Care Management Matters February 2019

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FEBRUARY 2019

www.caremanagementmatters.co.uk

WAYS TO WELLBEING How you can support your registered managers

Consumer law compliance CMA’s latest guidance explained

Cameras in care

Can body cameras work in social care?

Resource Finder Technology


DRIVING

OUTSTA

NDING C

ARE

Person Centred Software has been extremely responsive to my needs and the software is very intuitive and closely aligned to our care homes’ needs. We’ve achieved an excellent return on investment and I wouldn’t hesitate in recommending the software. It’s worth every penny and then some. RISHI SODHA, CARE DIRECTOR, HANDSALE CARE HOMES

Person Centred Software interviews Rishi Sodha, Care Director at Handsale Care Homes. Rishi Sodha is the Care Director at Handsale Care Homes, a group of eight care homes that have implemented Mobile Care Monitoring (MCM), Person Centred Software’s electronic care system. Rishi explains that when one of Handsale’s homes, Treelands Care Home in Oldham, Lancashire, went fully paperless, it made an immediate difference to staff morale and efficiency for the care home, “At the time, a nurse pulled me into her clinic room and told me it was the first time she’d stepped foot inside there since her morning meds round and she felt it was the first full day of nursing she’d done in 10 years,” says Rishi. “She also showed me her office which contained just one shelf of paperwork replacing what she described as being a paper mountain rather than an office.” Rishi points to time saving as a major benefit. “Our nurses are saving up to 4 hours a day and the care staff between 45 minutes to an hour. I hear many homes complain about lack of staff but if a nurse can save four hours, it’s like having another staff member for a third of a shift.”

Book a demo of MCM with us: Call 01483 604108 or email hello@personcentredsoftware.com

“Initially at board level, we saw Mobile Care Monitoring as a way to save time, but it has given us insight into things we just didn’t know. For example, we discovered that one resident was missing a sleeping care plan, and we were able to rectify it immediately.” “At a corporate level, we can now sleep calmly at night. And our home managers can go on holiday, confident that the right care is being given to everyone.” And since implementing Mobile Care Monitoring, Rishi confirms that no risk assessments have expired. “Person Centred Software has been extremely responsive to my needs and the software is very intuitive and closely aligned to our care homes’ needs. We’ve achieved an excellent return on investment and I wouldn’t hesitate in recommending the software. It’s worth every penny and then some. I know all home managers wouldn’t go back. And if I ever threatened to remove Person Centred Software, I think I’d have a riot on my hands.”

Read the full interview with Rishi at www.personcentredsoftware.com/handsale


In this issue From the Editor

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Inside CQC Debbie Westhead, Interim Chief Inspector of Adult Social Care, provides an overview of what we can expect from the Care Quality Commission this year.

07

CMM News

09

Business Clinic Our panel takes a look at the use of body cameras in social care settings, discussing whether they could work.

30

Rising Stars 2018 Jamie Smith is Assistant Manager of Supported Living at emh care & support.

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3rd Sector Care Awards The winners of the Markel 3rd Sector Care Awards were announced in December. Find out who they were in this month’s article.

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Event Preview We preview the CMM Insight Dorset Care Conference 2019.

48

What’s On?

49

Straight Talk Nadra Ahmed OBE tackles the Brexit issue and asks, what can the social care sector expect?

50

25

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FEATURES 36

REGULARS

40

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Driving change: consumer rights in care homes Mike Lambourne from the Competition and Markets Authority (CMA) delves into the detail of the latest consumer law guidance.

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Supporting registered managers on the road to wellbeing Wellbeing and resilience are an essential part of supporting our leaders. Oliver French from Skills for Care shares his tips for ensuring registered managers have the tools to look after themselves.

36

Infection control: practice what you preach Clare Long, Care Sector Specialist at Miele GB, explores the steps providers can take to improve infection control and avoid negative outcomes.

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Resource Finder: Technology From care management systems to recruitment trackers, find the technology solution that’s right for you. CMM February 2019

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EDITORIAL editor@caremanagementmatters.co.uk Editor in Chief: Robert Chamberlain Editor: Angharad Burnham Content Editor: Emma Cooper

CONTRIBUTORS

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

ADVERTISING sales@caremanagementmatters.co.uk 01223 207770 Advertising Manager: Daniel Carpenter daniel.carpenter@carechoices.co.uk Director of Sales: David Werthmann david.werthmann@carechoices.co.uk Senior Sales Executive: Aaron Barber aaron.barber@carechoices.co.uk

@CQCProf

@CMAgovUK

@skillsforcare

@vicrayner

Debbie Westhead Interim Chief Inspector of Adult Social Care, Care Quality Commission

Mike Lambourne Assistant Project Director, Competition and Markets Authority

Oliver French Project Manager, Skills for Care

Vic Rayner Executive Director, National Care Forum

@scottmoncrieff

@everyLifeTech

@emhcare

@MieleProf

Errol Archer Consultant Solicitor Advocate, Scott-Moncrieff & Associates Ltd

Taffy Gatawa Chief Information and Compliance Officer, everyLIFE Technologies Ltd

Jamie Smith Assistant Manager of Supported Living, emh care & support

Clare Long Care Sector Specialist, Miele GB

SUBSCRIPTIONS Non-care and support providers may be required to pay £50 per year. info@caremanagementmatters.co.uk 01223 207770 www.caremanagementmatters.co.uk Care Management Matters is published by Care Choices Ltd who cannot be held responsible for views expressed by contributors. Care Management Matters © Care Choices Ltd 2019 CCL REF NO: CMM 16.0 Photo Credit: Laurence Cawley/BBC

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CMM February 2019

Nadra Ahmed OBE Co-convenor, Cavendish Coalition and Chair, National Care Association

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From the Editor Editor, Angharad Burnham looks at how we ended 2018, gives a snapshot of this month’s features and shares her hopes for 2019. The close of 2018 saw promises broken once again, as the Green Paper was delayed further – now reportedly being published ‘soon’, with Mr Hancock saying he intends its release ‘before April’. We’re hoping that the Department of Health and Social Care has made a resolution to publish the Green Paper to this deadline and finally offer some potential solutions for the funding of future services. With Brexit to blame for the Green Paper delay, we turned our thoughts to the impact that any type of EU exit might have on social care. Nadra Ahmed has shared her concerns around this on page 50. She suggests that immigration is our biggest potential issue and discusses what needs to be done to avoid a crisis.

KEEPING COMPLIANT More big news towards the end of 2018 was the publication of the Competition and Markets

Authority’s final guidance on consumer law for care homes. To help you to digest the publication, Mike Lambourne breaks down the key points and ensures you know exactly what you need to be doing.

TECHNOLOGY For those seeking to implement new technology, our Resource Finder on page 40 can help you find a solution that will fit your business’ needs. Whether you’re seeking technology to improve your GDPR compliance, hoping to improve your quality rating, or just streamlining your processes, the organisations listed can support you to achieve your aims. With the benefits of CCTV in care homes highly debated, our Business Clinic looks at an alternative. Body cameras are designed to be switched on when something needs to be recorded. Do they provide a solution to keeping people safe? Read our panel's thoughts on page 30.

LOOKING FORWARD We are continuing our look into the mental health of registered managers this month and will be revisiting the topic later in the year. This issue, we’ve got tips from Skills for Care on ensuring your registered managers have the tools to maintain and improve their mental wellbeing. Read more on page 25 to make sure you’re following best practice. With the arrival of 2019 came the NHS Long Term Plan. The sector welcomed the shift of focus from acute care to care in the community and prevention, but there are reservations from

some who think it could be too ambitious and question its deliverability. We’d love to hear your thoughts on the plan and how it might impact services. Share your ideas on the CMM website, where there's also additional content to accompany this month’s features. As for the rest of 2019, I’m hoping social care will be put on the platform it deserves. It could be the optimist in me, but with a focus on solving the funding issues, the promise of a national drive for recruitment, and a shift towards a more integrated system, maybe the sector will be looking back from a different position this time next year.

Email: editor@caremanagementmatters.co.uk Twitter: @CMM_Magazine Web: www.caremanagementmatters.co.uk

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It’s great to be back writing for Inside CQC, this time in my new role of Interim Chief Inspector of Adult Social Care. I want to start by saying a big thank you to all of you who worked over the festive period to ensure people continued to receive the support and care they rely on and could enjoy a special time with friends and family. It might be part of the job, but it still deserves to be shouted about. Now onto 2019! With changes to leadership at CQC it’s no surprise that questions have been raised about what this means for our regulation. I want to reassure you that there are no big surprises coming; our focus is on strengthening how we carry out our role and improving the experience providers have of working with us and our interactions with the public. We’re all in this business for the same reason – making a difference to people who use services – and developing strong relationships with CQC is important to us. With this in mind, I was disappointed to read concerns raised by Neil Grant in the December issue of Care Management Matters that CQC risks losing sight of the basics. The article makes a number of allegations – including that CQC applies arbitrary ratings limiters and does not give due regard to the need for consultation. I do not agree with these claims. It’s important to say that a breach of the regulations is serious and our enforcement policy reflects this. Where there is a breach, there is a risk to people’s safety and experience and I make no apologies for not compromising on the standards of care people have the right to expect. Our guidance for providers and inspectors does detail the small number of circumstances that are sufficiently serious to apply a ratings limiter; but it also makes clear that inspectors will make proportionate judgments about applying these based on each individual case. In fact, making proportionate judgments is a key part of an inspector’s role. We know that this happens best when an effective relationship is built between inspectors and services, so we’re committed to supporting inspectors with this. From 28th January, we will be rolling out improvements to ‘how we report’. This follows work to coproduce and pilot these with providers and inspectors (find full details on this in our next provider newsletter). Reports will be clearer to the reader and a small but important

Inside CQC D E B B I E

W E S T H E A D

Debbie Westhead, Interim Chief Inspector of Adult Social Care, provides an overview of what we can expect from the Care Quality Commission (CQC) this year.

improvement we’re introducing means that, after the registered manager receives the draft report, the inspector will call them to talk through the evidence. In our piloting of this, we’ve found it has helped providers to better understand how we arrived at our judgments and helped clarify issues or concerns or celebrate Outstanding care. As a result, some challenges that might previously have been

“I want to start by saying a big thank you to all of you who worked over the festive period.” made have been avoided which has allowed us to publish some reports more quickly – a good thing for providers, CQC and the public. It’s this type of change that you’ll be seeing from CQC this year – changes that come from us listening to our staff, providers and the public

about what works and where we can refine our approach to help us work better together. We remain committed to working in coproduction to make these changes not just because it’s the right thing to do, but because it helps us get these improvements right. We may not always be required to carry out a formal consultation by law, but – in the spirit of the Quality matters commitment we made with the sector in 2017 – we will always engage with our stakeholders to ensure we hear first-hand from you what the impact of any change might be. Before I sign off for this month, I want to give you an advance update that we’ll be publishing the latest issue of our Learning from safety incidents series soon. These resources – developed with the help of our online community of providers – describe critical safety issues and the steps providers can take to avoid them happening in their services and have proved hugely popular. With the coldest months of winter still to come, the new issue will focus on avoiding risks of people developing hypothermia. I hope you’ll read and share the information within your organisations when it’s available.

Debbie Westhead is Interim Chief Inspector of Adult Social Care at the Care Quality Commission. Share your thoughts and feedback on Debbie’s column on the CMM website www.caremanagementmatters.co.uk Not a member? Sign up today. CMM February 2019

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APPOINTMENTS ARTHUR RANK HOSPICE CHARITY Sharon Allen OBE, Skills for Care Chief Executive, has been appointed Chief Executive of Arthur Rank Hospice Charity. See page 13 for the full story.

