Care Management Matters (CMM) May 2024

MAY 2024

www.caremanagementmatters.co.uk

THE FUTURE OF THE SECTOR Establishing a Social Care Council

Mixed market delivery Making the case for choice

Deprivation of liberty Fixing a failing system

Social care procurement Standing out from the crowd

International social care workforce A global challenge

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In this issue 05

Inside CQC Rebecca Bauers updates on the steps that the regulator is taking to reduce inequalities for people with a learning disability and autistic people.

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CMM News

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Into Perspective Two industry leaders share the importance of engaging people who draw on care and support with their local communities and provide tangible takeaways to implement.

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Celebrating Excellence The Markel 3rd Sector Care Awards 2024 saw the national social care charity, Community Integrated Care, awarded the Campaigning for Change Award.

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Event Preview Join Care Management Matters (CMM) and The National Care Forum (NCF) for the latest free CMM Insight webinar.

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What’s On?

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Straight Talk Jo Guy discusses proven strategies to generate candidates in challenging markets.

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REGULARS

Social Care Insights David Brindle explores how social care may play its part in contributing to the outcome of May’s local elections.

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Pick and mixed: Making social care sweet for all Mike Padgham evaluates the strength of the mixed market approach to social care delivery and promotes the freedom of choice for individuals.

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Deprivation of liberty in care homes: Fixing a failing system Natalie Cresswell and David Broome discuss a crucial yet often overlooked issue impacting people drawing on residential care and support.

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Social care needs long-term reform: Now is the time to act Dan Ryan responds to the outcomes of this year’s Spring Budget and outlines what MHA believes should be the priorities for the next Government.

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Are you fit to compete? Navigating social care procurement Peter Hamilton updates on the topic of social care procurement, revealing what you can do to make your offer more attractive and set yourself apart from your competitors.

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Reimagining the international social care workforce: A global challenge Professor Vic Rayner OBE discusses the critical implications of the recent International Social Care Workforce Summit and newly published report, calling for global unity to overcome shared challenges.

FEATURES

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SOCIAL CARE INSIGHTS From David Brindle David Brindle, social care commentator and Chair of Ambient Support, explores how social care may play its part in contributing to the outcome of May’s local elections.

The alliance of interests urging a better deal for social care can at times seem fragile. From large care provider groups, trade unions, charities and local authorities to individuals who employ personal assistants and family carers, it’s a broad and unwieldy church.

In the run-up to council budget-setting for April and the local elections in May, tensions surfaced over how some local government voices were portraying the rising costs of adult social care and children’s services at the expense of other municipal undertakings.

Most prominently, the County Councils Network (CCN) issued a press statement saying its research showed that adult social care and children’s services combined now accounted for 69% of a typical county’s total budget, even though ‘they are not used by the majority of the population’. Calling for ‘honest discussion’ of what councils should be expected to deliver against this backdrop, the network said there was ‘simply less and less each year for us to spend on highly valued services such as libraries, road repairs and street lighting’.

To be clear, the CCN did stress that care and support for all age groups were some of the most important services provided by councils, that they protected the most vulnerable in society and indeed that they changed lives. But its comments were seen by

some in the care sector as sending a divisive, indeed provocative, message to voters. As The Times headlined its report of the statement, ‘Councils warn bills for social care are threat to parks and libraries.’

Election candidates and party workers who have been out and about on doorsteps in recent weeks will tell you that social care is rarely raised as an issue compared to, say, potholes. Yet as leading sector analyst Richard Humphries commented in response to the CCN, if you add together all those involved in receiving or providing care, it works out as at least one in four of the population at any one time – ‘hardly a tiny minority’.

We all learn the value of good care, and discover the problems in getting it, when we have personal experience. Humphries himself decided to pen his excellent 2022 book, Ending the Social Care Crisis, after wrestling with the challenges of arranging and sustaining care for his late father. As he writes, ‘It left me feeling a stranger to the system in which I had worked for over 40 years.’

For others without such knowledge of the system, the experience is typically a shocking eye-opener. Writer Adam Luck described his family’s struggle in a diary published recently in The Times Magazine, relating the two-month hospital stay of his 82-year-old mother, Ann, after a suspected mild stroke.

In a Kafkaesque saga, in which the family is first told to expect Ann’s imminent discharge after just six days, the apparent dysfunction between health and social care teams becomes almost literally maddening. ‘Please get me out of here, darling, I am going crazy,’ she repeatedly texts.

