NOVEMBER 2019
www.caremanagementmatters.co.uk
WHOLE SYSTEM APPROACHES Opening the door to wider strategic discussions
Walking the walk
End of life care from a carer’s perspective
GDPR
Do you know your data protection obligations?
Resource Finder Specialist solicitors
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“Tissue viability nurses have a complex job in care homes that use paper documentation to collate information from body maps, repositioning charts, nutrition and hydration charts, and risk assessments to see signs of progress in healing wounds. It can sometimes take up to ten hours to gather the information needed. It is much easier to gather information at care homes that use Person Centred Software’s Mobile Care Monitoring system as live care is recorded digitally and is automatically collated with information from relevant charts and reports, a SSKIN assessment and body map with automatically attached photo evidence. Person Centred Software’s system is the future of care.” Siobhan Mccoulough, Tissue Viability Nurse Specialist, working with OSKA
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DRIVING O
UTSTANDIN
G C ARE
In this issue 05
Inside CQC Mary Cridge, Deputy Chief Inspector of Adult Social Care, explains what she hopes to bring to her new role.
07
CMM News
09
Business Clinic Our panel looks at Flourish, a project introducing driverless cars in an attempt to revolutionise mobility for older people.
30
NCF Rising Stars 2019 Philip Smith of Pilgrims Friend Society tells CMM about his career and where he hopes to be in the future.
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Celebrating Excellence Dementia adviser, Irene Jervis won the Leading Change, Adding Value Compassion Award in the Markel 3rd Sector Care Awards 2018.
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Event Review A review of the Lancashire Care Conference 2019.
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What’s On?
49
Straight Talk Richard Muncaster shares his thoughts on why mental health and wellbeing in the workplace should be a priority.
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20
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FEATURES 36
REGULARS
From the Editor
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20
Changing systems: whole system approaches in health and social care Raina Summerson takes a look at whole system approaches and how providers can ensure they are taking part in key conversations and influencing future change in the sector.
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Data protection law: ensuring you are covered The introduction of data protection laws last year brought with it some new obligations for organisations. Faye Spencer of the Information Commissioner’s Office shares her knowledge so you can ensure your business is protected.
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Walking the Walk: a carer's perspective of end of life care Claire Henry MBE, Marie Cooper and Roberta Lovick give an insight into how organisations can extend end of life care beyond death to carers and family members.
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Resource Finder CMM profiles specialist care sector solicitors for businesses that need advice or guidance. CMM November 2019
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EDITORIAL editor@caremanagementmatters.co.uk Editor in Chief: Robert Chamberlain Editor: Angharad Burnham Guest Editor: Emma Cooper
CONTRIBUTORS
PRODUCTION Lead Designer: Holly Cornell Director of Creative Operations: Lisa Werthmann Studio Manager: Jamie Harvey Creative Artworker: Ruth Clarry
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
@Agincare
Mary Cridge Deputy Chief Inspector of Adult Social Care, Care Quality Commission
Raina Summerson Group CEO, Agincare
Faye Spencer Head of Customer Contact, Information Commissioner’s Office (ICO)
Vic Rayner Executive Director, National Care Forum
@johnnycosmos
@RichmondVillage
@PilgrimsFS
@clairehenry_
John Kennedy Independent Social Care Consultant
Philippa Fieldhouse Managing Director, Richmond Villages
Philip Smith Registered Manager, Florence House
Claire Henry MBE Independent Consultant in Palliative and End of Life Care
@MakingSpaceUK
@richmunc
Steph Johansen Regional Head of Operations, Making Space
Richard Muncaster CEO, Care Workers’ Charity
@vicrayner
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 16.8
CMM magazine is officially part of the membership entitlement of:
ABC certified (Jan 2018-Dec 2018) Total average net circulation per issue 19,630
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CMM November 2019
@mariecooper100
Marie Cooper RGN BSc MSc Independent Nurse Consultant – Palliative and End of Life Care
Roberta Lovick Expert with personal experience
From the Editor Guest Editor, Emma Cooper looks at the latest State of Care report and how it proves that going back to basics is key. The Care Quality Commission (CQC) has just published its annual State of Care report and, although it concludes that the overall quality of care has improved slightly, there are still leaps and bounds to be made. The report made it clear that people who need care and support are falling at the first hurdle. Not being able to access appointments or being directed to unsuitable services diverts people from what should be a clear pathway to care to a maze, which can feel impossible to find a way out of. We know that when people reach a level of crisis that demands immediate intervention, the outcomes are rarely positive.
BACK TO BASICS All of this tells me that we need to go back to the beginning. There is an open agreement about the need for all parties to work together to strengthen the social care sector and this means
listening to the people who really understand what needs to change. On page 20, Raina Summerson offers advice to providers on how to get their voices heard at a strategic level and take part in more meaningful engagement. Providers are so busy delivering care and managing their businesses that it can be difficult to find the time to commit to engagement and influencing, but it is important if they don’t want other organisations speaking on their behalf. The CQC’s report also acknowledged the need for innovation in technology and, on page 30, there is an interesting project spearheading this notion. A multi-sector consortium of organisations has been working together in an attempt to revolutionise mobility for older people and help them maintain their independence. Could driverless cars transform
the future of transport? Will they allow older people to remain engaged with their community whilst giving freedom of choice? Sector experts have their say.
DELIVERING PROMISES The building blocks for a stable social care sector are there. The initiatives and ideas have been given a great deal of thought and the sector is proving itself to be impressively adaptable in the face of adversity. Social care is packed with people who continually go above and beyond for those they care for. Read our profile of Irene
Jervis, a dementia adviser who won the Leading Change, Adding Value Compassion Award at the Markel 3rd Sector Care Awards 2018 for proof of this (page 46). However, without long-term funding, ideas will only prove well-meaning when they could have been transformative and we will be back where we started, having fallen at the first hurdle once again. As we wait for the overdue Green Paper and watch its delay impact market stability, we can only hope that Government will deliver on its promise and allow those in the sector to do what they do best.
Email: editor@caremanagementmatters.co.uk Twitter: @CMM_Magazine Web: www.caremanagementmatters.co.uk
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Daily Record Management | Care Planning | Management Insights
Hello, my name is Mary and in September I joined the Adult Social Care team, taking up the post of Deputy Chief Inspector in our Central region. Prior to that, I was part of our Hospitals Directorate for five years, working in the South West with a great team and, I’m pleased to say, leaving a trail of improvement behind us. I’m grateful for the opportunity to write for the Inside CQC column this month and have the chance to tell you a little about myself, my background in health and social care and what I hope to bring to my new role. I would describe myself as a professional regulator having worked in regulation for many years, in both the private and public sectors. I have covered everything from electricity supply, legal services, charities and health and social care. I joined the Healthcare Commission before the CQC was born, just at the point when the first annual health checks were introduced. I have stayed in regulation because I have seen the very positive impact that good regulation can have; driving improvement, raising standards and making things better both for those delivering a service and those receiving it. All of the roles I have held, and the organisations I have been part of, have had a focus on aiming to make a difference to people’s lives. This is, and will remain, the key driver in my career and it is one of the reasons I took on my new role. As well as leading our Central team I am also leading on change and quality improvement within adult social care. I have another role at CQC as our Freedom to Speak Up Guardian, which I took on in 2016. If my career in regulation has shown me anything, it is that there is an incredibly strong correlation between the culture of an organisation – including the experience of the people who work there – and the experience and lives of people who receive the service. There is a large and growing body of evidence which shows that people will have a better experience and better outcomes in a place where the staff are well engaged, feel comfortable to challenge their colleagues and are able to speak up. I am a passionate believer in a positive speaking-up culture; creating a place where it is safe to come up with a new idea, safe to have a drastically different opinion to others, and safe to make a mistake but learn from it. I believe that all providers should have a strong focus on making the culture of their organisation open
Inside CQC M
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Mary Cridge, recently appointed Deputy Chief Inspector of Adult Social Care at the Care Quality Commission, introduces herself and explains why making a difference to people’s lives has been the driving force behind her career choices.
and honest, no matter what their size. In her last column for Care Management Matters, Kate Terroni talked about innovation and the benefits it can bring to services in health and social care. As the adult social care lead on change and improvement at the
as the core of a good service. A big part of this is working across the health and care sectors to create a smoother patient journey; crosssector working is becoming more and more prevalent as time goes on and is definitely a priority for CQC going forward.
“I believe that all providers should have a strong focus on making the culture of their organisation open and honest, no matter what their size.” CQC, I know that my role will involve speaking to lots of stakeholders and providers about what new innovative practices they are using to overcome challenges, including using new technologies. Technology can transform a service, there is no doubt about that, but I also always stress that we must get the basics right
Thank you for reading my first column for Care Management Matters and I hope this has given you a bit of an insight into what I will bring to my new role. I hope to have the opportunity to write for you again and share with you some more of my views on hot topics in adult social care.
Mary Cridge is Deputy Chief Inspector of Adult Social Care at the Care Quality Commission. Share your thoughts and feedback on Mary’s column on the CMM website, www.caremanagementmatters.co.uk CMM November 2019
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APPOINTMENTS AUTISM TOGETHER Autism Together has appointed Sue Stubbs as its new Chief Executive Officer (CEO). Sue replaces former CEO Robin Bush, who had been with the Merseyside-based charity since 2013.
State of Care report Providing the right access to the right care at the right time is increasingly key to the sustainability of health and social care as services struggle to cope with increased demand, the Care Quality Commission’s (CQC’s) annual assessment of the state of health and social care in England has found. This year’s State of Care considers the pressures faced by health and social care as a whole, but focuses particularly on inpatient mental health and learning disability services. While the overall quality picture for the mental health sector, which includes community mental health services, remains stable, this masks a real deterioration in some specialist inpatient services, says CQC. As at 30th September 2019: • 10% of inpatient services for
people with learning disabilities and/or autism were rated inadequate, as compared to 1% in 2018. • 7% of child and adolescent mental health inpatient services were rated inadequate, compared to 3% in 2018. • 8% of acute wards for adults of working age and psychiatric intensive care units were rated inadequate, compared to 2% in 2018. Although inspectors have seen much good and some outstanding care, they have also seen too many people using mental health and learning disability services being looked after by staff who lack the skills, training, experience or support from clinical staff to care for people with complex needs. Access and staffing are also
HFT presenting challenges across other care settings, with geographic disparities presenting barriers in some parts of the country. People sharing their experiences with CQC have described having to ‘chase’ care to receive basic services, or experiencing worsening health as they move between services, unable to access the care they need. Issues around workforce – including a lack of qualified staff – and funding continue to contribute to the fragility of the sector. 2018/19 saw providers continuing to exit the market and, in 2018, CQC twice exercised its legal duty to notify local authorities that there was a credible risk of service disruption because of provider business failure. These were the first notifications of this type CQC has issued in four years of running its Market Oversight scheme.
ADASS calls for focus on social care Julie Ogley, President of Association of Directors of Adult Social Services (ADASS) has written to the Minister for Care and Shadow Ministers to restate the importance of looking at longterm funding and a plan for adult social care. The letter calls for a cross-party discussion to create something truly fit for the 21st century. Julie said, ‘We should all be able to receive good quality care and help when we need it most. All politicians need to look towards the long-term future of social care so that this can be a reality.
It is potentially all our futures... Although short-term support announced in the Spending Round was, of course welcome, we need to continue working with the government, partners, and most importantly, those who receive care and support to look at how adult social care is funded in the long-term and an adult social care plan that will ensure absolutely everyone can access the care and support they need.’ Any solution needs to work for everyone, suggests ADASS, regardless of how much money people have or where they live.
It needs to ensure that everyone can access care and support that is built around their lives, circumstances, and needs. It should meet the needs of the growing number of people living longer and with increasingly complex needs, and be able to deal with the challenges of the coming decades, not just the challenges of the next parliamentary term or the next spending cycle. Forward-looking long-term funding will then enable us to achieve the final ask, says ADASS – a long term plan for social care.