BALLYCARA

NHS Long Term Plan The NHS Long Term Plan has been published, committing to saving more lives by tackling major conditions and investing in cuttingedge treatments. The measures outlined in the plan aim to prevent 150,000 heart attacks, strokes and dementia cases while more than three million people will benefit from new and improved stroke, respiratory and cardiac services over the next decade, according to NHS England. People will benefit from services including life-changing stroke therapy and integrated support to help older people stay out of hospital, live longer and have more independent lives. The NHS Long Term Plan also

promises that investment in primary, community and mental health care will grow faster than the overall NHS budget. This will fund a £4.5bn service model, where health bodies come together to provide better, joined up care in partnership with local government. The commitment to tackle major physical conditions comes alongside investment in mental health services rising to at least £2.3bn a year by 2023/24. Over the next 10 years, around two million more people who live with anxiety, depression or other issues will receive help, including new dads as well as mums, and 24-hour access to crisis care via NHS 111. According to NHS England, the

NHS Long Term Plan will also: • Open a digital ‘front door’ to the health service. • Provide genetic testing for some people with dangerously high inherited cholesterol. • Give mental health help to 345,000 more children and young people. • Use cutting-edge scans and technology, including the potential use of artificial intelligence, to help provide the best stroke care in Europe. • Invest in earlier detection and better treatment of respiratory conditions. • Ensure every hospital with a major A&E department has ‘same day emergency care’ in place.

Immigration White Paper Home Secretary, Sajid Javid has set out plans for a single, skills-based immigration system which marks the end of free movement. The new system will introduce a route for skilled workers which favours experience and talent over nationality. It will enable employers to have access to the skills they need from around the world, while ensuring net migration is reduced to sustainable levels. The White Paper proposals will, in line with the recommendations made by the Migration Advisory Committee (MAC); • Remove the annual cap on the number of work visas issued. • Widen the skills threshold to

include people with qualifications equivalent to A-levels. • End the requirements for labour market tests by employers wanting to sponsor a worker. Regarding social care, the White Paper says, ‘The MAC did not recommend a route specifically for low skilled workers and we intend to accept that recommendation. Employers have to some extent become reliant on lower skilled workers from the EU for certain jobs. Leaving the EU provides an opportunity to drive business change and ensure that UK companies are at the forefront of innovation going forward.

‘However, we recognise the challenges faced by these employers, particularly in sectors like construction and social care, who would find it difficult immediately to adapt. We propose, as a transitional measure, also to institute a time-limited route for temporary short-term workers. This route will allow people to come for a maximum of 12 months, with a cooling-off period of a further 12 months to prevent people effectively working in the UK permanently. We will engage extensively with business and stakeholders as part of the engagement process on the duration and cooling off periods.’

Sharon Blackburn CBE, Policy Director at the National Care Forum, will be moving to Brisbane, Australia to join Marcus Riley CEO and his team at BallyCara. Read the full story on page 10.

INDEPENDENT AGE Rabbi Baroness Julia Neuberger DBE has been appointed as Chair of the Board of Trustees at Independent Age. She will take up the role in mid-October 2019 succeeding the current Chair, Justine Frain.

THE FREMANTLE TRUST Sara Livadeas has been appointed Chief Executive at The Fremantle Trust.

JEWISH CARE Jewish Care has appointed two new directors. Angela Murphy has been appointed as Director of Community Services and Gaby Wills as Director of Care Services.

NURSING AND MIDWIFERY COUNCIL Dr Ruth May has been appointed as Chief Nursing Officer for England.

REGARD GROUP Tracy Kite has joined the Regard Group as Director of Learning and Leadership Development, and Graham Farrington-Horsfall has been appointed Director of Quality. CMM February 2019

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NEWS

Benefits of intergenerational care for young people A report from United for All Ages examines the benefits of intergenerational care for young people as well as the older generation. It shows how greater interaction between older and young people can help tackle crises facing children and young people and counter ageism in Britain. While the benefits of

intergenerational projects for older people are widely acknowledged and well-documented, United for All Ages is claiming that bringing young and older people together can also help tackle issues facing the next generation – from poor health, anxiety and loneliness to educational attainment and social mobility. The report also says that

Future funding of care in Wales The Welsh Health and Social Services Minister has announced that the future funding of care in Wales is a priority for government. Vaughan Gething outlined the programme of work to explore a social care levy for Wales. He will take over the work of chairing the inter-Ministerial group on paying for social care, which was set up last year to investigate options for social care models and the future funding of care in Wales to meet rising demand. The group will use the report by Professor Gerald Holtham about a social care levy as the basis for its work. Mr Gething said, 'How we meet the costs of caring for an ageing population is a complex and challenging question, which faces most of the developed world. '…The Welsh Government has prioritised social care and we are committed to developing innovative funding models to

support future costs. 'A levy is one of the options for raising additional funding for social care. This requires careful consideration alongside all other options including insurance models.' Professor Holtham’s idea for a social care levy was one of four new tax ideas to emerge from the national debate about new taxes in Summer 2017. His report and economic analysis was published in June 2018 and was debated by Assembly members yesterday. The Welsh Government has prioritised funding for health and social services combined – official Treasury figures show spending per person on these functions increased by 3.8% in Wales in 201718, the highest increase of any of the four UK countries. Spending per person on health and social services in Wales is 11% higher than in England, equivalent to an extra £290 per person.

LGA green paper findings The Local Government Association (LGA) has published its green paper findings, saying that doing nothing is no longer an option. It says that years of significant under-funding of councils, coupled with rising demand and costs for care and support, have combined to push adult social care services to breaking point. The organisation has called on Government to abandon shortterm incremental 'handouts' and make the case for national tax rises, so that current and future 10

CMM February 2019

generations can be confident they will have the care and support they need to live the life they want to lead. LGA received more than 540 submissions from the general public, service users, councils and many other interested parties. The final report forms the basis of 14 recommendations to Government. It contains a summary of responses, including recognition of the importance of adult social care and a consensus that the system is unsustainable in its current form.

intergenerational projects can boost confidence, skills and opportunities for children and young people while changing attitudes towards ageing. The next generation: how intergenerational interaction improves life chances for children and young people shows how the benefits of intergenerational care for young people can give

children a good start in life, raise educational attainment, change attitudes, solve tough issues and shape the future. The report makes eight key recommendations for increasing the number of intergenerational projects. The full report and findings can be found on the United for All Ages website.

Markel 3rd Sector Care Awards winners announced The 3rd Sector Care Awards celebrate excellence and innovation in voluntary, not-forprofit support services. Entries came from across the sector. Hosted once again by Dame Esther Rantzen, who this year was joined by her daughter, Rebecca Wilcox, the day was a truly remarkable showcasing of the talent and efforts put in by all the finalists, winners and the sector as a whole. Dame Esther's interviews were paired with festive performances from the Chelsea Pensioners singing group and St Joseph's

Roman Catholic Primary School, which had everyone singing and dancing along. The judges were impressed by the high calibre of this year's finalists and congratulations go to them all. A full list of finalists and winners can be found on the Markel 3rd Sector Care Awards website, or read about the ceremony and the projects that won on page 46. This year's ceremony will be held on Friday 6th December 2019. Sign up to CMM to make sure you stay up-to-date.

Shortage of nurses in sector Care England has voiced concerns about the significant workforce pressures in the social care sector. Professor Martin Green OBE, Chief Executive of Care England says, ‘We are appealing to the Migration Advisory Committee to continue to include Registered Nurses on the Shortage Occupation Lists. 'It is imperative that the newly-created Nursing Associate

role, as well as direct care staff and Registered Managers, are on the lists in order to stem the workforce shortages.’ Care England has responded to the consultation on the Shortage Occupation Lists Review 2018. Its response highlights the significant workforce pressures including the growing reliance upon both EU and non-EU nationals to fill vacancies.

Sharon Blackburn to leave National Care Forum After almost 10 years of working for the National Care Forum (NCF), Sharon Blackburn CBE will be leaving the organisation this Spring. She will be moving to

Brisbane, Australia, joining Marcus Riley and his team at BallyCara. NCF has started the recruitment process for a new Policy Director; details are on the NCF website.


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NEWS

Homecare sector struggling A lack of both funding and staff is resulting in the homecare sector struggling to stay afloat in some areas, according to a report from The King’s Fund and the University of York. Home care in England: views from commissioners and providers has found that the market for homecare providers is extremely fragile, with squeezed margins and low fees forcing providers to leave. In 2017, providers handed back homecare contracts in over one in three local authorities, and some of the largest providers withdrew from the publicly-funded homecare market altogether.

Staff shortages are a ‘relentless challenge’ for homecare providers in many places. The report highlights concerns that fees paid by some local authorities are too low to maintain quality services, resulting in high turnover of providers and staff, which has negative impacts on continuity of care, as well as potentially wider effects on care quality. Researchers also uncovered fears that some staff are being paid below legal minimum wage levels. The report has also found that: • Four in 10 homecare workers leave their role every year. • Over half of homecare workers

are on zero hour contracts. • In 2016/17 around 500 new homecare agencies registered each quarter and 400 left the market. • In a 2017 survey, many council directors of adult social services had experienced homecare providers ceasing to trade in the previous six months (39%) or having contracts handed back (37%). Faced with reductions in their central Government grant, council spending on social care was 3% lower in 2017/18 than in 2009/10. Part of this reduction

has been achieved by holding down the amount local authorities pay providers for care. Analysis suggests a link between prices paid by councils and the quality of homecare. Despite this, some local authority commissioners are sceptical that increasing fees will boost quality or staff wages, fearing the extra funding will go into care providers' profits. The report concludes that homecare needs to move away from ‘time and task’ payments to commissioning services based on achieving outcomes for people, integrated more closely with health care services.

Ombudsman’s annual review of complaints Social care pressures are being reflected in the quality of people's support, according to the Local Government and Social Care Ombudsman’s (LGSCO) annual review of complaints. Over the past year, the

Ombudsman has become increasingly concerned about the way some authorities are handling the need to balance the pressures they are under with the way they assess and charge for care. The report, which looks at the

data behind every adult social care complaint the Ombudsman has received over a 12-month period, shows there has been a 9% increase in complaints about charging. Of those complaints, it is upholding 67%. This is higher than

the average uphold rate for adult social care of 62%, and greater still than the 57% uphold rate for all complaints the Ombudsman investigates. The full report can be found on the LGSCO website.

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CMM February 2019


NEWS

Skills for Care Chief Executive to step down

Local authorities failing adults with Down’s syndrome

Sharon Allen OBE, Chief Executive of Skills for Care will be leaving the organisation later this year. Sharon joined Skills for Care in 2009 and has helped to put workforce development at the heart of the future of adult social care services. Sharon will take up her new role at Arthur Rank Hospice Charity, which supports people in Cambridgeshire living with a life-limiting illness and those who need end-of-life care, in April. Sharon said, 'I wanted a new role that really embedded me in the local community where I live and this opportunity at Arthur Rank Hospice Charity offers me a chance to make sure that people across Cambridgeshire can access palliative and end of life care services that meets their needs. 'Leading the highly skilled hospice team brings together my absolute commitment to local

Local authorities are failing adults with Down’s syndrome – resulting in unlawful practices in some cases – because they are taking too long to assess their basic needs and get adequate support in place, says the Down’s Syndrome Association. Almost half (43%) of adults surveyed reported being in need of a social care assessment, with some waiting as long as two years. The findings come as a result of a survey undertaken by The Down’s Syndrome Association, which spoke to more than 1,200 of its members about their personal experiences following concerns raised through calls, letters and emails to their helpline service. The survey looked at a number of key areas, including assessments, care planning, health and personal budgets. It found that: • 43% of carers said their adult child needed a social care assessment.

services with everything I have learnt throughout my career, particularly over the last nearly nine years at Skills for Care. 'I have really valued the skills, knowledge and commitment of everyone who has worked at Skills for Care who have transformed us into the go-to organisation for all workforce matters in adult social care. I know whoever succeeds me will be taking over an organisation that is in a very good place thanks to the tireless efforts of a hugely talented group of professionals who I will miss greatly.' The Skills for Care Board has announced that it will now begin the process for appointing a new Chief Executive. The Arthur Rank Hospice Charity announced in November 2018 that Dr Lynn Morgan will retire as Chief Executive at the end of March.

