenge is tracking down past employees who are owed money.

Rhidian Hughes shares his thoughts and recent action on the sleep-ins back pay crisis.

Social care is on the brink of crisis. The figures show the scale of the catastrophe we face: yearly cuts since 2010 come to £6.3bn; planned savings in 2017/18 are a further £824m; the additional £150m in the latest local government finance settlement is welcome, but inadequate. Little wonder that the National Audit Office recently described social care as a ‘Cinderella service’. Add to this precarious situation a sector-wide bill of £400m, and it is easy to see how social care will be tipped into collapse. And yet this is what we face, thanks to the Government retrospectively forcing providers to pay six years’ worth of back pay for sleep-in shifts. Following a significant public affairs lobby, the sleep-in crisis has now been recognised by Government, but the big unanswered question is who should foot the back pay bill? It beggars belief that the Government has failed to identify how the bill will be

paid. This challenge is uniting the sector. Government must take responsibility and fully-fund all back pay – this is what the Stop Sleep-in Crisis Alliance is arguing for. The Alliance brings together trade bodies challenging Government to plug the funding gap. It includes the Association for Real Change, Care England, Learning Disability England, Learning Disability Voices and VODG.

CRUCIAL ISSUES Why is this issue so crucial? Because 350,000 of the 1.5 million learning disabled people in the UK need 24-hour support from sleep-in staff. Faced with footing a significant bill for which they are entirely unprepared, some providers face closing services. At best, people supported will experience massive upheaval to their support. At worst, entire organisations will hand-back contracts.


There will be an impact on future support, given the reduced funding for new services and fewer providers to deliver them. Charities could be forced to use their reserves where, in some instances, liabilities exceed reserves. This is despite the fact that reserves exist to maintain stability and to encourage new developments in care. Other providers may choose to exit the market because cash is king, and the back pay liability could exceed the cash balance, or if not, providers may be left with inadequate liquidity to service regular bills. Could providers borrow in order to pay the bill? Only if there are sufficient assets to charge it against and/or contract income is secure and reasonably long. But are banks prepared to take risks associated with the sleep-in crisis? There are also workforce issues. Some providers cannot fund six years’ worth of back pay and are not adept at the complexities of

Sleep-in support is a public service, for which Government has statutory responsibility. People who need it are assessed and funded by the State. So, why must providers pick up an unexpected tab brought about by changes in case law and government guidance? We are determined to resolve the situation, and our lobbying is having an impact. Heidi Allen MP has questioned the Prime Minister on the subject at Prime Minister’s Questions (PMQs). As a result, the Prime Minister agreed to discuss the issue with back-benchers. Dan Kawczynski MP also asked a question of the Prime Minister at PMQs, while Nicky Morgan MP, Chair of the Treasury Select Committee questioned Liz Truss MP, Chief Secretary to the Treasury on it at the recent session of the Treasury Committee. While the Department of Health and Social Care is seeking to establish a figure for the back pay liability, it is imperative that we understand the full impact of the crisis on the future sustainability of services, the workforce and, most crucially, care and support for those that need it most. It is for this reason that the Alliance is launching an independent survey to discover the true picture. All affected providers are encouraged to take part and we will be publicising the link via www.vodg. and on social media soon. Overnight support is an essential service. The staff who provide it are entitled to their back pay. But imposing a huge and sudden bill further threatens an already beleaguered system, and the people who depend on it.

Rhidian Hughes is Chief Executive of VODG. Email: Twitter: @RhidianHughes CMM March 2018




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The future of social care funding inquiry The Communities and Local Government and Health Committees have launched a joint inquiry on long-term funding of adult social care. It is intended to feed into the Government’s forthcoming Green Paper, which will be published this summer. The inquiry seeks to identify funding reforms that will command

broad consensus to allow progress in ensuring the long-term sustainability of both the health and care systems. The Committees are inviting written submissions on how to fund social care sustainably for the long-term (beyond 2020), bearing in mind in particular the interdependence of the health

Lack of quality care homes A new poll of MPs in England has highlighted that many believe there’s a lack of choice of quality care homes for older people. Two-thirds (66%) of MPs in England, including just over half (53%) of Conservative MPs and four in five (82%) Labour MPs, agree that their older constituents do not have enough high-quality care homes to choose from. In addition to this, more than half (51%) of Conservative MPs and four in five (83%) Labour MPs were concerned that, without action, the quality of the care homes market in their constituency will deteriorate over the next year. The poll by ComRes, commissioned by Independent Age, found a majority of MPs were concerned about their older constituents and the local care homes market. According to the survey, more than four in five (82%) Conservative and around nine in ten (92%) Labour MPs agree that older people who are eligible for residential care should be given a choice of at least one care

home rated Good or Outstanding. Moreover, more than one-third (37%) of Conservative MPs and more than two-thirds (68%) of Labour MPs do not believe that the care homes market in their constituency is functioning well for older people. A recent Freedom of Information request sent to local authorities by Independent Age found that councils are not routinely taking CQC inspections into account when arranging residents’ care home placements. Many of those that do, do not keep a record of how many people they place in Inadequate or Requires Improvement rated care homes. Although local authorities are not legally required to take CQC ratings into account, the Independent Age survey shows that two-thirds (66%) of MPs agree that older people who are eligible for residential care need legal protection to prevent them being offered only care homes rated by the CQC as Inadequate or Requires Improvement.

and social care systems and the mechanism for reaching political and public consensus on a solution. Written submissions to the inquiry on long-term funding of adult social care can be sent via the Commons Select Committee website. The closing date is 7th March. The Committees are expected to report in May.

Contingency planning – help needed The Care Provider Alliance (CPA) is developing guidance for care providers on contingency planning. To make the guidance as useful as possible, it is looking for input from providers. Have you been able to maintain care and support in challenging circumstances because of good contingency planning? If so, CPA would like to hear from you to share your good work with others. The CPA would also be interested to hear from providers who are willing to review and comment on a draft version of the guidance – particularly if your work on contingency planning is less advanced. Finally, CPA would like to hear from any providers who have existing contingency planning materials and resources that they can share. To be involved, contact Peter Cheer: peter.cheer@care-inc.

The Department of Health and Social Care has confirmed that Caroline Dinenage MP has been appointed Minister of State for Care. Caroline Dinenage’s role includes: overseeing all aspects of adult social care, including dementia, loneliness and disabilities; hospital care quality and patient safety; community health services; and health and social care integration.

CQC The Care Quality Commission (CQC) has appointed Kirsty Shaw as its Chief Operating Officer. She takes up her post on 1st March.

MAKING SPACE Making Space has appointed a new Director of Development, following the promotion of previous incumbent, Rachel Peacock to Chief Executive. Gemma Shepherd has joined from Barnardo’s, where she was Assistant Director of Development. Prior to that, she spent a decade in development roles with both Community Integrated Care and Creative Support.

REGARD Sandie Foxall-Smith has stepped down as Chief Executive of the Regard Group. Managing Director, Carole Edmond will become the company’s new Chief Executive.

TARGET Ian Webster has resigned as Non-Executive Director of Target Healthcare REIT. Craig Stewart has been appointed as Non-Executive Director.

CMM March 2018



Securing health and social care A new report by a panel of leading experts has set out plans for securing the future of health and social care. It recommends a ‘single ringfenced tax’ to replace National Insurance and that the costs of adult social care should be capped. Health and Social Care: Delivering a Secure Funding Future is the report from an eminent panel of health and social care experts, including Sir Stephen Bubb, Former Chief Executive of the Association of Chief Executives of Voluntary Organisations (ACEVO), Sir David Nicholson, Former Chief Executive of NHS

England and Professor Clare Gerada, Former Chair of the Royal College of General Practitioners. The panel was brought together by the Liberal Democrats to explore how to deliver a new funding settlement for the longterm sustainability of our health and social care system. The panel’s recommendations include: • A real-terms rise in NHS funding in England of at least £4bn in 2018-19. • Increases in council tax won’t put health and social care on a sustainable financial footing in the long-term. • Health and social care funding

should come together in a ‘single ring-fenced tax which would replace National Insurance’. • Additional funding for the NHS and social care should be ringfenced as an investment in out of hospital care, at least for the next three years. • Introduce incentives to encourage people to save for adult social care costs. • Reinstate the commitment to cap adult social care costs. In the conclusion to the report, the panel states, ‘We are unanimously of the opinion that it is necessary to raise additional revenue for health and care

through taxation... ‘We are also clear that the use of social care precepts added to council tax is neither an adequate way to resolve the funding crisis (in terms of the low amount of revenue raised) nor the fairest (in terms of where the burden of costs fall, and the unequal distribution of revenue raised). ‘Instead, we think that bringing together health and care budgets to increase transparency of the costs associated with these services; combined with a measured and progressive tax increase to address the black hole in funding represent the best solution in the immediate term.’

Council imposes immediate spending controls Northamptonshire County Council’s Director of Finance has issued a section 114 notice imposing immediate spending controls on the organisation. It means no new expenditure is

permitted, with the exception of safeguarding vulnerable people and statutory services. The notice has been served in light of the severe financial challenge facing the authority

and the significant risk that it will not be in a position to deliver a balanced budget by the end of the year. Councillors have 21 days to discuss the implications of the

section 114 notice and this is due to be addressed at the Full Council meeting on 22nd February. The notice does not affect staff pay and the council will continue to meet its statutory functions.

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Financial viability of care providers The Care Quality Commission (CQC) has introduced new guidance on assessing the financial viability of care providers applying for registration. For new providers submitting a new registration application, the CQC will now seek assurance in the form of a statement letter from a financial specialist. This could be an accountancy, bank or financial services firm. This is new registration guidance; the assessment of the applicants’ financial viability takes place at the point of registration application. CQC says that it has introduced

this new streamlined method of assessing compliance with Regulation 13 because providers applying for registration said that they were not always clear about what they needed to provide to demonstrate their compliance with Regulation 13, and that this had led to delays in registration applications. The new approach will apply to new providers submitting a new registration application. Existing care providers applying to remove or vary a condition, add a location or add a regulated activity are not generally required to submit a statement. However, it may also

apply to some existing providers seeking to make changes to their registration (for instance, for increases in scale or when CQC has intelligence that suggests a provider does not have the financial standing to provide the services set out in their Statement of Purpose). NHS Trusts and local authorities are exempt from the requirement. Adult social care providers currently in the Market Oversight Scheme will not be required to provide a letter; this is because the financial sustainability of these providers is monitored by CQC’s Market Oversight team.

CQC has also produced a template of the statement letter. It recommends that applicants use this template as it clearly explains to the financial specialist what is being requested and why, under the regulations. Applicants do not have to use the template, but it will help to make sure that the information required is included. In exceptional cases, CQC has said that it will consider other third party evidence such as a guarantee from an investor or shareholder. The application cannot be approved until assurance has been received.

to long-term recruitment, as the sector waits to see the shape of the agreement negotiated in leaving the EU. The increase in deal flow has led to further expansion of the Health and Care Team as the firm

continues to provide specialist advice to small and mid-market businesses on a wide range of transactions. Clients are particularly interested in longer-term strategy and planning, often working with one to three year exit horizons.

Hazlewoods’ record year in 2017 Hazlewoods Healthcare Corporate Finance Lead Advisory and Transaction Services teams have continued to see an increase in deal volumes in 2017. During the year, the team advised on 60 completed transactions valued at

£408m, representing an increase of 57% over 2016. Deal flow remained high in 2017, despite the pressures and potential implications of backdated sleep-in payments, and the ongoing uncertainty on medium

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Tackling hospital readmissions A new report by British Red Cross looking at tackling hospital readmissions says that repeat visits to A&E should trigger automatic home checks. In and Out of Hospital warns of an ‘endless cycle of avoidable hospital readmissions’, in which some people are sent home from hospital without the right care in place, only to go straight back to emergency departments. The report recommends automatic home checks to prevent a person’s condition deteriorating further and to help put a stop to repeated visits to hospital. The charity argues that while a patient might appear to be medically fit enough for discharge, repeated visits to hospital signal that something might be amiss in their home environment. The British Red Cross highlights

that there is no agreed, consistent approach to flagging repeat admissions and attendances. Often it takes a person falling into crisis before any kind of support package is put in place, by which time their needs have spiralled and become increasingly complex. The charity argues that a series of simple interventions between hospital and home, including home checks, could prevent this cycle of readmissions and discharge much earlier. In and Out of Hospital identifies too many missed opportunities to help prevent people from falling into crisis. It recommends simple interventions that could be adopted at each stage of a patient’s journey, ensuring they are sent home from hospital appropriately with full support and prevented from readmission.