Hft, the national learning disabilities charity, has appointed Steve White as its Interim Chief Executive for the next six months after the departure of Hft’s former CEO, Robert Longley-Cook in August.
PRESTIGE NURSING + CARE Prestige Nursing + Care has appointed Belinda Berkeley as Managing Director. Belinda joins from The Good Care Group where she was Managing Director.
ORCHARD CARE HOMES Orchard Care Homes has announced that Tom Brookes will be stepping down from his role as CEO with Hayden Knight appointed as his successor. Hayden joined Orchard Care Homes in May and has 23 years' experience within the industry.
OUTLOOK CARE Barbara Hunt has taken on the role of Director of Operations and Business Development at Outlook Care.
CARETECH FOUNDATION The CareTech Foundation has announced the appointment of three new trustees: leading charity CEO Jessica Taplin, Senior Chartered Accountant, Nash Jaffer; and, Cambian Group’s Chief Financial Officer, Chris Dickinson. CMM November 2019
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NEWS
Brexit update for social care providers A letter from the Department of Health and Social Care (DHSC) has been published detailing steps adult social care providers can put in place to get ready for Brexit on 31st October. The letter, written by Jonathan Marron, Director General of Community and Social Care, highlights some of the steps already taken by DHSC in preparation for Brexit and some practical information about how providers can do the same. These include: • Check with your local suppliers about their contingency plans in
the case of disruption – e.g. food suppliers. • Update your business continuity plans accordingly to prepare for any disruption. • Do not stockpile any medicines or medical products. • If you have any maintenance of machinery or equipment (this could include lift services or similar) due in the next few months, consider bringing this forward before 31st October. This is subject to your contractual or leasing provisions, where you think there may be an EU touchpoint – e.g. lift parts that
come from Germany. • Review your contracts with suppliers to identify any potential Brexit issues. • Encourage your employees and the people receiving your services to consider whether they should apply for the EU Settlement Scheme. • Contact your local authority to identify relevant Brexit leads (this may include your Director of Adult Social Services and/or Brexit Lead Officer). • Make contacts across your region or local area to share best practice and ways of working
ahead of 31st October. Essential individuals or organisations could include your local Association of Directors of Adult Social Services (ADASS), Local Government Association (LGA), local care regulator, local authority commissioners, NHS partners, trade body associations, or local care associations. • Stay abreast of any local or regional adult social care events which may be taking place in your area to offer guidance and support on how to prepare for the UK leaving the EU.
Employers urged to encourage uptake of flu jab Skills for Care is calling on adult social care employers to encourage their staff and those who use their services to get a free flu jab this winter. The Department of Health and Social Care (DHSC) states that
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frontline health and social care workers should be provided with flu vaccinations by their employer which would benefit them and the organisation as a whole. Frontline care staff often work with people who are at high risk
of contracting flu, and getting a flu vaccination can help to prevent the virus spreading, as well as supporting a healthy workforce this winter. Flu has an average recovery time of between one and two weeks, and reducing sickness leave
from the flu can save employers between £875-1751 per employee. Free posters are available to download from Public Health England to help raise awareness of the importance of getting vaccinated.
NEWS
Independent Age calls for statutory appeals process
Royal Star & Garter expands
Independent Age has launched a report focusing on how people can challenge decisions about the care and support they receive. Reviewing the case: The right to appeal in adult social care is calling on Government to introduce a statutory appeals process for adult social care so that clear, consistent processes are in place to allow people to challenge decisions about care which will affect their wellbeing in significant ways. While the Government itself acknowledged the importance of a robust appeals system for social care and consulted on this in 2015, the issue has made no further progress in recent years. Councils have the ability to introduce an appeals process if they so wish and this is demonstrated by its inclusion in the Care Act 2014. However, this is not a statutory duty, with most instead using the existing statutory complaints system which can take
Royal Star & Garter has revealed its new name and logo as part of its brand launch, as it plans to reach out to more veterans through a range of new services. The charity has pledged to at least double the number of veterans it supports and to continue to rise to the challenge of caring for veterans living with dementia. It is introducing a homecare service, an extended day care service, and a bespoke residential service for younger disabled veterans, which will also support them with employment. Royal Star & Garter has adapted its name to reflect the changes above. The charity worked with Open Agency, an independent creative agency, and brand strategist Mark Radda, carrying out market research and seeking feedback from residents, relatives, staff, donors and its governing body.
many months to complete. New Freedom of Information research for the Independent Age report has confirmed that as few as one in five councils have put in place a separate appeals process. Furthermore, the high volume of social care complaints received by the Local Government and Social Care Ombudsman (and high proportions of these complaints being upheld) provides a strong indication that problems are not being dealt with effectively by local authority complaints processes. The report argues that there are clear advantages to a statutory appeals process including: • A more accessible, less intimidating option for those receiving care and support. • A more open, efficient approach for local authorities. • A fairer, more impartial overall process through the introduction of an independent reviewer role.
The report also states that a statutory appeals process should: • Be distinct from complaints, with its own separate timelines and process. • Include clear provision for the role of an independent reviewer. • Stipulate that during an appeals process the individual’s current level of care is upheld and maintained until the case has been resolved. • Be clearly explained to individuals receiving care so that they know access to an appeals process is something they are entitled to. • Have assigned timescales, which individuals are kept informed of at all stages. • Include requirements for local authorities to collect data in a consistent way. • Be adequately resourced so that it can be properly staffed and administered.
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NEWS
Grants awarded to social care projects Collaborative grants worth a total of £6.5m have been awarded by the Economic and Social Research Council (ESRC) for four social science-led research projects focusing on innovation in social care and how it leads to improvements in people’s lives. ESRC is part of UK Research and Innovation (UKRI), a new organisation that brings together the UK’s seven research councils, Innovate UK and Research England to maximise the contribution of each council and create the best environment for research and innovation to flourish. ESRC’s mission is to promote and support high-quality research and training on social and economic issues, develop and support the national data infrastructure that underpins high-quality research, advance knowledge and provide trained social scientists who meet the needs of users and beneficiaries and promote public understanding of social science. The four successful projects are: • Professor Jane Callaghan, University of Stirling – Developing the evidence base for innovation in social care for children and families affected by domestic abuse. The research
will contribute to the evidence of what works in support of children who experience domestic abuse, and will also provide an understanding of how other organisations in the UK and internationally might adapt and implement similar services effectively. • Professor Graeme Currie, University of Warwick – Exploring innovations in transition to adulthood. The purpose of this research is to investigate and build an evidence base for innovation in services and processes designed to improve outcomes for care leavers. • Professor Michelle Lefevre, University of Sussex – Improving social care systems and practices for safeguarding young people at complex risk: what promotes and sustains innovation? The project will inform the development of future innovation, both in complex safeguarding and in social care and public services more broadly. • Dr Juliette Malley, London School of Economics and Political Science – Supporting adult social care innovation. The aim of this research is to support the adult social care sector to start up, implement, spread and scale-up affordable innovations that work well for all adults needing care.
Music therapy campaign for those with dementia Methodist Homes (MHA) has launched a national campaign to raise awareness of the impact music therapy has on people living with dementia. MHA’s goal is for everyone living with dementia in the UK to have access to a music therapist, in a bid to increase the potential for it to be socially prescribed. MHA’s campaign will support this aim through a series of video stories showing the effect of music therapy on MHA care home
residents and their families. A specially commissioned animation will also demonstrate the power of music therapy, even for those living with the most advanced stages of dementia. As part of the campaign, MHA is encouraging as many people as possible from across the UK to show their support by sharing one song that has brought them joy in life, using the hashtag #MyMomentOfJoy on Facebook, Twitter and Instagram.
Skills for Care workforce report Skills for Care has published a comprehensive report analysing the adult social care workforce in England and the characteristics of the 1.49 million people working in it. The sector is growing rapidly. In 2018, it comprised of around 18,500 organisations across 39,000 careproviding locations and a workforce of around 1.62 million jobs. The number of full-time equivalent jobs was estimated at 1.13 million and the number of people working in adult social care was estimated at 1.49 million. The state of the adult social care sector and workforce in England report covers a range of topics including recruitment and retention, demographics, pay, qualification rates and future workforce forecasts. Key findings of the report include: • The estimated turnover rate of directly employed staff working in the adult social care sector was 30.8%, equivalent to approximately 440,000 leavers over the year. • It is estimated that 7.8% of the roles in adult social care are vacant, equal to approximately
122,000 vacancies at any time. • Around a quarter of the workforce (24%) were on a zero-hours contract (370,000 jobs). Almost half (43%) of the domiciliary care workforce were on zero-hours contracts. This proportion was even higher for care workers in domiciliary care services (58%). • The average number of sickness days was 4.8, this equates to approximately 6.94 million days lost to sickness in the past 12 months. • The majority (84%) of the adult social care workforce were British, 8% (115,000 jobs) had an EU nationality and 9% (134,000 jobs) a non-EU nationality. • Since the introduction of the mandatory National Living Wage (NLW) care worker pay in the independent sector has increased at a higher rate than previous years. • Care workers in the bottom 10% of the pay distribution benefitted the most from the introduction of the NLW (an increase of 9.4%) whereas the pay for the top 40% of earners increased at a slower rate.
Chair of CQC re-appointed The Secretary of State for Health and Social Care has re-appointed Peter Wyman as Chair of the Care Quality Commission (CQC). The appointment is for a further two years, commencing on 4th January 2020. In response to continuing his role at the organisation, Peter Wyman said, ‘I am delighted to have been re-appointed as Chair of CQC, and excited that I will be here not only as we continue to work towards meeting the ambition of our current five-year strategy, but as we move into the next stage of our journey. ‘Our core purpose – to make sure that health and social care services provide people with safe, effective, compassionate, highquality care and to encourage care services to improve – remains
unchanged. But we are now bringing increasing focus to improving our processes and technology, to make it easier for people to share information with us – and for our staff to act on this information and to share what we find with the public so that we become an ever more effective regulator.' Ian Trenholm, Chief Executive of the Care Quality Commission, said, ‘It's great news for CQC that Peter has been reappointed as our Chair. I look forward to continuing to work with him as we take forward our plans to support providers to improve, to encourage innovation in how care is delivered and to help our people to do their best work where they are most needed – so that more people receive safe, highquality care.’ CMM November 2019
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NEWS
Supporting registered managers’ wellbeing
Local leaders pledge to tackle ageism
Care Management Matters (CMM) has launched a new Wellbeing Area on the CMM website, dedicated to the mental health and wellbeing of registered managers. The area features blogs from experts in the sector, real-life stories from managers themselves, resources to take away and implement as well as links to useful organisations, support networks and groups. Although deeply rewarding, we are often told that the role of the registered manager can be an isolated, tiring and lonely one. Care Management Matters hopes that the steady stream of support
Across the UK, local leaders have signed an open letter committing them to tackling ageism and talking more positively about later life. The letter has been coordinated by the Centre for Ageing Better and the UK Network of Age-Friendly Communities, part of a World Health Organisation Global network of over 900 places committed to fostering healthy and active ageing. Signed by around 30 local leaders, the letter commits signatories to challenging ageism within their own communities and organisations. Recent research into perceived age discrimination and health and wellbeing in England showed that a quarter of people over the age of 50 have felt discriminated against whilst doing everyday tasks or accessing services. With this in mind, the open letter also asks the public to commit to speaking more positively about later life. Anna Dixon, Chief Executive of the Centre for Ageing Better said, ‘Many of us are living longer. While some of us can look forward
and coping strategies featured on the Wellbeing Area will help to alleviate this and protect the mental health of some of the most crucial care workers in our sector. Paul Simic, Chief Executive of Lancashire Care Association, said, ‘Lancashire Care Association is really pleased to be collaborating with CMM on a new Wellbeing Area. It will be an invaluable resource for registered managers and it is much needed in the sector.’ Explore the Wellbeing Area and contribute your experiences at www.caremanagementmatters. co.uk/wellbeing.