• 27% of respondents were unhappy with the quality of support provided around needs assessments, with some reporting social workers lacking the expertise and professionalism required. • 50% of carers said the assessment was not being reviewed annually. • 92% of people did not get an initial 6-week review as recommended in Care Act guidance. • 61% of carers reported their adult child received no hours of support for education. • 42% of carers were not satisfied with the level of support for evening and weekend activities. • 66% of respondents said they received no support for accessing employment. • 33% of carers were concerned about inadequate support for emotional and mental health issues.

CMM February 2019

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NEWS / IN FOCUS

Funding for primary and community healthcare Theresa May has announced additional funding for primary and community healthcare, saying that more people will be looked after at home and in their communities. The aim is to avoid people going into or staying in hospital unnecessarily. The Prime Minister pledged to cut needless hospital admissions and help inpatients return home sooner, through communitybased rapid response teams and dedicated support for care home residents. The 24/7 rapid response teams are made up of doctors, nurses and physiotherapists and will provide urgent care and support in the community as an alternative to hospital. This includes emergency treatment as well as support to help patients

recover closer to home, which will help people stay healthy and independent for longer. The new investment – worth £3.5bn a year in real terms by 2023/4 – builds on the existing NHS budget for these services. As well as this, the Prime Minister has announced the national roll-out of a successful pilot that sees healthcare professionals assigned to care homes where they get to know individual residents’ needs and can provide tailored treatment and support. The teams include pharmacists and GPs who can also offer emergency care out of hours. The announcement of additional funding for primary and community healthcare forms a key part of the Long Term Plan for the NHS.

Healthwatch annual report published Chair of Healthwatch, Sir Robert Francis has used the Annual Report to explore how people are experiencing care day-to-day across England. Over the course of the year, Healthwatch shared 2,053 reports with local services and decision makers about the improvements people would like to see. Healthwatch reports that people are continuing to receive outstanding care, and much of which people say is down to the dedication shown by the ‘extraordinary staff’. However, it is also becoming clear that others struggle to access the support they need, with services not getting the basics of care right. Examples Healthwatch has worked on over the last year include care home residents not being able to see an NHS dentist and hospitals not providing the right information to help prevent patients having to return unnecessarily.

Issues like these require the NHS and social care system to be looked at as a whole, yet services are not always able to spot the gaps between them and the impact this is having on the people they care for. Four common themes for improvement for all services are identified in the report: 1. Better information to make the right choices – including being able to find the right information and it being easy to understand. 2. Easier access to support – avoiding delays and cancellations, ensuring quicker and easier access to services. 3. Improved conversations – involving people in decisions about their health and care and keeping people informed so that they understand their choices. 4. Well-coordinated services – making the navigation of health and social care more seamless, to reduce the risk of issues and to make things easier for people.

IN FOCUS Review of the Mental Health Act WHAT’S THE STORY?

The Independent Review of the Mental Health Act 1983 has set out recommendations for Government on how the Act and associated practices need to change. The review looked at the rising rates of detention under the Act; the disproportionate number of people from black and minority ethnic groups detained under the Act; and processes that are out of step with a modern mental health care system. The ultimate aim was to make recommendations to ensure the Mental Health Act works better for everyone, reducing the use of coercion, giving people more choice and control, and insisting on better care, even where detention is required.

WHAT ARE THE RECOMMENDATIONS?

Modernising the Mental Health Act: Increasing choice, reducing compulsion takes into account the views of people with direct experience of the Mental Health Act, as well as those who support them and the organisations that represent their views. The panel also invited professionals and organisations that use the Mental Health Act to share their thoughts on the current Act. The final report recommends four principles that should underpin the reformed Act. These intend to provide the basis for any action taken under the Act, setting the standards against which decisions can be held to account and providing patients with clear expectations for their care.

The principles encompass the concepts of: • Choice and autonomy – ensuring people's views and choices are respected. • Least restriction – ensuring the Act’s powers are used in the least restrictive way. • Therapeutic benefit – ensuring people are supported to get better, so they can be discharged from the Act. • People as individuals – ensuring people are viewed and treated as rounded individuals.

WHAT DOES THE SECTOR SAY?

Responding to the final report, Paul Jenkins OBE, Chair of the Mental Health Network, said, 'We welcome the recommendations in this important review. We hope these will help to increase choice and provide alternatives to detention following years of rises in detention rates… Restricting someone’s liberty should always be a last resort. Putting this right requires all of us taking steps to ensure we close the gap in terms of inequalities in access and outcomes.' President of the Association of Directors of Adult Social Services (ADASS), Glen Garrod also commented, saying, 'The recommendations in this report are welcome as a contribution to the modernisation of this country’s mental health services, which are about giving people who need these services more control and the specific support they need.’ The full final report of the Independent Review of the Mental Health Act can be found on the GOV.UK website. CMM February 2019

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NEWS

#GladtoCare winner announced CQC mental health survey The #GladtoCare competition, run by Person Centred Software and The Care Workers Charity, has drawn to a close. Care staff from across the UK were invited to take part in the photo competition, judged by David Brindle from The Guardian, Professor Martin Green, Chief Executive of Care England, Vic Rayner, Executive Director of the National Care Forum and Alex Ramamurthy, former-CEO of the Care Workers Charity. Alice Taylor, the cook at Primrose Lodge Southbourne in Bournemouth, won the Haven

holiday prize. She entered a photo of herself cooking with the message, ‘I’m #GladtoCare making home cooked food daily for my residents and have been for seventeen years.’ The #GladtoCare competition was designed to boost the profile of care workers and the recognition of the work they do. Person Centred Software received many entries from care workers who were delighted to share their skills, creativity and dedication. The finalists can be viewed on Person Centred Software’s website.

People’s experiences of the care they receive from community mental health services have continued to deteriorate, according to an annual survey from the Care Quality Commission (CQC). The survey highlights concerns around access to care, care planning and support for people with mental health conditions in relation to physical health needs, financial advice or benefits. Although 71% of respondents felt they were ‘always’ treated with respect and dignity by NHS mental health services, less than a third

(30%) rated their overall experience of community mental healthcare as nine out of 10 or above – down from 34% in 2017. This contrasts with the 2017 Adult Inpatient Survey where 50% of acute inpatients receiving care for a physical health problem answered nine or above out of 10 for this question. The survey results have been released for community mental health services to review the experiences of people who use their services and to make improvements where needed.

Future of care: Leadership in integrated care systems The latest in Social Care Institute for Excellence’s (SCIE’s) Future of Care series has set out the findings of research into leadership of integrated care systems. Leadership in integrated care systems comes as Sustainability and Transformation Partnerships (STPs) continue to work to

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improve services. Where strategic partnerships and collaboration are most advanced, STPs have now developed further to create integrated care systems (ICSs). The research reveals that leaders in ICSs need to be skilled at identifying and scaling innovation; having a strong focus on outcomes

and population health; and building strong relationships with other leaders, which can often mean working with them informally to develop joint priorities and plans. They can also establish governance structures which drive faster change. Leaders of ICSs told SCIE

that they spend more time than ever before developing good relationships with colleagues and listen to and empathise with their concerns and issues. Often, these relationships were fostered outside formal meetings, with lots of ‘prework’ to prepare for more formal partnership meetings.


NEWS

Caring for adults with disabilities New NCF Board members The cost of caring for adults with learning disabilities is projected to increase by almost £2bn by 2025, according to the County Councils Network (CCN). The CCN has released analysis showing that the rise in the number of adults with severe learning disabilities requiring care, and the increase in the cost of supporting them, will see the annual cost of caring for adults with learning disabilities rising from £4.8bn in 2015 to £6.7bn in 2025. This figure is collectively for all 152 councils with care responsibilities. The figures show a large variation in costs across the

country. County local authorities will bear the brunt of these additional costs; with costs rising by £918m in the 36 county authorities by 2025, which is half of all additional costs. This compares to £313m in London and £350m in other urban metropolitan areas and cities. CCN argues that these additional costs are outside of councils’ control, and as a result they will have to cut other highly valued services or introduce new or increased charges for other services to make up the shortfall if no extra resource is made available to councils from 2020 onwards.

Anchor Hanover Group Anchor Hanover Group has been formed from the successful merger of Hanover Housing Association and Anchor Trust. The new organisation is responsible for over 60,000 homes across 1,700 locations, supported

by over 9,000 staff. It operates in more than 90% of local councils in England and provides rented and leasehold retirement housing and residential care homes. More information is available on the Anchor Hanover website.

The National Care Forum (NCF) has announced the appointment of four new Board members. Martin D’Mello, Group Director of Housing Care & Support at One Housing, Martin Farrow, Chief Executive of Optalis, Dan Hayes, Chief Executive of The Orders of

St Johns Care Trust, and Karen Knight, Managing Director at NorseCare have joined the Board. Two Board members have also stepped down; Carole Sawyers, Chief Executive of Brendoncare and Rory O’Connor, Director of Welfare and Policy at RAFA.

Healthwatch’s top priorities for 2019 The Healthwatch England network has published its list of top priorities for 2019. These set out the key health and care topics Healthwatch's local teams will be working on over the year ahead. These are: • Primary care (including access to GPs). • Children and young people. • Mental health. • Services working better together. • Adult social care, including care homes and care at home.

The projects undertaken by Healthwatch will build on the dayto-day activities of the network visiting hospitals, GPs and care homes and engaging with local people to gather their views. At a national level, Healthwatch aims to use the combined findings to provide insight for decision makers across the NHS, social care sector and Whitehall about the sorts of improvements people would like to see.

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NEWS

Lack of older people’s care services

CPA’s seven principles for engagement

Only one in five local areas in the UK have enough older people’s care services to meet demand, suggests research from Coram Family and Childcare. This means that over 4.3 million people aged 75 or over are living in areas without enough care. The third annual Older People’s Care Survey found significant regional variation: no local authorities in Inner London or Northern Ireland reported having enough older people’s care services to meet demand in their area, while almost half (44%) in the East Midlands and the North East said they did. 34% of local authorities expect the situation to get worse in the next year, compared with only 1% who expect it to get better. According to the report, older people who need care at home will struggle to find it, with only half of local authorities (51%) reporting enough support in their area. Those with more complex needs, such as dementia, may face even tougher odds of finding suitable care, with just 42% of areas having

The Care Provider Alliance (CPA) has published seven principles for engagement to support strategic engagement between local authorities, the NHS and the independent and voluntary adult social care sector. The CPA’s principles for the engagement of individual providers on behalf of the wider independent and voluntary adult social care sector aims to help all parties. Based closely on the widely recognised 'Seven Principles of Public Life', they suggest how adult social care providers should approach any situation in which

enough specialist nursing care to meet local demand. People who pay for their own care are likely to struggle with high costs and information black spots, says the report. It found that: • Older people paying for their own care face prices which are 13% higher than those paid by local authorities for residential care. • Even if they only pay the same price as local authorities, at nearly £17 an hour, it takes just one year and one month for selffunders using 21 hours of support a week to spend £20,000 of savings on average UK homecare fees. • One in six (16%) local authorities knew about the prices that selffunders pay. • One in five (19%) did not have enough information to say whether there were enough older people’s care services in their area to meet demand. The full report is available on the Coram Family and Childcare website.

Mental health among LGBT people Research from Stonewall, Britain’s leading charity for lesbian, gay, bisexual and transgender (LGBT) equality, has exposed the levels of poor mental health among LGBT people compared to the general population. The study also reveals a high level of hostility and unfair treatment faced by many LGBT people when accessing healthcare services. The research shows more than half of LGBT people (52%) have experienced depression in the last year, and three in five (61%) had anxiety. This compares to one in six adults in England who faced a common mental health issue, such as anxiety and depression, according to Mind. Almost one in four patients 18

CMM February 2019

(23%) had witnessed negative remarks about LGBT people from healthcare staff while accessing services. One in seven LGBT people (14%) said they have avoided treatment altogether for fear of the discrimination they may face. Of those who do seek support, one in eight (13%) have experienced some form of unequal treatment from healthcare staff because they’re LGBT. A quarter of LGBT people also faced a lack of understanding of their specific health needs; a figure that rises to 62% for transgender patients. Stonewall is calling for better training for all health and social care staff, with specific guidance on how to meet the needs of LGBT patients.

they are acting as a representative of the wider sector. Bridget Warr CBE, Chair of the Care Provider Alliance’s Programme Board, said, 'The independent and voluntary adult social care sector is ready to work more closely and strategically with local authorities and the NHS. The adoption of these principles by care providers should reassure our statutory sector colleagues that there is nothing to stop them working with the sector, and if people are to receive care that is properly joined up, it is essential that this should happen in every local area.'

