Care Management Matters (CMM) March 2024 by Care Choices Ltd

MARCH 2024

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CLIMATE CHANGE The impact of rising temperatures

Shape the debate

Growing the not-for-profit sector

COVID-19 Inquiry Lessons to be learnt

Mental Health Act A call to action

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In this issue 05

Inside CQC In the wake of recent Government announcements concerning the workforce, James Bullion CBE outlines how the regulator will play its part in their implementation.

CMM News

Into Perspective This month’s Into Perspective explores technology in social care, from the barriers preventing providers from embracing it to the steps providers can take to effect change.

Celebrating Excellence Paula Plaskow tells CMM what Jewish Care has been working on since it won the End of Life Care Award at the Markel 3rd Sector Care Awards 2022.

Event Review CMM, in association with the National Care Forum (NCF), is back with a new programme of CMM Insight webinars designed to give delegates the information they need.

What’s On?

Straight Talk Appointed as the first Social Care Nurse Fellow, Dr Zena Aldridge explains her commitment to increasing research participation among nurses and midwives in social care.

FEATURES

REGULARS

Social Care Insights David Brindle discusses the financial pressures facing local authorities and calls upon the next Government to commit to meaningful reform.

The politics of profit – why growing the not-for-profit sector matters National Care Forum (NCF) Policy Director, Liz Jones, looks ahead to the General Election and outlines the NCF’s social care must-haves for the next Government.

The UK Covid-19 Inquiry – lessons must be learnt Care Rights UK Director, Helen Wildbore, highlights what lessons must be learnt from the pandemic, including the voices of those overlooked.

Rising temperatures, rising responsibilities – social care and climate change It is time to highlight the impact of global warming on social care and plan for change. Karen Davies shares her thoughts on the vital adaptations that must be made amidst rising temperatures.

Looking back, moving forward – reimagining mental health legislation The journey towards genuine reform remains arduous, with persistent inequalities. Association of Mental Health Providers Chief Executive, Kathy Roberts, explains how reform must now come into sharp focus.

2024 – the year of older people’s housing? ARCO Policy and External Affairs Manager, Sarina Kiayani, explores the evolving landscape of Integrated Retirement Communities (IRCs) and looks towards an independent future for older people. CMM March 2024

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David Brindle Former Public Services Editor of The Guardian and Chair, Ambient Support

James Bullion CBE Chief Inspector of Adult Social Care and Integrated Care, Care Quality Commission

Liz Jones Policy Director, National Care Forum (NCF)

Helen Wildbore Director, Care Rights UK

@everyLIFETech

@BlueStreamNews

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Duncan Campbell Director, everyLIFE Technologies

Abi BowlerRopinski Marketing Manager, Blue Stream Academy

Karen Davies Senior Nurse – Projects, HC-One

Kathy Roberts Chief Executive, Association of Mental Health Providers

@SarinaKiayani

@jewish_care @blimeysimon

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Sarina Kiayani Policy and External Affairs Manager, Associated Retirement Community Operators (ARCO)

Paula Plaskow End of Life and Palliative Care Lead, Jewish Care

Dr Zena Aldridge Social Care Nurse Fellow, National Institute for Health and Care Research (NIHR)

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CMM March 2024

SOCIAL CARE INSIGHTS From David Brindle David Brindle discusses the financial pressures facing local authorities and calls upon the next Government to commit to meaningful reform. By the day, harsh reality in local government draws closer and closer to the once unthinkable nightmare portrayed by the infamous Barnet ‘graph of doom’. Social care, for adults and children, is eating your local town hall. For the uninitiated, the graph of doom was sketched in 2011 by officials at Barnet Council in north London to illustrate, purely hypothetically, what would eventually happen if the trend of remorselessly rising demand for social care across the generations was to continue without radical change. In short, within 20 years there would be no money left for any other services. It was a neat concept and it made a good slide for presentations. No one seriously thought it could ever come to pass. As Nick Walkley, who was Barnet Council’s Chief Executive at the time, recently told The Guardian, ‘We never envisaged an un-solution.’ Well, here we are 13 years later and we are living with that un-solution. Adult social care and children’s services are between them devouring the lion’s share of local authority budgets – reports of up to 80% in some cases – as councils prioritise statutory duties at the expense of parks, libraries, leisure services and bin collections. Treasurers keep casting anxious glances to the horizon, but there’s no sign of the cavalry.

Ministers hailed February’s local government finance settlement for 2024-25 as a 7.5% increase in cash terms for councils in England, ‘making available up to £64.7bn’. Note the careful phrasing: the figure assumes every council raises council tax and the additional social care levy by the maximum allowed without a referendum (a total of 4.99%). As the Health Foundation thinktank points out, however, this rise – which includes about £1bn extra grant earmarked for adult and children’s social care and the £500m boost announced in January – still leaves local government with some 12% less in spending power in real terms than in 2010-11. Councils, it says, have been left facing ‘near impossible’ decisions to cut services. This is going to continue, regardless of who forms the Government, as long as we stumble on with the un-solution to how we fund adult social care. Children’s services have their own challenges in desperate need of fresh answers – safeguarding, residential care costs, special educational needs and disabilities – but the adults’ sector has been teased with an on/off reform package now for more than a decade. There is no sign of either the Conservatives or Labour going into the coming general election with a pledge to ‘get social care done’ any time soon. A twice-delayed cap on personal liability for care costs plus revision of

the hopelessly outdated capital limits for state support are due to take effect in October 2025, having been first proposed in 2011, but don’t hold your breath. Instead, the present Government is focused on measures to upskill the care workforce and make the job an attractive career, accelerate adoption of assistive technology and make much better use of data. Labour is committing to more radical workforce reform, including a pioneering ‘fair pay’ deal in the first 100 days of a new Government that would be replicated later in other sectors, and is talking vaguely of ironing out variation in the quality of care. Both parties are approaching wider adult social care reform as a 10-year project. They are each, undoubtedly, fighting shy of promising more meaningful change in their election manifesto this year because of the risk of being attacked by the other for planning a ‘death tax’ or ‘dementia tax’ to fund it. Why should they be so scared? Because the Tories did exactly that to Labour in 2010. And Labour, in turn, did it to the Tories in 2017. So, the graph of doom looks set to keep climbing. We in social care can do no more than our best to keep our doors open, keep campaigning for the change we need and keep faith that our elected leaders will finally find the courage to embrace it on the other side of the election.

David Brindle is former Public Services Editor of The Guardian. He is chair of Ambient Support. Email: david.brindle@ambient.org.uk X: @DavidJ_Brindle

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CMM March 2024

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INSIDE CQC James Bullion

In the wake of recent Government announcements concerning the workforce, James Bullion outlines how the regulator will play its part in their implementation. The Department of Health and Social Care published the Care Workforce Pathway at the beginning of the year. I’m acutely aware of the workforce challenges faced by care providers at present. It was a key theme in our 2022/23 State of Care report, and I’m pleased that it’s the ambition of this new pathway to go some way to addressing some of those challenges. The first part of the pathway focuses on staff working in direct care roles in four categories: new to care; care or support worker; supervisory/leadership; and practice leader. The pathway sets out a defined set of behaviours, knowledge and skills for each role, helping someone working at a specific level to develop within each category and be able to provide the best care to the people who receive their support. We see frequent evidence of the skills and dedication of the care workforce in our assessment activity. One of our key questions at inspection is whether a service is well led. A recent outstanding example of a well-led service is run by Marcus & Marcus Limited in north London. The service provides specialist care and support to people with a learning disability, autistic people and people with mental health needs who are living in their own homes. We found that the leaders promoted a positive, person-centred, open, inclusive and empowering culture. They involved all staff in workshops on how to assess and improve their workplace culture, enabling reflection on practice in a supportive environment. A well-led service, with inclusive and positive continuous learning and improvement is key to delivering good and outstanding care. Effective support and development pathways must be in place for staff if they’re to be able to provide the person-centred care that

enables people to live rich and fulfilling lives. I encourage all leaders and managers to explore the Care Workforce Pathway and take opportunities to begin embedding it within your wider teams. The pathway will take time to embed. And workforce pressures can be more immediate, of course. Challenges in recruiting and retaining staff are widespread, though international recruitment has gone some way to plugging staffing gaps. Changes announced by the Home Secretary in December last year may on the ways in which care staff can be recruited from overseas, with only health and care organisations that fall under the scope of CQC regulations able to sponsor care worker visa applications. This will affect organisations that deliver or co-ordinate health and care services that are not registered with us, as the services they provide fall outside the scope of our regulation. This includes, for example, provision of personal care or nursing care in cases where a care worker or a nurse works directly for the individual receiving care, or for a third party acting on their behalf. It also includes introductory or employment agencies who help people find registered nurses, nursing associates or care workers and do not manage or direct the nursing or personal care themselves. The ongoing challenge in recruitment and retention remains – to ensure that the staff have the right values and support to deliver safe and high-quality person-centred care. Now, as the days begin to lengthen, it’s easier to feel as though a long winter is moving behind us. The hard work and dedication of colleagues across the sector during winter doesn’t go unnoticed. I’m proud to see the work done in services to increase capacity. And where we can we’ve accelerated inspections to release beds to support timely discharge from hospital to care homes. As we undertake more assessments of local authorities and integrated care systems under our new responsibilities, we’ll be able to build a clearer view of how services work together across systems. Identifying local good practice and sharing it nationally will support staff and leaders across sectors in their contingency planning. Working effectively together across systems can help support the workforce and enable people to move through their local health and care system in ways that best support their needs.

James Bullion CBE is Chief Inspector of Adult Social Care and Integrated Care at the Care Quality Commission. Email: providerengagement@cqc.org.uk X: CQCProf CMM March 2024

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NEWS

APPOINTMENTS Community Integrated Care

Support package for councils announced Councils across England will receive a £600m support package to help them deliver key services, the Levelling Up Secretary has announced. The support package will primarily see an additional £500m added to the Social Care Grant to bolster social care budgets. In response to the announcement, Cathie Williams, joint Chief Executive Officer of the Association of Directors of Adult Social Services (ADASS), said, 'This additional funding for social care is much needed and will be welcomed by people using and working in care and support. 'But given the well documented pressures on council finances and adult social care budgets, more still needs to be done to help people stay independent at home for longer, support unpaid carers and address workforce challenges, or we risk denying people the care and support they need to live well.’ Karolina Gerlich, Chief Executive Officer of The Care Workers’ Charity, said, 'While acknowledging the Government's immediate response to the challenges faced by councils, The Care Workers' Charity continues to stress the importance of a

sustained and comprehensive approach to secure the future of social care and ensure the wellbeing of care workers and the individuals they support. 'The Care Workers’ Charity remains committed to collaborating with stakeholders to achieve lasting solutions that safeguard the interests of care workers and uphold the standard of care in our communities.' Homecare Association Chief Executive Officer, Dr Jane Townson OBE, said, 'We welcome news of an extra £500m from central Government to councils to support social care and other key services, though this goes only some way to plugging the £4bn gap in council finances. 'Care providers remain worried that councils will struggle to increase fee rates for care enough to cover the 9.8% increase in the national minimum wage to £11.44 per hour in April. ‘To save money, some councils are driving down prices for homecare, which are already too low, and we fear this is creating the conditions for unscrupulous providers to prevail, leading to a decline in care quality and an increase in labour abuse and modern slavery.’