Simpler process for overseas nurses The Nursing and Midwifery Council has announced a more straightforward process for overseas nurses applying to work in the UK, to support people to come to work in the country. As part of the professional regulator’s commitment to improving its approach to overseas registration, the latest changes have been designed to offer a more efficient and streamlined experience and help ensure qualified nursing and midwifery professionals can get into practice where they are needed. Coming into effect in October 2019, key improvements include: • Moving from a paper to an online application system from 7th October that provides applicants with a personal account to track their progress instantly. • Streamlined requirements to confirm a candidate’s competence – for example, instead of asking for training transcripts, the Nursing and Midwifery Council will confirm they hold the qualification that would lead to registration in 14
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their home country. • A redesigned guidance page on the Nursing and Midwifery Council website, including easy read guidelines and a new preapplication checklist tool that can be shared with employers and recruiters. • A further reduction in the cost of the computer based test (CBT) that overseas nurses, midwives and nursing associates must take to work in the UK. This has been reduced from £90 to £83 from 1st October – a 36% reduction in the total cost since 30th March 2019. Unnecessary delays in registration can mean applicants aren’t able to practice in their chosen profession and it can put them at risk of losing work or, sometimes, having to return home. The Nursing and Midwifery Council is creating this simpler process for overseas nurses to ensure that highly-skilled nursing and midwifery professionals can join the UK workforce as quickly as possible in order to carry out their role of delivering better, safer care for people using health and care services.
with confidence to enjoying later life, others are being held back by outdated and damaging attitudes. ‘Negative stereotypes about older age can have a pernicious effect on our self-perception, limit our ideas of what we can do as we get older and stop us making the most of these extra years... ‘It is great to see so many influential leaders who are committed to making their communities more age-friendly, now collectively affirming their commitment to talk more positively about later life. We hope everyone will join us to end ageism.’ Mayor of Greater Manchester, Andy Burnham said, ‘As the UK’s first age-friendly city-region, Greater Manchester is committed to becoming one of the best places in the world to grow old. We know this includes having a modern and positive narrative on ageing that emphasises the contribution older people make. Ageism affects us all – now is the time to change the way we think and talk about ageing.’
Best practice actions for integration The Local Government Association (LGA) and the Social Care Institute for Excellence (SCIE) have produced a new resource with 15 best practice actions to support integration. The actions in the resource draw on evidence about what works from international research, emerging best practices and engagement with the organisations' stakeholders and partners. The actions are aligned with national policy, legal frameworks and regulatory guidance, and they allow for local variety in system design and service delivery. For each action, the resource sets out the rationale, 'how-to' tips, and signposts to evidence
and examples of good practice. The 15 best practice actions for integration are: • Risk stratification. • Access to information. • Multidisciplinary team (MDT) training. • Personalised care plans. • Rapid response. • Operational framework. • Integrated commissioning. • Shared records. • Community capacity. • Partnership with voluntary, community and social enterprise (VCSE) sector. • Common purpose. • Collaborative culture. • Resource allocation. • Accountability. • Workforce planning.
NEWS
Adult social care recruitment campaign: phase two The adult social care sector is being urged by the Minister for Care to back the next phase of a recruitment campaign launched by the Department of Health and Social Care (DHSC). The first phase of the campaign generated a 14% increase in clicks on the apply button for care roles on the Department for Work and Pensions' (DWP) Find a Job, as well as 97% more searches for jobs containing ‘care’ or ‘care worker’. The next phase of the campaign will run from Autumn 2019 to April 2020 with the Department calling for support from providers from across the adult social care sector
to advertise vacancies and share success stories. Providers are being urged to send in case studies of those working in the sector and to continue to advertise vacancies both on DWP Find a Job and on local jobs boards. Kicking off with updated advertising that captures both the diversity and reality of working in the care sector, the next phase of the campaign will be promoted across outdoor posters, online TV adverts, radio, social media and digital channels, as well as PR and partnerships activity. This will include two big bursts of activity
– one in the autumn and another in January – underpinned by a constant drumbeat throughout the year. An updated campaign toolkit and suite of materials free to download from the website will also be available. The first PR activity burst in the autumn will showcase the values and flexibility of working in care through recruitment events where those considering a career in care work, in particular those with existing caring responsibilities, will be invited to come for an interview with the person they care for in tow. Two events will be held in London and Southampton, with
care providers across the UK also encouraged to hold their own recruitment events – a toolkit to help them to do this will be available. The second burst will build on people’s desire for change and selfimprovement in the New Year by showcasing how a career in care could offer professional growth and development as well as more fulfilment. Over the coming months the DHSC team will also be sharing activity plans and engaging directly with specific members of the sector to help them best showcase the variety of roles in the care industry.
Levanter has focused on the retirement sector over the past two years with 151 units either consented or in the planning process across three separate schemes in Surrey. The organisation
is keen to secure more sites by the end of 2019 on either an unconditional or subject to planning basis or in partnership with an operator seeking to remediate their planning risk.
Housing with care development Christie & Co has acquired a development site for Birchgrove, a housing with care operator. The site, known as Lower Mill, is situated close to Ewell in Surrey. Birchgrove, alongside
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CMM November 2019
Levanter Developments, recently obtained planning permission for 53 extra care apartments with associated facilities that will provide accommodation for elderly residents in the area.
NEWS
End of life care in retirement communities The Association of Retirement Communities (ARCO) and Gold Standards Framework (GSF) have come together to support four ExtraCare Charitable Trust locations to become the first retirement communities to be recognised with a national award for their end of life care. The four locations – Shenley Wood, in Milton Keynes, Earlsdon Park in Coventry, Rosewood Court, Wellingborough, and Lark Hill in Nottingham – all received the GSF Quality Hallmark Award. The GSF Retirement Community programme is the latest GSF programme, designed like its
counterparts for primary care, care homes and hospitals, to extend to proactive, personalised, coordinated and compassionate end of life care to all. It was developed in recognition of the anticipated significant population increase in this type of provision. The programme is specifically tailored to suit the needs of retirement communities and includes all residents, not just those considered to be in their final year of life. GSF is designed to build on the good care already being provided in retirement communities so that every resident receives gold standard care right up
until the end of their life. The award is co-badged with the main body representing the sector, ARCO. Michael Voges, Executive Director of ARCO, said, ‘GSF have understood how retirement communities are a different offering to anything else out there and have rightly produced a framework which works for residents living there. This approach will benefit thousands of people over time and is a very welcome development for our sector.’ 19 ExtraCare locations have completed the training and the remaining 15 are going forward for GSF accreditation in 2020.
RAF Surrey A survey conducted by the RAF Association has found there is increased pressure on family carers serving in the military due to often being deployed outside of their home area, sometimes at short notice and overseas. The RAF Association and Alzheimer’s Society are now working to develop initiatives based on interviews with staff who are also informal carers. Prototype initiatives will be tested by RAF personnel, with a view to rolling them out to the RAF as quickly as possible. It is hoped the initiatives will provide a framework to support carers serving in the other Armed Forces.
New housing group for Staffordshire and Shropshire Housing Plus Group and Stafford and Rural Homes have officially merged, launching a new housing, care and property group for Staffordshire and Shropshire. The merged Group comprises
landlords Severnside Housing, South Staffordshire Housing Association and Stafford and Rural Homes. It also includes Care Plus and Severn Homes which specialises
in private sector housing for rent, sale and shared ownership, along with repairs and planned maintenance specialists Property Plus and Housing Worx. The Group will own and
manage approximately 18,000 homes across a wide operational area and has an annual turnover of almost £100m. Anthony Collins Solicitors acted as joint adviser on the merger.
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NEWS
McCarthy & Stone McCarthy & Stone has announced that it is to commence construction on a £32.2m development of 92 specialist retirement apartments in Thatcham, Berkshire. The development will include 52 apartments built to McCarthy & Stone’s Retirement Living PLUS specification – a form of extra care housing. These will be made up of a mix of self-contained oneand two-bedroom apartments, alongside the option of flexible domestic and personalised care and support packages from McCarthy & Stone’s on-site team. Retirement Living PLUS offers a
range of facilities to residents, including an open-plan bistro, residents’ lounge, wellness suite and a guest suite. A further 40 apartments will be built to McCarthy & Stone’s Retirement Living specification, which is aimed at the more active older homeowner, but still provides on-site support and maintenance for peace of mind, as well as a shared homeowners’ lounge. A range of tenures will be on offer, reflecting McCarthy & Stone’s new strategy to offer customers more choice around how to enjoy the retirement living
lifestyle. This follows the news that McCarthy & Stone will now be directly delivering all the regulated care, domestic support and property management services provided in their 92 Retirement Living PLUS developments, having agreed to conclude its partnership with Somerset Care in July this year. YourLife Management Services has now become a wholly-owned subsidiary of the company. This move represents part of McCarthy & Stone’s stated strategy to create deeper and longer relationships with its customers.
injuries. The facility will enable the company to support more people in the Derbyshire, Nottingham and Yorkshire regions, with the expansion adding around 50 new jobs locally. Cherry Tree House provides short and long-term nurseled residential care for people with mental illness, brain injury or neurological illness. All 18
bedrooms are en-suite, with two specialist bariatric bedrooms, designed for those dealing with obesity or mobility challenges – the first facility to provide the service within the local area. Yorkshire Bank also provided £200,000 of working capital, to support the company as it moves towards its goal of establishing a group of successful care homes across Chesterfield.
Lime Tree Care An established care home business in Derbyshire has added a new care facility to its portfolio, backed by funding from Yorkshire Bank. Lime Tree Care Ltd, based in Clowne, Chesterfield, has used £1.2m in lending to redevelop office accommodation into an 18-bed residential care home, named Cherry Tree House, designed to cater for adults suffering from mental health challenges and brain
Runwood Homes Runwood Homes has launched a new on-person care guide, which is being given to every care worker across all 72 of its homes. The ‘Residents Every Day’ (R.E.D.) Care Guide, is full of supportive material for carers to refer to, if and when required, and aims to support and promote safe, reliable, evidence-based care. In the form of a laminated A6, multipage flipchart is now carried on shift by Runwood Homes’ 3,700+ carers, in their tunic pockets as part of their everyday uniform. Gavin O’Hare-Connolly, Chief Operating Officer of Runwood Homes, said, ‘The Guide is an easily accessible support, and assists - using traffic light signal cues - to check residents’ health... it provides standardised suggested next steps, highlighting when any issues require escalation...this goguide will give [staff] heightened confidence in decision making.’ Runwood Homes has received positive feedback from local authority and council partnerships, as well as other care industry professionals regarding the launch of The R.E.D. Care Guide.
Nursing associates film from Skills for Care Nursing associates, their employers and people from supporting organisations are starring in films designed to highlight the impact of this new role in adult social care. The nursing associate role creates a new career pathway for care staff and Emily Gillott talks
in the film about how she used that route to become a registered nursing associate at Drovers Call Care Home. She says, ‘Before I became a registered nursing associate, I started here as a care assistant and worked my way up through senior carer, and then the
nursing associate post came about. ‘The course itself has helped me massively. I didn’t have the qualifications to begin with to go on and do my nursing degree straight away, so this is like a stepping stone to get me to where I want to be.’
Skills for Care is using the film, and six shorter ones, to increase the number of nursing associates to help employers retain highly skilled and motivated workers. To watch the videos, go to www.skillsforcare.org.uk/ nursingassociates.