Helping carers in employment A project that supports carers into employment and whilst they are working has been evaluated and has shown that there’s encouragement for the country’s carers who want to be part of the world of work. The Government-funded and independently evaluated project, which ran from 2015-2017, looked at what works to support carers to remain or return to the workplace. Known as the Carers in Employment (CiE) project, it took place in nine local authorities,

who were encouraged to develop local solutions to support carers to remain in or return to work; work involving employers was found to be vital to the project’s success. The evaluation reports that, out of the nearly 3,000 carers who took part, CiE sites supported nearly 60% to stay in work. It’s hoped that the findings of the independent evaluation will make an important contribution to ensuring that carers’ needs are reflected in future employmentrelated carer policy and practice.

No change to capital limits The Department of Health and Social Care has published its annual Local Authority Circular on charging for care and support. It states that for the financial year 2018/19, there is to be no change in the capital limits, Personal Expense Allowance, Minimum Income Guarantee or savings credit disregard. The capital limits remain at their current level (i.e. lower capital limit £14,250 and upper capital limit £23,250). The Personal 12

CMM March 2018

Expenses Allowance (PEA) for local authority-supported care home residents remains at its current level (i.e. £24.90 per week). The Minimum Income Guarantee (MIG) for people receiving local authority-arranged care and support other than in a care home remains at its current levels. The savings credit disregards remain at their current level (i.e. up to £5.75 per week for individual supported residents and up to £8.60 per week for couples).

Department of Health and Social Care’s objectives The Department of Health and Social Care has published its objectives and how it will achieve them. With regard to social care, it intends to enable a sustainable adult social care system that meets people’s needs and prevents health and care needs from escalating. To do so, it will: • Implement the Dementia 2020 challenge. • Support improved outcomes through better joint-working at the interface between health and social care through the Better Care Fund, greater transparency and performance oversight and

better metrics. • Develop a Green Paper which will set out proposals to reform care and support for older people. • Ensure a sustainable social care provider sector. There is also an objective to transform the use of technology, digital services and data to improve health and social care. Regarding workforce, the Department intends to secure the staff needed to deliver affordable high-quality health and social care. It will work with national NHS and social care bodies to agree a workforce strategy by July 2018.

The nursing workforce The Commons Health Committee has published its report into the nursing workforce and says that, ‘too little attention has been given to retaining nurses in the NHS, which has resulted in more nurses now leaving than joining the professional register.’ There are many causes for this shortfall, including workload pressures, poor access to continuing professional development (CPD), pay and a general sense of not feeling valued. During its inquiry, the Committee heard that access to CPD plays an important role in retention. The report calls for Health Education England to reverse cuts to nurses’ CPD budgets. Funding allocated to trusts should be specifically ring-

fenced for CPD for nurses, and specific funding should also be made available to support CPD for nurses working in the community. The Committee recommends that further assurances be given to nurses who originate from other EU nations that they will be able to remain in the UK with their families after Brexit. The Committee also recommends that nursing remains on the Shortage Occupation List. The Committee says that the Government needs to closely monitor the impact of the removal of nursing bursaries and the impact on mature students. The Committee welcomed the introduction of the Nursing Associate role and the expansion of career opportunities this brings for healthcare assistants.

Workforce intelligence Skills for Care has launched a new, dedicated Workforce Intelligence area on its website offering invaluable insights into the state of the adult social care workforce, including reports, trends, demographics and statistics. This new dedicated home for workforce intelligence showcases Skills for Care’s workforce

intelligence products and services that support its customers and stakeholders to make use of data with key decision-making, service development at local level and wider strategic decisions within the sector. Workforce intelligence is the vital ingredient for the future development of adult social care.

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Rise in detentions under MHA The Care Quality Commission (CQC) has published a report into the causes for the rise in detentions under the Mental Health Act (MHA). The review has concluded that there is no single reason why more detentions are being made under the MHA than ever before. Instead, CQC says that the rise in detentions is down to a range of different factors, which can vary across the country. Some of these are also indicators of a healthcare system that is under considerable strain. In the 10-year period between 2005/06 and 2015/16, the number of detentions increased by 40%, from 45,484 to 63,622. As part of its role in monitoring the use of the MHA in England, CQC made a commitment to

explore what could be causing this trend. This involved reviewing the available data, visiting specialist mental health (independent and NHS) services, and speaking to patients and representative bodies to gather their views. CQC has now published the outcome of this review. It found that the causes of the rise in rates of detention can be grouped under four main themes: changes in mental health service provision and bed management; demographic and social change; legal and policy developments; data reporting and data quality. In terms of further trends to explain the ongoing rise in detentions, CQC found no evidence that professionals had been misusing the MHA.

Transition to care home nursing The Queen’s Nursing Institute (QNI) has launched a new educational resource for nurses who work or are considering working in the care home environment. The resource is the latest in the QNI’s series of Transition resources for nurses new to community nursing roles or who wish to enhance and update their knowledge on current practice and approaches in specific community settings. The resource, written by Queen’s Nurse Sharon Aldridge-Bent with input from an external review

group of nurses and professionals who work in or have responsibilities for residents in the care home setting, is structured into ten chapters. The resource is intended for registered nurses who may have overall responsibility for nursing within the care home environment, as well as educators, students, and unregistered carers who work in this setting. As with its other Transition resources, the QNI recommends that the Transition to Care Home Nursing is used with the support of an experienced mentor.

Group drops ‘after death’ fees The Competition and Markets Authority (CMA) has welcomed Maria Mallaband Care Group’s decision to stop using a contract term requiring the payment of one month’s fees following the death of a resident who paid for their own care. The move comes as part of CMA’s consumer law investigation into fees charged by a number of providers, and its year-long study of the care home market where the CMA made clear its concerns that it is unfair to continue to

charge fees for an extended period after a resident has died. Maria Mallaband and sister company, Countrywide Care Homes, operate 64 care homes in England and Northern Ireland. The Group has agreed to amend its contract terms at these and any future care homes it operates so that fees will only be charged up to the date of death. As part of its work, the CMA found that charging fees after death was widespread across the sector and that practices vary.

IN FOCUS Homecare providers write to CQC about fee increases WHAT’S THE STORY?

Major homecare providers have written to the Care Quality Commission (CQC) to raise concerns about fee increases from the inspectorate. The collective represents the largest homecare providers in England, the majority of whose work involves operating under local authority homecare contracts. The group of 13 providers has expressed its concerns about the latest set of fee scheme proposals that recommend fee increases of 50% or more. These increases follow previous consultations by CQC in the past financial year that already saw most of their fees increase by up to 60% on the prior year. The collective represents Agincare, Allied Healthcare, Ark Home Healthcare, Carewatch Care Services, City & County Healthcare, Direct Health, Grosvenor Health and Social Care, Human Support Group, Mears, MiHomecare, Radis Community Care, Somerset Care and Westminster Homecare.


The collective says that such proposals place further pressure on the sector and must be seen in the context of wider challenges facing social care. Whilst it is appreciated that the HM Treasury has required that the CQC complete a cost recovery programme, the collective says that CQC surely has to face the same dilemma as social care providers and the NHS: how to do more for less, more effectively and efficiently, whilst still meeting legal duties and public expectations?


The collective says that unfortunately, with actions such as these, the CQC is in danger of contributing to more providers pulling out of the provision of publicly-funded social care. It says that larger providers contribute significantly to the total capacity of the homecare sector and withdrawal would challenge many local authority or sustainability and transformation markets. With increasing workforce challenges across the sector, increasing NLW costs, Apprentice Levy tax and pension costs, the collective says all providers would rather see money directed at this vital workforce, rather than in additional fees to the regulator.


The collective goes on to say that, ‘Although the CQC purports to understand the pressures on the social care sector, indeed describing it as at ‘tipping point’ and ‘in crisis’ within its own State of Social Care annual reports, as an entity it seems to be operating as if protected from the challenge of resources in the social care sector, and simply passing its own pressures on to others. ‘Any organisation, nondepartmental government body or not, proposing increases to annual charges by such significant amounts and without detailed rationale or alternative methodology options, must be held to account.’ The letter calls for further action from CQC and highlights the issues involved to other external bodies and MPs. CMM March 2018



STP funding used to help NHS cope The National Audit Office has found that additional Sustainability and Transformation Partnership (STP) funding, to help the NHS get on a financially sustainable footing, has instead been spent on coping with existing pressures. The NHS received an additional £1.8bn Sustainability and Transformation Fund in 2016-17 to give it breathing space to set itself up to survive on significantly less funding growth from 2017-18 onwards. It was also intended to give it stability to improve performance and transform services, to achieve a sustainable health system. The Fund has helped the NHS

improve its financial position. Despite this, the NHS is struggling to manage increased activity and demand within its budget and has not met NHS access targets. Furthermore, measures it took to rebalance its finances have restricted money available for longer-term transformation. On top of this funding, many trusts are receiving large levels of inyear cash injections, most of which are loans from the Department of Health and Social Care, which have worsened rather than improved their financial performance. Clinical commissioning groups and trusts are increasingly reliant on one-off measures to deliver

savings, rather than recurrent savings that are realised each year. This poses a significant risk to the financial sustainability of the NHS. The NAO says that progress has been made in setting up 44 new partnership arrangements, which are laying the foundations for a more strategic approach to meeting the demand for services within the resources available. In reality, partnerships’ effectiveness varies, and their tight financial positions make it difficult for them to shift focus from short-term day-to-day pressures to delivering transformation of services. The NAO has made a number of recommendations.

Carterwood completes Hereford site sale Carterwood has successfully completed on the sale of a 70-bed care home site with full planning permission in Hereford, on behalf of long-term client, Prime Developments. The 2.68-acre site has been purchased by care developer, Albion Care Communities, and will be operated by Dormy Care Communities.

Social interaction improves dementia care Increasing the amount of social interaction for people with dementia living in care homes to just one hour a week improves quality of life when combined with personalised care.

The large-scale trial was led by the University of Exeter, King’s College London and Oxford Health NHS Foundation Trust. The trial involved more than 800 people with dementia

across 69 care homes. Two ‘care staff champions’ at each home were trained to take simple measures such as talking to residents about their interests and decisions around their own

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CMM March 2018

care. The researchers found that the approach also saved money compared to standard care. Researchers say the next key challenge is to roll out the programme in the UK.


Performance of large care home providers Half of England’s large elderly care home providers have at least one in four homes in their network rated Requires Improvement or Inadequate, according to Which?. Which? undertook an analysis of Care Quality Commission (CQC) inspection data for 54 providers that operate at least 12 homes in England, caring only for the over65s. It found that some had half or more of their homes classed as Requires Improvement or Inadequate by the regulator. Two of the biggest providers, Four Seasons Health Care (43rd)

and Orchard Care Homes (49th), finished near the bottom of the Which? rankings. More than a third (35%) of 167 Four Seasons homes in the analysis were rated as Inadequate or Requires Improvement by CQC, while it was almost half (46%) of 44 Orchard Care Homes. Which? says that Ideal Care Homes, which runs 16 homes across the Midlands, the North West and Yorkshire, had more than three in five (63%) classed as Requires Improvement or Inadequate by the regulator. 60% of Akari Care Ltd’s

20 homes across the country were classed as Requires Improvement or Inadequate in the Which? analysis. There were some success stories, however. At the top of the table, both Avery, which operates nationwide, and North Yorkshire County Council, had all their homes rated as Good or Outstanding. Small homes fared better than large ones. Just 13% of homes with 10 beds or fewer were rated as Inadequate or Requires Improvement, however, for homes

with 120 or more beds, 41% were in these categories. Which? says that, overall, its analysis demonstrates how deep problems with quality and choice run in the care system. Which? has already heard from more than 1,000 people who have highlighted serious problems with finding highquality, affordable long-term care for older relatives. The consumer champion is warning that the situation could deteriorate rapidly as demand for places starts to outstrip supply in some areas.

Local Government Settlement

Guidance on FNC in contracts

The Secretary of State for Housing, Communities and Local Government, Sajid Javid MP has announced the local government finance settlement for 2018 to 2019. He announced an Adult Social Care Support Grant of £150m in 2018 to 2019. Mr Javid said, ‘This will be taken from anticipated underspend

The Local Government and Social Care Ombudsman has developed new guidance for providers to help them give clearer cost information on Funded Nursing Care (FNC) in their service user contracts. Based on learning from its investigations, the Ombudsman’s guide offers good practice on how

in existing departmental budgets, and will not affect existing revenue commitments made to local government. ‘This will be allocated according to relative needs and we will expect to see councils use it to build on their progress so far in supporting sustainable local care markets.’

to approach FNC payments and ensure contracts properly reference them. The guidance explains the Ombudsman’s approach to handling complaints about funding where FNC payments are involved, along with links to other resources which may be of help.

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73% shared ideas and good practice with other managers.