Call for radical refocusing of health and care system England’s health and care system must be radically refocused to put primary and community care at its core if it is to be effective and sustainable, according to a new report published by The King’s Fund. The report has argued that the failure to grow and invest in primary and community health and care services, despite successive governments stating a commitment to this agenda, is one of the most significant and long-running policy failures of the past 30 years. Assessing the key reasons for this, The King’s Fund found that progress has been hampered by an incorrect belief that moving care into the community will result in short-term cash savings. Other factors include a lack of data about primary and community services leading to a ‘cycle of invisibility’, funding flows that prioritise hospitals and urgent challenges such as A&E waiting times and planned care backlogs becoming the priority for politicians tempted by quick fixes instead of

fundamental improvement. The report proposes several steps to begin the shift, including reform of the ‘ailing’ social care system, without which the ambition of ‘care closer to home’ cannot be fully realised. In response, Anna Hemmings, Joint Chief Executive at the Association of Directors of Adult Social Services (ADASS), said, ‘The evidence in this report is clear, now is the time to act. We need to make the shift to preventing ill health the political focus of the next decade to make sure everyone can get the care and support they need, when they need it.’ Professor Martin Green OBE, Chief Executive at Care England, said, ‘This report brings to life the consequences of the Government’s continued focus on trying to fix the NHS, without fixing the social care sector. Care England wholeheartedly supports shifting the national focus away from hospitals towards primary and community health and care.’

Tom Gibbs has been appointed as Chief Financial Officer at Community Integrated Care taking the reins from Stephen Perry. Tom previously served at Barnardo’s, the children’s charity, holding a number of senior roles across six years and remains Trustee and Treasurer at food bank charity, The Trussell Trust, bringing a wealth of expertise to his new role.

Cornerstone Healthcare Group

Cornerstone Healthcare Group, a leading provider of specialist and complex care, has announced Paul Hayes as its new Chief Executive Officer. Paul has spent over 30 years working in the sector and has served at some of the largest providers in the UK, including his role as Non-Executive Director of Care England. Under Paul’s leadership, two new services are set to open up in Somerset and Bristol.

Westgate Healthcare

Dan Scott-Elder has been appointed as the new Operations Director of Westgate Healthcare after 20 years in the healthcare sector. Chief Operating Officer Deborah Christian says his expertise will add great value to the team amid the expansion plans for 2024.

Care England

Angela Boxall has been appointed as the new Chair of the Board of Trustees at Care England, taking over from Avnish Goyal CBE who will remain on the policy board. With extensive knowledge and experience in the sector, Angela will bring new strengths to the Board and will continue to steer towards positive change.

CMM March 2024

NEWS

New Disability Action Plan Government has launched its new Disability Action Plan, aiming to make the UK the most accessible place in the world for disabled people. Specific actions announced include: • A new fund to support disabled people who want to be elected to public office. • Building an online information hub for local authorities on creating accessible playgrounds. • A new working group to educate businesses on the legal rights of assistance dog owners and make it simpler to report when they are refused access to a business. • Leading new research into emerging issues affecting disabled people in the UK over the next 20 years. • Ensuring disabled people’s experiences are fully taken

CMM March 2024

into account during resilience planning for emergencies. • Publishing research into the accessibility of private sector products and services in Spring 2024. • Holding a conference on climate adaptation and disability. • Addressing concerns that the Ultra Low Emission Zone and Clean Air Zones have led to some disabled people feeling excluded from city centres and across London. In response to the launch of Government's new Disability Action plan, Dr Rhidian Hughes, Chief Executive of the Voluntary Organisations Disability Group (VODG), said, 'The Disability Action Plan provides welcome steps forward in some of the areas we know matter most to disabled people. The emphasis

on inclusion, accessible communications and involvement of disabled people in emergency and resilience planning is good to see and also reflects the findings from our Commission on COVID-19, Ableism and Racism. This is however a short-term plan in an election year. We continue to call on political parties to be big and bold in their ambitions for disabled people. That involves prioritising co-decision making when it comes to the ongoing challenges that need addressing such as further support for people in employment, fully funding cost of living support and improving access to housing.' In addition, Jackie O'Sullivan, acting Chief Executive Officer at Mencap, said, 'Despite some encouraging steps forward, the Disability Action Plan is unlikely to bring about the change people

with a learning disability need from our Government. 'We welcome new initiatives, like improving how Government will undertake research on disabled people’s experiences; support for disabled people who want to seek public and elected office; and work to make Government communications more accessible. But these positive steps do not address the most pressing issues for people with a learning disability: access to social care, healthcare, employment and cost of living support. 'The unacceptable inequalities experienced by people with a learning disability can only be addressed through a robust long-term strategy to tackle the biggest barriers people with a learning disability face.' To read Government's new Disability Action Plan in full, visit GOV.UK.

NEWS

Latest LGSCO confirmed The new Local Government and Social Care Ombudsman (LGSCO) has been confirmed as Amerdeep Somal. Ms Somal has also been appointed as Chair of the Commission for Local Administration in England, which runs the LGSCO service. Amerdeep Somal sits on the board of the Parliamentary Health Service Ombudsman. Ms Somal has previously served as the Complaints Commissioner to the

Financial Regulators and Chief Commissioner at the Data and Marketing Commission. She was the Independent Assessor to the Financial Ombudsman Service and board member at the General Medical Council and Nursing and Midwifery Council. She is a former founding Commissioner at the Independent Police Complaints Commission and has held several other board roles following an earlier career as a senior civil servant.

The Ombudsman is appointed by His Majesty the King on the advice of the Secretary of State, and the Ombudsman’s investigations are independent of central Government. Ms Somal was appointed following an open recruitment competition overseen by the Commissioner for Public Appointments, and her appointment was endorsed by the Levelling Up, Housing and Communities Select Committee

following a pre-appointment scrutiny hearing held in Parliament on 18th September 2023. In response to the announcement, Minister for Local Government, Simon Hoare, said, 'The Local Government and Social Care Ombudsman provides a vital role in holding our public services to account, ensuring the public has the power to challenge decisions on the issues that matter most to them.'

The Orders of St John Care Trust merges with The Fremantle Trust OSJCT supports nearly 3,000 older people in 61 care homes and eight extra care housing schemes across Gloucestershire, Lincolnshire, Oxfordshire, Suffolk, West Sussex, and Wiltshire. The Fremantle Trust supports over 750 people across 11 care

homes for older people and residential and supported living services for people with learning disabilities. Dan Hayes OBE, Chief Executive of OSJCT, said, ‘Our two organisations share so many core values which ensures that this

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merger is an ideal fit. We are both not-for-profit charities, absolutely dedicated to those who depend on us and those that deliver life-changing care and support.’ Jim Burness, outgoing Chair of Trustees at The Fremantle Trust, said, ‘I am really delighted

that The Fremantle Trust has found such a like-minded partner organisation as The Orders of St John Care Trust. This merger is a testament to our collective dedication to caring for some of the most vulnerable people in society.’

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NEWS

Finalists announced for the Markel 3rd Sector Care Awards 2024 CMM has announced its finalists for the Markel 3rd Sector Care Awards 2024. The winners will be announced at a daytime ceremony, taking place on Friday 15th March at The Grand Hotel in Birmingham. Over the last decade, the awards have grown and become a highly respected fixture on the care sector events calendar. The awards shine a spotlight on worthy individuals and organisations that improve the lives of people with tremendous challenges up and down the country. The entries demonstrate the diversity and capability of organisations in the voluntary and/or not-for-profit sector. The judging panel has included experts from Choice Support, the Nursing and

Midwifery Council (NMC), the Association of Mental Health Providers, the Royal Hospital Chelsea (RHC) and more. CMM is delighted to announce Sally Lindsay as the brand-new host of the Awards. Most recently, Sally created, co-wrote and stars in the brand-new series, The Madame Blanc Mysteries. Sally is an ambassador for the Alzheimer’s Society in loving memory of her grandmother, Ellen. Sally is also the President of the Women of the Year Luncheon & Awards. Commenting on being announced as the new host of the Markel 3rd Sector Care Awards, Sally said, ‘I’m so excited to be a part of these fantastic awards. I wish all the amazing finalists could be winners, but

it will be an honour to reveal the judges’ choice in each category and get to meet each of the winners on stage. ‘It is truly remarkable to hear about the achievements of the awards’ finalists who have all worked tirelessly to make a difference to the lives of people in their communities. As an Ambassador for the Alzheimer’s Society, I’ve experienced first-hand the positive impact that these invaluable services can have. The people behind them deserve recognition and I look forward to learning more about their stories in person. Good luck to all the finalists!’ Visit the CMM website for the full list of Markel 3rd Sector Care Awards 2024 finalists.

Apply for the Care Innovation Challenge 2024 The Care Innovation Challenge, a hackathonstyle creative weekend of idea generation and prototype trialling, will return in July 2024. With cash prizes for the top spots, expert mentoring and guaranteed media coverage, this is an opportunity not to be missed. Applications for a place at the weekend are now open, and creative thinkers, anyone who has a passion for making ideas a reality and people who want to make a positive difference to people’s lives are invited to apply on the Care Innovation Hub website. The Challenge, hosted by the Care Innovation Hub (CIH), is run by the National Care Forum (NCF) and is supported by

Think Local Act Personal (TLAP) through its National Co-production Advisory Group (NCAG) to ensure people with lived experience help to create solutions to key challenges faced by the care sector. NCF is dedicated to developing innovation in the social care and support sector and this is a natural home to drive the CIH into the future. Commenting on the launch of this year’s Care Innovation Challenge, Professor Vic Rayner OBE, Chief Executive Officer at the NCF, said, 'We welcome anyone who wants a chance to be part of the future of care. We hope to receive applications

from a diverse group of people, including individuals and teams from care providers, undergraduates and postgraduates from universities and people with social entrepreneurial ambitions. 'You do not need to be an expert in social care, or have any experience of social care yourself, to apply. You do not need to have any technical skills. You just need to have an intention to improve the quality of life of those receiving care in the UK.' Apply on the Care Innovation Hub website if you have a passion for making ideas a reality and want to make a positive difference to people’s lives.