Cooking videos for people with learning disabilities People with learning disabilities are making YouTube videos to help tackle obesity as part of a new project from United Response. CookABILITY aims to encourage people with learning disabilities, Down’s syndrome and autism to cook for themselves and eat healthy food. Research shows disabled people are more likely to have poor diets and not exercise enough, with over 80% of adults with learning disabilities failing to meet official

minimum recommended levels for physical activity. United Response will make 12 easy-to-understand recipes, including spaghetti bolognese, chilli con carne and quorn paella, broken down step-by-step. All the videos have been made with the help of people with learning disabilities, for people with learning disabilities. The team are aiming to reach people supported by United Response and many more supported by other organisations.

Replacing Carer’s Allowance A report by Demos think tank calls for a new settlement between the State and informal carers by replacing Carer’s Allowance with a new Universal Carer’s Income. The think tank is calling for: 1. Government to abolish the Carer’s Allowance and replace it with a new Universal Carer's Income for all carers providing more than 35 hours a week of care, paid at the same rate as Jobseeker’s Allowance. 2. Government to introduce a Carer’s Working Credit - a pay top-up for carers that go down to part-time hours. This is

based on the German policy, Familienpflegezeit which gives carers the right to request parttime working with better than part-time pay. 3. Government should work towards introducing one year’s paid care leave modelled on maternity pay, funded by abolishing the State Pension ‘triple lock’. 4. Employees to have the right to 10 days of annual paid care leave. 5. Duty should be placed on NHS bodies to identify carers and support their health and wellbeing.


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ES M HO E R A C

Recent advice from the Competition and Markets Authority (CMA) has been produced to help care homes understand their consumer law obligations. Here, Mike Lambourne from the CMA explores the advice and looks at the ongoing consumer protection work into care homes, including nursing homes, for older people.


Consumer law ensures people are given the information they need to make informed choices. It gives important protections to residents and their representatives, alongside the standards and regulations enforced by sector regulators. People should be confident they will be treated fairly and should be able to complain effectively if they have concerns. It is vital that, if you’re running a care home, you understand how consumer law affects you. Our advice sets out the standards that we expect all care homes to follow. It is relevant to care homes whether residents pay their own fees or are funded by the State. Remember that you are dealing with people who may be very vulnerable. They may be frail, in poor health, or under a lot of pressure and emotional stress. You should consider the difficult circumstances people might be in and their unfamiliarity with the process of choosing a care home.

CARING ABOUT THE MARKET In December 2016, we launched a UK-wide market study into care homes to examine how well the market was working, including whether care homes were treating residents and their representatives fairly. One of the reasons we launched this study was because concerns had been raised that some care homes might not be complying with consumer law. Charities such as Age UK and Citizens Advice thought that some care homes were, for example, imposing hidden charges or giving very short notice periods for fee increases. Our final findings report was published in November 2017. Whilst recognising that the sector performs a vital public service and is staffed by many dedicated and caring individuals, the report found that some residents were at risk of being treated unfairly. It identified concerns about some care homes’ practices and contract terms. These included: • A lack of indicative pricing

information on websites. • Contracts only being provided very late in the admissions process or after the resident had moved in. • Charging of compulsory upfront fees. • Deposits not being effectively protected against the risk of insolvency. • The charging of fees for an extended period after a resident had died. We were also told that some residents and their representatives found it difficult to make complaints, partly because complaints systems can seem complex to use, but also because the person lodging the complaint might be afraid of reprisals. It should also be noted that, once in a home, very few residents are willing or able to move. Therefore, they might find it difficult to change homes and could be more vulnerable to unfair treatment, particularly if they are self-funders.

HOMING IN ON COMPLIANCE During the market study, we opened an investigation into a number of care homes’ contract terms and business practices. This investigation has already led to positive changes in the sector. We secured more than £2m in compensation from one large care home provider as part of an investigation into the charging of compulsory upfront fees, and have told another large provider that it will face legal action unless it refunds over 1,600 residents who paid a compulsory upfront ‘administration’ fee of as much as £3,000. Other homes have also dropped contract terms relating to the charging of fees for extended periods after a resident’s death.

WHAT DOES THE CMA’S ADVICE COVER? Following the CMA’s market study, we published two pieces of advice on complying with consumer law. Our consumer law advice

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CMM February 2019

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DRIVING CHANGE: CONSUMER RIGHTS IN CARE HOMES

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on the charging of fees after death was published in May 2018. More recently, we have published further comprehensive advice to help care homes understand their responsibilities and obligations under consumer law. The advice has been developed with constructive engagement from the sector, including care homes and their representative bodies, and following a public consultation. The advice sets out what care homes need to do to ensure they are treating residents and their representatives fairly. In particular, this includes: • Providing upfront information – what information homes should give to potential residents and their representatives, and when, to help them make informed choices. • Treating residents fairly – what homes should do to make sure that their contract terms and the way they treat people are fair. • Quality of service – how homes must ensure their services to residents are provided with reasonable care and skill. • Handling complaints – how to handle complaints fairly and make sure the complaints procedure is easy for people to find and use. Upfront information Care homes must give people certain key information on first contact. This includes information about whether they accept selffunded and State-funded residents, key features of the service and how much people will have to pay to stay in the home. This information should be highlighted on the care home’s website and in any information packs or other written materials people are given, and should be explained upfront during initial telephone enquiries and at the beginning of any first visit. Care homes should also actively provide important additional information, such as information

about any trial period and the basis for asking residents to leave, when people want or need it, and in sufficient time for them to be able to consider it before they agree to have a care needs assessment with the home. This additional information should be easy to find on the home’s website, included in information packs, and explained to people on any follow-up enquiry. Treating residents fairly When someone signs a contract with a care home, the terms of that contract must be fair under consumer law, otherwise they are unenforceable. There are some key principles care homes need to

compensation if things go wrong. • Abuse their position of power to apply pressure, as this could limit people’s freedom of choice.

such as the Ombudsman, if they remain unhappy with how their complaint has been dealt with.

Quality of service If care home staff do not act with reasonable care and skill, residents may be able to claim compensation for breach of contract. Sector regulators enforce regulations that a care home must follow to provide a quality service. For example, the building and equipment must be suitable and safe, and residents must be treated with dignity and respect. If a care home does not follow

We will be carrying out a review in late-2019 to assess care homes’ compliance with consumer law and the progress that has been made since we published our advice. This will include, where necessary and appropriate, requesting information from care homes and asking them to demonstrate how they are complying with the law. We will work closely with other regulatory partners in holding care homes to account. If we find serious instances where care homes are breaking consumer law, either through our ongoing monitoring or during our review, further enforcement action could be taken. This may include taking a care home to court to get it to change its business practices or contract terms, requiring it to pay money back to residents, or even bringing a criminal prosecution, so it’s important to ensure you comply with the latest advice. We also intend to provide appropriate support to other stakeholder initiatives that will help to further embed our consumer law advice. For example, our market study recommended that the industry develops ‘model contracts’ for use by care homes with self-funding residents. We think this would help to address the variability we found in the user-friendliness and intelligibility of contracts for self-funders, encourage best practice across the sector, and ease the workload of care homes in designing and updating their individual contracts to comply with the law. Following this recommendation, the Care Provider Alliance in England is now intending to produce model contract clauses and supporting materials for its member care homes. CMM

“We will work closely with other regulatory partners in holding care homes to account.” follow. For example, terms must: • Explain all the rights and responsibilities between the care home and the resident. • Be simple, clear and easy to understand. • Not give the care home more rights than the resident. • Be written and agreed in a fair and open way. Examples of terms which may be unfair include those that: tie residents to ‘hidden’ terms that they haven’t had the chance to read and understand; do not hold the care home responsible if things go wrong when it is the care home’s fault; or that allow the care home to make unexpected changes to a resident’s fees. Care homes must also not: • Mislead residents and their representatives, for example, about their right to claim

the rules and requirements set by regulators, it may also be breaking consumer law. Complaints Every care home should have a quick, simple and streamlined procedure for resolving complaints. Staff must never pressure or intimidate someone against making a complaint, for example by threatening to restrict or ban visitors or asking a resident to leave if they have complained. Homes should have a written complaints procedure and ensure it is possible to make complaints in a variety of ways. Information on how to make complaints should be offered, as far as possible, in different languages and formats and care homes should explain how a resident can access independent advocacy or advice services and where they can go,

NEXT STEPS

Mike Lambourne is Assistant Project Director at the CMA. Email: carehomesconsumer@cma.gov.uk Twitter: @CMAgovUK How do you ensure you’re compliant with consumer law? What are the difficulties you face? Feed-back on this feature and share your thoughts on the CMM website www.caremanagementmatters.co.uk CMM February 2019

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SUPPORTING REGISTERED MANAGERS ON THE ROAD TO WELLBEING

Wellbeing and resilience are complex subjects and supporting the wellbeing of registered managers is no longer just a ‘nice-to-have’, but an essential part of supporting the leaders in our sector. Here, Oliver French from Skills for Care shares his tips for ensuring registered managers have the space, time and tools to look after themselves.

Wellbeing and resilience are frequently referred to in the context of employment, however, in reality, it’s not possible to think about either within only one sphere of our lives. This is why, when Skills for Care published its wellbeing guide for registered managers, it was intended as a companion for managers both at and outside of work. When practised and used deliberately, approaches to improving both wellbeing and resilience can be building blocks to good mental health. Although these approaches don’t replace the role of specialist help or dedicated mental health teams, they do complement this type of support and, for many, they may help to avoid burnout or crisis.

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SUPPORTING REGISTERED MANAGERS ON THE ROAD TO WELLBEING

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RECENT RESEARCH

Recent exploratory research by Skills for Care, What do registered managers do, and who are they? didn’t ask the participants directly about their wellbeing, but its findings did offer a timely reminder that, as a sector, we must look after our registered managers. There are around 20,000 registered managers in England, and the rewards of the role are matched by the responsibility that comes with it. It’s a role characterised by change; almost 80% of those who responded during the research felt the role had changed over time, becoming more varied (71%) but also more pressured (83%). The overwhelming majority of respondents (87%) were responsible for a dizzying set of tasks, including management of day-to-day operations, involving families and residents, building and maintaining external relationships, leadership and culture, and business strategy and management. Despite this, respondents who had worked previously in another sector told us that, whilst they viewed their current role as more challenging than their last in another sector (90%), they often felt (43%) that this was not recognised by the public or other professionals. However, to focus solely on the pressures and status of the registered manager role risks neglecting the other side of this picture, because when we have spoken to managers about their work, they have told us about how rewarding it is. Some of what we’ve been told includes: • The best thing about my job is that every day is different, I am very privileged to be in a position to support some amazing people who make me smile every day.’ • ‘I am extremely proud to be a registered manager.’ • ‘I can’t imagine being anything else.’ • ‘This hard work and dedication comes with great rewards, a sense of pride in your home and your team and a feeling of self-satisfaction seeing residents being cared for and happy.’

FIVE WAYS TO WELLBEING Whilst anyone’s influence over another person’s personal life is (rightly) limited, we have to ask, how can we – as a sector, and as colleagues and peers – help our registered managers? What can we do to ensure they are giving their own wellbeing the attention it deserves in their professional lives? This is where the Five Ways to Wellbeing, as researched by the New Economics Foundation, can come into play. Supporting registered managers to look after their wellbeing before it becomes an issue can be a huge help. We should support them to: • Connect. • Be active. • Take notice. • Keep learning. • Give.