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Continuing healthcare funding system is failing The Public Accounts Committee says that the Government must take steps to improve the complex continuing healthcare (CHC) funding process which is beset with delays and poor-quality assessments. CHC funding is intended to help some of the most vulnerable people in society, who have significant healthcare needs. However, too often people’s care is compromised because no-one makes them aware of the funding

available, or helps them to navigate the hugely complicated process for accessing funding. Those people that are assessed spend too long waiting to find out if they are eligible for funding, and to receive the care they need. About one-third of assessments in 2015-16 took longer than 28 days. In some cases, people have died whilst waiting for a decision. The Public Accounts Committee says that there is unacceptable variation between areas in the

number of people assessed as eligible to receive CHC funding, ranging from 28 to 356 people per 50,000 population in 201516, caused partly by clinical commissioning groups (CCGs) interpreting the assessment criteria inconsistently. The Department of Health and Social Care and NHS England recognise that the system is not working as well as it should, but the Public Accounts Committee says they are not doing enough

to ensure CCGs are meeting their responsibilities, or to address the variation between areas in accessing essential funding. NHS England wants CCGs to make £855m of efficiency savings in CHC and NHS-funded nursing care spending by 2020-21, but it is not clear how they can do this without either increasing the threshold of those assessed as eligible, or by limiting care packages, both of which will ultimately put patient safety at risk.

Adult social care workforce statistics

New longer-term neurological nursing service opened

NHS Digital has published the latest information on the number of adult social care staff who work for local authorities in England. The report covers the 109,300 workers employed by local authorities in adult social care services – accounting for approximately 7% of the total adult social care workforce in England. Personal Social Services, Staff of Social Services Departments, England 2017 contains information as at September 2017. The publication also includes figures

detailing the size and structure of the adult social care workforce employed by local authorities since 2011. Further details include demographic information such as the age, gender and ethnicity of the workforce, as well as details of average annual salaries by staff groups, the number of workers on zero hours contracts and the average number of sick days taken per year, compared with the independent sector and the overall workforce in England.

The Marbrook Centre in Cambridgeshire has just opened a specialist longer-term neurological nursing service to complement its successful active rehabilitation services. With the intention of creating a ‘home from home’ warm environment, the bespoke rooms feature overhead ceiling hoists and en-suite wet rooms, as well as light and airy lounges, with their own rehabilitation kitchen. Residents and their families will benefit from the therapy,

Hft in Wales

Care crisis for disabled adults and families

Hft has been awarded its first contract in Wales. From the beginning of February, the charity, which already runs services throughout England, will also be responsible for the delivery of day and work opportunities in Flintshire. Over the next five years, the charity will be working in partnership with Flintshire County Council to provide day and work opportunities for adults with a learning disability across the county. This will include enabling people to develop their skills and seek employment. All 60 existing members of staff currently working at the service will transfer to Hft to support more than 100 people.

Over two thirds (67%) of families caring for disabled adults with complex needs live in fear of what will happen to their loved one when they are no longer able to provide support, according to a new report by Sense. When I’m Gone reveals three in four (75%) families caring for a loved one with complex needs have no long-term plan in place for when they are no longer able to provide support. Nine out of ten (95%) family carers say they have little to no trust in local authorities being able to provide adequate care to their loved one. The report also highlights new Freedom of Information data that reveals only one in four councils are able to support disabled people and their carers to make


CMM March 2018

contingency plans for future care options; and only one in three local authorities are aware of how many disabled adults in their area are currently being cared for by family and friends at home. There are 1.3 million carers in England and Wales aged over 60, and the research raises fears of a looming care crisis for disabled adults with complex needs, who risk being placed in unsuitable crisis care placements. In the national poll of family carers, only 6% reported finding the process of planning for the future straightforward, with many saying they worried that a lack of quality care and a shortage of specialist services will mean their loved one’s needs will not be met in the future. One in two families

nursing and care teams to enable them to achieve their individual rehabilitation goals. The Marbrook Centre’s multi-disciplinary team includes neurological physiotherapists, occupational therapists, speech and language therapists, a neuropsychologist and a consultant in rehabilitation medicine. The Centre’s residents can also undertake sessions with music and art therapists plus enjoy time with the service’s pets-as-therapy dog, Brabham.

said that they worry that funding cuts will impact the availability of local services for their loved one. As part of a series of recommendations set out in the report, the charity calls for a duty on councils to ensure long-term care plans are in place for disabled adults. This call is supported by eight out of ten of the carers surveyed. Sense is also calling upon Government to ensure social care is adequately funded to meet the growing needs of families and disabled adults Alongside the report, Sense has also published a toolkit, Decisions to make: Steps to take aimed at helping disabled people and their families make decisions about future care and support.

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NAPA Challenge and Awards

NAO report on workforce

NAPA has announced its NAPA Challenge 2018 and moved the date forward to coincide with Care Home Open Day. The Challenge is A food journey around the Commonwealth and providers can take part anytime between 18th and 25th April 2018. NAPA suggests that homes might want to focus on Saturday 21st April as it is also Care Home Open Day which has a theme of Communities Near and Far. The Queen also celebrates her 92nd birthday on 21st April. The NAPA Challenge couldn’t be simpler. Choose at least three Commonwealth countries to focus on and then complete the three Ps to be in with a chance of winning £500. The three Ps are:

The Department of Health and Social Care (DHSC) is not doing enough to support a sustainable social care workforce; the number of people working in care is not meeting growing care demands, and unmet care needs are increasing, according to a report by the National Audit Office (NAO). The NAO says that DHSC cannot demonstrate that the sector is sustainably funded, which impacts workforce planning. It also says that DHSC has no national strategy to address the workforce challenge and key commitments it has made to help make the sector more attractive have not been followed through. Furthermore, the NAO has not found any evidence that DHSC is

overseeing workforce planning by local authorities and local health and care partnerships to help with the challenge. Without a national strategy to align to, few local areas have detailed plans for sustaining the care workforce. The NAO has recommended that DHSC produces a robust national workforce strategy with the support of the Ministry of Housing, Communities and Local Government and that it encourages local and regional bodies to align their own plans to it. The NAO says that DHSC also needs to invest more to enable commissioners to set appropriate fees for providers, so they can pay staff adequately and afford to offer career development and training opportunities.

choice specialist provider for people with autism, brain injuries, mental health needs and learning disabilities. The rebrand was a

collaborative process carried out in conjunction with the people the organisation supports, staff and commissioners.

• Provide food that will encourage conversations. • Persuade folk to move and mobilise more by setting up unusual places to ‘visit’ in the home or the community. • Post materials around that will tap into memories linked to the Commonwealth. NAPA has also announced that nominations are open for its 2018 Awards. Categories are: Unsung Hero; Best Activity Co-ordinator; Best Chef who Contributes to Activity Provision; Best Carer who Contributes to Activity Provision and Growing Old Disgracefully. More information is available from the NAPA website,

Tracscare becomes accomplish Tracscare has changed its name to accomplish. The change is part of a wider rebrand, which includes a brand promise, values

and behaviours – all of which are designed to set the goals for accomplish to achieve its mission to be known as the first-

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Skills for Care’s Accolades 2018 finalists The finalists for Skills for Care’s Accolades Awards 2018 have been announced. They are competing to win a national award celebrating excellence in workforce development. The winners will be announced at the Accolades awards ceremony on Thursday 1st March 2018 in London. The finalists are: • Best employer of between 51 and 249 staff: Saracen Care, Middleton Hall Retirement Village, Old Hastings House (Magdalen and Lasher Charity). • Best employer of over 250 staff:

Augustinian Care, Jewish Care, PossAbilities CIC. • Best employer of under 50 staff: Good Oaks, Ebury Court Care Home, Extra Care Home Services Limited. • Best employer support for your registered manager(s): Southern Housing Group, Care Management Group, Old Hastings House (Magdalen and Lasher Charity). • Best endorsed provider of learning and development: Consultus Care Training Centre, Lifetime Training, NAPA (National Activity Providers Association). • Best individual who employs

their own care and support staff: Charley Zakrzewski, Christina Candey, Patricia Sadio, Claire Steeples. • Best recruitment initiative: Love2Care and Wellbeing Teams, Castle Supported Living, Dimensions UK Ltd. • Best social care apprentice employer: NorseCare Learning and Development Team, Premier Care, St. Mungo’s Apprenticeship Scheme, Anchor. • Most effective approach to integrated new models of care: Overgate Hospice, Calderdale and Huddersfield NHS Trust,

Calderdale Council, Stockton and Hartlepool Integrated Discharge Team, Making Space/Doncaster Admiral Service. • Most effective approach to leadership and management: Somerset Care, Royal Mencap Society, Abbots Care Ltd, Old Hastings House (Magdalen and Lasher Charity).

in June 2017 by the Moorfield Audley Real Estate Fund (MAREF), taking the total equity raised to £285m. Moorfield Group, the UK real estate private equity fund manager, created MAREF to acquire Audley in December 2015.

As well as the 17 villages that sit under the Audley Villages brand, which when completed will provide at least 2,000 units nationwide, 500 units are currently planned at future Mayfield Villages sites, including the first location at Watford.

The Skills for Care Accolades are sponsored by Connect 2 Care, Unique Training Solutions, Jewish Care, The Guardian, NICE, ConsultusCare, Mears Group, Aged Care Channel (ACC) and QCS.

£125m credit facility for Audley Audley Group, the luxury retirement village provider, has completed the refinancing of its debt facilities with a five-year term loan of £125m, jointly funded by HSBC and Bank Leumi (UK). The facility will fund all existing developments within the group

across both luxury brand, Audley Villages and new mid-market provider, Mayfield Villages, as well as new locations, covering the cost of land acquisition and development. This news comes on the back of an additional £85m of equity raised

CMM March 2018


Mixing Matters shared sites for young and old

Stephen Burke explores the benefits of shared sites for young and old and why you should consider it.

Britain is one of the most age segregated societies in the world, particularly for the youngest and oldest generations. This can breed myths and stereotypes, misunderstanding, ageism and exclusion. That’s why we believe mixing matters. In our work since 2010, United for All Ages has been highlighting issues arising from age segregation or ‘age apartheid’ and how it can be tackled. One way to promote more integration and mixing between the generations is the sharing of sites where activities involving older and younger people take place alongside and with each other. Shared sites range from traditional community centres to the co-location of older people’s housing with care schemes and childcare facilities. There are many models of shared sites.

PROGRESS IN SHARED CARE 2017 saw significant progress in bringing older and young people together for the benefit of all generations and our wider society. There is increasing interest in co-location and increasing recognition of the social and economic benefits. While many more examples can be found in other countries, there has been a growth in the UK of ‘shared sites’, from nurseries co-locating with care homes 22

CMM March 2018

and older people’s housing, to schools, sheltered housing and community hubs working together. Media coverage has helped stimulate this grassroots action. The Channel 4 programme, Old People’s Home for Four Year Olds, and the coverage of the Apples and Honey Nightingale care home nursery in south-west London have created huge interest and prompted many nurseries and parent and toddler groups to link-up with their local care homes and older people’s housing schemes. Meanwhile, other examples are emerging. Downshall Primary School in East London is hosting a day centre for older people with depression and dementia. A sheltered housing scheme in Cambridge is letting some flats to students in return for volunteering with the older residents. There are many different ways to support mixing between generations.

using care services, for example, but ultimately, it will improve the quality of care and other services used by different generations. Britain is crying out for positive change. Economically, more needs to be done to address intergenerational fairness through affordable housing, wealth and taxation. Socially, mixing through shared sites provides thousands of opportunities across the country to bring people together for the benefit of all generations. Local people and their communities are taking the lead. By 2022, United for All Ages expects to see at least 500 shared sites across the UK. Many are building on existing activities and facilities. Some will be based in new developments.


There’s a wide range of benefits and beneficiaries from shared sites. A shared site scheme, such as an older people’s care and housing scheme co-located with a children’s nursery, can have the following benefits: • Older residents experience more activities, less isolation and loneliness, and better physical and mental health. • Children experience enhanced early learning and social development, giving them confidence. • Parents also get to interact with older people and can go to work knowing their children have good childcare. • Relatives and families of older people benefit from their increased interaction and better health. • Providers of eldercare and childcare have a USP, reduced costs and happier clients. • Staff of both providers have more interesting opportunities, as well as childcare support if they need it. • All involved can share experiences,

United for All Ages sees mixing between generations as key to tackling age apartheid. The benefits are many – not just for those directly involved, but for their families and the wider community. We also believe that shared sites will not just improve the experiences of those



CMM March 2018




activities, learning and mutual understanding. • The wider community has a centre for all ages that they can use and share locally. For older people’s housing and care providers, the economic benefits of colocation also include: • Sharing back office costs: from maintenance and catering to IT, HR, training and management. • Marketing across generations: reaching different parts of the same family whose care needs will change over time from childcare to eldercare. • Creating a USP: pioneers of co-located care have a special offer to families needing care. • Sharing skills and learning of staff: opportunities to grow and develop staff. • Recruitment and retention of staff: one of the biggest challenges for many providers, co-location provides opportunities for staff to undertake new challenges in different settings as well as access to childcare where they work. • Providing community facilities: a colocated or shared site will become a magnet at the centre of communities and be in demand from others looking for space, activities etc. • Growing demand: our ageing population means a growing demand for care, which will help businesses become more sustainable, while demand for childcare grows as more parents work. These benefits have been realised by shared sites in other countries, from the USA, Canada and Australia to Japan, Singapore and elsewhere in Europe. The UK is catching up. Now more evaluation needs to be undertaken of the emerging schemes in the UK. Starting young is the way to change our society and attitudes towards ageing.