Financial pressures facing Generation X Retirement specialist Just Group has shed light on the contribution Generation X is making towards the care of older relatives – creating a significant financial and emotional burden on this generation, the organisation has argued. Data has revealed that over one in 10 (11%) of Generation X are contributing to financial support for the care of their older relatives; covering things like contributions to care home fees, visits from a home carer, weekly shopping or funding home improvements. Those providing support estimated that they were spending an average of £237.50 a

week – or £12,350 a year, around £800 more than the full new State Pension will be worth from April 2024 (£11,542). Asked how they felt about contributing to their parents' or relatives’ care costs, the majority answered that they felt poorer (54%) and more tired (53%) as a result. A further four in 10 felt unprepared (39%) and a similar proportion were stressed (42%). Stephen Lowe, Group Communications Director at Just Group, said, 'When elderly parents or loved ones begin to need formal caring arrangements, it can be a difficult and emotional time.

'It is little surprise that Generation X feel that contributing financially to their parents' or older relatives' care is the right thing to do but it is clear that, for many, the cost of this additional support is adding to the already significant pressures squeezing this generation. 'The costs of contributing towards the care of elderly family members are not trivial – either in financial or emotional terms. Generation X is spending, on average, the equivalent of more than a full State Pension every year to provide this financial support.’

CMM March 2024

NEWS

New recruitment solution from Care England

Workforce skipping meals to afford training

Care England has launched a new end-to-end solution to aid issues arising from recruitment and retention for providers and local authorities. Care England has partnered with four organisations – Care Character, Care Friends, Jobtrain and Vivup – to create its new recruitment solution. The new partnership sets out to offer a collective end-to-end solution to address the current sector-wide vacancy rate, the quality and development of carers, lower turnover rates and significantly reduce costs for providers. Commenting on the launch, Professor Martin Green OBE, Chief Executive of Care England, said, ‘With a third of the workforce leaving their roles every year, at a cost of over £6,000 per rehire, there is an annual £3bn cost to the sector

Research from FuturU, an online education and career development hub, has found that 42% of nurses and care workers in the UK are paying for their own mandatory training. Additionally, nearly 32% are skipping meals to afford training that allows them to keep their skills up to date. The data has revealed that the average self-funder spends nearly 18% of their annual salary on training. In many cases, the report has found, this is forcing people to dip into savings to afford basic necessities. With a higher volume of courses to undertake, nurses are likely to spend a higher average percentage of their wages on training (19%) than care workers (16%). Among those who pay for their training, 31% are taking

which is simply unsustainable. We hope that our end-to-end solution will go some way in supporting care providers to navigate workforce challenges.' Will Shepherd, Chief Executive Officer at social care recruitment specialist, Cohesion, and Founder of Care Character, said, 'At Care Character, we are proud to have developed a psychometric assessment tool tailored to the unique demands of the care sector, which is delivering positive transformations in both recruitment and retention. We are delighted to share a platform with other innovative organisations thanks to Care England’s determination to make a difference in this field, welcoming a comprehensive end-to-end solution that focuses on quality and results.'

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out loans to cover the cost of working in the sector, with 17% going into debt. Commenting on the findings, Michael Manuccia, Chief Executive Officer at FuturU, said, 'Nurses and care workers have dedicated their lives to helping others, but we’re asking them to take on more work, with fewer people, in the most challenging conditions. 'On top of that, we’re expecting them to take on the economic burden of a health and social care education and often finance it with debt. It’s no wonder that so many people are leaving the sector.' The report, Prescription for Change – why nursing and social care training needs an injection of innovation, is available to read online.

NEWS

Care provider sets new sustainability standard

Online portal launched to encourage independent living

Cambridgeshire’s Askham Village Community has made significant efforts to reduce its carbon footprint and foster a greenminded atmosphere among its residents and staff. At the heart of its sustainability efforts are the centre’s solar panels, which have produced more than a quarter of the facility's total energy consumption over the past year. They also generated an excess of 20% energy that was exported back to the grid. This not only contributed to the community's green energy supply but also enabled the centre to reduce its energy costs which in the face of rising prices across many areas has enabled the organisation to maintain its investment in staff wellbeing. The facility's commitment to green energy extends beyond solar power. With the

A leading Scottish housing provider has launched an online customer portal which is set to improve access to a range of services and encourage independent living. As part of an ongoing commitment to digital transformation, Bield Housing and Care worked with a number of tenants to test a new online customer portal, which was launched as part of Safer Internet Day 2024. The portal gives Bield tenants 24/7 access to make paying bills, reporting repairs and viewing individual information easier and more convenient. Tenants involved in the trial were tasked with testing the quality and usability of the software using laptops, tablets and smartphones.

installation of car charging ports, which were used 178 times last year, resulting in a consumption of 3,308.28 kWh, Askham Village Community supports the use of electric vehicles (EVs) among its staff and visitors. Reflecting on the centre’s green initiatives, Aliyyah-Begum Nasser, Operations Director at Askham Village Community, stated, ‘At Askham, we pride ourselves on our commitment to sustainability and environmental stewardship. Our efforts over the past year demonstrate not just our dedication to reducing our carbon footprint but also our resolve to lead by example in the care sector. We are proud to continue this vital work, ensuring a greener, healthier future for our residents and the wider community.’

The group also considered the functionality, design and general use of the portal with their feedback helping to inform the final product. Following a soft launch at the end of 2023, over 170 tenants have already registered on My Bield. Zhan McIntyre, Head of Policy and Customer Standards at Bield, said, ‘Technology is essential to the future of housing services and we need to ensure our interaction with customers meets their needs and expectations as we take our services to the next level. ‘Getting tenants involved in the testing of the My Bield portal allowed us to find out exactly what they wanted to get out of the platform while making sure it was accessible and easy to use.’

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NEWS NEWS / IN FOCUS

Home Instead names Care Professional of the Year Home Instead has named Anthony Chinoso as its Care Professional of the Year. The 30-year-old, from the organisation’s Camden franchise, was one of three finalists selected from the 12,000 care professionals employed by Home Instead across the UK. Anthony received his award from Home Instead’s Chief Executive Officer, Martin Jones MBE and Sky News’ Sarah-Jane Mee at Home Instead’s Annual Conference, held in Manchester at the beginning of February. Originally from Nigeria, Anthony looked after his grandparents before moving to England where he settled in the Camden area. The judges were particularly impressed with Anthony’s

patience and commitment to ‘getting through’ to a client who was living with dementia. Speaking about his work, Anthony said, ‘Caring gives you the opportunity to experience life from another person’s perspective. You need to take time to listen to each client’s story, so you understand them better and then you are able to bring the right energy. ‘My clients look forward to my visits and I make sure that I bring my best every time. ‘Working with Home Instead has put a smile on my face – the work gives me a great deal of energy and I like to pass that on to my clients.’ Also recognised were Angela Marsh from the Salford and Worsley franchise and Tinashe Mutore from the Glasgow North franchise.

New partnership to deliver integrated care platform North East London NHS Foundation Trust (NELFT) has partnered with The Access Group to implement a digital platform to tackle issues such as bed management, capacity and delayed discharge. NELFT and Access will together design and deliver the integrated care platform in what is a proof-of-concept pilot. This unique care model is designed to streamline patient flow, support virtual wards, and handle patient discharge from hospital to home. The solution sets out to help the trust meet the NHS England Delivery plan for recovering urgent and emergency services and will aim to lead the way to join up care across primary and secondary healthcare, social care and the care sector within the region.

Umesh Gadhvi, Chief Digital Information Officer at NELFT, commented, ‘Our digital front door can help keep people out of hospital, discharge patients early, reduce clinical time and give patients autonomy and choice. ‘The Trust has developed an ambitious digital strategy which has been designed with our patients, and our virtual wards digital pathway enables patient choice of care. The design allows patients to use digital options to access and receive their healthcare. ‘Virtual wards (also known as hospital at home) is a key digital offering to allow patients to get the care they need at home safely and conveniently, rather than being in hospital, therefore supporting hospital avoidance.’

IN FOCUS

Sector Pulse Check 2023 published WHAT’S THE STORY? The report has suggested that the sector is in sustained crisis, despite Government investment. Unsustainable financial and workforce pressures are forcing providers to turn down new admissions and close services, as Government grants are not reaching the people who need them most. This is according to independent research from learning disability charity, Hft, and Care England. The report, based on a large-scale survey of adult social care providers, has found that despite a £7.5bn funding boost in the 2022 Autumn Statement, there has been little progress in the key challenges facing the sector.

WHAT WERE THE FINDINGS? Energy cost increases of up to 350% and unfunded rises in the National Living Wage left 40% of providers in deficit in 2023. Care England has stated that this is particularly concerning when 84% of care providers said that recent funding initiatives from Government – such as the Market Sustainability and Improvement Fund and International Recruitment Fund – made no difference to the financial sustainability of their organisation over the past year. These challenges are compounded by a deeprooted and systematic crisis in the workforce, the report has found. Despite a rise in international recruitment, staffing shortages remain widespread. Nearly half (44%) of organisations had to turn down admissions due to a lack of staff.

According to Care England, the findings indicate that the current approach to sector funding is insufficient. The recent tightening of immigration rules for overseas care staff and a growing concern about local government finances only serve to add to the distress surrounding the future of the sector, the report has summarised. Hft and Care England have called on Government to implement immediate measures to support the sector – including improving commissioning practice, revising VAT arrangements and removing barriers to ethical international recruitment.