TIME TO CONNECT One of the key findings from our research was that, for many registered managers, their peers are the best source of support. 26

CMM February 2019

Remembering that the majority of registered managers are responsible for a single service at a single site, we need to ensure opportunities to engage with peers are available. Having access to peer networks, both face-to-face and virtual, is crucial. Whatever our role or profession, as one registered manager told us, ‘Confidence, reassurance, knowing you’re in the same boat as others, and having someone to share problems with’ is an important part of the support we draw on. But creating these opportunities isn’t enough by itself. We also need to encourage and support managers to take these opportunities. The ability for a registered manager to step away from their service should not be a luxury, it must

“There are around 20,000 registered managers in England, and the rewards of the role are matched by the responsibility that comes with it.” be an expectation. This means that managers must be given the time to take the opportunity to make these connections with peers. It also means thinking about the team around them. We often talk about the importance of succession planning (as many as 10,000 registered managers may retire in the next 15 years), but this shouldn’t just be about filling a gap. For managers, supporting a good deputy is also about supporting themselves. Being able to delegate, take leave and share responsibilities is easier with well-trained and supported staff.

MAKING SMALL CHANGES A cynic might look at most managers’ to-do lists and say that they are active enough and a sit down is really what’s required, but being busy and being active are two different things. Time is a key factor here, but just as important is creativity. The idea of ‘walking meetings’, supervisions or one-to-ones outside the office might sound fanciful, but they’re a way of being active whilst still ticking things off that list. Most of us will know at least one colleague who, at some point or another, has obsessively checked a pedometer. Walking challenges – the most steps a week or the first to 1,000,000 steps – and bike to work schemes are common in the workplace now and have the added advantage of bringing staff together. These initiatives are cost-effective, positive and bring benefits beyond exercise and activity. The most important thing we can encourage

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SUPPORTING REGISTERED MANAGERS ON THE ROAD TO WELLBEING

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employees, peers and colleagues to do is make small changes, for example changing how we commute one day per week.

SHOWING APPRECIATION At its most elemental and personal, taking notice should be about enjoyment and personal fulfilment through an appreciation of the people, places or things around you. So how do we address this need with regard to registered managers and their role? Perhaps the most obvious and crucial reminder here is that we must notice, which is to say celebrate and champion, the great work that managers do. Everyday Excellence, published by the National Skills Academy for Social Care in 2012, found that only 20% of the registered managers who responded felt their role was acknowledged outside of the sector. In our own research, only a small proportion of managers reported that recognition of their role had improved. This is one of the reasons it’s so important to raise the profile of the registered manager role. We need to increase people’s recognition of its importance and complexity, whilst ensuring registered managers have access to the support that they need. It’s also worth thinking about the opportunities available to managers that support the concept of ‘taking notice’. If we accept that opportunities to reflect and ‘know yourself’ are important, then we should all be asking how we can support reflective initiatives like mentoring, coaching, buddying and action learning for the managers we’re working with. These sorts of activities don’t just help a manager solve problems, but encourage a more reflective approach to management as well as wider personal development. It’s also never a one way street. For instance, most mentors will tell you they gain as much from working with their mentee as their mentee gains from working with them.

CONTINUED DEVELOPMENT Registered managers are usually exceptional at continuing to learn. Just think about the 80% who say that their role has changed; dig deeper and they will tell you that their knowledge has grown and adapted with it. The call here is a simple one – to remember that sometimes learning for learning’s sake is important. We must never limit ourselves or others to learning only what we need to know. When opportunities come along to pursue a passion or interest, we need to ensure that we support registered managers to take it.

MAKING A DIFFERENCE The quotes near the start of this article prove how much giving registered managers do. They are dedicated professionals, working hard to improve people’s lives every day. And they are often just as dedicated to enabling staff to

flourish with support, trust and praise. This might be through providing new opportunities, developing ‘champions’ for specific areas or delegating responsibility, or it can simply be through saying ‘thank you’ for a job well done. What we mustn’t forget is the significance of these actions – sharing trust and recognition gives people the confidence and pride to do a great job. While we champion the role of registered managers by showing appreciation and supporting them to learn, we must make sure we remind them what they already do. The exceptional is often business as usual in our sector and unless we challenge this, the stories we all hear will continue to be those negative headlines, which don’t do justice to the work being done.

THE FIRST STEPS Of course, these suggestions themselves won’t relieve the pressure on managers. Not only is wellbeing deeply personal (and certainly not limited to our professional life) but even a brief chat with a registered manager will tell you that there’s a lot for us to get right. None-the-less, the first step towards supporting registered managers to maintain or improve their mental health is to recognise the contribution they make and put the building blocks in place to support their wellbeing. CMM CMM is committed to raising the profile of registered managers' mental health. Keep an eye out for more on the topic in future editions of the magazine.

Oliver French is Project Manager at Skills for Care. Email: oliver.french@skillsforcare.org.uk Twitter: @skillsforcare How are you supporting your registered managers? Have you trialled any successful initiatives to improve wellbeing amongst your staff? Share your experiences on the CMM website www.caremanagementmatters.co.uk CMM February 2019

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BODY CAMERAS IN THE SOCIAL CARE SECTOR – CAN THEY IMPROVE OUTCOMES? The idea of CCTV in care homes gets a lot of coverage in the media and divides opinion amongst staff, residents and families. However, some companies are looking to take this one step further and trial body cameras in social care too. Calla, an organisation which is looking to trial body cameras in care homes, has developed a camera that can be worn by staff, so that they can record certain situations or events. The cameras are worn at all times, but can be switched on when the wearer wants to record something in line with policies. The idea behind the cameras is that they make staff and the people they’re supporting feel safer. Much in the same way as CCTV is intended to make sure that negative incidents don’t occur, these cameras are trying to reduce potential risks to staff and residents, ensuring that each party has protection and evidence should an incident be reported.

THE CAMERAS The body cameras have a frontfacing screen, so that people are able to see if and when they are being recorded; this aims to take away the issues surrounding people not being aware of the cameras and means that staff must be honest about what they are recording. The footage is securely encrypted on the camera and it cannot be deleted or edited. It is then decrypted by a computer app and is automatically transferred to an online account. These accounts are built with the same level of security as the systems police are using. The footage can then only be accessed by an authorised person 30

CMM February 2019

logging into the account and all actions are recorded by an audit log. Every item is given a retention period, which can be set by the account holder. This ensures that videos are only stored for the amount of time that they are needed. They are then deleted automatically after this time period so that nothing is kept that isn’t necessary. Footage that is required for a case or for evidence is kept for longer, until it is no longer required.

PREVIOUS EVIDENCE Calla has already been conducting trials with Northamptonshire Healthcare NHS Foundation Trust. The hospital where the cameras have been trialled provides inpatient mental health services for adults and older people, as well as services for people with learning disabilities. Although some employees were sceptical at first, staff suggested that the use of the cameras may have altered the behaviour of patients. For example, a gentleman who had a habit of hitting staff stopped when the cameras were on. The NHS Foundation Trust published a paper with findings that resulted from equipping nurses with specialist body cameras. This outlined the feasibility of using the technology in an inpatient setting and noted a

reduction in emergency restraints as a result. A number of NHS Trusts are now also rolling out or planning their use of body cameras on nurses. In November 2018, 16 NHS Trusts from around the country met at a conference dedicated to the use of body cameras in healthcare, with a view to progressing projects and rolling out cameras to staff. A spokesperson from Calla said, ‘We think body cameras could have a similar impact in care homes, where staff may face abuse or aggression from people using the services. 'Body cameras record an independent account of events, which have been shown to increase confidence of both staff and the people they support.’ The aim is that providers can use the video collected to help with addressing complaints quickly, maintaining reputation and resident trust.

THE CHALLENGES Despite its ultimate success, the NHS Trust pilot did initially face some scepticism. Staff in particular were unsure of the impact the cameras might have, but after using the technology and seeing the results, these uncertainties were no longer an issue. Similar reservations are expected to be seen in care home pilots. Alongside this, there could be

hesitation from family members and the residents themselves, who may object to being recorded or who are unable to provide consent. Calla is hopeful that these issues can also be overcome, by ensuring that all parties involved have the necessary information on the safety and effectiveness of the body cameras and supporting care homes to implement the cameras.

HOPES FOR THE TRIALS Body cameras have had an impact in policing across the world. In this context, they are shown to alter and diffuse aggressive or challenging behaviours, as well as capturing the true sequence of events. In policing, body cameras are usually used to protect the wearer. This is also the case in other sectors where body cameras are being rolled out, such as retail and education. Calla is hoping that in social care, the cameras will serve as protection for all involved, including the people being supported. CMM

OVER TO THE EXPERTS... Will these body cameras fulfil their aim to make people safer? Are they a good idea for the care sector? What are the potential barriers to the project? How can they be used to improve safety for the people being supported?


WE MUST ESTABLISH A SHARED PURPOSE This is an area where it is very valuable to be having a more public debate. Over the next few years, as portable technology of this sort becomes more readily available to the care sector, we will find ourselves needing to have a clear set of measures against which we view these increasingly accessible and affordable pieces of kit. The proposition is that body cameras are a way of making people safer. The safety of the workforce is of course a huge priority for employers across the sector, and indeed, employers should be considering positively anything that becomes available to increase the safety of their staff. However, it is less clear how people receiving care will benefit. This seems in contrast to other discussions around the use of surveillance monitoring, where either the monitoring is continuous, or is triggered by sound, activity or incident. Where I

have heard of this being introduced effectively, there is the potential for a more ‘shared benefit’ discussion with people receiving care and their families. Here there are opportunities to discuss how the use of cameras will enable early identification of distress or safety concerns, and the opportunity to film and record a successful resolution. I think, for me, one of the measures of success for the introduction of new technology is that we can establish a shared purpose, where the technology enhances both the life of people receiving care and benefits the workforce. It will be key that the trials of this new approach provide answers to this, and that we get this potentially positive tech to focus on enabling and to shake off its enforcement roots.

Vic Rayner Executive Director, National Care Forum

REQUIRES A THOROUGH APPROACH The use of covert recording in care homes is not new to the care sector, nor is the use of CCTV surveillance. However, the proposed use of overt surveillance using body cameras represents a step change. The Protection of Freedoms Act 2012 provides a code of practice about surveillance camera systems, including body cameras. The key legal issues relate to balancing privacy with the legitimate aims of the provider, all within the context of data protection requirements. Article 8 of the Human Rights Act 1998 provides a qualified right to the protection of a private, family and home life, with residents viewed as being at home when living in a care home. Recording residents infringes this privacy, even if the recording is overt. Providers must be able to show that this is both 'legitimate and proportionate' on the basis that it protects staff and safeguards residents.

Providers must deal with video or audio recordings in line with the General Data Protection Regulation (GDPR) and the Data Protection Act 2018. They would also need to let people know they are being recorded using appropriate signage. Providers must comply with requirements enforced by the Information Commissioner’s Office (ICO), and by the Care Quality Commission (CQC) who view recordings in care homes as part of the care provided and therefore covered by regulations under the Health and Social Care Act. There are strong arguments to be put forward by providers for the use of body cameras. There are obvious benefits for both residents and staff. With a thorough approach, the legal and compliance risks are capable of being resolved to the benefit of all affected.

Errol Archer Consultant Solicitor Advocate, Scott-Moncrieff & Associates Ltd

ALLOWS GREATER TRANSPARENCY IN CARE The precedent for the use of surveillance cameras in care homes has already been set, with cameras being used in other environments like mental health wards and clinical settings in acute medicine. To date, use of cameras within care homes has mostly been highlighted when safeguarding concerns and cases of abuse have arisen, often detected via covert use of surveillance cameras. The use of cameras in care homes has therefore often been associated with a defensive style of care delivery. However, there are examples where surveillance cameras have successfully been used as part of a continuous quality improvement strategy, e.g. staff development and manging violence. When use of cameras is known to all, the ethical and legal issues are less challenging to overcome. Consent of all parties should be sought utilising guidance relating

to the management of personal information. Privacy impact assessments should be completed prior to deployment to consider what personal and sensitive information will be captured and how this could affect those involved. The validity and utility of using cameras has been questioned by those who argue that care workers might adapt their behaviour when in the presence of cameras, negating the potential benefit of detecting wilful unsafe acts. It is more likely that, as people become accustomed to surveillance, their natural behaviour will prevail. In the era of duty of candour and greater transparency in care, the ability to capture footage that can be later referred to is one of the strengths of using surveillance.