SLIDING SCALE OF APPROACHES Every day, news emerges of joint activities between nurseries and older people’s housing and care schemes across the country.

These developments reflect a sliding scale of interaction and intergenerational care: • Nurseries undertaking occasional visits to care homes, for example, at Christmas. • Nurseries and parent and toddler groups visiting care homes on a weekly basis and undertaking structured and spontaneous activities. • Nurseries and care homes that are located nextdoor or as close neighbours enabling more frequent joint planned activities. • Nurseries and care homes located on the same site that undertake some joint activities during the week. • Nurseries and care homes that are co-located and fully-integrated where older people, children, staff and families interact every day in both planned and informal ways. The scope for new activities is massive given the number of older people’s housing and care providers and the number of childcare providers in the UK. Most will be on existing sites of housing with care providers – some developments will convert unused space and facilities for nurseries, some will be new builds in the grounds. There will also be new developments enabling the opportunity for purpose-built, integrated facilities for older people and children in the heart of communities where their families live and need care. International experience shows that there are many models of intergenerational care. The key is to get going right across the sliding scale of intergenerational interaction as schemes are rolled out and evaluated in the UK.

MIXING MATTERS United for All Ages’ new report Mixing Matters sets out why increasing connections between generations is key to the health, wellbeing and future of individuals, communities and, ultimately, our country. While Britain has become more age-segregated in recent decades, the report demonstrates there is a growing movement to tackle ‘age apartheid’. It focuses on how older and younger people can come together through ‘shared sites’ with many inspiring

and practical examples that could be replicated across the UK. Four specific themes are explored: • Shared care and play. • Shared housing and living. • Shared learning and work. • Shared community spaces and activities. Our ambition is for 500 shared sites to be developed by 2022. With some 75,000 care homes, nurseries and schools in the UK, there is massive scope for the shared sites challenge to achieve much more. To make this happen, we need action and support from: • Policymakers: support and promote mixing between different ages, explaining why it’s key to creating a stronger Britain at all levels as part of national strategies for our ageing society and intergenerational fairness. • Providers: build links with other local providers to facilitate intergenerational interaction; share lessons about what works (and doesn’t); learn from each other and get on with it. • Regulators: recognise the importance of intergenerational interactions to older people and young people in the inspection and regulation of care, education and housing services; offer guidance to providers. • Local authorities: bring providers of services for older people and young people together; transfer assets to support community-based businesses and organisations; develop strategies to create communities for all ages. • Planners, developers, architects: think ‘mixing’ when planning and developing new and existing care, housing, education and other community schemes. • Evaluators: provide evidence of what works and why, recognising there are many models of shared sites. • Funders: support capital and revenue funding bids to make mixing happen. • Service users, families and staff: ensure they are involved from the early stages of all intergenerational projects; don’t underestimate the enthusiasm of the public whatever their age for bringing older and younger people together. We are now working with a wide range of older people’s care and housing providers to make this vision a reality. CMM

Stephen Burke is Director of United for All Ages. Email: Twitter: @united4allages Access Mixing Matters case studies on the CMM website Subscription required. 24

CMM March 2018




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Luis Zenha Rela explains how change management is integral to the digital transformation of care. Digital transformation in the care sector is no longer the future and the benefits of the technological revolution have been felt far and wide across the sector. Portable diagnostics equipment has made the delivery of care easier, faster and more accurate; smart assistive technology has given patients and services users increased 26

CMM March 2018

independence and improved rehabilitation; and advances in medical technology have cured some of the world’s deadliest diseases. More recently, the digitising of care planning and recording has allowed for more accurate, timely and secure records and the seamless sharing of information. Despite this, and the

numerous benefits that technologies have shown in all areas of care, we are still seeing some reluctance towards digital transformation. While there is a common misconception that this is down to many care professionals fearing technology, this is simply not the case. Past research from Skills for Care revealed that 95% of those working in the sector use digital technology in their work; and that the great majority are strongly positive about the potential of digital technology to improve efficiency and quality of care services. We also know

that digital transformations are occurring, because we work with care providers up and down the country who are looking to digitise their care records every day. It is, therefore, not the fear of technology that acts as the barrier, but, in fact, the fear of change.

THE PERCEIVED BARRIERS TO DIGITAL TRANSFORMATION In our experience, there is a clear misunderstanding between what the perceived barriers are to

adopting technology, versus what the actual barriers are. Few worry about job automation. There are many instances where advancements in technology remove the need for physical people – you only need to go to your local supermarket to see self-service check-outs, or go online to realise how much of your daily life you can manage without interacting with a person. In the care sector however, suggestions that Pepper the Robot will eventually replace care staff are disregarded because there are two key things that computers cannot impersonate:

social intelligence and emotional interpretation. The adoption of technology in care is not about replacing human interaction, but facilitating more of it through time-saving. In contrast, the biggest barrier that we do hear care providers talk about is their concern that their staff will not have the necessary skills or inclination to adopt technology. In reality, we actually find the opposite is true. According to Skills for Care’s The State of the Adult Social Care Sector and Workforce in England, 2017, the average age of a care worker is 43 and


CMM March 2018




a fifth are aged over 55. Data from Statista shows that in these age groups, smartphone ownership is at 88% and 47% respectively. So, the physical use of technology is not alien. With a new younger generation of care workers coming into the sector, all of whom have grown up using technology, confidence in ability is only likely to increase. The level of notes we have to record in care is often a point of contention and this can also act as a barrier. However, the fact of the matter is that we have to record notes, because without doing so, we have no method of evidencing care. After all, ‘if it wasn’t written down, it didn’t happen’. It’s not about working out how we can get away with recording less information, but instead how we can improve the amount of high-quality information we record in the least amount of time. This is exactly what digital solutions allow you to do. Further to this, technology also allows you to make use of all of that recorded information, so that it can be better used to directly benefit care; rather than being filed away in a locked room.

EFFECTIVE CHANGE MANAGEMENT IS KEY As we’ve discussed, the problem, usually, is not care team capability or the use of the actual technology, but how the digital transformation process is approached, and the tools and support provided during this process. Going from paper to electronic care notes and care plans is not just a change in the physical process, but also to the content that is recorded. As a result, the approach to managing the change must address culture as much as technology. From a management perspective, the capabilities of a

digital system, especially when it comes to access to records, ease of reporting and health tracking, can lead to overcomplication. Rather than taking it step-by-step, people can be consumed by the detail potential and for example, rush to increase the information in care plans, which can slow down effective implementation. What’s crucial is that care providers tackle each change separately. For instance, first stick to mastering the change in methodology from written to digital notes, recording the exact same content. Then, once the technology is being used well, look to improve the level and detail of content recorded and start maximising the benefits.

BEFORE YOU START YOUR DIGITAL TRANSFORMATION JOURNEY Before you start your digital transformation journey, first and foremost, you need to ensure the technology is suitable for the care you provide, the people you support and the people who provide that care. Two elements are critical for effective adoption: 1. Ease of use The technology has to be easy-to-use and welldesigned. It’s not just about functionality, but the look and feel of the technology as well. Is it enjoyable to use? Is it intuitive? Does it follow a logical process? Too often these aspects are overlooked in care technology, when it is actually critical to successful integration into care practice. You want to empower your care teams. Provide them with technology that works for them, that is intuitive and simple to use, so that the experience is positive and the transition as smooth and efficient as possible. 2. Customisable Every care service and every

person that you care for is different. You must ensure that the electronic solutions you select are customisable to your needs. The objective is to be able to record more information in a more timeefficient way, and the care you provide should not be dictated by features. Rather, the system should be adaptable and enable you to effortlessly record what you want and need to.

DURING THE DIGITAL TRANSFORMATION When you have chosen the right provider for your service, try implementing the following change management process. 1. Open communication Adopt an open, educational approach, rather than ‘forcing’ change on care staff. Talk to the care teams and services, explain why this technology is being introduced and the benefits to them. This is not ‘just another thing’ they have to do and be aware of. Yes, it takes a change, and that will take some getting used to, but make sure you provide a platform for staff to raise any concerns and thoughts. Get your team on board and create a culture of empowerment and growth so that staff understand the importance of the technology and want the adoption to be successful. 2. Take responsibility and accountability It is essential that someone owns the transformation as a project, either by allocating dedicated time to the change management process or by delegating such a role to an experienced company. Having one point of contact ensures all stakeholders know who to approach with any questions or concerns. It also ensures that there is control and visibility across the process, so that key milestones and deadlines are

achieved; minimising any risk of inconsistencies and delays. 3. Plan, implement and feed back Digital transformation, like any change, is a journey, and clearly documenting a road map of how this change is going to take place, and who needs to be involved and when, will make this change effective. This could include a timeline and resource allocation for data transfers, staff training, trialling the system, reviewing feedback and resolving any issues. During this phase, it’s also important to celebrate successes. Each part of the journey is a step closer to the end goal and recognising milestones and individual achievements will aid the change management process. Digital transformation will never be a ‘one-size-fits-all’ scenario, and as we’ve discussed above, the power of technology comes just as much from how it is being used, as the technology itself. The care sector is in a very strong position in that it is still considered an early adopter; meaning there is room for growth and improvement which presents care providers with a great opportunity to ride the crest of the wave and shape the future rather than follow in the footsteps of others. CQC has already begun to show signs of digital adoption in their 2016-2021 strategy, recognising the role technology is playing in blurring boundaries between hospital, private and community care; whilst committing to ‘learn alongside providers who offer new care models or use new technologies, to encourage innovation’. Embrace this innovation, choose the right solution for you and give special consideration to the change management process, and you might be surprised by how much technology can enhance the quality of care your service provides. CMM

Luis Zenha Rela is Head of Digital Transformation at Nourish. Email: Twitter: @NourishCare Have you embraced digital transformation? Share your experiences on the CMM website Subscription required. 28

CMM March 2018




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CMM March 2018


VIRTUAL CARE HOME – INNOVATION IN INTEGRATION A Surrey care provider is piloting a virtual care home to help with the cost-effective integration of health and social care for older people, whilst ensuring it is person-centred at the core. Simon Whalley, Chairman of Birtley House in Surrey and Vice Chairman of Surrey Care Association is looking to work with Royal Surrey County Hospital, Surrey Heartlands Sustainability and Transformation Partnership, Guildford and Waverley Clinical Commissioning Group and local domiciliary care services and care homes to develop a virtual care home pilot.

DEVELOPING THE VIRTUAL CARE HOME Simon explained how the idea came about, ‘I developed the concept following discussions with Royal Surrey County Hospital, Surrey Heartlands Sustainability and Transformation Partnership and Surrey Care Association. ‘The model has been developed to facilitate the cost-effective integration of health and care for older people, whilst also ensuring that appropriate and personcentred care is maintained. ‘It’s still at the conceptual stage, however, it has been well-received by all involved in discussions held to-date. We’re currently exploring ways in which to deliver potential savings for the NHS and adult social care.’ The initial pilot, which is being driven by Simon, will be used to build an evidence-base for future roll-out and delivery of the model. Simon added, ‘A pilot is being prepared. However, key personnel within the public sector keep disappearing, which makes it very challenging. ‘Those involved recognise the issues that arise from the constant movement of key people in the NHS and the siloed-thinking that is common within the public sector, but it’s often a case of one step forward and two steps back.’ 30

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AIMS OF THE PROJECT The concept is called a virtual care home because the services of the care home can be delivered in a number of settings and monitored by technology. However, it also aims to give all those supported a sense of belonging. On an operational level, it aims to: help people get out of hospital sooner; manage care to reduce unnecessary admissions to hospital; help older patients go home and remain living there in a fully supported way; and prevent readmissions to hospital. ‘We want to centralise the dialogue between all parties,’ Simon explained, ‘and, as a result, reduce the number of obstacles people face, duplication and the opportunity for time to be wasted. By doing this, we hope that the concept will save hospitals money, enable them to use local health resources more appropriately and support the pooling of funds from local authorities and the NHS.’ There will also be a central role for technology to reduce overheads and enable communication and interaction between all parties to support the individual throughout the process.