WHAT DO THE EXPERTS SAY? Steve Veevers, Chief Executive of Hft, said, 'It is difficult to offer words of hope and motivation when the past 12 months have seen the adult social care sector engulfed in a sustained state of crisis. 'Despite moving away from the immediate challenges posed by the COVID-19 pandemic, there has been little respite from the fundamental financial and workforce pressures that have faced our sector for many years. The fact that 43% of providers told us they closed a part of their organisation or handed back contracts last year is testament to this. 'It is extremely disappointing that the overarching recommendations from last year’s Sector Pulse Check report haven’t been actioned and, despite additional investment from Government, we continue to operate amid significant challenges.' CMM March 2024

NEWS

NEWS FROM ACROSS THE GLOBE Australian Government launches workforce advisory service In a bid to bolster the quality and sustainability of aged care services across the nation, the Australian Government, through the Department of Health and Aged Care, has initiated the Aged Care Business and Workforce Advisory Service. Delivered by EY, a leading professional services firm, this service aims to offer tailored advice to eligible aged care

providers facing various business and workforce challenges. Residential aged care facilities and home care providers meeting eligibility criteria can now avail themselves of this service which provides independent, confidential and free-of-cost support. Funded until 30th June 2025 by the Australian Government, interested parties

are encouraged to apply. Eligibility for the advisory service is limited to residential aged care and home care providers. EY will assess applications based on factors like location and past support, with final approval from the Department of Health and Aged Care. Successful applicants will receive tailored advice

on financial performance, workforce planning and organisational design, aiming to enhance operational efficiency and meet industry standards. The process includes submission, clarification, eligibility review and engagement with Ey potentially involving site visits and consultations for practical guidance.

US multivitamin study offers hope against cognitive decline A recent study, known as the COcoa supplement and multivitamin outcomes study (COSMOS), has shed light on the potential of multivitamin supplements in combating cognitive decline and Alzheimer's disease. The study was conducted by researchers at Mass General Brigham, the largest hospital-based research

enterprise in the United States. Results from the study revealed a significant benefit of multivitamin supplementation over a two-year period, particularly in improving global cognition and episodic memory. These findings come at a critical time as the ageing population continues to grow. The study's lead author, Dr. Chirag

Vyas, emphasised the practicality of daily multivitamin intake as a potential strategy for combating cognitive ageing. Senior author Dr. Olivia Okereke highlighted its importance for older adults striving to maintain brain health. Led by Dr. JoAnn Manson and Dr. Howard Sesso, the COSMOS consortium aims to delve further into the underlying

mechanisms of these findings. Dr. Sesso emphasised the need to explore the role of baseline nutritional status in preserving cognitive health, suggesting avenues for future research. With the ageing demographic on the rise, the study’s findings offer a beacon of hope in the quest to preserve cognitive function among older adults.

India widens reach of psychosocial care services in prisons In a significant move towards addressing mental health concerns within the prison system, Ahmedabad, a major city in the Indian state of Gujarat, is set to expand its psychosocial care services to three more correctional facilities. This decision comes as part of a concerted effort to prioritise the wellbeing and rehabilitation of inmates across the city. The initiative, spearheaded by the Gujarat Government, aims to establish dedicated psychosocial care centres within these prisons, enhancing access 18

CMM March 2024

to mental health support for inmates. With mental health increasingly recognised as a crucial aspect of overall wellbeing, particularly in carceral settings, this expansion marks a proactive step towards holistic inmate rehabilitation. The three prisons set to receive these psychosocial care centres are expected to benefit from a range of mental health services tailored to meet the diverse needs of their inmate populations. These services may include counselling, therapy sessions and mental health

education programmes aimed at promoting emotional resilience and coping skills. According to officials, the decision to expand psychosocial care services aligns with broader efforts to reform the criminal justice system, emphasising rehabilitation over punitive measures. By addressing underlying mental health issues among inmates, authorities hope to reduce recidivism rates and facilitate successful reintegration into society upon release. Furthermore, the establishment of psychosocial

care centres within prisons reflects a growing recognition of the interconnectedness between mental health and criminal behaviour. As these new psychosocial care centres become operational, they are expected to play a crucial role in promoting inmate wellbeing and fostering a rehabilitative environment within Ahmedabad's correctional facilities. This initiative hopes to demonstrate the city's dedication to promoting social justice and holistic rehabilitation within its criminal justice system.

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THE POLITICS OF PROFIT:

Why growing the not-for-profit sector matters

Amidst election fervour, the imperative to prioritise social care in political discourse resonates deeply. Liz Jones looks ahead to the General Election and outlines its must-haves for the next Government.

CMM March 2024

In an election year, it would be great to think that opportunities abound for us to make social care a critical political priority. While many despair of this possibility, there is hope and now is the time to #SpeakUpForCare, to provide a strong voice for those who use it, their families and friends and those who work in and provide it. More politicians seem prepared to talk about social care and, in the case of the Labour Party, talk explicitly about not-for-profit (NFP) care. The NCF attended the most recent Labour Party Conference and learned that the proposed reforms will, ‘promote the public sector and non-profit delivery of care services. A Labour Government would not allow new contracts to be given to care providers who do not meet high standards. We will not tolerate poor-quality, extractive providers that have opaque and irresponsible financial practices and poor working conditions in the sector’. Labour also plans to focus on fair pay deals for workers. Its ‘New Deal for Working People’ talks of creating strong collective bargaining rights for working people, which will cover pay and conditions, training, etc. with Fair Pay Agreements, starting with the adult social care sector. The Liberal Democrat Party has made social care a key focus of its campaign, involving free personal care, improving pay terms and conditions, career progression and training for care providers, a focus on prevention, a national minimum standard for care and the addition of unpaid caring to the protected characteristics list under the Equality Act.

Shape the debate As the NFP part of the sector, we need to actively encourage and shape this debate by engaging politicians and policymakers, those who receive care and support, their friends and families, and those who work in the sector. We want to explain all the benefits of NFP care – care for people, not profit – and this part of the sector can can grow. As the leading voice of the NFP sector, we see this as a fantastic opportunity and are working hard to ensure a strong voice of social care including those who use it, their families and friends and those who work in and provide it. One of our key ‘must haves’ for any future government is to invest in people, not profit. As we all know, social care delivers public good, much of it funded by the public purse, while many people also pay for their own care. NFP care ensures that all funding from Government or citizens remains in the sector and is reinvested into the workforce and improvement of care rather than ‘leaking’ out of services, a term coined by the Centre for Health and the Public Interest’s 2019 report, Plugging the Leaks in the UK Care Home Industry: Strategies for resolving the financial crisis in the residential and nursing home sector. NCF members, like Borough Care (featured in the following case study), are all NFP care and support providers of different sizes, offering a diverse range of services. They emphasise the long-term sustainability of those services and many have strong heritage and deep roots in the communities they serve. They respond to need, focus on person-centred care and many offer specialist provision for people with specific needs, such as people from different faith traditions, veterans and the LGBTQ+ community.

CMM March 2024

THE POLITICS OF PROFIT: WHY GROWING THE NOT-FOR-PROFIT SECTOR MATTERS

> Borough Care – valuing diversity and inclusivity

as an NFP care provider

Borough Care operates 12 care homes for older people in Stockport and parts of Staffordshire, providing residential, intermediate, short stay and day care. In 2021, Borough Care became the first large residential care provider in the UK to pay the Real Living Wage in direct response to staff feedback and recognition of the continued dedication shown by its team. Reflecting the evolving and increasingly diverse communities it serves, with a focus on person-centred care with inclusivity and responsiveness that characterises the very best NFP care, Borough Care has made major strides in the dining options available to residents. The provider considers the needs of residents from different faith traditions, veterans and the LGBTQ+ community and is in the process of securing the Pride in Care Accreditation. Borough Care has also invested in focus groups to obtain the views of autistic people and people with other forms of neurodiversity in care together with specific sessions with members of the Gujarati community.

Why NFP? You may ask why it matters who provides care and support, as long as it is good quality, responsive and doing what we all need, and why we need more NFP provision. There are several reasons – public perception, transparency, value for money for the public pound and responsiveness to need. Starting with public perception, we ran a public poll a couple of years ago asking, ‘If you or a close relative could no longer manage at home and were choosing a care home, would you prefer one run by a charity (or “not-for-profit” organisation), a private company or a local council?’ The polling covered 1,500 adults and found 54% of respondents preferred care homes to be run by NFP organisations, while 21% preferred them to be run by a local council. Only a quarter preferred a privately run care home. There is regular outrage about media coverage of large corporate care providers allegedly extracting profits, focusing on profit over quality and employing opaque financial arrangements. A very interesting paper in The Lancet noted while looking at the quasi-marketisation of long-term residential and nursing care internationally, ‘Widespread use of predatory financial practices by these entities has sparked concerns about the implications of financialisation for quality of care, working conditions and economic and operational stability across the sector.’ The NFP model is very different to these financial practices as all the money generated is reinvested back into services. This is usually called surplus. Of course, voluntary, community or social enterprise (VCSE) organisations need to make a surplus to remain sustainable and that surplus is reinvested in the workforce, quality of care and support, futureproofing, innovation, environmental sustainability and more. It is important to note that the NFP model does not mean organisations can operate a ‘for loss’ model.

The workforce matters We know that great care needs a great workforce and workforce retention factors are simple. The following factors matter – pay, terms and conditions, flexibility and predictability of hours, being valued

and recognised, having access to high-quality training, learning and development, together with clear career progression options. Skills for Care data reiterates this and finds that pensions, sick pay and no zero-hours contracts all matter (section 8.1). Being able to invest in better pay, terms and conditions, excellent training and offering great career progression are key to resolving the current social care workforce challenges. For NFP providers, control of your surplus enables you to make these choices, as The Lancet article aforementioned said, ‘In the UK, research suggests that quality ratings (which capture a range of clinical and non-clinical quality criteria) and staff pay are both lower in for-profit (FP) facilities, as compared with their voluntary and public sector counterparts and strategies such as restricting annual leave, decreasing staff-to-resident ratios and removing sick pay are common.’

Lessons from abroad There is international precedence for NFP provision dominating care markets. For example, in Norway only 4% of care is run by FP organisations and in the Netherlands, care is almost exclusively NFP. Meanwhile, in England, FP care dominates with 76% of care being delivered by FP operators. Closer to home, the Labour-led Welsh Government is seeking to eliminate profit from the care of children who are being looked after. It is now also running a multi-agency programme board to explore how to progress the technical and development work to support its legislative options, shape the future approach and deliver market stability. Evidently, the case for NFP provision is gaining strength elsewhere within the UK and is already the dominant model in other parts of the world. Effective strategic planning, funding and commissioning could grow the size and scale of care for people, not profit over the next 10-20 years, but that needs action now. This is why we need the next government to help grow the volume of NFP care provision in the following ways: • Putting people before profit through a strategic, mindful and deliberate focus on commissioning and funding of NFP care. • Developing a pathway to enable more care organisations to adopt an NFP care model. • Ensuring regulation has a focus on financial transparency to provide confidence and accountability.