Hallmark Care Homes launches construction company Hallmark Care Homes has launched a construction company, Savista Developments to build its own care homes. This new company will source land, obtain planning permission and build and fit out Hallmark’s care homes into the next decade. The Essex-based company will be run by Avnish Goyal as Managing Director, running
alongside his role as Chair of Hallmark Care Homes. Avnish said, ‘It makes great sense to utilise our in-house skills to build a new brand in care sector development. ‘We will continue to build Hallmark Care Homes’ new homes, and hopefully look to work for other operators to deliver their schemes, using our
extensive experience in design and construction. We already have a number of projects in the pipeline and we are excited to be expanding and controlling the delivery of outstanding environments for Hallmark Care Homes’ residents.’ Savista’s first project is Henley Manor Care Home, a luxury 80-bed care home in Oxfordshire, which is scheduled to open in December
2019. Also under construction is Hallmark’s first care village scheme in Hutton, Essex where Savista is building a 77-bed care home alongside a 55-apartment assisted living scheme. Forthcoming projects include new care homes in Angmering, Eastbourne, Bath, Camberley, Brentwood and Buckinghamshire. CMM November 2019
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CHANGING SYSTEMS WHOLE SYSTEM APPROACHES IN HEALTH AND SOCIAL CARE
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Broadly, a whole systems approach is about identifying the various components of a system and assessing the nature of the links and relationships between each of them. Whilst it is not just about getting each party around a table to talk about their parts in the system and understand how they could work better together and impact on a wider population benefit or outcome, this is a key part of it. With the increased drive towards integrated care within NHS planning over the past 10 years, the talk has turned to ‘whole population’ approaches; tackling the wider public health challenges through a broader consideration of roles and through ‘systems leadership’. Again, for this to work people have to understand the different parts of a system, their roles and how they could work together to achieve an agreed outcome. Sounds simple doesn’t it? In practice, independent social care providers have found ongoing challenges in getting their voices heard at a strategic level, and many barriers to being part of the new systems that should be enabling this to happen. This is despite open agreement about the need for all parties to work together amidst the recognition that social care is in crisis. Engaging and influencing for an independent social care provider is actually not so simple.
ACTIONS, NOT WORDS
There has been an increasing amount of talk about ‘whole system’ approaches to planning in health and social care. So, how can providers ensure they take a central role in conversations and influence approaches in the future? Raina Summerson, Group CEO of Agincare shares her ideas.
The NHS Five Year Forward View (NHS England, 2014), and Next steps on the NHS Five Year Forward View (NHS England, 2017) required NHS commissioners and providers to work together to develop sustainability and transformation partnerships (STPs) to improve services, taking a population-based approach to their geographical ‘footprints’. The word ‘provider’ is clear in here, as is the importance of community-based services for the plans and, critically, for the performance of the NHS. However, I will not be alone amongst social care leaders, whether from larger or smaller providers, in my frustration about the historical lack of proper engagement with the sector. Central government, local government and NHS services across the country deliver multitudes of papers and plans talking about ‘consultation’ and ‘engagement’, as well as the ubiquitous ‘integration’, and yet the independent social care provider so often finds themselves excluded from key conversations. At best, our social care perspective is relayed through our local authority partners, whom we may feel themselves do not truly understand what we do, what our issues are and importantly, what we could do under different ways of working. This is a paternalistic approach better suited to the
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CHANGING SYSTEMS: WHOLE SYSTEM APPROACHES IN HEALTH AND SOCIAL CARE
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days when most social care delivered was directly from statutory services; not so much in the current system where independent care providers are an essential and integral part of our social and health care infrastructure. Following on from the STPs, where strategic partnerships and collaboration were recognised as more advanced, there was further work to create integrated care systems (ICSs). These now see NHS commissioners, providers and local councils work collaboratively, taking collective responsibility for resources and population health. With no basis in law, ICSs are entirely dependent on a collaborative approach to leadership and a willingness on the part of the organisations involved to work together. What this can do is bring together the right people, with the right commitment and the drive to find solutions. This should give a better platform for more meaningful engagement with independent social care providers.
MAKING A BREAKTHROUGH Dorset is one such ICS area. Agincare has been the largest independent social care provider in Dorset for some years, providing a wide range of services across frontline homecare, live-in care, project work and care homes. The councils and the clinical commissioning groups (CCGs) spend significant sums on social care provided through our services and we have long-standing contractual relationships with them requiring ongoing interaction, review and monitoring. On our journey and growth into other areas across the country we have often sought to share knowledge or experience from other areas or to offer a more ‘whole system’ observation about our own and others’ working, investment into the area and our own active links into national sector issues. However, even though the ICSs, (like the STPs, like the PCTs, like... ok you get it), should see NHS commissioners, local councils and providers working together to take collective responsibility for resources and population health, in reality this has usually meant the NHS and the councils still speaking on behalf of their independent sector providers. Such ongoing challenges with whole system approaches and ‘real’ inclusion of all parties are of course understandable. As Professor Chris Ham, The King’s Fund (NHS Providers, 2018), said ‘it is important to recognise that ICSs have no basis in law and are entirely dependent on the willingness of the organisations involved to work together. NHS Trusts and CCGs have
their own statutory duties and members of their boards may need reassurance that these duties are not being compromised by ICSs... Different accountabilities in the NHS and local government may also cause tension.’ In Dorset, whilst we had two longstanding and professionally-managed provider associations, neither provided a high enough representative number of providers, either across the county or across service provision; this made it more difficult to include them in wider strategic discussions. After some impetus from an interim director and many months of negotiations (and the use of external consultants via the Care Provider Alliance), we have been able to successfully work together to form a plan for a recognised strategic provider group, which will be able to put forward independent sector representatives for a range of groups, including the ICS. Hindsight is a wonderful thing, so some key points I would recommend based on experience include: • Know what is going on nationally and locally; think about how your services link in and can support current programmes or un-met needs. • Think big and think realistically; providers won’t be asked round the table for strategic debate if they simply bring a micro view about their own provider issues, or another £0.50 on an hourly rate. This is bigger, longerterm thinking and, for credibility, you need to be prepared to speak on behalf of the sector, not just your own position. • Be aware of your local networks and leaders. There will be a range of approaches, from people working in their own bubble, blissfully unaware or uninterested in roles and functions outside of this, right through to passionate individuals who are just as eager as you are to link in and innovate. • Get used to the jargon and understand each other’s language; the dreaded acronyms, the people, the places, the plans. • Engage with your provider associations, especially the national ones who can help advise and support you on effective approaches and methods of engagement. • Smaller providers may find it useful to link through their own local provider association, to stay informed and updated via nominated representatives. • Write to your local groups. Let them know about social care issues and the vital services we provide. But don’t whinge! • Be prepared to put in the work if you want to be directly involved. No matter how
well-intentioned all parties are, you must be prepared to put in the time and effort, sometimes even when it feels like there is no obvious benefit. • See all interaction as a potential for learning. I firmly believe that a large obstacle in working better together is often a simple lack of awareness about others’ roles, services and the relationships between them. Offer to attend meetings and present on social care. And keep an open mind about the stresses and strains for other colleagues and link in how your social care provision could alleviate some of them.
SMALL STEPS FORWARD There will always be issues with the capacity of people working across health and social care, thanks to changing roles and high turnover sometimes leading to a short-term working approach. There are obvious differences and tensions in relation to funding streams and priorities. The NHS has particularly bureaucratic constraints that can at times clash with social care decision-making and frustrate independent sector providers. We also know that the social care ‘market’ is huge and dispersed – that’s partly why it’s so important that we are in the discussion – but that brings major issues for direct public services. The poor media coverage of the social care sector does not help foster trust and confidence. There are multiple independent providers in any given area, too many to invite all of them and many not engaged with their sector through formal measures of public contracts or membership of professional associations. Many micro-providers are busy delivering care as well as managing their businesses and simply do not often have the time to commit to engagement and influencing. Despite having been engaged in sector debates at a national level for many years, often through our hard-working and effective United Kingdom Homecare Association (UKHCA), the journey into any strategic debates in our local areas has been tough. In Dorset, it feels like we have made a breakthrough, but having attended these meetings, I still feel there is much work to do. We can only hope that with an increasing number of integrated services and with more interaction through strategic groups, the independent sector will become both more confident in its approach and more accepted by the public services it forms such a critical part of. CMM
Raina Summerson is Group CEO of Agincare. Email: raina.summerson@agincare.com Twitter: @Agincare What are your experiences of these conversations? What hurdles have you encountered and how have you overcome them? Share your advice on the CMM website, www.caremanagementmatters.co.uk 22
CMM November 2019
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Data protection law
VERED O C E R A U O Y ENSURING
The introduction of new data protection laws last year brought with it some new obligations for organisations that process personal information and keep people’s data safe. For businesses large and small, a diligent approach to data protection law is essential. Faye Spencer, Head of Customer Contact at the Information Commissioner’s Office (ICO) shares the information providers need to know and how to avoid paying a penalty.
The General Data Protection Regulation (GDPR) came into force on 25th May 2018 and relates to personal data, that is, information which can identify a living person, for example names, addresses and birth dates. The GDPR covers the processing of personal data in two ways: • Personal data processed wholly or partly by automated means (that is, information in electronic form). • Personal data processed in a nonautomated manner which forms part of, or is intended to form part of, a ‘filing system’ (that is, manual information in a filing system). It also identifies certain types of information which require extra protection such as medical information, religious beliefs and race. For the first time, genetic data and some biometric data is included, for example, fingerprints and facial images. This ‘special category’ data is broadly similar to the concept of sensitive personal data under the previous data protection laws – Data Protection Act 1998. The requirement to identify a specific condition for processing this type of data is also very similar.
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THE REGULATOR Alongside the new laws brought into place, there were some changes to how organisations register with the ICO and the data protection fee. The law says that every organisation or sole trader that processes personal information must pay a fee unless they’re exempt. The ICO is the regulator responsible for upholding data protection law in the UK. It offers advice and guidance, promotes good practice, monitors breach reports, conducts audits and advisory visits, considers complaints, monitors compliance and takes enforcement action where appropriate. The data protection fee directly funds its work, providing advice and guidance to organisations across all sectors about how to comply with the GDPR. It produces a wealth of online resources, including guidance for smaller businesses and who may need more support in meeting the requirements of data protection law. The ICO also provides a small organisation helpline, live chat service and digital toolkits.
INCREASING AWARENESS The ICO has identified a number of sectors where it wants to increase awareness and compliance with payment of the fee, including the care sector. Faye Spencer, Head of Customer Contact at the ICO said, ‘We want to make sure operators in the sector know what the fee is and why they need to pay it and we are here to help them with that. It’s a straightforward process and the annual fee can be as little as £35 for smaller operators. ‘However, we now have the power to issue penalties for nonpayment and we have stepped up action against those that
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CMM November 2019
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DATA PROTECTION LAW: ENSURING YOU ARE COVERED
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continue to flout the law. We have issued fines ranging from £400 to £4,350.’ In the first quarter of 2019-20, the ICO issued 56 fines to the social care sector. These fines go directly to the Treasury, not the ICO. Faye Spencer says, ‘We are a fair and proportionate regulator and fines are a last resort, we prefer to educate rather than enforce. Those who haven’t paid or renewed their fee have the opportunity to put things in order and pay before we take action but we will use our powers if necessary.’ The ICO is also writing to all care homes in the UK that aren’t currently registered with them to remind them of their obligation to pay the fee.
PROTECTING YOUR REPUTATION Aside from it being a legal obligation, there are also reputational benefits to paying the fee. When an organisation pays, its details are published on the public register of data controllers. Members of the public and other companies do check the register. It gives an indication about how seriously an organisation takes its data protection obligations. For care providers, it can make a good impression with those they care for and their families because, on a practical level, data protection is also about building trust between people and organisations. As part of its drive to raise awareness in the sector, the ICO attended the Residential and Care Home show earlier this year to provide information and speak directly to operators. Faye said, ‘It was a great opportunity to hear directly from those working in the sector. It was also an opportunity to answer questions on a broad range of data protection topics with subject access requests – requests from people for personal data held by operators – and the retention of personal information among the
most frequently asked.’ The GDPR says that people have the right to find out what information organisations hold about them and to request copies of that information. This is known as a subject access request. Organisations can no longer make a charge for doing this. The retention of personal information or ‘storage limitation’ as it is referred to in the legislation, has not changed significantly under the GDPR. It does not specify a time limit but says that you must not keep personal data for longer than you need it for the purposes for which you originally collected it. The ICO is there to support care homes with their data protection obligations through its extensive online guidance including on how to pay the fee. If you are unsure about whether you need to pay the data protection fee, there is an online self-assessment which is quick and easy to complete.