HOW IT’LL WORK It is intended that Birtley House and Royal Surrey County Hospital will work together to plan and deliver a step-down pathway for older people, to help them move into a more suitable setting. The system will be built around the care home as the central driver and co-ordinator for the approach. Birtley House also has the potential to manage a ‘step-down’ ward in the hospital to support

individuals in preparing for discharge. Supported for a maximum of six-weeks, individuals may be discharged into the care home or homecare services, with ongoing support and assessment. Wherever located – in a hospital ward, Birtley House or any individual’s own home, there will be ongoing support from the relevant medical professionals, including consultants, geriatricians, community nursing staff and GP surgeries. Simon explained, ‘The virtual care home will combine visits from professionals and technology. The aim is for medical professionals to see patients in the care home, but with the ability to access them at home via technology. We currently work with MED e-care and are looking to continue to develop this as the concept evolves.’ On a social level, individuals, whether in Birtley House or being supported at home, will have access to the home’s day club to encourage social interaction, meaningful activity and also enable staff to monitor them and ensure their health and wellbeing is improving. Simon continued, ‘Too often people feel isolated. With both technology and personal contact, we want them to feel connected and enjoy more social interaction, as well as care support in their own home and access to all that goes on in the community.’ It is hoped that if an individual’s condition deteriorates, it will be picked up quickly by the care home, homecare staff or day club. The individual can then be caredfor in the care home, with the support of medical professionals, to avoid readmission to hospital unless completely necessary.

NEXT STEPS Simon is in the process of getting agreement from Royal Surrey County Hospital, Surrey Heartlands Sustainability and Transformation Partnership, Guildford and Waverley Clinical Commissioning Group and local domiciliary care services and care homes to develop the virtual care home pilot. Simon continued, ‘I would like to see the pilot in place by the second half of 2018. We already have many of the key elements in place, such as a day club. The next objective is to ensure that any budget can follow the patient, in order to broaden the concept to those who cannot afford their own care. ‘I believe that the concept can be demonstrated over a three to six-month period. However, having a full year would help to identify savings. Ultimately, I would like to see the virtual care home rolled out across the entire county, although the nature of the concept means that it is also applicable to adjacent counties, too.’ CMM

OVER TO THE EXPERTS... Is this an innovative approach to integration? Could it ease delayed transfers of care and reduce unnecessary admissions? Could it help older people get back into the community quicker? Are similar pilots happening in other Sustainability and Transformation Partnerships? Is there any shared learning that can help get the virtual care home pilot up and running? What does our panel think?

THERE ARE THINGS THAT YOU CAN DO Simon, welcome to the world of complexity: where the path to success is rarely linear; where you’re having to work across boundaries with people with different perspectives and priorities, and who don’t see it as their job to unite around your position; and where it can feel messy, time-consuming, and (sometimes) like trying to push water uphill. We can’t wish complexity away, but there are things that you can do. Use what you have. This includes the evidence base that what you’re proposing works. In Nottinghamshire, an integrated care model linking primary care, care homes and community services has seen a 48% reduction in admissions to A&E from those homes taking part, along with better quality of life for residents. There were similar results from a GP-led scheme with 28 care homes in Staffordshire. Other Enhanced Health in Care Home vanguards

have successfully connected care homes with hospitals, making them integral to the system, in the same way you’re proposing. So there’s a good chance this will benefit the whole community. Use the evidence to develop resonant stories of what this means for the individuals involved, not just for the bottom line. The money is important, but it’s the stories about people that will drive change. Work with a coalition of the willing who can be effective messengers and do some of the heavy-lifting, so you don’t feel you’re back to square one every time someone leaves (as they will keep doing). This is not to say this will be plain sailing, but we know that these techniques can work in enabling you to negotiate the path and, eventually, get to where you want to be. Hang on in there.

Debbie Sorkin National Director of Systems Leadership, The Leadership Centre

WORTHY OF TRIAL AND WIDER ATTENTION The concept seems a positive way to respond to the changing role of care homes. The thousands of homes across the country could be, and should be, much better utilised (and supported) than they are, as they are often well-placed to act as key community link sites within a multi-disciplinary team and to provide hub and spoke services for a range of needs. This project, which aims to combine the skills, experience and resources of multi-disciplinary professionals to provide improved pathways of care, is worthy of a trial and wider attention. The principles are sound and involve collaboration between the various parties that can help prevent hospital admissions from, and manage better discharges into, a community-based setting; preferably, the person’s own home. The introduction of technology as a further element in this model shows how we can better incorporate

technology into these pathways and maximise the use of increasingly scarce skills, people and facilities in the right place, at the right time and to produce the best results. Across Agincare, we are successfully managing several new models of care projects (both in and out of care home settings) and unfortunately, I can empathise with Simon’s fear and frustration about the changes in key personnel hindering the process. In the constantly changing face of local authority and NHS structures, we must not let the system and bureaucracy stifle innovation and become the reason why different ways of working cannot flourish. Independent care providers play a vital part in society and, through pilots such as these, the full potential of our contribution to the health and social care structure can be realised.

Raina Summerson Group Chief Executive, Agincare

LET’S HOPE INNOVATION IS EMBRACED It’s great to see organisations and areas innovating, and evaluating that innovation. We recently published a report, with Nesta, on how we take innovative examples of health, care and support and bring these to scale so that more and more lives are improved. Our work indicates that there are real added benefits in terms of outcomes and cost-effectiveness if services and commissioners think differently. Innovative care homes and other organisations are increasingly seeing the need to offer more person-centred and community-centred care; and they’re starting to use approaches such as Progress for Providers, Making it Real and My Home Life as ways to develop more personcentred care. The virtual care home might be seen as an example of intermediate care. Intermediate care ranges from bed-based services to communitybased services, but seeks to keep

people well for longer in their own homes, living fulfilling lives. System leaders and commissioners of integrated services can be at the forefront of developing models of intermediate care that work locally. Our paper on this topic highlights good examples of practice. If you get a virtual care home model, like the one planned for Surrey, it can reduce not only delayed transfers of care, but also increase patient and service user wellbeing. It is also good to see that these plans recognise the important role technology can play. Our resource, on using technology to support people with dementia, has some great advice, including films, about how technology can provide support, without compromising care, so people can stay independent. Let’s hope innovation is embraced and the best bits made more available.

Ewan King Director of Business Development and Delivery, SCIE CMM March 2018




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RICHARDMCKENZIE Richard McKenzie is Chief Executive at Christchurch Group.

REFLECTIONS ON THE LAST DECADE The biggest change for me has been the systematic dismantling of services with a complete lack of a ‘plan B’. This is no fault of our colleagues in local authorities and the NHS, but in my view, the leadership in the corridors of power has lacked transparency, direction and vision, leaving the most vulnerable exposed. Integrated funding has been talked about for years and, apart from a few pockets, has not happened as we continue to follow a ‘silo’ culture around health and social care budgets, the impact of which is felt by the sick and their families. PROJECTIONS FOR THE NEXT DECADE A strong NHS benefits local authorities and also organisations such as my own, whereby individuals can be funded appropriately to meet their clinical needs. Therefore, the picture is somewhat blurred currently. However, should integrated funding become a reality and could health and social care join up more effectively, then the outlook would improve for patients and their families. It will still be tough. Changing demographics and longer life expectancies will continue to add to the pressures and there is a likelihood that families will need to support loved ones more effectively. But at least appropriate aftercare would be in place and take some of the strain off services and carers alike. As far as the Christchurch Group is concerned, we will continue to look

for new opportunities, whether that is offering rehabilitation for new clinical pathways, opening more services or increasing our geographical coverage. We’re looking forward to the challenges ahead. INSIGHT I have worked in private healthcare organisations for 25 years in business development and at chief operating officer and chief executive level. I am currently Chief Executive of the Christchurch Group, which provides highly-compliant neuro-rehabilitation services across England. We specialise in all areas of complex care, offering different services at different locations. INFLUENCES Former Nottingham Forest manager, Brian Clough had a big influence on my life and I try to adopt a number of his principles, from when he managed the club. These include: focusing on people’s strengths and not their weaknesses to create a better team; recognising potential; ensuring people have recovery time; giving autonomy; and being slightly unorthodox, but in a stabilising way. Brian always saw the opportunities and joined everything up. He led the club in winning the European Cup twice on these merits, so they must have some basis. In a previous role, I learnt the relationship between management and leadership. At the top of the organisation, you need to be a leader

with a strong commercial mind, able to seek out and exploit opportunity. Within services, it is leadership that will make them Outstanding. You need good leaders at all levels of a business. LESSONS Many years ago, during a training session, someone said ‘valued staff value patients’. Many of my services have been run on those four words, because they reflect a process of transference and it is commercially sound to do so. Your service users are your best marketeers. Someone also told me to deal with today’s problems today and not over bother yourself with tomorrow’s. ADVICE Never, ever make promises – you may not be able to keep them. Listen to and respect your workforce, they have lots of good ideas. Be present at your services. Do not abdicate or procrastinate, make decisions in a timely manner, however tricky it may be; sometimes you may get it wrong, don’t worry about it. Look at potential in all levels of your organisation as part of succession planning. Be able to adapt your organisation to market forces – do not stick your head in the sand when there is a blip, because it may be a trend. Be the same person everyday, whatever is going on inside you and don’t transfer your anxieties. Have a good number two. Don’t let the job consume you and make sure you have a life outside of work. CMM

Read about Richard’s typical day on the CMM website Subscription required. CMM March 2018



CAREER HISTORY My first job was working for what used to be Midland Bank, which is now HSBC. While at school, this was all I ever wanted to do, following two weeks’ work experience at Barclays Bank. Unfortunately, due to personal circumstances, I had to leave the bank. I then spent a short period working in retail, before moving to my local Post Office, where I worked for five years. Whilst there, I applied for a job with Royal Mail, which unfortunately, fell through after I had already handed in my notice. Finding myself out of work, I applied to work nights at my local nursing home. Whilst I was there, I completed my NVQ Level 2 and 3, gaining a Distinction in Level 3. I stayed at the home for the next five years as a care assistant. Then, in 2010, I moved to Accord and started in the role of senior care assistant.


Julie Harwood is Registered Manager for Accord Housing Association. Accord is one of the largest housing and social care organisations in the Midlands.


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In February 2016, I took up the role of Registered Manager at Accord and recently moved to manage Showell Court, an extra care scheme in Wolverhampton. Showell Court has 64 apartments of which we are currently block-contracted to provide care hours for customers in up to 40 apartments. We support both local authority and private clients with palliative and domiciliary care as well as a reablement service. The building itself is very sheltered housing and has communal facilities including a restaurant, guest suite, hair and beauty salon, garden and a large communal lounge.

CURRENT ROLE I have only been a Registered Manager since February 2016. Initially, I didn’t want to move into the role, as I did not want to take on the responsibility that came with it. However, the opportunity came along, and I decided that if I didn’t take the chance, it may not happen again. When I started, I expected the job to be difficult compared to my previous role and that there would be a whole range of things I didn’t know and needed to learn. One thing I didn’t realise was that staff would be relying on me around the clock, seven days a week. I found this particularly difficult to get used to as it had a real impact on my life. However, over time, I have learned how to deal with it and it’s all part of the learning process for both me and the staff. The hardest thing for me, however, has been moving up from being a senior care assistant to managing the team I had been working with. I was surprised how differently I saw things now I was a Registered Manager. I initially thought that if I asked for something to be done, my colleagues would do it, especially as we had worked together for so long and were a good team. However, I found

that reality certainly did not meet my expectations. I think that until you are actually the Registered Manager of a service you don’t fully understand why things are done and the laws and regulations that have to be followed to ensure compliance. On my part, there has been plenty of learning along the way, especially as I am in the process of completing my Level 5 Diploma in Leadership and Management in Adult Care. Where I can, I have used my learning, not only to provide a better service to our customers, but also to pass on to staff to help them to provide a better service too. The best part of the job for me is the learning. It comes as part of the journey. I also enjoy leading the staff team to where we all want to be and having them share that same vision.

RISING STARS I wasn’t aware of the Rising Stars initiative until my manager asked me if it was something I would be interested in. I said I would give it a go, although I wasn’t sure at that point what it would involve. When I was chosen to become one of the first Rising Stars, I was surprised, shocked and really pleased. As part of this programme, I would like to learn new skills that will help me in my role and also have the opportunity to meet with others. I love to learn and feel this is a good opportunity for me to develop.

THE FUTURE Looking forward, I would like to keep on developing my skills and learning. There’s a whole range of information and knowledge out there for everyone. With this learning, I can then pass it onto my staff team to improve the service we provide.