Join the conversation If you only take away a few thoughts from this article, I would encourage you to think about the following and would welcome a conversation with anyone curious to know more: • NCF members offer NFP care in all parts of the country, in all types of service and supporting a wide range of people. Our commentary is embedded in members’ experiences. • NFP care is different to FP care – legislation around social value recognises this. It has long and established roots in the communities it operates within, and its constitutional structure guarantees reinvestment in people and place – these are elements that the public value and politicians have an increasing interest in understanding. • The journey towards greater NFP care will benefit all communities. CMM

Liz Jones is Policy Director at the National Care Forum. Email: liz.jones@nationalcareforum.org.uk X: @NCF_Liz How do you think the next government can grow the NFP care and support sector? Visit www.caremanagementmatters.co.uk and leave a comment on this article or join the conversation. 22

CMM March 2024

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CMM March 2024

THE UK COVID-19 INQUIRY: Lessons must be learnt The UK Covid-19 Inquiry is putting one of the darkest periods in recent history under the spotlight. Helen Wildbore highlights what lessons must be learnt from the pandemic, including the voices of those overlooked.

As a statutory public inquiry, the Chair – Baroness Hallett – has the power to compel the production of documents and to call witnesses to give evidence on oath. It is a hugely important task – the pandemic’s management had an immeasurable impact on the UK. The impact on the care sector has been catastrophic. Far too many lives were lost. Too many died alone. Relationships were destroyed. Untold suffering was caused to people living in care, their families and friends. It is imperative that lessons are learnt, and questions

CMM March 2024

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THE UK COVID-19 INQUIRY: LESSONS MUST BE LEARNT

> answered about the most sustained attack on

the rights of people in care we have ever seen. People living and working in care deserve answers. ‘Mum had Alzheimer’s and for the last 10 months of her life I was unable to be there for her, which caused immeasurable anguish for us both. I shall never get over it.’ Jane, whose mother lived in care.

Examining the care sector To take on this immense task, the Inquiry has been broken down into modules. So far, three modules are in full swing: Resilience and preparedness; Core UK decision-making and political governance; and the Impact of Covid-19 pandemic on healthcare systems in the four nations of the UK. The care sector will be examined as module 6, with preliminary hearings planned for ‘early 2024’. We have been urging the Chair of the Inquiry to bring forward the care module, sadly without success. Whilst not wanting to downplay the importance of other modules, such as on vaccines and procurement (modules 4 and 5), we believe examining the care sector is much more urgent. Covid-19 is still impacting on people's lives in care settings, particularly during outbreaks. Lessons must be urgently learnt and implemented. We are concerned that memories will fade, people will move roles and too many more people will have passed away before work even gets started. For bereaved loved ones, it is a long time to wait for closure. We have been granted Core Participant Status (alongside John’s Campaign and the Patients Association) for two of the modules so far and are in the process of applying for the care sector module (with the kind support of law firm Leigh Day). We’ll be working to ensure the voices of people needing care and support and their families are heard. A major flaw in the pandemic response was the lack of voice or representation for people needing care and support and their families when decisions were being made. This must now be rectified as lessons are learnt and implemented for future decision-making. ‘Little regard appears to have been taken regarding the views of individuals, particularly people in care homes not having contact with loved ones in a time of great need. Full understanding of personal relationships and contact must be of paramount importance, which was not the case.’ John, whose wife lived in care.

taking the witness chair. The sessions were a very difficult watch for families who have already been through so much, and no doubt for staff too. The suffering caused to people living in care and their loved ones by Government’s mismanagement of the pandemic cannot be overstated. We heard this distress and trauma daily via our helpline and support services. Watching our political leaders try to defend this mismanagement will only have added to the anger and pain felt by many. The Inquiry explored in detail the (then) Prime Minister’s reported views on older people during the pandemic: that they ‘had a good innings’, ‘will die anyway’ and should ‘accept their fate’. Despicable views from anyone, but to come from the very top of Government is astonishing. Johnson brushing these off in the session as ‘speaking bluntly and in an unpolished way’ has caused yet more upset. The Inquiry also covered the alarming absence of sufficient planning for people with learning disabilities and autistic people.

Partygate The parties and rule-breaking at Downing Street were defended by the former PM as ‘hard-working civil servants who thought that they were following the rules’. This has been particularly distressing for people who watched the deterioration of a loved one from behind a window, or people dying alone in hospitals and care homes, whilst the people making those rules were breaking them. It was undoubtedly distressing for people working in care too, given the sacrifices made during the pandemic to keep people safe, in extremely challenging working environments and as colleagues and those accessing care lost their lives. Johnson referred to the ‘flexibility’ written into the guidance, but perhaps that only applied in Downing Street? The sessions have exposed the former Prime Minister’s lack of understanding of the devastating harm and irreparable damage caused to people in care and their families. ‘The scarring of having to look at someone you love through a window, unable to communicate in any way, to calm them down when obviously distressed, is something that will stay with many of us forever. The continuous fight, with no voices heard from those living, working and supporting, yet collectively we were all making a noise.’ Kate, whose mum lived in care.

What we’ve heard so far

The ‘protective ring’

Evidence sessions on political decision-making took place during November and December with political leaders such as Boris Johnson and Matt Hancock

The former Secretary of State for Health and Social Care, Matt Hancock, also gave evidence on political decision-making. He finally admitted what the

CMM March 2024

THE UK COVID-19 INQUIRY: LESSONS MUST BE LEARNT

> sector has known all along – that there wasn’t

a ‘protective ring’ around care homes. Given the neglect of the sector, the claim was always nonsense. Take the lack of PPE or the slow roll out of testing, which wasn’t systematically available to the care sector until the autumn of 2020 and some wider community settings until February 2021. Couple this with Government policies to ‘protect the NHS’ which put the lives of residents and care staff at far greater risk, particularly the discharge of patients from hospital without testing. Under the scrutiny of the Inquiry, the former Secretary of State was finally forced to admit that the processes he put in place around the care sector did not form a ring, or an ‘unbroken circle’.

What lessons we want to see Given the pandemic’s devastating impact on the care sector, there are so many lessons that must be learnt. To name just a few: • A focus on people – policies must focus on people most at risk and in need, not on institutions. • Care and support must be seen as a vital, frontline service – care and support must never again be an afterthought and care staff must be given the vital tools and support to protect people most at risk. • Valuing lives – never again should the lives of older and disabled people be devalued, their voices must be heard and the rights of all people must be protected. • Holistic health and wellbeing – the response to a health emergency must ensure a better balance between protecting from the health threat and protecting wider health and wellbeing, to ensure fundamental rights are respected. • Recognise the vital support of family/friends – the practical, mental and emotional support provided by relatives and friends must be protected in law; people should have the right to a Care Supporter. • Oversight is critical – systems must be in place to safeguard rights in care, we need a robust regulator to act as the voice of people using care services and a reliable system of central Government oversight of the sector and its vulnerabilities. • Empower people to speak out – there must be support for residents, their relatives/friends and staff to raise concerns, such as a central, independent complaints procedure.

These lessons must be learnt swiftly. It is already four years since the pandemic struck and still, we have not examined the impact on the care sector. This must now happen at pace with lessons being urgently implemented.

The view from providers Echoing the disappointment felt in response to the Inquiry’s active modules, The National Care Forum said, ‘Module 2 was all about decision making, yet it is clear from the evidence presented that the critical impact of choices made by the core political and administrative decision-makers in the UK Government on social care was not under sufficient scrutiny. ‘At the outset of the module we made our proposition clear: firstly, that social care was overlooked at key decision-making moments; secondly, that social care was misunderstood and viewed solely as care homes for older adults; and thirdly, that social care was disadvantaged, especially in comparison to the NHS, with the focus of decision-making appearing to be to protect NHS hospital capacity. It was hugely frustrating that those appearing before the judge were not examined in relation to these fundamental points. ‘As the focus moves to the care sector in module 6, the Inquiry’s scope must widen to consider the impact on the whole of the care sector.’

Next steps The care sector module will finally get underway this year. This is when we will hear from political leaders about their policies and decision-making relating specifically to care. But it will also be a chance to hear voices from within the sector. This must include hearing from people directly impacted by care policies and decisions – people relying on care services, their families and friends and people working in care. These voices were not heard during the pandemic but must be listened to now. This is vital if we are to understand what happened, the impact it had on lives and to ensure the suffering caused never happens again. You can feed in your thoughts via the Inquiry’s Every Story Matters platform. Visit https://covid19. public-inquiry.uk/every-story-matters CMM

Helen Wildbore is Director at Care Rights UK. Email: helen.wildbore@carerightsuk.org X: @helenwildbore What are your thoughts on the progress of the Inquiry? Visit www.caremanagementmatters.co.uk and share your feedback on this article. 28

CMM March 2024

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INTO PERSPECTIVE How can social care further embrace technology in 2024?

themselves or being transported from room to room. Socially assisted robots, such as ‘Pepper’, who was introduced in the UK in 2016, support the activities of daily living and are designed to improve the overall wellbeing of users. Then there are cognitive assistance robots, with the potential to support people with dementia, Alzheimer’s and other cognitive impairments. One such example is the AI-driven BrightSign, which supports individuals with speech and hearing impairments. The Social Care Institute for Excellence (SCIE), in a webinar about the helping hand of technology, described how ‘simple, effective technology can foster both inclusivity and effective communication’, while an open access paper published in The Lancet in 2022 found ‘promising results’ from AI being used in care but called for further research into the technology and its benefits. Other devices available to the care sector include: a credit-card-sized device to capture a near-medical grade echo cardiograph (ECG) in 30 seconds that works via an app; digital records systems to promote joined-up healthcare; technology integrated health management, which uses AI to remotely monitor the health of people who have dementia while living at home; and digital care assistants, which monitor an individual’s movement, pulse and respiration at home.

Provider engagement

This month’s Into Perspective explores technology in social care, namely the barriers preventing providers from embracing it, the steps providers can take to effect change and the support that is available to help the sector move forward with digitisation. Looking back In the summer of 2022, the then Secretary of State for Health and Social Care, Sajid Javid, laid out in A Plan for Digital Health and Social Care an intention to ‘use the power of technology and the skills, leadership and

culture that underpins it, to drive a new era of digital transformation’. The Secretary of State identified four goals of reform with which technology could be equipped to assist: prevent people’s health and social care needs from escalating; personalise health and social care and reduce health disparities; improve the experience and impact of people providing services; and transform performance. So, almost two years on, what progress has there been in this era of digital transformation? How are you using technology in your setting to help people drawing on care and support?