Taffy Gatawa Chief Information and Compliance Officer, everyLIFE Technologies Ltd CMM February 2019

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CAREER HISTORY I’ve been working in the healthcare sector since 2008. I started as a support worker in a supported living service, working with adults with a forensic history. This included people who might have come from a secure unit, people who had been deprived of their liberty and adults with very complex needs. I left the health and social care sector in 2010 to pursue a career in the prison service. For five years, I worked as a prison officer on secure mental health units before making the decision to come back to health and social care in 2015. I realised how much I had enjoyed my work in social care – it’s not just a job – you have to want to help and support people and get fulfilment from that. In January 2017, after working as a support worker for two years, I took the opportunity to step up to become Care and Support Co-ordinator. I was then successfully promoted to Assistant Manager in 2018. I really enjoy my job. I get the opportunity to learn from others every day; I engage with colleagues across the business to find new ways of working and to develop innovative practices that will help the people we support. It is a challenging role, but it’s satisfying when you overcome the challenges.

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As Assistant Manager I am responsible for 25 supported living schemes across Derbyshire. Within these schemes, we support 45 people with learning disabilities, mental health and autism. My role includes managing three care and support co-ordinators and 60 support workers. I love this aspect of my work as it gives me an opportunity to see people learn new skills and help them to progress with their career development. I have always been hungry for career opportunities. Prior to working in social care, I was a team leader in a different industry and I took the first opportunity I had to progress in this sector. It is important to me to be able to make a difference at a higher level so that I can effect change and pass down skills and knowledge to benefit others. One of the biggest challenges within care is recruitment, and because of the remote area in which we operate, this can be even more difficult. There’s a low unemployment rate but I knew this when I took the role on and, in order to attract new support workers, I have led recruitment campaigns that included drop in sessions, radio advertising and mail drops. This has been very successful and has also led to us increasing our relief list of staff. I admit that I was worried about climbing the ladder at first. My hesitations were grounded in the concern that I might not get as much one-to-one time with the people we support. However, I actually get to interact with them and their families just as much as before. I also have the added bonus of being able to get the very best out of the people I manage

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RISING STARS

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helping them achieve their career aspirations. I think every care management position has challenges. For me, the most difficult thing is switching off. You are responsible for how the decisions you make affect the people you support; you’re looking after people’s lives and it can be hard to leave that ‘at the office’. I am also always thinking about new initiatives that will support the people using our services to reach their outcomes.

RISING STARS It was a great honour and privilege to be nominated for the Rising Stars programme by our Executive Director, Joanna Grainger. I didn’t know much about it to begin with, but the more I read about the programme, the more excited I got about it. Now, as we near the end of the programme, I am very keen to put into practice what I have learnt. It has been so beneficial for improving my networking skills and sharing ideas about innovative ways to improve service delivery. One of my improvement areas was to become more confident in engaging with people at conferences and events. I already feel more able to do this from the support I have received from my mentor on the programme and I am looking forward to future opportunities where I can put this into practice. I can be quite shy so it’s amazing for me personally to feel that I’m changing this. I’m relatively new to management and I have spent my whole career in social care in one organisation, focusing on one aspect of the service, so the programme has also helped me to broaden my knowledge of the sector as a whole. It has been great to get to know how other people are operating, their challenges, the rewards of their jobs and how we can all learn from one another. The whole cohort has formed a support network for each other – we ask questions and try to help each other out where we can. This is a great added benefit of the programme.

FUTURE CAREER I’m still very career hungry. I am aiming to be Registered Manager within the next 12 months. My Rising Stars mentor helped me put together a five-year career plan as, ultimately, I’d like to be Operations Manager. We have identified what areas I need to focus on and my organisation has provided opportunities for me to put my learning into practice.

ADVICE My main piece of advice is to keep trying, even if you get a few knock backs. I’ve taken constructive feedback from interviews, implemented it, and tried again. I see it as a learning experience. I also think it’s important to remain focused. All feedback allows for you to learn and understand your personal development areas.

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However, it’s also really important to recognise your staff and the great work that they do, and to take notice of their health and wellbeing. We are all dealing with everyday pressures, as well as the extra pressures that naturally come from working in care, and sometimes it’s important to take a step back, look at a person’s workload, and ask, ‘Are you alright?’. Working in care can mean unsociable hours and managing difficult situations, so it is important that everyone feels valued. I couldn’t do my job successfully without the commitment I receive from my staff. They go above and beyond for the people we support and I am extremely grateful for their dedication. CMM Jamie is part of the second cohort of Rising Stars. This innovative programme, developed by National Care Forum and supported by Carterwood and apetito, is designed to identify leading lights within organisations who will shape and form the care sector in the future. More information about the programme, the candidates and future opportunities can be found at www.nationalcareforum.org.uk


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INFECTION CONTROL PRACTICE WHAT YOU PREACH

Preventing the spread of infection in a care service is important to everyone. Following recent research into the impact of infection control on quality ratings, Clare Long, Care Sector Specialist at Miele GB, explains how providers can improve infection control through practical steps and quality procedures.

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Compound issues of staffing, inspections, compliance and efficiency challenge almost every care operator in the country. The same issues also impact whether the high standards of care and safeguarding demanded by the sector are met. The prospect of a CQC inspection is constantly looming and, while many factors affect the outcome, infection control and prevention must always be treated as a priority. Health Service Journal (HSJ) recently reported that 30% of Infection Prevention Society members had seen a reduction in the infection prevention and control services where they work. This is concerning given that cases of E coli, which can be easily transferred via human faeces, have risen by 30% since 2012. While Government says that continuing professional development funds for infection control will increase, experts argue these are thinly spread across the workforce and don’t make up for previous cuts. According to HSJ, ‘The 17% increase in the national budget for continuing professional development…does not come near to replacing the 60% cuts between 2015 and 2017.’ Considering the financial and resource pressures of running a care home or delivering community services, it is easy for hygiene to unintentionally slip down the priority list. Staff clearly understand the vital importance of infection prevention but delivering on this effectively is another matter entirely.

EFFECTIVE PLANS A well-documented and effectively communicated infection control plan is one way to ensure that policies and procedures are clearly adhered to. This covers everything that care providers must do to ensure hygienic standards, prevent the spread of infection and keep clients, staff and visitors safe. The plan provides an essential ‘rulebook’ for managers, staff and visitors. Even committed care teams can struggle to control infection if they don’t have clear and consistent guidelines. This is where a documented

infection control plan really helps. Plans and policies will differ from one care environment to another, based on things like size and the type of care provided. However, there are a number of factors and regulations that matter in all situations.

HAND HYGIENE It may seem like the most obvious thing in the world, but good hand hygiene is easy to overlook. This is the case even when staff know it should be done and is the single biggest trigger for infection spreading. Reports say that standards drop hugely without strict compliance monitoring. One Australian study discovered that staff overlook hand hygiene when they think no-one is checking. University of New South Wales’ medical researchers found hand hygiene rates fell from above 90%, to just 30% when human auditors were replaced by automated surveillance. There are no hard and fast rules but the NHS’ Infection Prevention and Control website provides some useful guidelines for care homes and home care providers. Make sure your policies define the processes that should be followed and when, for example after ‘hands-on’ contact with a resident.

PERSONAL PROTECTION Infection control plans should also define how, if and when staff should be using personal protective equipment, including disposable gloves and aprons. These are commonly required in acute care and nursing environments, due to the likely increased contact with bodily fluids. Care providers should carefully consider all activities and instances where personal protection measures need to be taken and define equipment and usage processes. For instance, an employee may need to use gloves and an apron when handling soiled clothing. They should then remove these and dispose of them safely before handling clean equipment or touching patients.

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INFECTION CONTROL: PRACTICE WHAT YOU PREACH

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Easy accessibility to personal protective equipment (PPE) is vital, and procedures should be integrated with hand hygiene too. In a home care environment, PPE should be carried separately to other cleaning equipment if it cannot be immediately disposed of. Hand washing and handling of soiled PPE must also happen in the right order. The Department of Health and Social Care and the World Health Organisation both recommend My 5 moments for hand hygiene – the key points when healthcare workers should carry out hand hygiene – as the below: 1. Before touching a resident. 2. Before clean/aseptic procedure. 3. After body fluid exposure risk. 4. After touching a resident. 5. After touching a resident’s environment.

EFFECTIVE DECONTAMINATION AND WASTE DISPOSAL It’s inevitable that care providers will deal with waste and potentially infectious substances, and it’s vital that soiled items are always effectively decontaminated. The Department of Health and Social care provides some useful best practice guidelines in its Decontamination of linen in health and social care document.

“Inspections review how well-organised and documented a home’s processes are and how rigorously they are followed by staff.” Laundry facilities should be equipped with commercial machines that are capable of turning over large volumes of dirty washing as quickly as possible and to a safe standard, minimising the chances of soiled clothing, towels or bedding piling-up and potentially spreading infection. Once each washing cycle has finished, it’s also important that care is taken to prevent cross-contamination. Any potentially contaminated waste, such as dressings and disposable clothing, should be put immediately into the correct coloured storage bag or container, labelled and stored. Clients and their visitors should also be made

aware of these procedures, especially if they are also involved in their care.

REGULATION AWARENESS There are many policies and regulations impacting care providers and several that relate to infection control. It’s vital to ensure these are being followed and met across different operations, and the infection control plan is an effective way of ensuring processes comply. Good sources of information on this include the websites of the Department of Health and Social Care, The National Institute for Health and Care Excellence, the Care Quality Commission (CQC) and the Infection Prevention Society. Linen decontamination is an area where regulation really matters. For example, NHS infection control guidelines state the required duration and temperature of washes as either: • 10 minutes at 65ºC or over. • Three minutes at 75ºC or over. • One minute at 85ºC or over. Washing machines used in care environments also need to be compliant with the Water Regulatory Advisory Scheme (WRAS) category 5 to prevent the mains water supply becoming contaminated from potentially hazardous or infectious waste.

INSPECTION IMPACT High quality and rigorous infection control procedures should go a long way to ensuring that this area of future CQC inspection has a positive outcome. However, it’s also worth doing some scenario planning, such as where infection control issues have led to poor or failed inspection outcomes in the past. When it comes to quality standards and inspection outcomes, laundry procedures are one area that can be a gap in a care provider’s armour. The challenge is that there is no definitive set of guidelines showing how a home’s laundry is assessed. This may apply to other areas of assessment too. Recent CQC inspection reports provide useful insights into the situations where laundry-related infection control issues have negatively impacted inspection outcomes. These show the types of incident that must clearly be avoided. Disorganised laundry One Midlands care home inspection report

found a failure to protect people’s safety because the laundry room was disorganised, meaning the risk of cross-contamination was high. This shows that inspections review how well-organised and documented a home’s processes are and how rigorously they are followed by staff. Effective separation At another care home, inspectors were told by staff that wet and soiled laundry were washed together, as well as with peoples’ clothes. Having measures to separate soiled and potentially infected laundry throughout washing and drying is a must. This should include water soluble laundry bags and, for extra certainty, potentially barrier washers and using commercial laundry equipment that kills infection through sustained high temperature cycles. One collection-to-clean process A group of nursing homes was put into special measures partly due to the fact that collection of soiled laundry from bedrooms did not adhere to suitable cleanliness standards. This shows the risks of hand-collecting laundry without protective equipment, rather than putting it straight into a sealed container such as a bag or bin in the bedroom where it should remain until being washed. It also demonstrates that a holistic approach to compliance needs to be taken across the home environment. Ensuring effective equipment is available One case highlighted equipment and process issues leading to improvements being required for infection control. These included a lack of access to Personal Protective Equipment (PPE) and handwashing facilities in the laundry, increasing the chances of staff becoming infected or carrying infections out of the laundry to the rest of the home. This again highlights the importance of having easily accessible and appropriate PPE at all key points throughout the home.