At various times, the family is told that responsibility for arranging Ann’s further care rests with either the social care team or the hospital’s integrated discharge team. Neither seems able to move forward. When there is eventually apparent clarity that responsibility should return to the NHS if three care homes say they cannot meet her needs, it is subsequently discovered the policy does not apply to the area where she lives.

As related by Adam Luck, his mother’s care journey was chaotic, deeply unpleasant for her and ruinously costly for the taxpayer. But as he concludes, it was ‘by no means unique’. The experience will, no doubt, inform his choices at the ballot box.

Given our ageing population, there will eventually be enough families like the Lucks to achieve a decisive shift in those election-time doorstep conversations from potholes to care.

But it will be a long wait. Better, surely, that we redouble our efforts to preserve and strengthen the alliance for change around a common narrative that all stakeholders can own.

David Brindle is a social care commentator and Chair of Ambient Support. Email: david.brindle@ambient.org.uk X: @DavidJ_Brindle

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INSIDE CQC Rebecca Bauers

Rebecca Bauers, Director for People with a Learning Disability and Autistic People at the Care Quality Commission (CQC), updates on the steps that the regulator is taking to reduce inequalities for people with a learning disability and autistic people.

Experiencing a mental health crisis can be particularly distressing for people with a learning disability or autistic people. In some instances, neurodiversity may mean that people’s reactions are not recognised by others as them communicating a need, emotion or distress, but seen as ‘behaviours to be managed’.

Getting the right support in the right place and at the right time goes a long way to helping people avoid a crisis. For those experiencing crisis, it’s important that they’re supported by teams who work together well and have enough staff with the right skills to give individual support.

Addressing challenges Unfortunately, we know that too many autistic people and people with a learning disability are still held in long-term segregation, or experience other restrictive methods, in mental health hospitals. This can be because community-based options didn’t prevent escalation to crisis point and admission to hospital – as well as there being too few community options for people to move into after hospital treatment.

Our Out of Sight report identified areas of progress to be made to reduce the use of restrictive practice for people with mental ill health, people with a learning disability and autistic people. They should receive high-quality, person-centred care and be supported to live in their communities. If hospital care is required, this should be given by the right staff, who are trained to support people's needs. In addition, from the point of admission, the aim should be for people to become well enough to leave hospital.

Following that publication, the then Secretary of State announced that all autistic people and people with a learning disability in long-term segregation would have their care independently reviewed. Independent Care (Education) and Treatment Reviews (IC[E]TRs) were introduced and the subsequent report, My heart breaks – solitary confinement in hospital has no therapeutic benefit for people with a learning disability

and autistic people, and recommendations were published last year.

The report recommended that the CQC should lead on IC(E)TRs for the next two years. We’re working with colleagues in NHS England to finalise our methodology, approach and quality assurance processes.

We’re also committed to enabling people to move out of long-term segregation, but that relies on there being the right models of care in the community. Whether that be through preventative support, or to facilitate people leaving hospital as soon as they can.

Acting on experiences Using our new powers through systems assessments, we intend to encourage models of care to offer the right support at the right time.

We need to work together across sectors and encourage providers to work collaboratively with local authorities and commissioners to ensure that the right services are available now and in the future. Along with colleagues, I see this as extremely important work. It complements other elements of work we’re doing around equity of access to care for autistic people and people with a learning disability.

Last year, we convened an expert advisory group to identify where we can have most impact in reducing inequalities for people with a learning disability and autistic people. I wrote about our ambitions in my last CMM column. At least half of the group’s members have lived experience or are from organisations representing people with lived experience.

Our most recent meeting was to explore how to make it easier for people and their carers to access GP services and an annual health check. We know that for some people, a lack of reasonable adjustments means that getting registered or making a GP appointment isn’t possible. If those routes are closed or difficult to access for people and their carers, large numbers of people miss out – both on treatment and care when they are ill, but also on preventative and proactive care through regular or annual health checks.

When we see person-centred care in our inspections of services, we’re keen to share it so others can be inspired. Last autumn, we rated Grasmere Avenue, a care home for up to six autistic people and people with a learning disability in Hounslow, as ‘Outstanding’. Leaders encouraged a culture in which people’s rights, needs and wishes were at the heart of everything the staff did. People living there who previously had experienced self-harm or low moods were happier and more at ease, and leaders supported a culture that was open and honest. I hope that by sharing this good practice we can promote improvements across sectors to support people to lead their best lives.