Key developments One technological development in social care is artificial intelligence (AI) and robotics. Physical assistance robots can support people with tasks such as feeding

Ipsos MORI and the Institute of Public Care on behalf of NHSX, partnered with Skills for Care, found that 85% of care providers reported better quality of care using support and monitoring technology, while 83% saw improved health and wellbeing outcomes. There were budget pressures identified by 56% of care providers, however, and only 44% were looking to adopt support and monitoring technology in the future. For those wanting to explore the options further, the Digital Care Hub (formerly Digital Social Care) offers free advice and support on using technology in care settings and is comprised of key care leaders such as Care England and the National Care Forum (NCF). There is still some way to go before all care providers fully embrace technology but, with new innovations arriving on the market at a growing pace, the full impact of technology on the care sector and the people it supports remains to be seen.

In your experience, has technology helped people drawing on care and support? If so, how and in what capacity? Visit www.caremanagementmatters.co.uk and leave a comment on this article or join the conversation. 30

CMM March 2024

Technology must enhance care, not replace it

Embrace a cultural shift towards innovation

Duncan Campbell, Director, everyLIFE Technologies @everyLIFETech Email: hello@everylifetechnologies.com

Abi Bowler-Ropinski, Marketing Manager, Blue Stream Academy @BlueStreamNews Email: abi@bluestreamacademy.com

The social care landscape is rapidly changing; technology and digital solutions are becoming increasingly important. Investments in making systems more standardised, interoperable, and accessible to care providers are getting a lot of attention. While Government-led efforts are improving how care works, it’s vital to remember the human side of the equation. In the past, new technology was seen as cutting-edge, but now it's just a normal part of life. Whether it's ordering groceries online, tracking fitness activities or checking train schedules, technology is seamlessly integrated into our daily routines. But the real power of technology lies in its ability to make big changes, especially in addressing important challenges in the care sector. There are many opportunities to improve the experiences of care teams, the people they help, and the wider community involved in caregiving. It's important to remember that while technology often gets the spotlight, creating meaningful change depends on engaging and empowering people. For providers to make meaningful changes, two things

are crucial: • Change readiness – have we really understood how the changes will affect care teams and the people they help? • Engagement – are care teams and others excited about the positive impact the project will have? Does it connect with their personal goals? There are several national initiatives across England, Wales, Scotland and Northern Ireland aimed at boosting confidence in digital technology and promoting interoperability. One standout initiative is the Minimum Operational Dataset (MODS), which ensures that data collected for direct care is consistent. Although MODS is very technology-focused, its main goals are about improving care quality, making data entry easier, and sharing best practices. To learn more about MODS, visit the Digital Social Care website. By using technology with a clear purpose that prioritises people's needs, the care sector can successfully adapt to digital changes, making sure that technology enhances care instead of overshadowing the human aspect.

Embracing technology in social care can improve efficiency, quality of care and overall outcomes for individuals receiving support. NHS England reports that approximately 30% of social care providers are partially digitised, with a further 30% still using entirely paper-based systems, so, what can be done to advance the embrace of technology in social care? Although good progress has been made to date, there is still plenty of scope for a greater focus on advancing the rollout of technology in social care. Whilst welcoming developments to date, we believe there is still room for improvement with regards to the Government’s prioritisation of investment in technology infrastructure, digital skills training for staff and incentives for providers to adopt innovative solutions within the sector. Several barriers prevent providers from fully embracing technology, including but not limited to cost, digital skill variation among staff, concerns about data security and privacy and resistance to change. To remove these barriers, there needs to be greater financial

support for investment in technology, comprehensive training programs for staff, robust data protection measures and a cultural shift towards embracing innovation. Care providers can take several initial steps to integrate technology into their operations. These steps involve assessing their current operations infrastructure, pinpointing areas for enhancement, investing in user-friendly digital systems to outdated paper-based methods and offering continuous training and support to staff to ensure their proficiency with technology. Prioritising the procurement process when investing in new technology increases the likelihood that the implemented systems will align with the organisation’s requirements, exhibit higher quality, entail lower risks, and foster better staff engagement. By addressing these priorities, overcoming barriers, taking proactive steps and investing time during the procurement process, social care providers can further embrace technology in 2024 to enhance the quality and North Yorkshire efficiency of care delivery. Lancashire Blackpool

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It is time to highlight the impact of global warming on social care and plan for change. Karen Davies shares her thoughts on the vital adaptations that must be made amidst rising temperatures.

The climate has changed. We can no longer suggest the time for action is somewhere in the future. We must act now. It is recognised that both the social care sector and the NHS face enormous pressures and are working at unprecedented levels. The added strain of increased hospital admissions due to heat stress must be addressed. If we are to support people in social care and reduce unnecessary admissions, we must work together through co-production and plan ahead. The future has caught up with us.

The impact of rising temperatures We all now face a changing climate. In July 2022, temperatures reached a record 40°C in the UK. It can impact on us negatively when we are facing higher temperatures for prolonged periods both at work and home. Humans regulate their temperature through a part of the brain called the hypothalamus. Internal and external elements can impact on a person’s ability to maintain their temperature at a safe level. People who share their space in a social care setting are facing the challenges of living and working in this new, hotter world.

CMM March 2024

Statistically, they are much more at risk of harm or death and are reliant on others to control the temperature around them. The changing weather patterns will impact on our existing health infrastructure. Already, research is showing mortality rates, hospital admissions, ambulance use, physical and mental health and wellbeing demands increasing in tandem with rising temperatures. In addition, supporting an older person who is living with a diagnosis of dementia to maintain their hydration and cognitive function will require additional resources and clinical observation.

Putting skills to the test As providers and clinicians, it is paramount we recognise the impact of rising temperatures on our services and those who use them. We need to utilise all our skills and experience and adapt to the changes faced. As a sector, we must question if we are doing all we can and understand how we can think differently. In a social care setting, we can support people to maintain a safe and comfortable temperature and mitigate some of the risks of extreme temperatures through an individual and dynamic risk assessment. As providers and clinicians, we must take measures to

support those who are assessed as high risk and can learn lessons from countries managing warmer climates more regularly. This may include those who are unable to independently change their position, those who are at risk of developing dehydration and those who are unable to voice their discomfort about conditions they find uncomfortable. As providers and clinicians, we must make social care environments and hospital spaces feel like home. The need to meet an individual’s wants and choices, alongside those who have equally challenging clinical, psychological and wellbeing needs, takes skill and is an ever-changing dynamic. In addition, dressing for the weather, providing natural fabrics and choosing loose-fitting clothing may take the idea of a summer wardrobe to a whole new level. The social care sector inherited its style of work wear from the NHS. However, is it now time to review how the workforce dresses in the setting to meet this change?

Using risk assessments for change Crucially, we must consider the development of non-intrusive visual and environmental risk assessment processes that can quickly identify individual and environmental areas of concern. CMM March 2024

> 33

RISING TEMPERATURES, RISING RESPONSIBILITIES

Countries with warmer climates have been developing risk assessments and acknowledge the impact heat can have on outcomes for the most vulnerable in hospital admissions, mortality rates and the pressure this places on those services. A thermal risk assessment conducted in Australia could be transferable to the social care sector. Assessing different hazards associated with an increase in temperature could be incredibly useful to protect residents and staff. Health and safety assessments in social care environments support people’s right to choose how to live their lives, both in private and

“The wellbeing of our workforce and how they feel about their roles impacts on performance and approach to work.” communal spaces. To implement assessments like this, we need an urgent review of the impact of increased temperatures on resources and to consider budget responsibility. An individual and community-level dynamic risk assessment would require quality data collection. An urgent audit of all our provision is essential to establish what our immediate priorities are and focus on what our future plans will be. This could include collecting data on: • Those living and working in the setting who know where it gets hot and remains cool. • Temperature and humidity level recordings at certain times of day internally and externally. This could mean investing in low-cost digital thermometers that show temperature and humidity. • Availability of safe outside spaces. • The capacity for short-term resource investment to establish priorities. • Shade sails, shaded seating areas and alternative outside communal spaces with security and accessibility in mind. • The impact and availability of safe ventilation, fans, air-con and other heat reduction methods. • Location, elevation, ventilation, orientation, time of day and seasonal changes that will impact on heat risk. • Obesity, capacity, age, mobility, co-morbidity and frailty.

risk of heat stress in those environments and to consider and support the needs, goals and aspirations of our most vulnerable. However, it is crucial to think too of the people providing care, meeting the demands of those sharing a roof, often in environments that were not built to adequately deal with a rapidly changing climate. It is all too easy from the comfort of an air-conditioned building or sat in a cool space at home to imagine the impact of strenuous work in heat. Times are changing. Working 12-hour shifts in 25-35°C heat, wearing a stiff tunic with limited ventilation and no access to outside space is extremely unpleasant. The wellbeing of our workforce and how they feel about their roles impacts on the performance and approach to work. In turn, that impacts the experience of those receiving support. Some small ways staff can be helped could include: • Offering increased drinks breaks and joining residents in taking a drink. • Access to laundry facilities to keep uniforms/work wear fresh. • Access to showers to freshen up and cool down. • Flexible working patterns. It is worth noting that existing Cold Weather Payments address the financial impact of maintaining a warm and safe environment for the older and more vulnerable in our society. Therefore, it would not be unreasonable to expect a similar policy for a warm weather payment. This would need to reflect the increased running costs of equipment and additional workforce resources required to make spaces habitable and maintain health needs in these new circumstances.

Heat mapping the future, now Time has caught up with us. We face challenges as clinicians, commissioners and policy makers to review where we are regarding heat management. Through audit and data collection, we can use this information to focus on what is possible. What small changes can we make to reduce the risk of heat stress both internally and externally in our communities? We must not stop collecting data and using it to develop our ways of working, influencing guidance and driving research to enhance the experiences of those sharing a roof. CMM

As well as this data, thorough consultation with those sharing community spaces would be necessary to hear staff and residents’ voices. Comprehensive, research-based guidance through co-production is essential to getting it right, as both the users of the service and the NHS will pay a high price if we don’t. Find a useful resource on conducting risk assessments on the Health and Safety Executive website.