CLEAR COSTINGS Your data protection fee depends on the size of your organisation or turnover. There are three different tiers of fees controllers are expected to pay – £40, £60 or £2,900. The payment is always VAT nil. For most organisations, the cost will be £40 or £60. There is also a £5 discount for anyone who pays by direct debit. The tier your organisation falls into depends on a number of things including how many members of staff you have and your annual turnover. • Tier 1 – micro organisations You have a maximum turnover of £632,000 for your financial year or no more than 10 members of staff. The fee for tier 1 is £40. • Tier 2 – small and medium organisations You have a maximum turnover of £36m for your financial year or no more than 250 members of staff. The fee for tier 2 is £60.
• Tier 3 – large organisations If you do not meet the criteria for tier 1 or tier 2, you have to pay the tier 3 fee of £2,900. You can use our fee-assessment tool to find out exactly how much you will need to pay.
MISCONCEPTIONS There are some common misconceptions about what providers need to do and the ways in which they can do it. It is easy to pay the registration fee online, following a straight-forward process which takes about 15 minutes. For businesses that operate a number of care homes, there can be some confusion about whether a fee needs to be paid for each care home. In this case, the easiest thing to do is to contact the data protection fee helpline for tailored advice. Typically, separate fees must be paid for each company individually if it is a data controller. There are some private companies who offer to complete the data protection fee payment on behalf of your organisation, often charging more than the standard cost. Be aware that these agencies have no official standing or powers under data protection law, and there is no connection between them and the ICO; we would always recommend that you pay the ICO directly. Once you have paid the fee, you can access a range of online practical advice and guidance you might find useful.
PAYING A PENALTY Part of the ICO’s role is to take action to ensure organisations meet their information rights obligations. You need to renew your data protection fee each year, or tell the ICO if your registration is no longer required. If you fail to do so, the ICO can issue a monetary penalty of up to £4,350 on top of the fee you are required to pay. CMM
Faye Spencer is Head of Customer Contact at the Information Commissioner’s Office (ICO). Email: casework@ico.org.uk What areas of GDPR are you unsure about? Share your questions and experiences on the CMM website, where you can also feed back on this article, www.caremanagementmatters.co.uk CMM November 2019
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DRIVERLESS VEHICLES: REVOLUTIONISING MOBILITY FOR OLDER PEOPLE When it comes to ensuring older people maintain their independence and freedom of choice, it’s clear that innovation in technology is going to play a vital part. Could driverless vehicles be the concept that brings this to fruition? A £5.5m project run by a multi-sector consortium of organisations and known as Flourish, is attempting to revolutionise mobility for older people by reducing loneliness and helping them to maintain a healthy level of independence. The project has culminated with a demonstration at the St Monica Trust’s Cote Lane retirement village, where residents experienced a journey in an Aurrigo Pod Zero, a first production line model of connected and autonomous vehicles (CAVs). Connected vehicles have the potential to revolutionise the way people travel; enabling traffic management systems to safely optimise traffic flow in real time, easing congestion and improving air quality. Taking it one step further, the findings from the Flourish project are also helping to future-proof infrastructure and make transport more inclusive.
CREATIVE COLLABORATION Participants from across the UK were involved in the co-design process, through workshops and a series of simulator and live pod trials, conducted by the The University of the West of England (UWE), Cardiff University, Connected Places Catapult, Designability and Traverse. Age UK was also a key Flourish partner, providing broader insights into the lives of older people and the mobility 30
CMM November 2019
challenges they face. The research has been supported by Bristol City Council and South Gloucestershire Council. It has found that older people have an acceptance of these vehicles and that they wish for the cars to become commonplace so that they can have freedom in the future to plan days out, pick up their grandchildren as well as run dayto-day errands.
THE DEMONSTRATION Sara Naylor-Wild, Director of Development and Research at St Monica Trust said, ‘We have a long-standing relationships with UWE Bristol, especially around technology and assisted living. 'When we were given the opportunity to host this demonstration it was a no brainer for us, our residents are open to new technologies and they certainly rose to the challenge. 'The demonstration has been thrilling, it’s such an exciting opportunity and the residents have met it with such enthusiasm.’ The physical demonstration lasted around 10 minutes before residents were invited to give feedback on their experience. Their thoughts and ideas, plus how they feel this technology can benefit them, will always remain central to this project. A safety ‘driver’ accompanied up to three participants at a time on a planned journey around the site.
HUMAN MACHINE INTERFACE An important part of the Flourish project was to study how older people interact with and operate vehicles using a human machine interface (HMI) and adapting this interface to allow for impaired vision, loss of hearing, restricted mobility, poor movement control and issues with balance and difficulties with speech, memory and attention. Looking at this in more detail, the team behind the project will develop a standardised assessment framework that will help determine the individualised adaptations needed for older people and those with disabilities to introduce these vehicles into their everyday lives.
NEXT STEPS The Flourish project concluded in May 2019 and the full results from the simulator and pod trials will be released over the coming months. As CAVs continue to be developed and deployed, it will be important for the findings of Flourish to be used to ensure that the technology is fit for purpose. Dr Chris Alford, Associate Professor in Applied Psychology at UWE Bristol said, ‘This was a perfect way to conclude the Flourish project – with a demonstration of how pods could be used to transport older people, and those with limited mobility, within their home environment. 'Our project team has been
able to gather a high quantity of useful feedback from St Monica Trust residents, offering a valuable insight into how older people might feel about the concept of driverless vehicles and the types of user interfaces that might work best for them. ‘Flourish is unique in being focused on older people, who will be among the first to benefit from the private and community availability of driverless transport. The project has shown that driverless vehicles have the potential to keep older people engaged in their communities and in touch with their family and friends.’ As the CAV sector continues to develop, the findings from the Flourish project can be used to ensure that this innovative technology is deployed efficiently and safely for the benefit of older people and those with a disability. Indeed, there may not be long to wait for this; it is anticipated the pods could be in operation on enclosed campuses like retirement villages within five to 10 years. CMM
OVER TO THE EXPERTS... What are the considerations when looking at this technology? Do you think smaller organisations would be able to utilise CAVs? What could be the challenges of implementing this? How might this be integrated into wider society?
AN INNOVATIVE INITIATIVE I am delighted that St Monica Trust has taken a lead in this pilot to enable greater understanding of how driverless cars can support living well in older age. The recent CQC State of Care report outlined the importance of innovation in social care, and recognised the need for the sector to be positively embracing the opportunities that new technology offers. Driverless cars are definitely part of the future agenda, however, like all new forms of technology that will feature in the care sector, it is absolutely critical that the technology is seen as an enabler rather than – excuse the pun – the driver! I recently attended the launch of an interesting report by doteveryone, entitled Better care in the Age of Automation, which included a fascinating film featuring driverless cars delivering homecare workers to individuals' homes. Whether driverless cars do
OLDER PEOPLE ARE MORE THAN READY FOR THIS or don’t feature in the provision of care in this way, the reality is that the mass market for driverless vehicles will be in the field of logistics, and the human factor of what they might do to liberate and empower individuals to live more independent and fulfilling lives is likely to be an after thought for designers. It is essential that we use the evidence generated by Flourish to show that there could be a substantial and sustainable market for CAVs made up of people who are older or have a disability. However, in order to access that population, the manufacturers must include considerations about full accessibility requirements within the vehicles, alongside the features that will be important to a logistics focused market interested in the secure drop off of goods and supplies.
Vic Rayner Executive Director, National Care Forum
Being a child of the mid-20th century, I’ve become used to the impossible of ‘Tomorrows World’ becoming the every day reality. Think Alexa, sat navs, smartphones. As a kid 'video calling' was restricted to the far-off future as hinted by Star Trek and Blake 7. So I may be forgiven for feeling that driverless vehicles are an inevitable reality. Personally, I hate driving, so for me the ability to jump into my automatic car and promptly nod off, as it whisks me to my destination is something to look forward to. As is often the case, what might be good for one group of people, in this case older people by helping to maintain independence and enabling engagement with friends and community, may actually turn out to be good for us all. They may bring some order to our roads.
No more speeding, cutting up or careless manoeuvres. I’ve occasionally reflected, whilst my white knuckled hands grip the steering wheel as I head over the Pennines on the M62, that – like tobacco – if driving was invented today it would be banned as a far too dangerous activity. One thing puzzles me though. When will we shake off the thing about older people being somehow reluctant to embrace technology and change? Dealing with the relentless technological development has become part of all our lives for several decades now. When computers began to be mainstream in the mid 1980s someone my age back then would now be in their 90s. Personally, I’m looking forward to the flying car. Or even more so to the Teleport!
John Kennedy Independent Social Care Consultant
SHOULDN'T REPLACE HUMAN SOCIAL INTERACTION This is a really exciting proposition and we’d be very interested in seeing how this pilot performs and in monitoring how the technology develops. At Richmond Villages, we are committed to building beautiful living environments for retirees and, as such, are always keen to keep abreast of the latest technologies that have the potential of making our residents, lives easier. Independence is a key consideration for many of those living with us or who are thinking about living with us. Those we meet fear the loss of their independence and also the right to make spontaneous choices and decisions about how they would like to spend their time. As such, with a percentage of older people having to give up their licenses due to health issues, this technology has the potential of giving them a little bit of freedom back. Being able to pop into a
driverless car and feel as if the world is their oyster that particular day is a feeling which will be indescribable to some. There are of course lots of other considerations, including the safety for both those using the vehicles and the logistics of having them on site. Another key factor is that we know that human contact and social interaction is very important to the older generation and so removing that during everyday tasks, such as being driven to the shops could pose problems. It’s a very forward-thinking idea so, while we’re probably a way off adopting this technology, it’s certainly one we’ll be following with interest. Innovative technology is going to be key in pushing positive change in the sector so this idea is encouraging.
Philippa Fieldhouse Managing Director, Richmond Villages CMM November 2019
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MARKEL
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NCF RISING STARS 2019 Philip Smith is Registered Manager of Florence House, run by the Pilgrims Friend Society.
District Nursing Team to an Assistant Practitioner. After working at this level for a couple of years, I decided it was time for a change and moved to a rural GP surgery as their treatment room nurse. Then I saw my current role advertised; it has always been my dream job, as it utilises my skills and varied experiences.
ORGANISATION
CAREER HISTORY I started my career as a care assistant in a nursing home at the age of 17. I worked my way up to a senior care assistant role and then went onto nights as night supervisor. I then decided I wanted to follow my passion for working with patients nearing the end of their life and went to work for a local hospice as part of their Hospice@Home team; working in the community with those patients in the last few days of life. I enjoyed this role for a few years, but then wanted to gain a wider experience within healthcare so I got a job as a community healthcare assistant for the District Nursing Service in Northamptonshire. Whilst working for the District Nursing Service, I gained new clinical skills and competencies which led me to go to University to do a Foundation Degree in Health and Social Care (Acute and Community). Because of this I received a promotion on the
I currently work as Registered Manager of Florence House in Peterborough, which is a 19-bedded residential care home for residents with general frailty or dementia and needing end of life care. It is part of a wider Christian organisation called Pilgrims Friend Society. The Pilgrims Friend Society run 15 care homes around the UK, providing environments in which elderly people are looked after, comfortable and secure. All of their homes are founded on Christian faith and opportunities to continue to be part of a Christian community are a core part of the home that are run by the organisation. This has been important to me in my role and I really enjoy knowing that residents are receiving the best care possible whilst maintaining the faith that is so important to them.
CURRENT ROLE I have been in my current role for just 10 months. I have always had a connection with older people and a passion to care for them.
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NCF RISING STARS 2019
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In my current role I can promote, through leadership, a high standard of person-centred care to enable residents to live that fulfilled life. The role is very different to what I first expected. You can have as many great ideas and visions as you want but you are unable to deliver them all yourself and not everyone is as eager to follow. However, by learning new skills on management training such as My Home Life and obtaining Level 5 in Leadership and Management, I am finding ways of empowering my staff and coaching them to share the vision so we can all work better together. The job in many ways exceeds my expectations, it is great to see the difference we can make, but it is not without its challenges. There is a lot that could be improved within health and social care from a national perspective; in particular, more funding is needed so this does make the job hard at times as a budget can only be stretched so far. The best part of my role is seeing the residents happy and living that fulfilled life. An example of this happened when we held a Songs of Praise at Florence House with a cream tea. One of the residents said to me that she was happy living here and this had been the best day of her life so far! The hardest part of my role is managing staff. I like to be liked by everyone, but as a manager this is not always possible as at times, we must implement things that people don’t like.