Rebecca Bauers is the Director for People with a Learning Disability and Autistic People at the Care Quality Commission (CQC).

Email: providerengagement@cqc.org.uk X: CQCProf The CQC listens to all feedback about care, whether it's good or bad, big or small. Unfortunately, not everyone's voice is being heard, including people who are more likely to experience poorer care and inequalities. Give your feedback on care now and join the conversation on X using ShareForBetterCare.

CMM May 2024

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NEWS

APPOINTMENTS McCarthy Stone

Hospice sector facing collective deficit of £77m According to Hospice UK, the UK hospice sector is facing a collective estimated deficit of £77m in the financial year 2023-24.

Expenditure increases are the main driver behind this. The cost of providing hospice care is increasing, with the cost of paying staff a fair wage growing quickly too. Hospice UK estimates that payroll costs have surged by 11%, equalling approximately £130m in additional spending.

Most hospice expenditure is spent on staff salaries. In addition, adult hospices only receive on average around one third of their funding from the state, and children’s hospices only receive around one fifth. This means most of the funding for essential hospice services comes from fundraising and charitable donations.

Earlier this year, a report by the All Party Parliamentary Group (APPG) for Hospice and End of Life Care found that despite a law passed in 2022, the way hospice services are commissioned in England is not fit for purpose. The cross party group of MPs found that services hospices provide for dying people and their families, and the support

they provide to the health system, are at risk.

Much of the debate centres around looking at the postcode lottery of hospice funding and how Integrated Care Boards (ICBs) can urgently address the funding for hospice-provided palliative and end of life care in their areas.

Toby Porter, Chief Executive Officer at Hospice UK, said, ‘These are the worst financial results for the hospice sector in around 20 years. Many hospices are spending more on their care than they receive in income. This is unsustainable and extremely worrying.

‘Costs for hospices will keep rising, and without a new model for funding end of life care, the coming years could be devastating for hospice care services, particularly for those in economically challenged areas.

‘With demand for end-of-life care in the UK guaranteed to grow due to our ageing population, we face an important choice as a society. Hospices are ready to meet this challenge, if only they are fully integrated and fairly funded as partners in our health and care system.’

New guidance targets health and social care transparency The Information Commissioner’s Office (ICO) is supporting health and social care organisations to ensure they are being transparent with people about how their personal information is being used.

The UK data protection regulator has today published new guidance to provide regulatory certainty on how these organisations should keep people properly informed.

The sector routinely handle sensitive information about the most intimate aspects of someone’s health, which is provided in confidence to trusted practitioners. Under data protection law, people have a right to know what is happening to their personal information, which is particularly important when accessing vital services.

Anne Russell, Head of Regulatory Policy Projects at the ICO, said, ‘Being transparent is essential to building public trust in health and social care services. If people clearly understand how and why their personal information is being used, they are likely to feel empowered to share their health information to both access care and

support initiatives such as medical research.

‘As new technologies are developed and deployed in the health sector, our personal information is becoming more important than ever to boost the efficiency and public benefit of these systems. With this bespoke guidance, we want to support health and social care organisations by improving their understanding of effective transparency, ensuring that they are clear, open and honest with everyone whose personal information is being used.’

The guidance will help organisations to understand the definition of and assess appropriate levels of transparency. It also provides practical steps to developing effective transparency information.

Following a public consultation earlier this year, the guidance incorporates feedback from health and social care organisations across the UK. Aimed at any organisation that delivers a health or social care service or uses health and social care information, it supplements existing ICO guidance on the principle of transparency and the right to be informed.

McCarthy Stone, a leading developer and manager of retirement communities in the UK, has announced that Jo Bennett has been appointed as its new Chief Financial Officer. Jo’s firm focus will be on delivering McCarthy Stone’s growth, helping the Group take full advantage of improving market conditions to build and sell approximately 2,000 new apartments and bungalows a year, and operate its 530 open retirement communities, including its 120 housing with care schemes.

Minehead Nursing and Residential Home

Louise Heppenstall has been appointed as Minehead Nursing and Residential Home’s new Home Manager.

Louise will bring over 15 years’ management experience to the role and will introduce bold new plans to enhance the lives of the residents in her care.

In her new role, situated just outside the coastal town of Minehead, Somerset, Louise will head up a team of over 100 dedicated employees providing a range of high-quality care services, including residential, nursing and specialist dementia for adults of all ages.