Supporting staff We must think of those who are beholden to others, spending their time in communal spaces and often unable to express how higher temperatures impact on their mental and physical health. Our challenge as providers and commissioners of services is to mitigate the Karen Davies is a Senior Nurse – Projects at HC-One. Email: Karen.Davies@hc-one.co.uk X: @karen.davies9040 Is your organisation taking steps to combat rising temperatures? Visit www.caremanagementmatters.co.uk and share your feedback on this article. 34

CMM March 2024

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CMM March 2024

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REIMAGINING MENTAL HEALTH LEGISLATION

As we pass five years since the Independent Review of the Mental Health Act, it becomes clear that the journey towards genuine reform remains arduous, with persistent inequalities. Kathy Roberts explains how reform must now come into sharp focus.

Assessing the landscape December 2023 marked five years since the Independent Review of the Mental Health Act. The initial aims of this Review were to confront racial inequalities faced by black and ethnic minority communities detained under the Mental Health Act, address the sharp rates in detention and modernise mental health-related processes, with the goal of creating responsive and modern mental health services, fit for purpose in the 21st century.

Persistent disparity – racial inequality There are substantial disparities between who becomes subject to the Act. The statistics are stark, particularly for black people, who are still four times more likely to be detained and eight times more likely to be discharged from hospital with the further restrictions of a Community Treatment Order (CTO). However, this is a slight decrease from 10 times more likely. There is an urgent need to ensure that people of Black African and Caribbean descent with poor mental health receive the treatment and support they need without being discriminated against. The latest NHS figures (January 2024) have only demonstrated the continued urgent need for reforms, especially inequalities that are deeply rooted in our society.

CMM March 2024

LOOKING BACK, MOVING FORWARD: REIMAGINING MENTAL HEALTH LEGISLATION

Whilst there has been an 8% reduction in the number of people detained under the Mental Health Act, the figure remains at over 50,000, with people from deprived communities also almost four times more likely to be detained. This highlights the disproportionate impact not just on racialised communities, but also from those that may otherwise be marginalised.

Missed opportunities As we look back, it’s clear that the recommendations from the Independent Review remain as relevant today as they were then – if not more so. While the mental health landscape has seen notable developments, including the launch of a Mental Health White Paper in 2021 and a Draft Mental Health Bill in 2022 which faced pre-legislative scrutiny in January 2023, the recent King’s Speech (Autumn 2023) omitted any mention of Mental Health Act reform, which means any reform will now most certainly be carried out by the next Government. We know that the Independent Review recommended changes to the law to make it easier for patients and service users to participate in decisions about their care, to restore their dignity and recognise the importance of human rights in mental health care. But, morally and ethically, we should all know that giving people more choice and control over what happens to them, ensuring they receive the care and support they need and are not treated differently based on their identity are the basic principles that should be upheld by all professionals and services. This shouldn’t require changes to a law. Is it not incumbent upon us all to read the original report again and take responsibility for enacting change where we can, to ensure that people who use services remain at the heart of everything we do and receive the support they need? At the same time, we also know that there is a need for mental health to be centred, for the longstanding aim of parity of esteem to be achieved and for voluntary, community or social enterprise (VCSE) mental health services to be equally considered and valued alongside the NHS. However, Government’s decision to not proceed with the Mental Health and Wellbeing Plan amounted to another lost opportunity.

Ongoing challenges In the years following the review, service providers and communities have continued to face considerable challenges, dealing with deep-seated structural inequalities worsened by the pandemic, an ongoing cost-of-living crisis and a renewed emphasis on tackling racial injustice, provoked by the tragic murder of George Floyd in 2020. Therefore, it is crucial to recognise that mental health is impacted by several factors, including wider social and economic determinants as well as inequalities. So, any related legislation and proposals for change cannot be enacted in silo but must take a cross-departmental Government approach and be achieved through collaboration. There needs to be a greater emphasis on preventing the development

or worsening of mental health conditions to avoid people reaching crisis and improving the lives of individuals with mental illness. Considering the wider determinants of a person’s mental health, such as education, employment, financial security, housing/accommodation and good access to appropriate health and social care services, it is important that policies in these areas do not place a person’s mental health at risk. Fixing a struggling mental health system is contingent on funding and we must emphasise that consistent financial support of NHS, VCSE, social care, community and primary care services is crucial to effect positive change and not burden a system already under strain.

Voices for change As we look back on the five years since the Independent Review of the Mental Health Act and 2022’s consultation on the Mental Health and Wellbeing Plan, it is evident that significant work lies ahead. The unified voices of advocates, professionals and communities echo a resounding call for timely and substantive reform. It is crucial for this Government and all political parties to not only hear but genuinely commit to reform – taking tangible actions and moving beyond mere promises and rhetoric. The mental health landscape necessitates a paradigm shift and the moment for transformative change is upon us. In the pursuit of reforming the Mental Health Act and the wider mental health system, of which the VCSE sector is a vital component, it is essential to persist in amplifying voices, challenging existing norms and advocating for a system that prioritises the wellbeing of all, with a particular emphasis on marginalised communities.

A call to action Despite breaking the Conservative Party’s manifesto pledge by excluding reform from the King’s Speech, the Minister of State for Social Care, Helen Whately, reaffirmed Government’s commitment to reform, achieving parity, and ‘bringing forward the Bill when parliamentary time allows’. The Labour Party, as the Conservatives did pre-election, have also pledged to reform the Mental Health Act, if elected, in their first King’s Speech, a commitment that has been welcomed by the sector. Concerningly, however, Shadow Cabinet Minister for Mental Health, Dr Rosena Allin-Khan, had only resigned two months prior, having been informed by the Party Leader that he does, ‘not see a space for a mental health portfolio in a Labour cabinet’, a role now downgraded to combine with another portfolio. Following many years of work and contributions by organisations, professionals and most importantly, people with lived experience of mental health conditions and their families and carers, we cannot lose the voices that have informed Mental Health Act reform and the Mental Health and Wellbeing Plan. As we draw closer to another election, it is essential that political parties make commitments that they can and will deliver to ensure that the mental health system is fit, not just for the future, but for now. CMM

Kathy Roberts is Chief Executive at the Association of Mental Health Providers. Email: kathy@amhp.org.uk X: @KathyRobertsMH What action do you think needs to be taken to reform the Mental Health Act? Visit www.caremanagementmatters.co.uk and share your feedback on this article. 38

CMM March 2024

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New eLearning resource for care staff From December, Better Security, Better Care are launching a free data and cyber security e-learning resource for frontline care staff that will satisfy key requirements in the Data Security & Protection Toolkit (DSPT). Return on Investment tool A new Return on Investment (ROI) tool will be available from the end of November to help

care services estimate an indicative return on investment and financial savings from adopting a piece of technology. The tool has been developed in partnership with ARC England and tested with care providers. It’s free to use with a full user guide. You can access the eLearning resource and the ROI tool on the Digital Care Hub website using the QR code above.

2024:

2023 saw a major milestone in housing policy: the establishment of an Older People’s Housing Taskforce. Sarina Kiayani explores the evolving landscape of Integrated Retirement Communities (IRCs) and looks towards an independent future for older people.

The year of older people’s housing?

With enormous pressures on the social care system and housing supply, as well as an ageing population, the opportunities arising from specialist housing for older people have never been more relevant.

Building momentum One of the fastest growing parts of the sector in recent years has been Integrated Retirement Communities (IRCs). Sometimes referred to as ‘housing-with-care’, ‘assisted living’ or ‘extra care’, IRCs are distinct from both residential care homes, as well as traditional retirement housing such as ‘sheltered housing’.

CMM March 2024

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Key features of an IRC include residents having their ‘own front door’, but with 24/7 on-site support, extensive shared facilities like gyms, lounges and restaurants, and on-site, CQC-regulated care and support services. Although the number of IRCs has grown significantly in the last decade, there is a significant shortage of supply to meet the growing demand of the UK’s ageing population. Only 0.6% of older people in the UK live in retirement communities, compared to around 6% in countries such as New Zealand and the USA.

“The Taskforce is a great example of Government departments working together to support the sector.” The final recommendations of the Older People’s Housing Taskforce, which are due in May 2024, represent a significant opportunity to change this, by encouraging the growth of housing like IRCs to address the UK’s ageing population.

The story so far The Housing Learning and Improvement Network, a member of the Older People’s Housing Taskforce, has reported that the Taskforce’s wider membership has been meeting regularly since its establishment, focusing on three main priorities: • People – seeking to develop a deep understanding of the needs, preferences and concerns of older people, their families and carers. • Products – examining what ‘good’ dedicated older people’s housing should look like in the future, in terms of the type of housing, the design and fabric of the home and the application of technology. This includes looking at consumer protection. • Places – focused on examining how to bring together the levers and partners in local systems to make change happen at a local level. During ARCO’s 2023 Annual Conference, Professor Julienne Meyer CBE, Chair of the Older People’s Housing Taskforce, unveiled two early recommendations of the Taskforce which ARCO strongly supports, both of which were accepted by the Housing Minister:

• Government should protect consumers from hidden event fees, as soon as possible, based on recommendations developed by the Law Commission in 2017. • Government should ensure older people’s housing is given due consideration and prominence in the forthcoming revisions of the National Planning Policy Framework.

The ‘missing middle’ A key focus remaining for the Older People’s Housing Taskforce is likely to be the ‘missing middle’. Current provision of IRCs tends to fall at either end of the income spectrum – sheltered, social and affordable housing for those on lower incomes and high-end offerings for higher earners. This was recognised in the Terms of Reference of the Older People’s Housing Taskforce, with its focus on the ‘private market for those on middle incomes’, known as the ‘middle market’. But who are middle-income households? Analysis of household income using data from the UK Wealth and Assets Survey found that, in 2018-2020, the median household income of over-75s was around £14,701 per year or £1,225 per month. Specialist housing for older people – in particular, the kind of housing-with-care models that deliver the most benefits to residents – is typically associated with higher ongoing costs for residents compared to mainstream housing. If the potential of specialist housing to transform older people’s lives is to be realised, the monthly cost of living in such housing must be affordable to people with these incomes, with Government support for an increased provision of ‘middle-market’ schemes required to address this. It is therefore crucial that the Taskforce examines this issue. Indeed, nations such as Australia and New Zealand provide for inspiration on this, where figures from the Retirement Villages Association of New Zealand and the Retirement Living Council (RLC) in Australia respectively, suggest that average annual fees are around £3,600 per year – significantly lower than in the UK, according to a sample of 60 IRC schemes. This is largely due to the larger size (scale) of villages in these countries, and how they have moved away from the traditional service charge model decades ago, towards event fee business models. An event fee is paid on resale (or assignment of the property), typically to lower ongoing costs for residents. Operators using event fees can set lower monthly management fees and take on liability for long-term maintenance and repairs, in return for a payment taken on sale of the property. This can therefore help to make the ongoing costs of IRCs more affordable to those on middle incomes.