ADVICE I think for anyone that is considering becoming a Registered Manager, my advice would be to just go for it. However, I should add that you mustn’t forget where you started, especially if like me, you were a care worker. This background and experience provides you with the understanding of care from your team’s point of view and also your customers’ point of view. Also, hold on to everything that you have learnt and grasp any opportunities for learning that are available. You may think further training doesn’t apply to you, but you never know when you will be able to use it. Without the support of my manager, and also all other managers that are part of the Rising Stars initiative, I don’t think I would be where I am now. At times, I’ve needed encouragement to get through things and hope I can pass this support and encouragement to my own staff team. CMM

NCF RISING STARS PROGRAMME APPLICATIONS OPEN Thanks to the sponsorship of Carterwood, the National Care Forum (NCF) is able to offer the NCF Rising Stars programme for a second year. It is now open for applications from NCF members. ‘At the NCF, we know that good leadership is key to the success of our sector…However, we also know that the future is only a day away, and to that end, we cannot rest on our laurels. The not-for-profit sector needs to focus on building a new set of leaders who can shape and transform the future provision of care in the UK. With this challenge in mind, at NCF we decided to take some action and begin the important process of investing in our leaders of the future – and so the Rising Stars programme was born.’ Vic Rayner, Executive Director, NCF. The programme: • Is open to Registered Managers who have taken up their post in the last year within NCF member organisations. • Provides an opportunity to develop the next generation of leaders within the sector. • Draws on the leading lights throughout the membership who offer inspiration, expertise and innovation. Send your completed applications to helen.glasspool@ by 30th March 2018. As part of the programme, NCF is offering ten free places to attend the NCF UK Care Conference on the 17th and 18th April 2018 to the successful candidates – registered managers who would benefit from the opportunity to engage with the conference programme, delegates and speakers. The conference provides Rising Stars with the opportunity to hear first-hand about key policy developments, best practice innovations and challenges facing the strategic thinkers within the sector. During the conference, there will be a dedicated session for the Rising Stars, and they will be introduced to a programme of support that will run through the year. The full details of how to nominate someone for this programme, and any organisational commitments, are on the NCF website, Julie is part of the first ever cohort of Rising Stars. This innovative programme, developed by National Care Forum and supported by Carterwood, is designed to identify leading lights within organisations who will shape and form the care sector in the future. More information about the programme, the candidates and future opportunities can be found at

CMM March 2018


Beyond Big Brother: the use of surveillance and monitoring in care The use of surveillance and monitoring technology in social care has been debated for many years. However, as the sector faces increasing pressure, is there a role for such technology to support safeguarding? Philip Scott shares his thoughts. There’s no doubt about it, society is growing older with an ageing population increasing yearon-year. According to the Office for National Statistics (ONS), the proportion of people aged 65 and over is projected to rise to more than 20% of the total population by 2024. Whilst this has its benefits, in terms of accrued wisdom and a sharing of familial responsibilities, it is in part offset by an anticipated need for increased social and health care services.

PRESSURE ON THE SYSTEM Added to this, the ongoing cost-cutting in social care is a hurdle to change and progress. Local authorities in England are making £824m of savings in their social care budgets in 2017-18, according to research by the Association of Directors of Adult Social Services (ADASS). This takes cumulative savings in adult social care since 2010 to £6.3bn. Although funds have been pledged to the sector, both by the Government and through the increased social care precept on council tax bills, plus the forthcoming Green Paper on social care for older people, the system ‘still remains on a cliff edge’ as a result of deep cuts in recent years, ADASS has said. While some individuals will remain fit enough to lead independent lives, it is likely that a significant number will become frail or have 36

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health issues, meaning they will require formal care and may need to move into a care home. This will create further pressure on the sector that everyone acknowledges is already creaking at the seams. As these factors pile pressure on the system, there are challenges around how to allocate and utilise increasingly limited care resources and ensure people receive safe, high-quality care. A definitive, sustainable answer to the issues the sector faces has yet to be found. However, most would agree that the use of a wide range of new technologies to support managers and staff is something all stakeholders must consider, whether that’s to change working patterns, establish positive cultures or allow for the supplementing of scarce manpower resources.

SAFEGUARDING The rigours of safeguarding the welfare of vulnerable people, whilst maintaining high standards of care, is challenging given the unprecedented squeeze on available funding. However, with the growing role of technology in supporting the sector, is there a growing place for monitoring and surveillance technologies to aid safeguarding? Some sectors have made significant inroads in their use, for example, childcare provision. In America, the use of such technology is common practice in kindergartens, and this appears to be growing in UK nurseries. Danish researchers, published in Surveillance & Society, called such technology in nurseries, ‘Just one of many modern technologies which over the next few years might change the relationship between children and parents (and parents and nursery teachers)’. The research concluded that the main ‘motives behind parents’ use of webcams are: to gain insight, to gain a feeling of presence in the nursery and to gain control’. Disciplining staff was a cited as a rare sub-motive.


CMM March 2018


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Social Care Showcase 2018 ‘Making Connections’ Wednesday 14th March 2018, 9:00am – 3:30pm Brighton Racecourse, Freshfield Road, Brighton East Sussex BN2 9XZ In it’s twelfth year, the region’s top business advice and training event for adult social care providers, The Surrey and Sussex Social Care Showcase, takes place at Brighton Racecourse on Wednesday 14 March 2018. Free*conference and exhibition for adult social care owners, chief executives, managers, senior staff and professionals across Sussex, Surrey, Brighton and Hove. * Free Event to those providing care services in East Sussex, West Sussex, Brighton & Hove and Surrey. Others are welcome to attend however will incur a £60 delegate charge.

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CMM March 2018

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The use of surveillance and monitoring technology in social care is a thorny subject that generates strong opinions. Understandably, it can be an emotive subject. For some, it conjures up negative connotations associated with a dystopian Big Brother society. However, major advances in such technologies has made intrusive ‘always on’ monitoring a thing of the past. Now, monitoring by cameras can be ‘event and trigger-based’. With the rise in interest in such technologies, the Care Quality Commission (CQC) has taken the subject seriously enough to issue guidelines for providers considering the option. Using surveillance: Information for providers of health and social care on using surveillance to monitor services was published in 2014 and updated with the new regulations in 2015. It sets out some of the key points to consider on the subject and signposts further resources. In the introduction, it says, ‘The decision whether to use surveillance is for care providers to make in consultation with the people who use their services, and with families, carers, trade unions and staff. This document does not give guidance on whether or not you should use surveillance systems, and CQC does not require providers to do so.’ Following an online petition to install CCTV cameras in all care homes to protect the vulnerable people, the Government responded saying that it, ‘does not object to the use of CCTV in individual care homes or by the families of residents, provided it is done in consultation with and with the permission of those residents and their families.’ It then links to the CQC guidance for providers.

DRIVERS FOR THE USE OF CCTV IN CARE The movement towards embracing the technology has come from individual cases of poor care delivery being exposed. Shameful instances of abuse in care homes regularly hit the headlines and this could offer an effective solution to the issue. Following the online petition, a Panelbase survey was carried out by Care Protect in September 2017. It found that 75% of the 1,010 people questioned were in favour of camera monitoring to safeguard residents in care homes. Indeed, according to mainstream media, many families have reverted to using hidden cameras without the consent of the elderly

person being monitored. In February 2015, CQC published information for families, carers and those who use health and adult social care services to help people make appropriate decisions on the use of hidden cameras, or any type of recording equipment, to monitor someone’s care. Commenting on the information for families, then Care and Support Minister, Norman Lamb MP said, ‘Cameras have helped to expose terrible cruelty and neglectful care and I welcome this new advice. Decisions about using surveillance are extremely difficult – there is always a balance to be struck between protecting people and respecting their right to privacy – but this information will help families to the make the right choice for them. ‘We are committed to preventing poor care from happening in the first place and have introduced tougher standards for inspecting care services as well as measures to shut down those that aren’t up to scratch.’ Unfortunately, there is still a proportion of care providers who need to improve their standards, meaning people receive inadequate, unsafe care. The CQC’s most recent State of Care report found more than 5,000 social care organisations were rated as either Inadequate or Requires Improvement for Safety.

ETHICS AND HUMAN RIGHTS While there are, quite rightly, questions raised over the ethics of using such technology, and how, when and from whom consent is required, things have progressed far beyond a bank of screens being continually watched. Individual privacies and liberties can be protected and respected by using intelligent cameras, which provide monitoring on an ‘events’ only basis. Such systems can be designed to safeguard residents’ privacy and dignity in-line with the Human Rights Act Articles 5 and 8 requirements. In addition, any camera system could and should operate independently of providers, with trained health and social experts reviewing any events. They would then use their experience to assess any incidents and recommend what action is required and within what timeframe.

BUSINESS BENEFITS OF MONITORING TECHNOLOGY At a time when public funds are limited, investing in camera monitoring technology could be a possible economic solution to ensuring acceptable quality care is delivered

every day. Initial findings from Care Protect’s own research suggest that, in care homes it makes a tangible difference to promoting a sustainable high-quality service, and in doing so, improving its commercial fortunes. Current providers using such technologies have reported to Care Protect that they have noticed sustained improvements in care delivery, increased fee rates and occupancy, declining agency expenditure and, on average, a 24% reduction in safeguarding events. One example is a Birmingham care home, which has moved from being rated as Requires Improvement to Good by CQC. Its expectation at the next CQC review is to receive an Outstanding rating in at least one of the five key questions. Before the technology was introduced, the 76-bed facility regularly had resident vacancies, it now averages just two in any given week. Another home, in the south of England, had 10 empty beds and an embargo imposed on admissions, yet a year after camera technology was installed, it achieved capacity and now has a waiting list. A third home has increased its occupancy by 10% since embracing camera technology. Beyond these benefits, surveillance technology also has the potential to save time, money and resources when investigating a safeguarding issue raised by a resident or family members. Usually the process involves staff suspensions, time taken interviewing witnesses, additional agency cover, and a possible admissions embargo. These all are costs borne by a home under review. Surveillance technology, however, provides footage that could be retrospectively reviewed, and any matter addressed immediately with the appropriate action taken. The debate is slowly but surely moving on from concerns over a Big Brother society to recognising the possible benefits of this technology including in reducing, if not completely eradicating, instances of abuse. Research into the use of such technologies in the mental health sector finds that it is a growing trend. Smart surveillance could be a very effective answer to the issue of limited resources and safeguarding vulnerable people. Demand is growing for services, but funds and manpower resources will remain constrained. It may be time to consider surveillance technology as part of an operational toolkit that promotes high-quality care and delivers trust, confidence, reassurance and transparency that all stakeholders want to see. CMM

Philip Scott is Founder of Care Protect. Email: Twitter: @CareProtectLtd Do you use CCTV in your service? Would you consider it? Share your thoughts at Subscription required. CMM March 2018

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CARE SECTOR SOFTWARE With a growing need to streamline operations, save money and ensure quality care, there is an increasing role for technology in the sector. Whether you need nurse call systems, compliance, care planning, medication management or back office software, there is a wealth of products on the market. Whatever your requirements, CMM has brought you a selection of the leading providers on the market.


CMM March 2018

Aid Call, a brand of Legrand

Ablyss Tel: 01625 535685 Email: Website:

SECTORS • Residential care homes. • Nursing homes. • Supported living. • Learning disability homes. • Mental health. • Rehabilitation.

PRODUCTS • Full care recording and evidencing. • Mobile app for recording at point of care. • Accident and incident monitoring. • Deprivation of Liberty Safeguarding. • Employee absences and training. • Assessment tools and body maps.

COMPANY PROFILE With the current media spotlight on care homes and the changes to legislation that will evolve, the care sector is facing a period of unprecedented change. You need to rest assured in the knowledge that your chosen care management software can cope with these changes, as well as being easy enough to use for your daily support team. The Ablyss Care Management System (CMS) offers you one of the most intuitive and adaptable systems in the marketplace. It was developed in 2003 and offers a range of cost effective products that can be used in a large range of care home environments. The software is fully supported and continually updated to comply with

industry regulations and our support team is at hand to help with any queries you may have. At Ablyss, we have looked to embrace the technology that surrounds us, whilst providing solutions that are workable, efficient and reliable. By providing you with the right tools, you can quickly record data and then ultimately assess how your residents’ needs have changed over time. This way you can easily evidence your care and adapt it to your residents’ changing needs. Ablyss CMS is fast becoming a favourite amongst a range of care providers, from nursing and residential homes to rehabilitation facilities. Users have experienced massive time saving benefits with reviews being completed in 10 minutes, rather than in two hours, and compliance checks being completed over 60% faster. Essentially, CMS will streamline the way you manage your information, leaving you free to do what you do best – care. To see what Ablyss CMS could mean to you, visit our website or call us on 01625 535685 for your free 30-day trial or to book a demonstration.

Tel: 01670 352371 Email: Website:

SECTORS • Care homes. • Care groups. • Nursing homes. • Hospitals. • Hospices. • NHS.

PRODUCTS • Nurse call. • Paging. • Staff presence. • Assistive technology. • Telecare devices. • Performance monitoring.

COMPANY PROFILE Fitting a nurse call system can often be disruptive, timeconsuming and expensive; but not with Aid Call’s wireless system. Aid Call has been leading the way in the design and manufacture of nurse call technology for over 40 years, with bespoke products and solutions designed to meet the needs of care homes, hospices and hospitals. The newest system, the Touchsafe Pro, has been specifically developed following feedback from those at the forefront of care delivery, to ensure it facilitates the provision of person-centred care while remaining easy-to-use. Wireless configuration allows the system to adapt to the everchanging priorities and demands of the healthcare sector, which is

reassuring at a time of increased pressure on resources and environments. Additional panels, call points and assistive devices can be added at any time and Aid Call offers an extensive range of assistive technology, such as fall detectors which facilitate individual patient and resident requirements. As Touchsafe Pro does not rely on cables or stationary wiring points, it is infinitely expandable and allows for complete flexibility and mobility. It is tailored specifically to work within each individual site and budget, with quick and undisruptive installation. Innovative features and powerful software achieve unrivalled functionality – improving the speed of call responses, and increasing the depth of information available to staff and management alike. This enhances team performance and supports staff in providing the most effective care. Aid Call’s nurse call systems are programmed to track and record all call information. Details of outgoing calls are stored, including call location and response time, to provide a comprehensive insight into staff activity and performance. With user-friendly touchscreens, antimicrobial properties, and the option of emergency or cardiac pull-stop or push button configurations; the Touchsafe Pro is truly the most advanced system on the market.