Aurem Care

A leading care provider for older people, Aurem Care, has announced the appointment of Daryl Martin as its new Regional Director (North).

Daryl brings more than two decades of specialised healthcare experience to the role. Based in the north east of England, Daryl’s new role will see him oversee five homes, with an anticipation for further growth. His responsibilities will be centred around providing effective leadership to the homes’ teams.

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NEWS

Public satisfaction with social care at all-time low New findings from the British Social Attitudes survey, published by the Nuffield Trust and The King’s Fund, show that public satisfaction with social care services has dropped to just 13%, the lowest level ever recorded.

The survey, carried out by the National Centre for Social Research (NatCen) in September and October 2023, is seen as a gold standard measure of public attitudes in Britain.

The latest results show the proportion of people dissatisfied with social care remains at a historically high level. 57% of respondents reported being either ‘quite dissatisfied’ or ‘very dissatisfied’.

"These are awful results, but they are sadly unsurprising."

The leading reason given was inadequate pay, working conditions and training for social care workers (57%). This was closely

followed by people not getting the social care they need (56%), and there not being enough support for unpaid carers (49%).

Dissatisfaction was markedly higher among respondents who had used or had contact with social care services (for either themselves or someone else) in the past 12 months (64%) compared to those who had not (49%).

Dissatisfaction varied considerably between demographic groups. Respondents aged 65 and over were more dissatisfied (63%) than respondents aged 18-64 (55%).

Those in the highest income quartile were more dissatisfied (62%) than those in the lowest (51%).

There is a notable difference in party affiliation, with both Labour and Liberal Democrat supporters saying they are more dissatisfied with social care services (both 62%), than Conservative supporters (51%).

Simon Bottery, Senior Fellow in social care at The King’s Fund, said, ‘These are awful results, but they are sadly unsurprising. For many years governments have taken too little action on social care

and this is now seriously affecting those who draw on services, the families who support them and the staff who work in the sector.

‘The results demonstrate the need for immediate action to stabilise the social care system, backed by long-term reform and investment. The next Government must take a strong step forward and prioritise social care.’

Cyril Lobont, Researcher at the Nuffield Trust, said, ‘Social care services are a vital part of society yet satisfaction with them seems to redefine “rock bottom” every year.

The results make it clear that too many people with care needs and their families are still struggling to access a reasonable level of support.

‘Even though social care services are far less visible to the average person than the NHS, well over half of respondents to this survey recognise that pay and conditions for those working in care services are just not good enough.’

Visit The King’s Fund website to read the findings in full.

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Carer’s Leave Act comes into force 2.3 million workers with unpaid caring responsibilities in Great Britain will be entitled to take up to five days' unpaid leave each year as the new Carer’s Leave Act comes into force.

New analysis of Census 2021 data by Carers UK shows that there are around 1.6 million people in full-time employment in England and Wales who were also looking after someone who is older, disabled or with a long-term health condition, and 948,000 people in parttime employment who were also unpaid carers.

The new rights are particularly important as previous Carers UK research found that around 600 people a day give up work to care due to a lack of flexibility and support.

With 317,000 directors, managers and senior staff juggling employment and caring responsibilities, this is an issue faced by employees throughout organisations, from the Board to the most junior member of staff.

The sectors with the highest numbers of unpaid carers set to benefit from these rights are public administration, education and health (976,000). This is followed by distribution, hotels and restaurants sector (443,000) and financial, real estate,

professional and administrative (396,000).

Employees can take time off in full or half days, or in a whole block of five days.

Those taking time off will have the same employment protection associated with other forms of family-related leave, such as protection from dismissal as a result of having taken the leave.

Helen Walker, Chief Executive of Carers UK, which led the campaign for those balancing work and unpaid care, said, ‘Juggling work with caring responsibilities isn’t easy and without the right support, this can take its toll. Too many skilled and valued workers are leaving employment due to the stress of balancing work and unpaid care.

‘Now every employer in the country must recognise carers in the workplace, employees can be confident speaking about their caring role – kickstarting a crucial conversation about the support they need to stay in work, which matters not just for carers, but for employers and the economy, too.’

Wendy Chamberlain MP, who introduced the Carer’s Leave Bill in the House of Commons, said, ‘Becoming a carer is

something that can happen to any one of us. It can take many forms: from day-to-day physical caring, making medical appointments or doing the shopping for a housebound elderly neighbour. Caring or being cared for is something that almost everyone will experience at some point in their life.