CMM March 2024

2024: THE YEAR OF OLDER PEOPLE’S HOUSING?

Progress through collaboration

A good example of how provision for the UK middle market is growing is Mayfield Villages. Thanks to scale and the use of event fees, well over half of Mayfield Watford’s over-75s could afford to live in the scheme, unlike many other types of retirement housing. Alongside Mayfield Villages, ARCO members including Anchor, the ExtraCare Charitable Trust, Belong and MHA are also taking strides to bring IRCs to those on middle and lower incomes, by offering homes for social and affordable rent. This is key to meeting the IRC sector’s aim to ensure that all who wish to live in an IRC are able to do so. The development of schemes such as these would not have happened without the support of local councils, who recognised the value of bringing an IRC into their regeneration projects. Therefore, the Older People’s Housing Taskforce – and the major UK political parties – need to do the same, supporting ventures like Mayfield and other more affordable IRCs to enable people to retain their independence for as long as they can. The housing-with-care sector will require cross-Government collaboration to achieve this ambition, bringing together different policy areas, and boosting a sector complementing the current social care landscape of care homes and domiciliary care. This will be a challenging task, as the housing-with-care sector cuts across numerous Government departments. For example, care regulation and market shaping is centred in the Department of Health and Social Care (DHSC), while planning guidance and tenure reform is the remit of the Ministry for Housing, Communities and Local Government (MHCLG). At the same time, consumer protection and regulation sits with the Department for Business, Energy & Industrial Strategy (BEIS). The Taskforce is a great example of Government departments working together to support the sector. However, if it is to continue to grow, collaboration between these departments must continue.

Looking forwards ARCO’s vision for the sector is for 250,000 people to live in housing-with-care by 2030, which we estimate would result in turnover of over £70bn and £5.6bn in savings for the NHS and social care. But to achieve this, action needs to be taken now.

By exploring potential areas for change, including sector-specific legislation on fees and regulation, clarity in the planning system and new tenure models, the Older People’s Housing Taskforce would help propel the sector closer to the levels of provision seen in other countries – where the legal and regulatory framework is much stronger. There are three key areas for reform that must feature in the final recommendations put forward to Government by the Older People’s Housing Taskforce, with clear policy solutions developed for each: • Sector-specific legislation – the lack of sector-specific legislation for housing-with-care results in less protection for consumers and uncertainty for operators. ARCO recommends that the Law Commission’s proposals for sector-specific legislation on fees and regulation are implemented. In addition, given that the leasehold system is not ideally suited to the expansion of housing-with-care, specific tenure models need to be developed which focus on services and operation. • Clarity in the planning system – it is currently much harder to build housing-with-care than care homes due to a lack of definition in the planning system. This needs to change through clear definition and categorisation of housing-with-care. Recent changes to the National Planning Policy Framework are a step in the right direction. • Funding options for affordable housing-withcare provision – while the majority of customers in the housing-with-care sector will have access to housing equity to be able to fund their move into a housing-with-care community, it is essential that the model remains an option suitable for all older people, regardless of their means or housing wealth. IRCs can provide a perfect balance between meeting the needs of an ageing population whilst ensuring that its independence is retained, providing more options for housing and care in older age and alleviating the pressures on other care settings. In an election year, ARCO is calling on the next Government to urgently action the much-anticipated recommendations of the Older People’s Housing Taskforce to unleash the potential of the housing-with-care sector. CMM

Sarina Kiayani is Policy and External Affairs Manager at the Associated Retirement Community Operators (ARCO). Email: SarinaKiayani@arcouk.org X: @SarinaKiayani What do you think can be done to support the expansion of IRCs? Visit www.caremanagementmatters.co.uk and share your feedback on this article. 44

CMM March 2024

NEC, BIRMINGHAM

20-21 MARCH 2024

UNITING THE CARE COMMUNITY First wave of speakers include:

Dr Jane Townson, CEO of Homecare Association

Professor Martin Green OBE, CEO of Care England

Avnish Goyal CBE, Chair of Hallmark Care Homes

Aneurin Brown, Managing Director of Hallmark Care Homes

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Markel 3rd Sector Care Awards

CELEBRATING EXCELLENCE REVISITED Paula Plaskow tells CMM what Jewish Care has been working on since it won the End of Life Care Award at the Markel 3rd Sector Care Awards 2022. Paula also touches upon the value of recognising outstanding achievements. Ongoing projects Since the Awards, we have been developing pastoral volunteers to support our residents, relatives and the work that our care staff do around end of life care in our care homes. We have also introduced a frailty/ palliative care/end of life audit tool, akin to the Gold Standards Framework. This is to monitor conversations about Advance Care Planning, to include ‘Do not attempt Cardiopulmonary Resuscitation’ (DNACPR) and Lasting Power of Attorney (Health and Welfare). Our residents’ spiritual and emotional needs have also been at the forefront of conversations to encourage what matters most – helping the bereaved as well and engaging with our residents’ families and those closest to them. We have continued working on after-death reflections to improve our learning and interactions. In addition, we’ve been helping our staff to understand Jewish funeral pathways with specific cultural and religious rituals and customs explained. This includes creating a funeral contacts booklet for staff use.

Making connections It was extremely positive to see work in end of life care being celebrated and acknowledged at the Awards. My particular benefit was having the networking opportunities which have been fruitful in nourishing raising further awareness of end of life, continuing in my work building relationships with others in the sector. It was also great to see Jewish Care featured online and in CMM Magazine and have opportunities to participate in podcasts with other colleagues in the field of end of life care.

Key reflections Awards really do give rise to a positive work environment and celebrating success together 46

CMM March 2024

boosts morale for those involved. But, they are also a way of showing that we value and appreciate staff, recognising their work. Receiving nominations and awards has a ripple effect across the organisation, which, in the case of Jewish Care, is like one big family. The sense of pride that comes from an employee at Jewish Care being nominated and winning awards is shared by our teams, and we feel it’s motivating for everyone. When we work for an organisation which shows appreciation for hard work and contributions, we know it leads to higher job satisfaction and a sense of loyalty to the organisation. This in turn helps us to recruit staff who share our values. It’s important to us that we recognise the dedication, talent and expertise that our staff have in their own specialist areas. For me, spreading the message that end of life care is vital for everyone at Jewish Care to think about as an integral part of our work and to understand how to find out what matters most to people helps us in every step of the care journey. This is especially true at the end of life so that they, and those close to them, have a good end of life experience.

Good luck, finalists! The Markel 3rd Sector Care Awards is a special occasion and a great opportunity to meet others in the care sector who are dedicated to improving the lives of others and giving support. We hope that 2024’s finalists enjoy the sense of pride in being shortlisted and also in winning awards. CMM

Paula Plaskow is Jewish Care’s End of Life and Palliative Care Lead. Jewish Care won the End of Life Care Award at the Markel 3rd Sector Care Awards 2022. X: @jewish_care Email: helpline@jcare.org

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CMM March 2024

EVENT REVIEW

DEVELOPING A JOINT VOICE FOR SOCIAL CARE AT THE NEXT ELECTION 8th February 2024

CMM, in association with the National Care Forum (NCF), is back with a new programme of CMM Insight webinars designed to give delegates the information they need to successfully navigate the ever-changing sector landscape.

The first CMM Insight webinar of 2024 discussed what we can do – as providers, as people working in social care and as members of the public – to influence MPs to put social care at the top of their manifestos for the next election. The webinar was chaired by Liz Jones, Policy Director at the NCF, who welcomed the webinar’s panel – comprised of Nathan Jones, Senior Policy and External Affairs Lead at the NCF, Karolina Gerlich, Chief Executive Officer at The Care Workers’ Charity, Dan Scorer, Head of Policy, Public Affairs, Information and Advice at the Royal Mencap Society, Chris Kirby, Campaigns Manager, MHA and Isaac Samuels, Lived Experience/Co-production Advisor.

Putting people first Changing the narrative around social care dominated discussions at this webinar, with the panel highlighting that people with lived experience of drawing on care and support are not currently involved enough in conversations about developing a joint voice for the sector. It was also raised that a greater diversity of people with lived experience must be supported to inform social care priorities for the next Government. In addition, the panel was eager to stress the role the media must play in challenging public perceptions of social care. According to the panel, the media are currently employing a ‘deficit model’ in their depiction of the sector,

CMM March 2024

choosing to report predominantly on what’s missing, rather than sharing success stories and improving the image of social care. Thirdly, the panel identified that change must be co-produced to remove the accessibility barriers that are currently preventing political influence, such as supporting people with disabilities to register to vote and cast their ballot. This will ensure that people drawing on care and support will input directly on policy changes affecting them. Furthermore, the panel explained that current calls for change are often disjointed and prioritising multiple different issues. Bringing together the sector’s leading voices to campaign for changes impacting on larger groups of people should help to create a joint voice for social care.

Creating opportunities A presentation from the panel referenced the higher-than-usual number of new MPs that will be taking their seats after the next election as an opportunity to influence change. The sector should take a renewed confidence from this forward into its campaigning efforts. At this point, the NCF shared its plans to launch and regularly update a new toolkit and accompanying resources to help its members engage with local and parliamentary candidates ahead of the next local and general elections. Moreover, the NCF spoke about its work with the Care and Support Alliance, which

has focused on creating a joint voice for social care amongst other objectives.

Supporting the workforce The social care workforce must be championed as part of the sector’s joint voice ahead of the next election, the panel determined. One call to action provided by the panel was upon providers to make the time for their care workers to attend their local polling station to vote. Delegates also heard from the panel that care workers are struggling to find the extra time to dedicate to campaigning, given the ongoing workforce shortages facing the sector. CMM, in association with the NCF, hosted six unmissable webinars between March and November 2023, discussing the sector’s most pressing current affairs topics – from recruitment and retention to integrated care systems. Watch them now on the CMM website. CMM is a member of the CPD Certification Service, working to certify each CMM Insight webinar so delegates can claim CPD points by attending. To claim your points, simply sign up and attend the session. Then, you will receive a follow-up email from a member of the CMM team to request your details for your CPD certificate.

WHAT’S ON? Event: Date/Location: Contact:

The Managers Conference 2024 11-12th March 2024, Wyboston www.nationalcareforum.org.uk/events/ the-managers-conference