CMM March 2018



Courtney Thorne

CareMeds Tel: 01794 400100 Email: Website:

SECTORS • Domiciliary care. • Residential care. • Nursing. • Pharmacy. • Residential educational establishments.

PRODUCTS • Medication adherence packaging and software. • MultiMeds blister systems. • CareMeds web. • CareMeds eMAR.

COMPANY PROFILE CareMeds came to market in 2012, with a goal to simplify the relationship between the pharmacy and the care provider, in order to improve patient outcomes. This was the first time both parties were able to log in to the same platform, where they could communicate with ease, manage patient medications and re-orders and generate


CMM March 2018

our bespoke colour-coded MAR charts. As an innovator in the health and care sector, we wanted to revolutionise the way in which medication administrations are recorded. Now, with over 30,000 patients receiving medications each day through our systems, we are well on the way to achieving this goal. 2015 saw the release of our first eMAR. Ever since, we’ve been listening to user feedback and are excited to announce the release of our next generation of CareMeds eMAR. If you would like to know more, please contact us and we’ll be happy to help. CareMeds eMAR offers: resident medication profiles; managed stock control with auditing tools; colour-coded labelling for original pack and blistered medication; ability to record patient measurements; notifications and alerts; barcode scanning; offline mode; live charts print backup; and clinical warnings at the point of admin.

Tel: 0800 068 7419 Email: Website:

SECTORS • Care homes. • Nursing homes. • Hospices. • Hospitals.

PRODUCTS • Wireless nurse call systems. • Online nurse call reporting. • Nurse call accessories. • Staff attack.

COMPANY PROFILE We are proud to be the leading innovators in the UK’s nurse call industry for 50 years. Our high-quality UK-manufactured technology coupled with classleading support is trusted by well-known care homes, NHS Trusts and private hospitals. To make care home management more efficient, we designed The Altra Care – SMART Wireless Nurse Call System that can integrate with a wide range of accessories and other technology used throughout your care home. The new generation SMART nurse call system is future-proof and comes

with a market leading three-year warranty. The online nurse call reporting feature allows you to monitor your care home remotely. You can analyse daily care home activity, monitor staff performance and compare with other sites. It acts as a crucial audit tool for service improvements and cost savings. Our installation process is simple and clean with no wiring required, allowing us to work in a care home without disruption to staff and residents. The modular nature of the system means it can easily grow with your business and adapt to future changes such as home extensions, changes in the layout or room use. We are committed to giving a high-quality service, from initial consultation and installation, to ongoing customer service. Our consultants are experienced at advising on the most economical solution whilst meeting your exact requirements. Visit to find out more and call us to arrange a free demonstration: 0800 068 7419.


Cura Systems


Tel: 0203 621 9111 Email: Website:

Tel: 01634 202101 Email: Website:

SECTORS • Residential care homes. • Nursing homes. • Supported living. • Learning disabilities. • Mental health support. • Local authority. • Charities.

PRODUCTS • Complete care management software. • Modern care planning. • Medication management. • Staff planning. • Details notes and how do I module. • Monitoring. • Reporting. • Alerting.

COMPANY PROFILE Cura Systems has developed the most comprehensive care home management software for your care home. We offer intelligent and modern care planning, medication management, staff planning, notes and time and attendance monitoring software. By using Cura’s suite of applications, your care team will have more time to care for your service users and will feel more confident and reassured in performing their care tasks. Together, we can go further to safeguard your residents and care workers. Wouldn’t it be a revelation to remove the use of paper within your care home? Cura uses facial recognition, images, videos and talk-totype functionality to create an all-digital care planning, monitoring and medication

management solution. You will have real-time access to a full data trail to prove you are delivering outstanding care to the Care Quality Commission, management, families and friends. Cura is tailored for each resident as we believe it is vital that care delivery is about the person. We give you the tools to achieve person-centred care and monitor health trends and individual residents’ outcomes. We understand you and your team are the experts on health and social care, the resident is the expert on themselves and how they feel and our expertise in building easy-to-use, modern care IT systems makes a powerful team. Working together, we can deliver continually outstanding care. We pride ourselves on best-in-class support and service, so our engagement is not just for the short-term. Our dedicated team will support and guide you through your adoption of Cura. Cura provides secure applications for every person involved in all aspects of a resident’s care. Contact us and see how we can support you to revolutionise the management of your care home services.

SECTORS • Care homes. • Care homes with nursing. • Domiciliary care. • Mental health. • Private hospitals. • Supported living.

PRODUCTS • CVMinder ATS. • Applicant Tracking System.

COMPANY PROFILE Lower your recruitment costs and improve results with an award-winning, low-cost Applicant Tracking System (ATS) that’s perfect for care. CVMinder is a securely-hosted ATS that helps care organisations manage and improve their own recruitment services. You can speed up everything and use some great compliance features to make the whole process safe and efficient. The system will publish adverts to your favourite job boards automatically, so they collect, share and manage applicants from everywhere in one, easy-to-use system. Assist HR, recruiters and managers with a simple, flexible system for shortlisting and tailor individual user views and responsibilities for seamless co-operation. Give candidates self-service access to their information and overcome GDPR concerns with a system that has always required candidate consent. To top it all, CVMinder ATS helps you to audit everything, from advertising to

hire, including pre-employment checks. We believe that CVMinder ATS is the ideal choice for care organisations managing their own recruitment, but don’t just take our word for it: Capterra awarded CVMinder ATS Best Value Applicant Tracking System 2017 and Best Support 2017. Our customers say, ‘… significantly reduced the amount of time…improved the candidate experience…self-explanatory, even for the non-technologically minded…would have no hesitation in recommending the system.’ – mcch ‘Amazing product and service…easy-to-use…any question asked is answered and dealt with almost straight away… would highly recommend.’ – Kent Autistic Trust If you’re paying too much to recruit or you want to find out how other care companies have transformed the way they hire, just give us a call. We’re here to help.

CMM March 2018



Intelligent Care Software Tel: 07801 786592 Email: Website:

SECTORS • All sectors. • Care homes. • Domiciliary care. • Nursing homes.

PRODUCTS • CAREis. • Care planning. • Policy and procedure. • Quality assurance.

COMPANY PROFILE Intelligent Care Software Limited design, promoting intelligent, intuitive and cost-effective solutions for care home and domiciliary care management. We aim to produce applications that are simple and easy-to-use, work seamlessly together, and provide the information and detail that is required to ensure regulatory compliance and a high quality of service. The CAREis suite of apps includes: Care and Support – From enquiry, though assessment and care planning, to care delivery, CAREis helps to develop the care plan and to provide relevant and up-to-date data for quality assurance purposes. Care planning and provision is personcentred and updated in real time. Carers know exactly what is required, and when to deliver support, with simple recording of any intervention.


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IPROS CUBE Tel: 01483 688000 Email: Website:

SECTORS Policy and Procedure – We develop the policies and procedures based on the latest regulatory and governmental guidelines to ensure that your practice is up-to-date, relevant, and compliant in an easy-toread format. With a facility for people to record that they have understood the policy, and a clear link to training requirements, knowledge of policy and procedure is improved significantly throughout the organisation. Quality Assurance – By extracting data from throughout CAREis in real time, quality assurance reviews and monitoring are far more efficient. This app provides audit templates for all areas of regulatory requirements, and ensures important inspections, audits and actions are addressed in the specified timeframe. Analysis and action planning is streamlined and effective in reducing paperwork time and improving quality and compliance. Security – All of our data is stored in the Amazon AWS Cloud satisfying compliance requirements for virtually every regulatory agency around the globe. Support – Live UK-based customer support, 9 to 5 Monday to Friday; urgent support by email 24/7; regular software updates; daily data backup.

Assured Compliance

• Care homes. • Care homes with nursing.

PRODUCTS • Assured Compliance software. • CQC compliance. • Risk management. • Quality care management.

COMPANY PROFILE IPROS CUBE provides the Assured Compliance software solution to enable more effective care quality management, transparency and accountability. IPROS is focused on enabling care providers to gain active insight into their care operations when and where they need it, in a form they can use right away. Nursing and care staff can spend more time engaged with people and less on administration. Reputational risk can be markedly reduced by enabling focus on exceptions and bringing all operating units up to the standard of the best – improving performance while keeping costs of compliance under control. Based on the Internet ‘cloud’, information is available, and up-to-date, anytime, anywhere and without the capital and support costs of traditional IT systems.

All care providers need to ensure delivery of high-quality care and compliance with statutory regulations. Uniquely, we can provide you with an affordable toolset and an approach which enables you to get a view across your all your care locations without constraining how you run your business or how you deliver care, all while keeping ahead of the compliance curve – Assured Compliance. Assured Compliance can meet your care assurance needs: replacing paper-based audits and quality assurance in all care settings, from one to hundreds of locations; a paperless audit trail to reliably meet CQC and other regulatory requirements; automated reminders, avoiding the need for constant chasing for information; management summaries to highlight areas of non-compliance and trends for concern; proactively managed action plans with closed loop audit trail; bespoke audit questions and response requirements and customer/ visitor surveys. We can have you up and running in a few weeks with a standardised and proven approach without disrupting your workforce. No gimmicks, no vapourware, no hidden costs. See what’s really happening in the organisation from anywhere, anytime and in real-time. Make sure you really know.


Person Centred Software

Nourish Tel: 0238 000 2288 Email: Website:

SECTORS • Residential care homes. • Nursing homes. • Supported living. • Learning disabilities. • Mental health support. • Local authority.

PRODUCTS • Digital solution for care planning and care notes. • Configurable, personalised care timelines. • Organic and integrated care plans. • Powerful form building and bespoke reporting. • Accessible to all with built in speech-to-text. • Well-designed and simple-to-use.

COMPANY PROFILE We are Nourish Care. Our vision is to enable better integrated health and social care, delivered by empowered care teams and connected communities. We are passionate about collaborating with the care sector to develop innovative solutions that will inform and improve the quality of care we all provide. For too long paperwork has taken the care team away from caring. We want to give carers their time back to care and managers their time back to lead. Focusing on user experience and

smart design, we have created an electronic solution for care planning and daily care notes. Our secure, intelligent and easy-to-use digital tool saves carers and care managers precious time and boosts productivity. With a focus on clear communication, quality care records and better access to information, the Nourish system simplifies care management to support care teams to provide the best quality of care possible. Fully customisable to the needs of your service and those you care for; our system enables you to record daily care tasks on the go via specially designed smart devices; so that you can focus on what really matters – spending time with those you care for. Instantly accessible, stored securely and always retrievable, you can say goodbye to paper forms and care plans and hours of note-taking. With expert consultation and training, we will fully support your transition onto digital. Care providers working with us are already reporting an improvement to the quality of care and are seeing genuine clinical impact. If you’d like to know more about how we can help you and your team embrace a smarter way of caring, visit us at nourishcare. Get in touch to discuss how digital care management can be tailored to you.

Tel: 01483 604108 Email: Website:

SECTORS • Residential care homes. • Nursing homes. • Dementia care homes. • Supported living. • Mental health.

PRODUCTS • Software. • Electronic evidence of care. • Care planning and assessment tools. • Electronic evidence of activities. • Wound care. • Care monitoring and reporting. • Relatives’ Gateway. • Group reporting.

ease-of-use for the type of role the person normally performs, which makes the app very easy-to-use and quick to learn. The main part of the system manages the care that is provided, and allows comprehensive care planning, reporting and auditing. Reporting extends across the organisation with Group Reporting, which highlights the performance of different communities. Care planning includes integration to call bell systems and activity planning, to provide a complete view of care each individual receives, which can also be shared with families and friends via the Relatives’ Gateway.

COMPANY PROFILE Person Centred Software provides an innovative mobile solution for evidencing care interactions and care planning, called Mobile Care Monitoring. Mobile Care Monitoring is already in use by more than 10% of all care homes rated ‘Outstanding’ by the Care Quality Commission, and has been evidenced to improve the quality of care, reduce administration, help the care service go paperless, and gives care staff more time to care. Mobile Care Monitoring includes apps for tablets and phones, that are optimised for

CMM March 2018




Quality Compliance Systems



Tel: 0333 405 3333 Email: Website:

SECTORS • Residential care homes. • Domiciliary care. • Supported living. • Learning disabilities. • Mental health. • GPs. • Dental.