‘The work unpaid carers do is so vital, yet it is extremely underappreciated. This hard work should be better recognised which is a key reason why I led the Carer’s Leave Act through Parliament.

‘I’ve met with some incredible organisations over the last two years, and I would like to deeply thank Carers UK with whom I worked closely with throughout the process of getting this bill passed.’

To ensure that unpaid carers are aware of their new rights, Carers UK has created new information and advice resources which can be accessed at www.carersuk.org/help-and-advice/workand-career/the-carers-leave-act-2023/ To ensure employers are aware of what is required of them, Carers UK has created a new guide on the Employers for Carers website.

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NEWS

Government confirms scope of Essex mental health inquiry The Department of Health and Social Care has published the terms of reference for the statutory inquiry following the deaths of mental health inpatients in Essex.

The inquiry – which is chaired by Baroness Lampard CBE – was set up to understand the events that led to the tragic deaths of mental health inpatients under the care of NHS trusts in Essex between 2000 and 2023.

The terms of reference will enable the inquiry to continue the work of the former Essex Mental Health Independent Inquiry and will play an important role in identifying learnings from those events for the future.

The chair will be responsible for the progress of the inquiry and will set out a series of recommendations to improve the provision of mental health inpatient care.

Health and Social Care Secretary, Victoria Atkins, said, ‘patients should feel confident, safe and supported – especially when receiving help for their mental health, which can be an incredibly vulnerable experience.

‘This was not the case for mental health inpatients in Essex between 2000 and 2023, where so many patients ended up tragically

and needlessly passing away – leaving their bereaved families with questions that need answering.

‘We take this need seriously and through the Lampard Inquiry, we will ensure lessons are learned and patient safety is improved. We have today published the terms of reference, to allow the inquiry to continue, and for families to get the answers they’re looking for.’

The terms of reference are set by the Health and Social Care Secretary after consultation with the chair, who has engaged with the families and other stakeholders.

When investigating the inpatient deaths, the inquiry will cover: • The serious failings related to the delivery of safe and therapeutic inpatient treatment and care.

• The actions, practices and behaviours of staff providing mental health inpatient care.

• The culture and governance of and at the trusts and how that affected care and treatment.

• The quality of investigations and responses by and on behalf of the trusts.

• The interaction between the trusts and

other public bodies including commissioners, coroners, professional regulators and the Care Quality Commission.

The Government confirmed on 28th June 2023 that the inquiry would be placed on a statutory footing and it was formally converted to a statutory inquiry on 27th October 2023. This gives the inquiry legal powers to compel evidence from relevant individuals and organisations. The chair undertook a public consultation on the proposed terms of reference for the inquiry in November 2023 and wrote to the Secretary of State with her recommendations in December 2023.

Baroness Lampard is a former barrister with experience in leading high-profile government reviews, including the NHS investigations into Jimmy Savile and investigations into the Borders, Immigration and Citizenship System.

She took over as chair of the inquiry from Dr Geraldine Strathdee, who stepped down in 2023 for personal reasons.

The chair will provide a final report as soon as practically possible. For more detail, visit the Lampard Inquiry website.

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Digital care platform secures £3m expansion Log my Care, a London-based company whose software platform enables care homes and social care organisations to ‘go digital’, has raised an additional £3m funding from existing investor Mercia Ventures.

This latest investment will further establish Log my Care as a leading supplier to the learning disability sector and help expand its presence in home care.

"Log my Care helps improve the quality of care for those who need it most."

Log my Care‘s intuitive care management software enables carers to record notes, access medical records and receive prompts and reminders via a mobile app. This helps care managers improve efficiency, care quality and oversight. The platform typically saves carers up to an hour per shift and enables them to create personalised care plans in a third of the time.

Founded in 2017 by former University of Oxford engineering students Sam Hussain and Adam Hurst, Log my Care is one of the fastest-growing platforms of its type. Over 1,300 care providers use it to support around 20,000 people across a range of care types, including learning disability, domiciliary care, supported living and more.

The company, which now employs 35 staff, increased annual recurring revenue by around 80% in 2023 and recently broke the £2m barrier. It is also about to launch a new GP Connect service that will integrate with the NHS and enable carers to access data from GPs' records.

The funding will allow the team to develop a rostering tool that helps care managers handle the complex staff schedules involved in providing home care visits. The latest funding round brings the total raised by the company to over £7m.