AVOIDING OUTBREAKS Infection control and prevention is something care providers know they need to focus on. However, it is a complex area that requires effective delivery of policies and education, and policing. Otherwise, there is every chance that hygiene standards could drop, leading to a poor inspection outcome or individual illness, or at worst, a major infection outbreak. CMM

Clare Long is Care Sector Specialist at Miele GB. Email: professional.info@miele.co.uk Twitter: @MieleProf How do you ensure your processes are compliant? Have your CQC inspection reports been impacted by the quality of infection control at your service? Share your thoughts and feedback on this article on the CMM website www.caremanagementmatters.co.uk CMM February 2019

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SECTORS • Domiciliary/home care. • Learning disabilities. • Mental health. • Nursing care. • Residential care. • Supported living. • Local government services.

PRODUCTS • Unrivalled digital care planning. • Intelligent person-centred configuration. • Digital care recording. • Available on the Cloud or locally. • Comprehensive care managing software. • Full suite of KPI reports. • Built in policies and procedures.

COMPANY PROFILE Care Management Systems Limited, established in 2008 represents CareDocs; the most innovative, comprehensive digital care planning and management system for any care setting. Trusted by care homes and care homes with nursing through to specialist care and domiciliary care agencies, our market-leading software reduces service staff administration times and enables the extra time to provide care. Available on the Cloud, CareDocs is highly innovative yet easy to use, which is why we are chosen by care managers nationwide. Recording data and events at the point of care is good practice. It helps towards compliance, improves accuracy and saves

significant amounts of time. Simplify your day-to-day care recording using our dedicated devices; ensure your care records are up-to-date from anywhere; and give your staff more time to care and reinvest your savings on alternative provisions. These are just some of the benefits of implementing CareDocs. CareDocs Cloud provides managers with quick access to vital information, no matter their location. The Home & Group Management dashboard is home to an overview of all your business KPIs, as well as mandatory, scheduled tasks that are necessary to run an efficient care home. With the ability to add and amend the categories as you wish, you can be sure that this will fit the needs of your home or group precisely. Analysing and comparing data is key to ensuring high performance across multiple care homes. CareDocs enables you to make quick and clear comparisons across multiple properties, raise concerns about performance and act upon issues far quicker than previous paper or desktop-based methods. Renowned for supporting our customers, we provide enhanced data security, unlimited technical help, initial and annual on-site training, and free legislative updates to the program, making us a truly complete care management solution. Capture and report what’s important and where its important.

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RESOURCE FINDER

Coolcare

CVMinder

Tel: 0113 385 3853 Email: info@coolcare4.co.uk Website: www.lntsoftware.com

Tel: 01634 202101 Email: enquiries@cvminder.co.uk Website: www.cvminder.co.uk

SECTORS • Administration. • Care home management. • Residential care. • Supported living. • Nursing homes.

PRODUCTS • Rostering. • Time and attendance. • Staff and HR records. • Training compliance. • Resident records. • Occupancy management. • Enquiry CRM system. • Resident invoicing. • Petty cash. • Home ledgers. • Virtual notice board. • Business analysis and reporting.

COMPANY PROFILE CoolCare saves care homes time and money by automating administrative tasks. It helps to prevent unnecessary overspend on items such as care home staffing, as well as boosting revenues through effective occupancy management and accurate invoice processing. Whether a single home or a multi-site group, CoolCare enables easy care home management and improves the profitability of your business. Our years of experience in running care homes means we know the complexities of key operational processes, such as invoicing, and understand the pressures of running a 24/7

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business. We truly get the needs of care home businesses and our software has been designed based on those decades of operational expertise. As a result, care home and head office staff alike find CoolCare very easy to use. Its exceptional user-friendliness comes from that deep understanding of what a day in the life of a care home is really like. We understand the way care homes work and how staff will want to use the software to your business’ advantage. The software’s careful design therefore ensures our customers’ care home management is as simple and efficient as possible. That also encourages more usage of the system and improved accuracy, which in turn makes business analysis and planning easier. Any information that requires action by your staff will be brought to their attention through their personal dashboard. Your staff’s time can therefore be better focused, giving them time to spend with residents and preventing potential errors. CoolCare can be accessed through any device, from anywhere in the world, as long as you have internet connection. It is quick and easy to get started on CoolCare, and your business will be reaping the financial and operational benefits of more efficient care home management within weeks of getting set-up.

SECTORS • Care homes. • Nursing homes. • Supported living. • Specialist care. • Private hospitals. • Charities.

PRODUCTS • Applicant Tracking System for care. • Job board advertising. • Flexible data collection. • Branded applications. • Shortlisting, interview and offers. • Integrated communications. • On-boarding. • CQC compliance.

COMPANY PROFILE Make recruiting easy with CVMinder, an award-winning Applicant Tracking System (ATS) that reduces recruitment costs and improves results. Manage your advertising, shortlisting, interviews, offers and onboarding conveniently and securely from anywhere. CVMinder ATS is built with input from our Ambassador Customers. They are care organisations, big and small, facing the same recruitment challenges as you. They have successfully addressed hardto-recruit locations, salary competition, pleasing the CQC and easing collaboration between HR and line managers. Try a more rewarding approach and let CVMinder publish your vacancies to free-topost resources, including Indeed, Google for Jobs and GOV Find a Job. Connect it to your favourite subscription job boards and

strengthen your advertising at the touch of a button. Lead all candidates through a flexible, branded application process via your website, external adverts, automated alerts and more. Select the application information you prefer to receive, with options including the CV, personal statement, work history, education, disability, convictions and referees. Be secure and share roles and applicants between HR and line managers online. You’ll benefit from faster, fairer shortlisting so you can contact your best candidates without delay. Applicants want to hear from you, so create your own templates to speed up communication. Personalise your messaging for each stage of the recruitment process. Stay compliant with GDPR and take control of employee onboarding so that you can audit all of your checks in a way that CQC will love. Get the recruiting advantage you deserve. We have options to suit every budget, so call us now to find out how much you could save with CVMinder ATS.


RESOURCE FINDER

Fastroi Ltd

Intelligent Care Software

Tel: 07756 668444 Email: sales@fastroi.fi Website: www.fastroi.fi/en

SECTORS • Housing with care. • Home care. • Care homes. • Residential care.

PRODUCTS • Real-Time Care™ – Care Management Software.

COMPANY PROFILE At Fastroi™, we believe that every residential and domiciliary care service deserves to be rated ‘Outstanding’. This belief has driven us for the last 15 years, when Fastroi™ began its journey in Finland. It is now established as the market leader in care management software, with over 1,000 installations and over 35,000 end users, including large private care companies and urban municipalities. We developed RealTime Care™ to give care organisations the tools to manage their processes and take the pressure off their staff, giving staff more time during

their days to spend on caring. Real-Time Care™ offers care companies a cost-effective way to take control of their operations. We offer a service that puts every aspect of care in one secure digital location. Having everything in one place means that care plans can be created and updated online with the input of all the necessary professionals. Staff rosters and hours can be planned and optimised to best suit the business. In-app communications ensures that staff and families are kept informed and up-to-date with events, regardless of where they are. One of the problems with a pen and paper system is that high-quality care is not easy to maintain. It is also difficult to demonstrate that processes are being adhered to. By switching to RealTime Care™ from Fastroi, care providers are making a commitment to improving and maintaining the quality of the care they provide. This has the added benefit of simplifying the inspection process and improving GDPR adherence.

Tel: 07801 786592 Email: info@careis.net Website: careis.net

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 to assessment, care planning and 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.

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, 9.00am to 5.00pm, Monday to Friday; urgent support by email 24/7; regular software updates; daily data backup.

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RESOURCE FINDER

Leecare Solutions UK Ltd

KareInn Tel: 0800 970 5185 Email: hello@kareinn.com Website: www.kareinn.com

SECTORS • Nursing, dementia and residential care homes. • Retirement villages.

PRODUCTS • Digital care planning. • Daily record keeping. • Management dashboards and insights. • Safeguarding escalations and incident reports. • Management audits. • Fully mobile and cloud-based anywhere access. • Secure and resilient storage of data. • GDPR compliant.

COMPANY PROFILE KareInn provides care group operators with a comprehensive suite of digital care management and insight tools, that frontline teams find simple to master and fast to adopt. Serving some of the best care providers in the residential, dementia and nursing sector, our smart care platform gives managers insights to improve business performance, reduce

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preventable risks and improve quality of resident care. The Care Quality Commission (CQC) has said in an inspection report, ‘A new electronic system [KareInn] had been implemented for care planning and recording. The system would immediately flag up if someone had not been repositioned at the required time. The electronic system would also highlight to the management team when people’s needs changed, such as if they lost weight. This meant the management team could take prompt action to review risk management strategies in place for the person.’ Benefits to the business include: • More informed, personalised resident care. • Improved alignment with the CQC Key Lines of Enquiry. • Ensure nothing gets missed. • Manager’s time focused on areas that require improvement. • Significant time savings for frontline staff – 30 days per home each year. Contact the KareInn team today for a demo or to find out more.

Tel: 07470 353659 Email: terry.t@leecare.co.uk Website: www.leecare.com.au

SECTORS • Residential care homes. • Nursing homes. • Supported living. • Domiciliary care. • Learning disability.

PRODUCTS • Medication management. • Fully customisable documentation and care planning. • Incident management. • Wound management. • Quality and continuous improvement. • Clinical, care, lifestyle management. • Facility management. • Credentials and education. • Document control. • Tailored reporting.

COMPANY PROFILE Leecare Solutions is the leading electronic health record platform in the care sector designed to help providers stay organised, save time and exceed inspection standards. Unlike other aged care software vendors, Leecare is solely focused on resident, health and care provider success, using one easy-to-use system for care delivery management and financial performance. Leecare boasts a rich history of supporting care providers to demonstrate and provide the highest standards in elderly, residential, retirement living and domiciliary care through consulting and technology. Today, our 650+ clients include small, independent businesses to larger corporate multi-facility organisations across Australia, New Zealand, Singapore, the UK

and China. What makes us the experts? Over 25 years of experience have given Leecare the knowledge and insight to become a global leader in the field, with a richness of content only achieved after so many years. Equally as important has been the development of our single platform, Platinum 5 Suite – an unparalleled clinical, care, lifestyle, operations and financial management software solution specifically created for the health and social care sector. Simple, secure and customisable, the Platinum 5 Suite leverages technology to bring you a fully-integrated Electronic Health Record (EHR) platform whilst also providing everything you need to manage the business of care. One central location, one database – anywhere, at any time and on any commonly used device. It’s that easy. Proud as we are of our award-winning software, we believe that the ability to deliver exceptional care calls for the human touch as much as technology. Like you, we want life for residents and service users to be the very best of experiences. Together, we can achieve this goal.


RESOURCE FINDER

Person Centred Software Tel: 01483 604108 Email: hello@personcentredsoftware.com Website: www.personcentredsoftware.com

SECTORS • Residential care homes. • Nursing homes. • Dementia care homes. • Supported living/care villages. • Mental health. • Learning disability. • Local authority.

PRODUCTS • Electronic evidence of care. • Works online and offline. • Built-in voice to text. • Electronic care planning. • Electronic monitoring and reporting. • QR code and NFC tag scanning. • API integration and reporting. • Body map/wound care. • Electronic activities evidence. • Relatives gateway. • Group reporting. • GDPR compliant record-keeping.