NCF RISING STARS I feel so privileged to have been nominated by the Society’s Director. When they asked me if I was happy
to be nominated by them, I felt so blessed that they thought I was a suitable candidate. I didn’t really think that I would be successful in being one of the chosen Rising Stars. However, I was successful and became one in June 2019. I am
would like to look for a promotion to that of my line manager. One of the best things about the Rising Stars initiative is that I feel like it will help give me the tools and confidence to gain new qualities to reach my career goals. They may change as
“One of the best things about the Rising Stars initiative is that I feel like it will help give me the tools and confidence to gain new qualities to reach my career goals.” hoping to gain lots of new skills and ideas from the programme which I can take back to Florence House and enable me to be a better leader. I want to help all of my staff become rising stars. I am looking forward to working closely with my mentor and learning from his experiences and seeing how the company he works for does things and see if we can share ideas.
THE FUTURE At this point in time, I don’t have any desire to move on from my current position; I enjoy the contact with residents so would never want to be completely away from that. Residents are the people who make my job worthwhile and not seeing them or having daily contact with them would definitely take something away from my role. However, maybe in the future I
time goes on but as long as I have the knowledge base, I can build on it as I go.
ADVICE My advice to other registered managers would be to follow your dreams and aspirations. Do all you can to fulfil your ‘vision’ of how you want you and your team to give the best care you can deliver. Also, it is really important to believe in yourself. I don’t always find this easy but my managers have encouraged me; they have seen qualities in me that I may not have seen in myself and that has given me the confidence to be where I am today. Senior management can support potential rising stars by giving their staff the chance to try new things and grow in confidence. If you show people that you believe in their ideas then they will flourish. CMM
Now in its third year, the NCF Rising Stars Programme addresses the need to invest in and develop the skills of the next generation of leaders in social care, with registered managers from the NCF membership selected to take part each year. For more information, contact Helen Glasspool at National Care Forum. Email: helen.glasspool@nationalcareforum.org.uk Twitter: @NCFCareForum
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Top Leaders programme
Connecting commissioners and providers to lead across health and social care A leadership programme focusing on the key challenges facing the health and social care sector. The programme aims to improve your effectiveness as a leader within, and across, organisational boundaries to achieve the greatest impact at multiple levels for people who need care and support. Learn from others in similar positions to improve the effectiveness of your organisation in partnership with other senior leaders. Expand your political intelligence and learn how to influence and communicate within the political climate. Increase your own personal impact within your organisation to identify and lead change. Enhance your leadership capabilities and influence within your organisation and across sectors.
Find out more at www.skillsforcare.org.uk/top-leaders leadership@skillsforcare.org.uk I 07717 723443
A CARER'S PERSPECTIVE OF END OF LIFE CARE
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End of life care touches us all, both at work and in our own personal lives. We often find it difficult to talk about, which can lead us to not always thinking about the impact it has on the people we care for, their families and staff. When it comes to care after death, we are even less likely to discuss this but getting it right is vital.
WHY THIS IS IMPORTANT
When we think of end of life care, it is right to assume the focus falls on the person who is dying. Their comfort, their needs and their wishes. For carers, however, holding a loved one’s hand every step of the way can have a huge impact on their health and wellbeing. So how can care settings ensure that carers are looked after when a loved one dies? Claire Henry MBE, Marie Cooper and Roberta Lovick share their thoughts.
With over 70% of deaths occurring in a hospital, care home, hospice or supported living, it is clear that dying is a regular occurrence in these settings. Have you ever thought about what it is like for carers to come in and visit their loved one in the last days of their loved one’s life? Or to come and pay their respects after they have died? For some carers, it may be the first time they have experienced a death and it may be the first time they have to find out about what to do when a loved one dies with the need to follow a procedure that they know nothing about. This can be stressful. Carers’ needs can be easily but unintentionally overlooked. In order to understand whether you are thinking about the whole family when it comes to end of life care, try asking yourself the following questions: • How was the experience of carers who attended your organisation this week? • How confident are you that their experience was the best it could be during a vulnerable time? • Are your processes of care working well? • Do staff in your organisation know what to do when someone dies, how to support their loved ones and what information to give to the families? • Are there areas which could be improved? The answers to these questions will have a lasting impression on the bereaved carer, which is why care after death needs to be seen as an essential component of high-quality care.
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NCF supports its members to improve social care provision and enhance the quality of life, choice, control and wellbeing of people who use care services. We work directly with not for profit providers of care and support services across the UK offering: ME MBE RSH
• Expert response to government consultations and engagement with senior politicians and staff • Innovation focus - influencing the future of the health and social care sector
FIT IP • NO T FOR PRO
• Direct support for individual members and their senior teams • Regular specialist and general forums – bringing together practitioners from across the UK • Weekly policy and information briefings • National events spread throughout the year – offering expertise, collaboration and knowledge exchange
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• Regular benchmarking surveys on key sector issues • Opportunities for national and international networking
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• Strong relationships with trusted industry partners
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• NCF Quality First - a key sector mark of quality
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EX
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• and so much more… RT
ISE
• IN SHIP R NOV E D AT I O N • Q U A L I T Y • L E A
NCF is the strongest voice for the not-for-profit care sector - Join us!
www.nationalcareforum.org.uk @NCFCareForum info@nationalcareforum.org.uk 02475 185 524
WALKING THE WALK: A CARER’S PERSPECTIVE OF END OF LIFE CARE
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WALKING THE WALK
Walking the Walk is a quality improvement initiative to better the experiences of carers whose loved one is dying or has died in a care setting. Using an experiencebased approach adapted from two programmes; The Fifteen Steps Challenge: Quality from a Patient’s Perspective (NHS England) and Promoting Healing Environments
visiting room smells, tired decor and its lighting can and does make a lasting impression. Get these things right and it shows to families you care about their loved one even after death. To make effective change, observation is key. A Walking the Walk review is not an inspection, rather it provides supportive and objective feedback for care settings. Critical to that feedback
“Calm, clutter-free spaces and private rooms for difficult conversations could transform a carer’s experience of their loved one's final days and those following after.” (The Kings Fund), the Walking the Walk team visit the care setting and consider the environment and end of life care provision through the eyes of a carer. Carer involvement in this project has been essential, as these are the very people that will, at some stage, have walked this long and difficult path with their loved one. Hindsight is a valuable thing as it fixes the lens on the less obvious. When you are in a state of loss and grief, everything seems exaggerated. Something that a professional may overlook might be the very thing that has a lasting and profound effect on a carer or the family as a whole. This can make the healing process lengthier and much harder to navigate. For example, when the bereaved have to take a long walk down a dark, cold corridor to the mortuary viewing room in a hospital. Their loved one is wearing a hospital gown rather than their own clothes; their hair has not been combed in the usual way. How the viewing/
is the voice of the person with experience – the carer. Their contribution adds a veracity which is insightful and often quite surprising.
WHAT DOES A WALKING THE WALK REVIEW ENTAIL? A Walk the Walk review is undertaken by an independent team outside of the care organisation. The team includes two to three members who have professional end of life expertise, as well as carers who have had personal end of life experiences with their loved ones whilst in a care setting. The team walk the walk of the carer from the entrance of the organisation right through to the place where a deceased person is laid to rest ready for the family to visit. During the walk through, the team will observe the environment and speak with staff and hear their views on the organisation’s end of life care policies. Could
anything be improved to enhance the experience of a grieving carer? Would overnight stays be helpful? Should there be more information available about what will happen after their loved one has died? A review will also take into account faith and the spiritual needs of the dying person and their family. Do arrangements need to be made to ensure that families are comfortable and need not worry that their loved one’s wishes will be respected once they have died? At the end of the review, the Walking the Walk team will meet with the setting’s manager and members of the team to offer some immediate feedback which will then be followed up by a written report supported by evidence and photographs, where permission has been granted and privacy respected, to show what was working and what could be put in place to enhance the experience of carers when their loved one is dying and has died.
THE BENEFITS The importance of someone being in a pleasant environment when they are bereaved is not to be underestimated. They may be in shock and they will almost certainly be in distress which means they are likely to experience heightened awareness of their surroundings. Poorly ventilated rooms, stark and unfriendly waiting areas and dreary corridors may add to a carer's distress and lead them to think that an organisation takes little pride in what they do and indeed little care for their loved ones after death. Calm, clutter-free spaces and private rooms for difficult conversations could transform a carer’s experience of their loved one's final days and those following after. These things can take little time to resolve but can have
a long-lasting effect on carers’ emotional health and wellbeing. There are also benefits to staff who will feel engaged and listened to when asked for their direct contribution to their organisation's improvement action plan. Putting staff training in place so that they can confidently inform families what to expect when their loved one has died will only benefit each staff member and the organisation as a whole.
VITAL INFORMATION It is important that staff are aware of the information on offer about what to do after the death of a loved one. This means they are able to tell a carer who they need to call, how to register the death, make contact with funeral directors and let them know about the practical services which exist, such as Tell Us Once. Information about where carers can get bereavement support for themselves and other family members is also essential. There are national resources available, but many organisations will have local information which may be more useful. To find this out, you can contact your local palliative care team, hospital bereavement officer or coroner’s office. Care after death should also include remembrance and celebratory acts. Remembrance books can feature contributions from family members, other residents and staff who looked after the person who has died and got to know them well. Some organisations may hold a yearly remembrance service, where families, friends, residents and staff can come together to remember their loved ones. It is often the simple acts which mean the most to carers and family members and ensure they are not forgotten when it comes to end of life care. CMM
Claire Henry MBE is an Independent Consultant in Palliative and End of Life Care. Email: clh.associatesrutland@gmail.com Twitter: @clairehenry_ Marie Cooper RGN BSc MSc is an Independent Nurse Consultant in Palliative and End of Life Care. Twitter: @mariecooper100 Roberta Lovick is an expert with personal experience. What does your service do to look after all parties during and after a person's death? Would you consider a Walking the Walk review to see where improvements could be made? Tell us your thoughts and feed back on the ideas here on the CMM website, www.caremanagementmatters.co.uk CMM November 2019
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RESOURCE FINDER
SOLICITORS If you need advice on corporate compliance, regulation, employment law, financing, mental capacity, appeals or something else, these specialist care sector solicitors will be able to help.
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bevan brittan
Gordons Partnership LLP
Tel: 0370 194 1000 Email: stuart.marchant@bevanbrittan.com Website: www.bevanbrittan.com
Tel: 01483 451900 Email: neil@gordonsols.co.uk Website: www.gordonsols.co.uk
SECTORS
SECTORS
• Care homes, domiciliary care. • Supported living. • Extra care, retirement living. • Community healthcare services. • Primary care. • Independent hospitals and clinics.
SERVICES • Healthcare regulation. • Incidents, safeguarding and health and safety investigations. • Court of Protection, mental health and capacity (and DoLS) issues. • Corporate compliance and information governance. • Commercial – contracting, partnering and competition. • Property and construction. • Corporate transactions. • Finance and funding. • Procurement and commercial disputes. • Employment, pensions and business immigration. • Inquests, clinical negligence claims, employer's/public liability and insurance.
LEAD INDIVIDUALS Stuart and Carlton lead Bevan Brittan’s regulatory support. They say, ‘Most of our clients are care providers. We work with small and large organisations on quality, compliance, commissioning and strategic commercial issues. We work
hard to develop an in-depth understanding of our clients and the challenges they face both on a daily basis, and strategically. We believe this is vital to providing the best support, whether on operational matters, disputes and challenges from regulators, commissioners, or suppliers, or on strategic issues, such as governance arrangements, partnering, and optimising delivery and use of resources.’