While many care providers still rely on paper records, the Government is providing funding to encourage them to switch to digital social care records (DSCRs). Its £25m-a-year scheme has recently been

extended until March 2025 and can only be used on approved suppliers verified by the NHS, such as Log my Care.

Sam Hussain, Chief Executive Officer at Log my Care, said, ‘By giving carers more time to spend with patients and access to better information, Log my Care helps improve the quality of care for those who need it most. The funding will enable us to continue scaling our business in the UK and extend our positive impact by increasing the number of people supported by our platform from 20,000 to over 100,000.’

Henry Hamilton, Investment Manager at Mercia Ventures, added, ‘Care providers are recognising the need to move to digital technology, aided by Government incentives. Log my Care really resonates with independent care homes as an easy-to-use product that improves efficiency at an affordable price. The company has been growing rapidly. This latest investment will enable it to further expand its market share and establish itself as the leading platform for care providers in the field of learning disabilities.’

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NEWS

Research finds lack of planning for seniors’ housing New research produced by global property consultancy Knight Frank and law firm Irwin Mitchell has revealed that planning remains one of the largest challenges for the seniors’ housing market as nearly a third of councils across England remain unprepared to provide suitable housing for their ageing populations.

Just under a third (32%) of local authorities still do not have clear policies in place to support housing for seniors according to new research from Knight Frank and Irwin Mitchell. According to the report, this shortcoming in the level of planning for seniors' housing is particularly worrying given the UK’s ageing population – it is forecast that the number of people aged over 65 will increase to over 15 million or to one in four of us by 2043.

The new survey builds on similar research carried out in 2017, 2020 and 2022, which ranked local authorities between ‘A’ and 'D' according to the provisions in their local plans towards seniors' housing. Those local

authorities with an A rating had clear policies indicating details of the required number of dwellings and care home beds and how this will be achieved together with specific site allocations for such development, whereas those with a D rating had neither clear policies nor site allocation.

This year’s survey results found that out of 326 local authorities in England 75 (23%) were graded A, 100 (33.7%) were graded B, 47 (14.4%) were graded C and 104 (31.9%) were graded D. Oliver Knight, Partner and Head of Residential Research at Knight Frank, said, ‘While previous research has shown significant progress, our latest analysis suggests that over the last two years, the pace of change has stalled. A third of local authorities are still to adopt specific planning policies and site allocations addressing seniors' housing.

‘Some 34 have moved backwards over the last two years. The appetite from investors

and developers to deliver more age-appropriate housing is clear and growing.

A more consistent and supportive policy environment will unlock more supply, more propositions, and more choice for seniors.’

Nicola Gooch, Planning Partner at Irwin Mitchell, said, ‘Planning remains one of the biggest challenges facing the seniors' housing sector in England. It’s now 2024, seven years since we started running this survey, and there are still less than a quarter of A graded local authorities – only 75 out of 326 that have both clear policies in place and site allocations.

‘The number of councils not adequately planning for an ageing population remains significant. More concerningly, the rate of change has stalled over the last two years, meaning that we are failing to make progress just when the need is becoming increasingly acute.’

To read the findings of the report in full, visit the Irwin Mitchell website.

UK work policies not fit for people living with long COVID New research has found current sickness absence and return to work policies in the workplace are unfit for purpose for those living with long COVID. In one of the first qualitative studies to investigate attempts to return to employment by people with long COVID,

"People with long COVID have experienced marked changes in their ability to participate in paid employment." researchers from the University of Stirling and the Universities of Oxford and York spoke to 65 adults in 2021 and 2022 who were dealing with continuing disability as a result of the condition.

They found that existing workplace policies that classify employees simply as either ‘able’ or ‘disabled’ are not helpful for people with illnesses, like long COVID, which are unpredictable, often involve invisible symptoms and vary in their severity.

Dr Alice MacLean, of the University of Stirling’s Institute of Social Marketing and

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CMM May 2024

Health (ISMH), said, ‘Long COVID is not yet officially classified as a disability in the UK and there is very little advice for people with long COVID on how best to return to work.

‘Study participants told us that existing sickness absence, return to work and welfare policies do not meet the needs of workers with long COVID, and that they often experienced a lack of support on attempting to return to work.

‘As well as trying to manage the demands of work alongside their ongoing symptoms, they also had the additional tasks of educating employers and colleagues about the debilitating effects of their symptoms and negotiating workplace adaptations, such as a change in role, working hours or workplace location.