PRODUCTS • Compliance management system.

COMPANY PROFILE Quality Compliance Systems (QCS) is the leading compliance management system for the UK care sector. Our service provides over 35,000 care, dental and medical professionals with access to the most comprehensive set of customised policies, procedures and compliance toolkits, enabling our users to stay compliant with current Care Quality Commission policies. Over 2,700 dedicated pages are reviewed and updated regularly in line with legislative


CMM March 2018

and regulatory requirements, and best practice guidelines, by our team of leading industry experts. Instant policy updates are delivered digitally, 24/7, directly to our customers via the online management system and QCS app. Furthermore, our policies and compliance tools reflect the Care Quality Commission’s changes to their Key Lines of Enquiries (KLOEs), enabling social care providers to stay up-to-date with current Care Quality Commission thinking and inspection frameworks. How does QCS support your care service? • Policies aligned with CQC Fundamental Standards. • Updates delivered digitally, 24/7. • Unlimited number of users. • Mock inspection toolkits. • Dedicated telephone support staff. To find out more or to sign-up for a FREE no obligation trial, go to or call us on 0333 405 3333.

• Care homes. • Domiciliary care. • Nursing agencies. • Learning disabilities. • Social care. • Corporate.

PRODUCTS • HR and compliance. • Electronic monitoring. • Invoicing and payroll. • Reporting. • Timesheets. • Audits. • Recruitment. • Portals.

COMPANY PROFILE Since starting in 1992, Ulysses has gone from strength-to-strength. We have continually developed to become well-known, specialist software providers within the care industry, supplying to some of the biggest domiciliary care providers in the UK. Our continuous development is driven by listening to our customers’ needs. Having done this for over 20 years, the ability to tailor our software to your needs comes easy, with most clients’ requests available ‘off the shelf’. We pride ourselves in not only providing a complete management solution for your business, but also an unbeatable support service to our clients. The past few years have introduced a variety of technologies, which have advanced our systems rapidly, but this doesn’t stop us continually working on developing new and fresh ways to help you and your carers provide a seamless service to every client, every day. Helping you meet your business needs. We have a range of products available, with the ability to

provide an all-in-one business management solution. We can tailor our solutions to specifically fit your business needs. Our experienced team will consult with you and learn about what is important to your business and help you find the perfect solution. Become paperless. No more relying on receiving paper timesheets, paper care plans or texting and emailing out jobs. Your remote workforce can use their phone to check rotas, log-in and out and even record notes and outcomes of each visit they attend; providing you with information in real-time logged straight on to the NewCare system. Keep the cost down. With carers able to use their own device, by a simple download of our app on to their mobile device, as well as saving on paper and administration time, we can guarantee you will see a return on investment and a much more practical way to monitor time and attendance.

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DORSET CARE CONFERENCE 2018 8th February, The Lighthouse, Poole

CMM held its second CMM Insight Dorset Care Conference in early February. The event was held in conjunction with the Bournemouth, Dorset & Poole Care Providers Federation and Dorset Care Homes Association. The 100-strong delegation from across the Dorset region represented a broad range of providers all keen to hear about what’s happening in the sector both regionally and nationally. Brian Westlake of Bournemouth, Dorset & Poole Care Providers Federation chaired the event and opened with a rousing speech, summarising the issues facing providers in Dorset. He set the tone for the day and was followed by social care consultant, John Kennedy. John explored policy and what needs to happen to secure a sustainable care sector of the future. He declared that the sector needed ‘a systematic approach to change’ and that to have Outstanding services, social care needs great managers working with adequate resources.

INSPECTION Amanda Stride and Sally Newell of the Care Quality Commission were next to take the stage. Their interesting and engaging presentation looked at changes to the assessment framework, the new Key Lines of Enquiry and developments with Registering the Right Support. They also delved into the performance of providers across Dorset, Bournemouth and Poole – highlighting how they rate when compared with the national average. After the break, where delegates were able to visit the numerous exhibition stands covering a range of sector products and services, the next main stage presentation was from Ed Watkinson of Quality Compliance Systems.

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CMM March 2018


Ed gave delegates a lot of ideas for how to approach the inspection process, including putting together a file of evidence for the inspector, showing any innovative practice you’re undertaking and trusting your staff to deliver a high-quality service. Delegates were then able to put their questions to the panel, to get answers to their questions and delve into presentations in more detail.

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WORKSHOPS The day then broke into workshop sessions. With the opportunity to attend two of the three workshops, the topics were: • FIRE! Property Protection vs Life Safety with Lloyd Smith of LS Fire Solutions. • Investing in Quality to Support Business Outcomes with Tom Owen of My Home Life. • The Role of Digital Technology in Modern Care Delivery with Luis Zenha Rela of Nourish. Feedback was incredibly positive and delegates appreciated the opportunity to learn more about each important topic.

AFTERNOON SESSION The main stage afternoon session then delivered two very interesting and practical presentations to help providers run their businesses as effectively as possible. Adrian Porter of Porter Dodson engaged the audience with guidance on how to manage difficult conversations with staff. He gave out many different strategies, a number of useful phrases to use in conversations and other advice, including ‘be prepared’, ‘take good notes’ and ‘be aware that someone may be voice recording it’. The final speaker to take to the stage was Sophie Coulthard of the Judgement Index. As

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a very knowledgeable speaker on values-based recruitment, Sophie informed delegates of how they can develop a good care environment and find and keep the right staff. Her top tip was to have a ‘good, structured induction’ because it can reduce turnover by 50%. That’s one piece of advice everyone in the sector should implement. Summarising the event, Brian thanked all the delegates, the speakers, exhibitors and sponsors: Quality Compliance Systems, Judgement Index and Nourish Care. Delegates left with a huge amount of useful information to take back to their organisations and help them to operate effectively.

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WHAT’S ON? Event: Health and Care Explained Date/Location: 7th March, London Contact: The King’s Fund, Tel: 0207 307 2409

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Event: Care Showcase 2018 – Making Connections Date/Location: 14th March, Brighton Media Partner Contact: Surrey Care Association, West Sussex County Council, East Sussex County Council and Brighton and Hove City Council Web: Event:

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Ageing in Common: An International Perspective, incorporating NCF UK Care Conference and Commonwealth Elders Forum Date/Location: 16th-18th April, Reading Contact: CommonAge and National Care Forum, Web: www. and Event: Naidex Date/Location: 25th-26th April, Birmingham Contact: Naidex, Web:

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Event: Delivering the Future of Health and Care Date/Location: 27th-28th June, London Contact: Health + Care, Web:

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Event: Digital Health and Care Congress 2018 Date/Location: 10th-11th July, London Contact: The King’s Fund, Tel: 0207 307 2409 Event:

NAPA Annual Conference London: Getting activity right for everyone Date/Location: 11th July, London Contact: NAPA, Tel: 0207 078 9375

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CMM Insight Lancashire Care Conference 27th September, Blackburn Care Choices, Tel: 01223 207770

Please mention CMM when booking your place.

CMM March 2018


S A L LY B O W E L L • R E S E A R C H F E L LO W • I N T E R N AT I O N A L L O N G E V I T Y C E N T R E – U K

Sally Bowell discusses ILC-UK’s new report on dementia and music which outlines a blueprint for positive change.

For many, music is a part of the fabric of life. Encompassing different cultures, genres and eras, music brings people together, promotes communication and helps with emotional expression. Music is also indelibly tied to memories; a nursery rhyme, the song for the first dance at a wedding, or a favourite Christmas carol can take us back to a time, place and feeling. Research also shows that our connection to music stays with us throughout our lives, even whilst living with dementia. The implications of this have been explored by a recent Commission on Dementia and Music, co-ordinated by ILC-UK and supported by

The Utley Foundation. In a unique new report, ILC-UK explores the dementia and music ecosystem of activity, the evidence base of proven benefits and opportunity areas for further work. The report brings together learning from a literature review, alongside a combination of both oral and written evidence from interested individuals and organisations. The report highlights recent research in the journal, Brain, which helps begin to explain why musical memory may be preserved in advanced Alzheimer’s disease. The study observed brain responses to music, then used this data to demonstrate an overlap of brain regions key to musical memory with areas that are relatively spared in Alzheimer’s disease. The report also points to a ‘memory bump’, with people with dementia retaining the clearest memories for music they enjoyed and heard between roughly the ages of 10 and 30, which is based on research published in Memory & Cognition. Whilst we are still not fully sure why music is such an invaluable tool for people with dementia, research into the proven benefits is becoming increasingly well-developed. Outcomes include minimising the impact of behavioural and psychological symptoms of dementia (BPSD) such as wandering, agitation and physically aggressive behaviour; helping to tackle anxiety and depression; better retention of speech and language; and improvements in wellbeing and quality of life. Throughout the lifecycle of the Commission, academic studies have been enhanced by site visits which have provided highly-valuable, first-hand evidence of the amazing impact that music can have for people living with dementia. Online footage is also doing much to help raise awareness of the value of music, for example, the Alive Inside project’s video. Interestingly, some studies into music

and dementia have demonstrated a reduction in the use of antipsychotic medication for study participants. This is crucially important given the recent concerted effort to review and reduce the reliance on antipsychotic medication for individuals living with dementia. Studies also discuss the positive impact of music for carers, such as reduced stress and, for those employed in caring, increased capacity for other tasks. For example, if day-to-day tasks can be made less stressful for the resident through using therapeutic music (for example, getting dressed), the care worker can have more time to dedicate to other residents and activities. We conclude that there is a need to unify existing activities in the field, and improve local information and data collection for use by professionals and the public alike. At the same time, researchers should focus on developing cost-effectiveness evidence, particularly important in a time of belttightening. Meanwhile, private sector and philanthropic organisations can play a powerful role by recognising the value of music, and by utilising their own resources and expertise to help grasp some of the opportunities available. This could include the increased involvement of technology companies to help make music available to all, for a minimal cost. Ultimately, raising public awareness will be crucially important. With the ambitious aim that every person with dementia should be able to access music by 2020, The Utley Foundation is committed to launching a new Ambassador for Dementia and Music role to help provide leadership and impetus to the agenda. This Ambassador will lead a taskforce dedicated to positive change and will be key in taking this work forward. At the heart of this debate is the right for people with dementia to have not just a life, but a good life and to be comforted and enlivened by the power of music. After all, without a song or a dance, what are we?

Sally Bowell is Research Fellow at International Longevity Centre – UK. Email: Twitter: @ILCUK For the references mentioned here and to access the report, visit Subscription required. 50

CMM March 2018

Ageing in Common: An International Perspective


Incorporating the inaugural Commonwealth Elders Forum and the NCF UK Care Conference #EldersForum2018 #AgeingInCommon #NCF2018

Katie Sloan Chief Executive Global Ageing Network

Hon. Anthony Agius Decelis M.P. Parliamentary Secretary for People with Disability & Active Ageing, Malta

John Beard Head of Ageing and Lifecourse World Health Organisation

Ngaire Hobbins Dietitian Specialising in Ageing, Brain Health and Dementia

DAY ONE CommonAge Elders Forum

DAY TWO CommonAge Elders Forum



Opening Address from CommonAge and National Care Forum Commonwealth Agenda Ageing Across the Globe LUNCH & EXHIBITION WHO – Decade of Healthy Ageing 2020 – 2030 Mental Health, Dignity in Care

Focus on Dementia

Global challenge, women and dementia, Dementia Friendly Communities

Ageing in the Commonwealth, Oxford Institute of Population Ageing Research Report Discussion Panel: Response to research report


d Park l e fi e k o W e De Ver 16 –18 April

Debbie Ivanova Deputy Chief Inspector Adult Social Care Care Quality Commission

Panel Discussion: Older People and

Communities Workshops: Older People and Communities Intergenerational Communities Building Communities Health Communities Sharing Communities & Care Home Open Day

CommonAge NCF UK Care joins UK Conference delegation Registration

LUNCH & EXHIBITION Workshops: Smart Solutions to Global Problems Age Friendly Cities Developing Leadership Disruption and Design


NCF member Trustees and Non-Executives

What Next for Ageing?

Francis Njuakom Nchii,Executive Director, Community Development Volunteers for Technical Assistance Cameroon


Opening Address from National Care Forum Panel Discussion: Human Rights & Care CQC, Life Changes Trust, Dept of Health NI Workshops: Rights in Action Older people & learning disability, Mental Health Recognising Faith & Spirituality. End of Life Care, LGB Rights

LUNCH & EXHIBITION Workshops: The Future looks Bright

Taking Activities to the next level Alternative Sources of Funding The Future of Home Care Retirement Living Nursing Provision Panel Discussion: Reform across the UK Representation from the 5 Nations and Age UK

The Global Ageing Network – Ageing in Common CLOSE


Sanchita Hosali Acting Director The British Institute of Human Rights

Claire Henry MBE Director of Improvement and Transformation, Hospice UK

Anna Buchanan Director Life Changes Trust

Prof Paul Burstow Chair SCIE

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