COMPANY INFORMATION As a firm, Bevan Brittan specialises in advising health and social care providers. We support providers to: grow their business, deliver quality services; and respond to challenges and disputes. Our ‘one stop shop’ provides advice on all issues clients encounter including: • Regulatory advice on: restructuring, due diligence in transactions, CQC registration, inspection preparation, responding to reports and enforcement action. • Commercial advice on: contracting and partnering, including New Models of Care and STPs and related structuring and commercial transactional and property arrangements. The firm has a wide range of specialists across all legal areas and experienced external health and social care consultants.
Stuart Marchant Tel: 0370 194 7712 Email: stuart.marchant@bevanbrittan.com Carlton Sadler Tel: 0370 194 1633 Email: carlton.sadler@bevanbrittan.com
• Care homes. • Domiciliary care. • Supported living and extra care. • Learning disability services. • Independent hospitals.
SERVICES • Regulatory action. • Responding to civil and criminal enforcement action, and draft inspection reports. • Safeguarding enquiries. • Contract disputes (including fees and embargoes). • Police investigations and prosecutions. • Mental health, mental capacity and DoLS. • Health and safety. • Inquests. • Employment law. • Corporate finance and banking. • Sales and acquisitions. • Property related matters. • Commercial law advice. • Commercial litigation.
LEAD INDIVIDUALS Neil Grant heads our Health and Social Care Provider Team, based in Guildford. Neil is an expert in the regulation and funding of care services and only acts for providers. He has a wealth of experience, having acted for inspectorates and other public bodies at a senior level. Neil has an interest in Regulatory Policy and its impact on the sector. He offers a unique perspective on regulatory and commercial issues.
James Gordon is the firm’s founder. He is a corporate and banking lawyer based in London. James has expertise, knowledge and experience, along with an ability to match the service provided by the ‘bigger guns’ of the corporate world. Timely and informed legal advice is essential to the successful running of any operation but particularly in the care sector. Our approach is strategic and commercial, working in partnership with the client. We aim to resolve and improve matters through dialogue in the interests of service users, the provider and other stakeholders. However, we are assertive in defending our clients’ rights. The firm only acts for providers. As a result, we offer truly independent advice and defend providers without worrying about conflicts of interest.
COMPANY INFORMATION Gordons Partnership LLP is a respected and growing law firm and is a recognised leader in the healthcare field. It was formed in 1994 by three lawyers from leading practices who were fed up with the ‘factory’ approach to law. Their philosophy was to provide high-quality, practical and affordable advice, in a professional and friendly environment. Throughout Gordons’ growth, we have not lost sight of that philosophy.
Neil Grant Tel: 07968 861242 Email: neil@gordonsols.co.uk James Gordon Tel: 0207 421 9425 Email: james@gordonsols.co.uk CMM November 2019
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matters
www.thecarebadge.org #badge4CARE
RESOURCE FINDER
RadcliffesLeBrasseur
Ridouts
Tel: 0207 222 7040 Email: info@rlb-law.com Website: www.rlb-law.com
Tel: 0207 317 0341 Email: paul@ridout-law.com Website: www.ridout-law.com
SECTORS • Care homes. • Hospitals. • Mental health specialists. • Homecare. • NHS and private. • Learning disability.
SERVICES • CQC regulatory issues. • Inquests and inquiries. • Confidentiality and data protection. • Corporate transactions and financing. • Court of Protection matters. • Dispute resolution, including debt collection. • Employment. • Health and safety. • Liberty Protection Safeguards. • Local Authority or CCG funding disputes. • Mental Capacity Act. • Mental Health. • Police and Fire Authority presentations. • PR issues and press statements. • Property development and construction. • Untoward incidents.
LEAD INDIVIDUAL Andrew Parsons specialises in health and social care law. He acts for a large number of private sector healthcare providers and care home operators as well as the NHS. Andrew regularly advises on care home law, mental health law, public law and judicial review and all areas of healthcare law. He is seen as a leading practitioner in his field and is the Hon. Legal adviser to Care England.
COMPANY INFORMATION We are one of the UK’s leading medico-legal practices, with a national reputation for first rate legal services in the healthcare sector. We have 20 partners who specialise in healthcare law. We are ranked in the Legal 500 and Chambers and Partners legal directories for providing services to both healthcare providers and professionals. We are proud of our reputation as a leading law firm for the care homes sector. Our lawyers act for many of the largest care home groups as well as many of the smaller and specialist providers. As a full service law firm we provide our care home clients with a comprehensive suite of legal services including employment, corporate, commercial and property. We pride ourselves on offering the very best and well-informed advice combined with a responsive and cost-effective service. We understand that problems can arise at any time in a healthcare setting, so we operate a 24-hour helpline to provide advice and support to our clients around the clock. Our services are complemented by educational lectures, seminars and briefings to enable our clients to keep up-to-date with the latest developments. We also offer a free monthly care homes bulletin focusing on the latest news, guidance and legislation affecting the care homes sector.
Andrew Parsons Senior Partner, Head of Healthcare Providers Tel: 0207 222 7040 Email: andrew.parsons@rlb-law.com
SECTORS • Care homes/nursing homes. • Domiciliary care agencies. • Mental health and independent hospitals/NHS Trusts. • Learning disability services. • GPs and dental practices. • Substance misuse providers.
SERVICES • Challenging inspection reports, ratings, notices to suspend, cancel or vary registration and warning notices, fixed penalty notices and prosecutions. • Appeals to the First-Tier Tribunal. • Health and safety investigations and prosecutions. • Registration advice and challenges to refuse. • Mental health and DoLS. • Safeguarding investigations and Safeguarding Adults Reviews. • Commissioner fee and contract disputes/embargos. • Coroners' inquests. • Police investigations. • Regulatory due diligence. • Operational consultancy.
LEAD INDIVIDUALS Paul Ridout, Managing Director has been providing advice to the sector for over 40 years. Throughout his career, Paul has been instructed in matters relating to the operation, regulation and funding of care service businesses. Paul has a unique knowledge of how regulation has changed and is regarded as one of the most experienced advisers in the sector.
Caroline Barker, Director has specialised in health and social care law since 2005. Caroline strives to achieve the best for the firm’s clients and is careful to ensure that strategy and process within the organisation remain client focused with a bespoke feel. The unique client relationship has always formed the basis of Ridouts’ offering, ensuring that Ridouts is regarded as an operational partner, imparting practical advice, rather than just an academic legal adviser.
COMPANY INFORMATION Ridouts offers legal, operational and strategic advice to health and social care providers. We have the single purpose of delivering time-sensitive, effective and results-driven advice. We only act for providers, enabling us to provide robust advice, without compromise. We get to the heart of clients' issues to find solutions. Ridouts provides advice, training and consultancy services to build lasting relationships with its clients, who often find themselves in daunting and unchartered situations. The combination of staff skill mix, knowledge and experience means that our clients receive a service which is intuitive and bespoke. We believe we have the largest and most experienced dedicated team of lawyers in the sector, with unrivalled knowledge and understanding of the key issues facing providers.
Paul Ridout Managing Director Tel: 0207 317 0341 Email: paul@ridout-law.com Caroline Barker Director Tel: 0207 317 0348 Email: caroline@ridout-law.com CMM November 2019
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RESOURCE FINDER
Royds Withy King Tel: 0800 051 8058 Email: james.sage@roydswithyking.com Website: www.roydswithyking.com
SECTORS • Care homes/nursing homes. • Learning disability and specialist homes. • Domiciliary care. • Supported living. • Extra care/retirement villages. • Hospices. • Housing and support associations. • Charities.
SERVICES • CQC registration, challenging inspection reports, enforcement action and ratings. • Challenging notices to suspend or cancel registration. • Fees, tenders and commissioning contracts, challenging embargos. • Safeguarding investigations. • Inquests. • Buying and selling, leases, development and construction. • Commercial structuring and finance. • HR and employment law. • Mental capacity and DOLS. • Service user contracts. • Dispute resolution, debt recovery. • Intellectual property. • All aspects of charity law. • Free e-bulletins.
LEAD INDIVIDUALS The Health and Social Care team is a multi-disciplinary group of
specialist lawyers led by partners James Sage and Hazel Phillips. They have substantial experience advising care providers on legal and regulatory issues and regularly share their expertise at regional and national care conferences. They say, ‘We offer clients a complete legal service, giving them peace of mind that they are fully compliant so they can concentrate on doing what they do best – running successful businesses delivering the highest levels of care. We also advise a large number of providers who are registered charities, assisted by our charity law specialists. Our team’s in-depth knowledge of the challenges facing care providers and the fact we take the time to fully understand our clients' needs, means that we can provide a personal approach and become part of their trusted team.’ The Health and Social Care team are the recommended lawyers for a number of regional care associations.
COMPANY INFORMATION Royds Withy King is a UK Top 100 law firm, providing a national service to care providers from offices in London, Bath, Wiltshire and Oxford. The firm uses the breadth and depth of its expertise to provide practical, commercial and cost-effective advice.
James Sage Tel: 07508 297597 Email: james.sage@roydswithyking.com
Hazel Phillips Tel: 07776 241235 Email: hazel.phillips@roydswithyking.com 44
CMM November 2019
Scott Moncrieff & Associates Ltd Tel: 0207 129 7961 Email: errol.archer@scomo.com Website: www.scomo.com
SECTORS • Care homes/nursing homes. • Domiciliary care agencies. • Independent hospitals. • Learning disability services. • Mental health services.
SERVICES • Advice on and defence against CQC, Ofsted and HSE enforcement action. • Appeals to the First-Tier Tribunal. • Challenging inspection reports and ratings. • Coroners’ inquests. • Safeguarding investigations. • Mental Health Act and Mental Capacity Act compliance. • Contractual disputes with local authorities. • Employment advice. • Commercial contracts. • Business and property transactions.
LEAD INDIVIDUAL For over 20 years, Errol Archer has successfully acted for businesses, clients, regulators and central government, including advising senior civil servants and government ministers. He has worked both in-house and in private practice. Having successfully set up, run and managed a highly regulated business himself, he is keenly aware of the need to protect his clients’ ‘bottom line’ and business reputation. Errol is a health and social care law expert in dealing with CQC, Ofsted, HSE and other regulators.
He has: • Won appeals at tribunal against CQC and Ofsted Notices of Decision. • Successfully challenged Notices of Proposal. • Persuaded regulators to withdraw Fixed Penalty Notices. • Successfully defended and mitigated Health and Safety Prosecutions. • Guided providers through local authority safeguarding matters. Errol is a Solicitor-Advocate (Civil) and is authorised by the Solicitors Regulation Authority to exercise ‘higher rights of audience’ in courts and tribunals. He has represented clients in hundreds of hearings at courts and tribunals, including at the First-Tier Tribunal (Care Standards) and at Coroners’ Court Inquests. As a former Law Society Mental Health Tribunal Panel Member for 10 years, Errol is very well placed to work with staff to provide advice, guidance and legal assurance that they are acting lawfully; within the Mental Health Act, Mental Capacity Act and their Codes of Practice.
COMPANY INFORMATION For over 30 years, Scott-Moncrieff has been providing innovative legal solutions. As we’ve grown, our nationwide network of over 40 lawyers remain committed to delivering skilled and affordable legal services, on employment law, contracts, dispute resolution, company law and more.
Errol Archer Consultant Solicitor Advocate (Civil) Tel: 07729 421836 Email: errol.archer@scomo.com
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Markel 3rd Sector Care Awards
CELEBRATING EXCELLENCE IN COMPASSION Irene Jervis, dementia adviser, North Yorkshire Dementia Service, won the Leading Change, Adding Value Compassion Award in the Markel 3rd Sector Care Awards 2018. Here, Steph Johansen, Regional Head of Operations at Making Space explains why Irene was so deserving of her award.