COMPANY PROFILE Mobile Care Monitoring (MCM) is an intelligent mobile solution for evidencing care interactions, electronic care planning and reporting from Person Centred Software. We help care providers to be recognised for innovative, transparent and person-centred care. Sector regulators often cite MCM in inspection reports as supporting providers to improve care quality. Our system is used by over 1,000 care homes across the UK, 94% of which are rated as Good or Outstanding by CQC. MCM enables care providers to reduce the time spent on paperwork, exceed compliance measures and improve the quality of care. Andrew Long, CEO of Oakdale Care Group says, ‘Person Centred Software’s MCM system played a significant part in our achieving an

Outstanding rating at Kingfisher Court’s first CQC inspection.’ Carers can quickly create meaningful care records that typically saves at least an hour on paperwork, so they can spend more time with residents. Person-centred care plans are informed by real-time evidence of care, and are accessible at any time on shift. Body maps, wound care, review cycles and assessments are all integrated to provide comprehensive, detailed, up-to-date care plans. MCM gives managers the information they need quickly, accurately and in detail whenever it’s needed. All the usual reports and graphs are automatically created, and information can be shared securely with outside professionals to join up people’s health and social care journey. The Relatives Gateway gives you the opportunity to engage more with relatives, share magical moments and give comfort that loved ones are being cared for, to promote an inclusive and transparent environment. MCM is a secure solution to keep your personal data safe, exceeding GDPR requirements. Book a demo today to find out how MCM can help your home.

Quality Compliance Systems Tel: 0333 405 3333 Email: info@qcs.co.uk Website: www.qcs.co.uk

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 53,000 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

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 www.qcs.co.uk or call us on 0333 405 3333.

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Markel 3rd Sector Care Awards 2018 On 7th December, more than 250 people came together in Central London to celebrate the finalists of the Markel 3rd Sector Care Awards 2018 and hear the winners’ stories. The Chelsea Pensioners singing group sang some classic favourites as guests found their seats, before Vic Rayner, Executive Director of the National Care Forum opened the ceremony. Vic honoured all the fantastic finalists and the high standard of work taking place across the sector. Vic then handed over to Dame Esther Rantzen and Rebecca Wilcox to run the proceedings. With their warmth and laughout-loud interactions, as well as Esther’s interviewing technique that puts even the most nervous finalist at ease, the mother and daughter duo announced the winners of the 12 categories. Attendees were able to hear about some truly innovative work, which has the potential to change service delivery, improve lives, join-up systems and save money. When the ceremony was complete, the audience was treated to another live performance from the Chelsea Pensioners, this time joined by pupils from St Joseph’s Roman Catholic Primary School. Everyone sang along to the Christmas tunes, which got us all in the festive spirit.

Corporate sponsor:

Supported by:

Sponsored by:

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“The 3rd Sector Care Awards champions staff who are ensuring their clients have a special day every day. I am proud to be part of this wonderful event.” Susan Williams, Royal Hospital Chelsea

“The Awards are really important as they offer a real opportunity to celebrate and showcase great practice. It has been a privilege to be a judge on these awards and see them go from strength to strength with more nominees every year.” Claire Henry MBE, Hospice UK

Organised by:


The winners of the Markel 3rd Sector Care Awards 2018 are: Leading Change, Adding Value Compassion Award Irene Jervis, Dementia Advisor, Making Space. Community Engagement Award Halas Homes. Leadership Award Shirley Campbell, Housekeeping Manager, The Royal Alfred Seafarers' Society. Citizenship Award Ben Whelan, Making Space. Technology Award Chasing the Stigma – Hub of Hope. Creative Arts Award Penny Allen, Creative Ageing, Courtyard Centre for the Arts. Collaboration (Integration) Award Saints4Sport. Innovative Quality Outcomes Award Barbara Tait, Lead Fitness Instructor, Belong. Beyond Governance Award Captain Glass, Chairman, The Royal Alfred Seafarers' Society. Contribution to Sector Development Award Countrymen UK at Future Roots. End of Life Care Award Hospiscare@Home Team. Making a Difference Award David Williams, Chief Executive Officer, St Monica Trust. Winners will be featured in CMM each month, sharing their stories and the initiatives they won for. Congratulations to all the winners and finalists and thanks to the event’s wonderful supporters and sponsors.

“The Awards are special as they shine a light on innovations, large and small, that are achieved by people who go the extra mile. The team have taken the time to ensure that we hear from each winner at the ceremony. It’s an event that makes me proud to work in this sector.” Sarah Maguire, Choice Support

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EVENT PREVIEW

CMM INSIGHT DORSET CARE CONFERENCE 7th February 2019

The CMM Insight Dorset Care Conference will return to The Lighthouse Poole on 7th February 2019. The agenda, which has been developed with Dorset Care Homes Association and Bournemouth, Dorset and Poole Care Providers Federation, promises an informative day, packed with the latest tips on beating the issues facing social care in Dorset.

MORNING SESSION Delegates will be greeted by the Dorset Care Homes Association, who will provide a brief update on the local scene and the challenges being faced. A Keynote will follow, presented by Tim Golby, Deputy Chief Officer for Adult Commissioning and Health from the Association of Directors of Adult Social Services (ADASS). The session will focus on how local authorities can work with providers to deliver better outcomes, examining the different ways collaboration can improve service delivery. Following this, Greg Palfrey and Stuart Goodman from Smith and Williamson will delve into the local care market, taking a look at what can be worked on to ensure your organisation is performing at its optimum and what specific barriers are faced in providing care across Dorset. After a short break for networking, refreshments and exploring the exhibition of select organisations, Jill Manthorpe from King’s College London will take to the stage to speak about how you can remain adaptable to the needs of the people using your services. Jill will tease apart the issues in clients’ changing needs and provide solutions for finding training, support and advice. Before breaking off into workshops, a selection of the day’s speakers will engage Corporate sponsor

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CMM February 2019

Sponsors

in a panel discussion, giving delegates the opportunity to ask specific questions and seek advice on providing support in Dorset.

WORKSHOPS As well as insightful main stage presentations, the Dorset Care Conference will provide delegates with a choice of three engaging workshops, led by experts in the sector. Rachel Adamson, Head of Practice for Crime at Slater and Gordon, will deliver an unmissable talk on investigations and inquests. The Q&A session will focus on three case studies, looking at what can be learnt and what providers should do if they find themselves involved in this scenario. With the latest guidance from the Competition and Markets Authority on everyone’s radar, Ellis Jones will establish exactly what the new consumer law advice means for you and your business. This workshop will look specifically at managing continuing healthcare payments and top ups alongside the recommendations. If you’re looking for advice on recruitment and retention, Urtle’s Founder, Mav Kopczewsk will be bringing us up to speed on the newest tools and efficiencies in finding and keeping staff. Find out how to improve your return on investment, and get ahead of the curve, with predictions of how the recruitment landscape might change over the next decade.

best practice in the sector. The last presentation of the day will come from Laura Guntrip, Partner at Lester Aldridge. Laura will investigate the best ways to prepare for inspection from the Care Quality Commission (CQC) and ensure you are equipped with the tools to improve your rating to Outstanding. Closing the day will be Dorset Care Homes Association, summing up the day’s key points for delegates to take away.

JOIN US Book your ticket to attend the CMM Insight Dorset Care Conference. Reserve your place online at www.caremanagementmatters. co.uk or call 01223 207770 to make sure you don’t miss out on what promises to be a day of knowledge-sharing, resolving the issues that affect you most.

AFTERNOON SESSION Lunch will provide plenty of opportunity to explore the exhibition and speak to likeminded professionals before the workshops are repeated, allowing delegates to pick again and attend another in-depth session on the latest Supported by

Organised by


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Event: Future of Care Date/Location: 19th March, London Contact: Broadway Events, Tel: 01425 838393 Event: Naidex Date/Location: 26th-27th March, Birmingham Contact: Naidex, Web: www.naidex.co.uk Event: ADASS Spring Seminar 2019 Date/Location: 29th April – 1st May, Staffordshire Contact: ADASS, Tel: 0207 072 7433 Event: LaingBuisson Social Care Conference Date/Location: 16th May, London Contact: LaingBuisson, Tel: 0207 833 9123 Event: Digital Health and Care Congress 2019 Date/Location: 22nd-23rd May, London Contact: The King’s Fund, Tel: 0207 307 2409 Event: Heath Plus Care Date/Location: 26th-27th June, London Contact: Health Plus Care, Web: www.healthpluscare.co.uk

CMM EVENTS Event: Date/Location: Contact:

CMM Insight Dorset Care Conference 2019 7th February 2019, Poole Care Choices, Tel: 01223 207770

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The Transition Event 2019 16th May, Solihull Care Choices, Tel: 01223 207770

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BAPS – SEND Blogging Awards 16th May, Solihull Care Choices, Tel: 01223 207770

Please mention CMM when booking your place. Sign up online to receive discounts to CMM events. CMM February 2019

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NADRA AHMED OBE • CO-CONVENOR • CAVENDISH COALITION

As the leave date for Brexit draws ever-nearer, Nadra Ahmed OBE discusses what the sector might face and what needs to be done to lessen the impact.

The nation appears to be at an impasse, which future historians will debate for many years to come. At the time of writing, a Brexit deal has not been agreed. Dates for votes have been repeatedly moved and disagreement reigns. At times, it feels as though the leaders of this country are playing a game of chance – a real-life deal or no deal on an enormous scale. However, we cannot change the position we are in. What we can and must do now is take stock of the reality of the decisions that have been made and evaluate what we as a sector might face as the exit date approaches. The biggest challenge for us is the uncertainty over immigration, and what

we need most for our EU staff is clarity and certainty. Both health and social care rely heavily on talented colleagues from abroad to provide the care our communities need, and the recently published White Paper on immigration has not offered a definitive answer on whether a salary threshold of £30,000 will be imposed. This proposed threshold, based on the advice of the Migration Advisory Committee, suggested the distinction between a skilled and unskilled workforce should be made based on salary, when we know the value and skill of our lower-paid colleagues is not defined by their wages. It is a relief that there will be further discussion on this, and we can only hope either the threshold will be scrapped altogether or lowered considerably. An immigration policy based on skills and benchmark pay scales will no doubt add to uncertainty and could affect providers’ ability to deliver care and support to those who need it. The new immigration system must adjust skills and salary levels to ensure that social care can be properly staffed. While it is anticipated that there will be some provisions for doctors and nurses coming to the UK after Brexit, this does not include allied health professionals, and there will be major implications for the social care workforce in particular. Either Government must fund wage increases or it must make special provisions for health and care. There is an ever-growing elderly and vulnerable population who need care and support around the clock – set to double to nearly 5 million by 2035 – while predictions indicate the care industry could face staff shortages of 380,000 by 2026. If the salary threshold is maintained without wage increases or other provisions, we could find ourselves letting people down who most need our help. Furthermore, if the social care crisis is not addressed, there will be major knock-on effects for the wider population and the economy. People

who are best cared-for in their homes or in the community will need more support from their families, straining other areas of the labour market as well as the NHS. In addition to the White Paper, Government announced the current Immigration Health Surcharge would double as of December 2018. This means, for example, that a migrant care worker on a five-year visa will now pay £2,000 to use the NHS. According to the Home Office, the health surcharge has brought more than £600m to the public purse over the past four years. The increase will bring in a further £220m and this will be used, we are told, to fill NHS funding gaps – but it could have serious implications for those who have to pay it. This, combined with the lack of clarity over the salary threshold, could well make a potential migrant worker think twice about moving to the UK. For years, providers have looked overseas to help address the ongoing recruitment crisis in social care and, over the past three years, this has led to an increase of about 40% in workers coming from EU countries. With this in mind, and with the knowledge that there are more than 100,000 vacancies in the sector currently, it is perhaps not surprising that employers are concerned about their ability to attract care workers from outside the UK post-Brexit. Alongside this, we may have some real challenges with supplies of medicines and medical equipment as we are heavily reliant on the EU for these vital supplies. Whether we leave with a deal or without, the shape of our relationship with our neighbours in continental Europe will change. We must now focus on ensuring we do not create barriers that will have a fundamental impact on the sector’s ability to provide care and support in a sustainable manner to those who need it. We must find ways to make careers in social care appealing, both financially and professionally, to those from the UK and from abroad. CMM

Nadra Ahmed OBE is Co-convenor of the Cavendish Coalition and Chair of the National Care Association. Email: nadra@nationalcareassociation.org.uk Twitter: @NationalCareAsc 50

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Photo credit: Laurence Cawley/BBC


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WITHOUT QCS WE WOULDN’T HAVE BEEN RATED AS AN ‘OUTSTANDING SERVICE’ Rupert Stocks Registered Manager, Guyatt House

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