As head of operations for Making Space, I’m surrounded by people who work towards improving the lives of people with dementia. But every now and again, you see someone for whom it’s not just a job; it’s a way of life. Irene Jervis is one of those people. As a dementia support worker, Irene has a deep knowledge of the condition combined with a level of empathy which allows her to connect with people on many levels. She’s also incredibly determined and was the driving force behind the Scarborough Dementia Engagement and Empowerment Project (DEEP) group.
CAMPAIGNING When Irene saw a post advertising funding for DEEP, which is a UK-wide network, she immediately started making enquiries and bringing together people who could help. She’s really dynamic and won’t let things drop, and that’s exactly what she did when she saw the post asking for applications. She spoke to friends and approached other groups she thought could help, and was the only bid from North Yorkshire that was successful. The resulting group – Scarborough DEEP – is made up of people with dementia, supported by their carers, who meet monthly. One of their main focuses has been to campaign for people with dementia to be given blue badges for disabled parking. Currently, you need to demonstrate that you have difficulty 46
CMM November 2019
with mobility to get a blue badge if you live in England. Wales allows people with cognitive problems to get a blue badge and Scotland has been piloting a similar scheme. The members of DEEP orchestrated a comprehensive campaign to persuade the government in England to do the same. Dementia, particularly in the early stages, can be very much an unseen illness. However, the problems caused by short-term memory loss mean that a simple shopping trip can cause confusion and distress if a car is parked in the middle of a large car park, or a distance away from the location being visited. With over 450,000 people living with dementia in England, 15,000 under the age of 65, the potential benefits of awarding them blue badges are huge.
SIMPLER PROCESSES As well as lobbying the government for countrywide change, DEEP highlighted problems with accessing the online application form to their local authority. The way the form is designed prevents people who don’t have physical mobility difficulties from moving to the next stage of the process; when asked if they have mobility issues, clicking ‘no’ closes the form. After highlighting this issue, the local authority has now created a special questionnaire for people with dementia to complete over the phone to allow them to grant blue badges
under the current criteria. After starting with just six members, DEEP’s campaign and awareness-raising resulted in almost 1,400 signatures and prompted a public consultation. The blue badge campaign is just one of the activities of the DEEP group under Irene’s guidance. The group also developed an education programme for people living with dementia who are newly diagnosed to reassure them they can still live an active and fulfilling life. They have also performed a dementia audit of gardens on the South Cliff in Scarborough and successfully applied for a heritage lottery grant to improve signage and pathways to make them more accessible for people with dementia.
MARKEL 3RD SECTOR CARE AWARDS
IMPROVING LIVES As a whole, DEEP is a team who have, without a doubt, improved the lives of those in their community and are well on the way to orchestrating real change for people living with dementia across England. The drive and commitment of this group of people living with dementia and their carers, plus the determination to improve lives for others in similar positions not just in their community but across the country, is remarkable. This is in no small part down to Irene, who includes, empowers and motivates members. She’s highly experienced in her knowledge of the different dementias, and in dementia care. She brings this knowledge and understanding to everything she does, and her quiet demeanor and natural empathy enable her to win the confidence of very different individuals living with dementia. Her innate ability to identify the skills and capabilities of individuals and ensure that they are fulfilled in a manageable way is a skill in itself. The extensive observations she makes of the subtle changes people undergo and the changes she makes accordingly mean that no group member feels their voice is not being heard or they are not able to contribute. The blue badge campaign is a key example of her drive, and her mastery of detail enables those with dementia and their carers and volunteers to have an effective voice. Another DEEP project has been the ‘banner unfurling’ campaign at York Rail Station to raise awareness about the need to make train travel more accessible – Irene’s creative thinking allows her to develop ideas that will help promote awareness around dementia, both on a national level and within her local area. She has forged excellent relationships with the local theatre, where the DEEP group meet and they now have input into dementia friendly scripts and performances. She also managed
to direct some funds towards a play about dementia in Scarborough, using the money to subsidise ticket prices at a matinee performance for sixth formers and nursing students, and arranging a Q & A session with those living with the condition.
LIVED EXPERIENCE Thorough, caring, compassionate – they’re words often overused, but that’s Irene. Whatever needs doing, she’s there backing up the people she works with. Clients are never left out; Irene started a couple of groups, including DEEP, but she also attends the DAA groups. When Dementia Week comes around, Irene is always the first one to come up with ideas, that’s just what she does. Dementia has been part of her life, she nursed her mum when she lived with the condition and she is happy to use her experiences to help others. We were delighted when she won the Leading Change, Adding Value Compassion Award at the Markel 3rd Sector Care Awards. She’s one of a rare breed of people who don’t even realise what they’re doing is special, even though they have such a positive impact on people’s lives. Now that her achievements have been recognised with a national award, hopefully she will know just how valued she is by so many people. CMM Steph Johansen is Regional Head of Operations at Making Space. Email: enquiries@makingspace.co.uk Twitter: @MakingSpaceUK
The Markel 3rd Sector Care Awards is run specifically for the voluntary care and support sector. Nominations are now closed for this year’s Awards. Be the first to find out who the finalists are by following the Awards on Twitter: @3rdSectorCare #3rdSectorCareAwards With thanks to our supporters: National Care Forum, Learning Disability England, The Care Provider Alliance, Association of Mental Health Providers and VODG. The Compassion Award was sponsored by
CMM November 2019
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EVENT REVIEW
LANCASHIRE CARE CONFERENCE 2019 19th September, Blackburn Organised by Care Management Matters, with an agenda developed in conjunction with Lancashire Care Association, the Lancashire Care Conference took place at the Mercure Dunkenhalgh in Blackburn with great success. Starting the day with a cry to unify the social care sector and raise its profile, Paul Simic, Chief Executive of Lancashire Care Association took to the stage wearing his CARE badge with pride as he welcomed delegates and stressed the importance of holding the event to highlight local issues and work together to find potential solutions. Clare Mattinson from Lancashire County Council gave an in-depth look at the Market Position Statement and urged providers to feed-back their thoughts so that engagement and collaboration could be strengthened in the future. As well as collaboration, integration was a word that came up more than once throughout the day and Annlouise Stephens RN, Independent Regulated Care Sector Lead for NHS England North discussed this in more detail during her presentation. As well as looking at how social care providers, NHS and local authorities are coming together to help develop new models of care, Annlouise detailed how providers could push change in their area. The panel discussion allowed delegates to pose their own questions to speakers and technology was clearly at the forefront of people’s minds. Lots of people were keen to hear about the expectation from Lancashire County Council when it came to providers utilising technology enabled care and some delegates were keen to point out that, with so many new and innovative technology solutions becoming available, there was huge pressure to choose the right one for their business and implement it effectively. Corporate sponsor
WORKSHOPS AND EXHIBITION As well as informative presentations, there were also interactive workshops where delegates could ask the questions that mattered to them. Managing medications to prevent mistakes, consumer law guidance and getting the best out of CQC inspections all proved hugely popular and were repeated throughout the afternoon so that delegates could get the most from the day. There was a wide range of exhibitors to explore throughout the breaks, from interactive products for those living with dementia to regulatory lawyers and care management software services. The lively atmosphere enabled delegates to network and take the time to talk to like-minded people.
FOCUSING ON THE MENTAL HEALTH OF MANAGERS Towards the end of the day, we heard from Richard Muncaster, Chief Executive of the Care Workers’ Charity who detailed the grants available for care workers and the importance of a complete overhaul in thinking by creating a supportive culture for staff in social care. This was followed on by the last presentation of the day from Christine Burkett, Head of Area for Skills for Care North West who focused on putting resilience into practice and offering useful tips to maintain the wellbeing of staff. The day closed with a Registered Care Managers Network Session which allowed a space for managers to have an informal chat, as well as swap ideas about how to raise their voice in the sector and push through their ideas to decision-makers. Thank you to our sponsors for the day – QCS, Atlas, Slater and Gordon and SRG Care Consultancy. CMM Supported by
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CMM November 2019
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WHAT’S ON?
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Event: Date/Location: Contact:
Change Makers: NCF Managers’ Conference 4th-5th November, Kenilworth National Care Forum, Web: www.nationalcareforum.org.uk
Event: Date/Location: Contact:
Care England Conference 2019 13th November, London Care England, Tel: 0207 492 4840
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Hospice UK National Conference 20th-22nd November, Liverpool Compleat Conference Company, Tel: 01489 668333
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National Children and Adult Services Conference 20th-22nd November, Bournemouth Local Government Association, Email: events@local.gov.uk
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Future of Ageing 5th December, London ILC-UK, Email: events@ilcuk.org.uk
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Naidex 17th-18th March, Birmingham Web: www.naidex.co.uk
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CMM November 2019
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R I C H A R D M U N C A S T E R • C E O • C A R E W O R K E R S ’ C H A R I T Y
Richard Muncaster of Care Workers’ Charity explains why the mental health and wellbeing of registered managers and frontline staff should be made an organisational priority.
The fact that mental wellbeing is a key issue for the care sector shouldn’t come as a surprise to anyone. The work is emotionally demanding, the shifts are long and those performing the work are often juggling a host of additional pressures from outside the workplace. This is echoed in the Care Workers’ Charity’s recent report The Beating Heart of Care – supporting care workers better. The following is just a quick snapshot of the report’s findings: • 51% of care workers considered leaving their role in the past three
years due to work related stress or poor mental health. • 42% of care workers said they experienced stress and 27% said they experienced anxiety ‘often’ or ‘most of the time’ as a direct result of their care work. • 37% of survey participants took time off work due to stress or poor mental health caused by their care work. • The average number of sick days taken in our sector is 25% higher than the national average. • 23% of survey participants said they experienced low mood ‘often’ or ‘most of the time’ as a result of their care work, which inadvertently impacts those being cared for. Now these might not be surprising statistics, but that shouldn’t make them any less worrying. And to illustrate that, instead of using words like ‘mental health’, ‘anxiety’ or ‘stress’; I’m going to use the word ‘ill’, because when you are experiencing anxiety, stress or poor mental health you do feel ill. So, to put it another way, 42% of care workers (that’s around 800,000 people across the UK) have jobs that are making them feel ill and around 750,000 are being forced to take time off as a result. Equally concerning is that just over half of the workforce (almost 1 million people), have considered leaving their role because the job is making them ill. Given the challenges that our sector faces in terms of recruitment and retention of good staff, these are certainly statistics that should make us sit up and take notice. There is undoubtedly a growing awareness across the sector that mental wellbeing is an issue that needs to be addressed; and during the course of our research we found many examples of excellent employers who were doing just that, and we are certainly seeing the subject of ‘wellbeing’ feature on conference agendas. But my question is, as
a sector, are we really taking this seriously enough? If you ran a restaurant where 42% of your customers were falling ill (often or most of the time), it would not take you long to realise that there was something seriously wrong with the food. Furthermore, you would clear every meeting in your diary, and you would work night and day to fix whatever was wrong with the food. It would take priority over everything else. And why? Because everybody knows that it is business critical that a restaurant doesn’t serve food that makes its customers ill. I’m sure you get where I’m going with this, so I won’t labour it; I also realise that the analogy is far from perfect, but it does still serve to make the point that we should be taking this far more seriously than we are. The quality of care that our sector delivers is mainly determined by the quality of the care workers providing the care. It is they who are the critical factor in providing good or outstanding care, just as food is the critical factor for a restaurant. If 42% of those care workers are feeling ill often or most of the time, and if 37% are taking time off because of poor mental health, it stands to reason that the quality of the care being provided will fall. There is no magic wand that we can wave to fix the mental health challenges that the sector faces. Being a care worker is hard work and those that take it on are always going to be vulnerable to stress, anxiety and depression. But that doesn’t mean that it should just be tolerated. Ensuring the wellbeing of care managers and frontline staff needs to be given the same level of organisational priority as ensuring the wellbeing of the people our sector cares for, as the two things are inextricably linked. This requires a determined and sustained effort from the whole sector to embed staff wellbeing into the DNA of our organisations. CMM
Richard Muncaster is CEO of the Care Workers’ Charity. Email: richard@thecwc.org.uk Twitter: @richmunc 50
CMM November 2019
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