‘Many talked about feelings of sadness, guilt or fear about being unable to work as well as they had done before and said that people at work often did not recognise the severity of their symptoms nor realise how much symptoms prevented them from being able to work in the same ways as they had previously.’

People with long COVID have experienced marked changes in their ability to participate in paid employment.

Economic inactivity has risen significantly among people with self-reported long COVID in the UK, compared to those without long COVID. More than 50 countries, including most recently Belgium, have classified COVID-19 as an occupational disease, providing workers who have long-term disability associated with COVID-19 infection with long-term disability and additional financial protection and compensation.

Participants also told researchers about experiencing relapses when attempting to return to work before they were well enough to or not returning to work gradually enough.

One said, ‘It took me a really long time before I accepted that I wasn’t well enough to work. I probably drove my managers mad, because I would email every couple of weeks and say, “Right, I think I’m better, I’ll be back on Monday”, and then low and behold, I would be ill again.’

The research, funded by the Scottish Government’s Chief Scientist Office is published in Disability & Society. It is one of several studies led by Stirling health experts which seeks to understand the lived experiences and support needs of people suffering from the long-term effects of COVID-19.

NEWS / IN FOCUS

New chapter for Championing Social Care Championing Social Care has become an independent entity.

The initiative started life in 2018 as the Care Sector Fundraising Ball and during the pandemic, became Championing Social Care, to promote and unite the care sector with various programmes and shine a positive light on the great work of social care and its 1.6 million-strong workforce.

An application has now been submitted to the Charity Commission for its registration as an independent charity.

"...a hugely successful project that aims to tell positive stories..."

Avnish Goyal CBE, Chair of Championing Social Care, said, ‘This is a really exciting move

which shows how far we have come since Championing Social Care was formed. It has grown into a hugely successful project that aims to tell positive stories about the sector through its various initiatives.

‘We feel that the time is right to register Championing Social Care as a charity in its own right. Our aim is to expand its work and grow its impact even further. We’d like to thank the CareTech Foundation for hosting the initiative up to now, and to thank all of our Patrons for their enthusiastic support.’

The mission of Championing Social Care is led by a group of volunteers and ambassadors from the leading figures in health and social care. It has been incubated by the CareTech Foundation since its launch.

HC-One invests over £39m in colleague pay This investment will mean that over 80% of colleagues will move immediately to be at or above the new Real Living Wage rates, with all colleagues able to earn at or above the Real Living Wage after two years of service. The investment also means that care colleagues will receive a pay award averaging 9%, which is once again ahead of the public and private sector’s averages, and, for the vast majority of colleagues, outstrips inflation.

The announcement is the latest in a raft of significant investments that HC-One has made in its workforce. Over the last three years, HC-One has invested substantially in colleague pay in recognition of

the valuable role they play in supporting some of the most vulnerable people in our society and making a real difference to residents’ lives.

James Tugendhat, Chief Executive Officer at HC-One, said, ‘I am delighted that we are announcing another substantial investment in colleague pay and are pleased to be making a positive step forward on sick pay.

‘Our colleagues at HC-One make up the biggest health and care workforce outside the NHS and are vital to how we deliver care. We would not be able to do what we do without them, and it’s incredibly important to us that we do everything that we can to reward them for the crucial work they do.’

IN FOCUS

CareTech announces progress on its sustainability targets WHAT’S THE STORY? CareTech – a leading provider of healthcare, education, social care, training and technology innovations – has published its third annual Purpose Report, setting out the achievements to date in delivering on the Group’s commitment to sustainability.

This report covers the first full year of CareTech as a company returned to private ownership and demonstrates the company’s commitment to its Environmental, Social and Governance (ESG) responsibilities.

WHAT WERE THE FINDINGS? Key achievements highlighted in the report include: • A 50% reduction in direct carbon emissions across the company’s UK operations in the last year.

• 104 services participating in Care Home Open Week, up 30% from last year.

• CareTech ranking number 54 in the 2023 Top 100 Apprenticeships Employers list, the highest-placed social care provider in the country.

• 20% of staff undertaking charitable fundraising activities in the last year, with match-funding provided by the independent CareTech Foundation.

• Purple Tuesday 2023, the global disabled customer celebration day delivered by CareTech’s Purple subsidiary, was the most successful ever.

The campaign trended at #1 on the social media platform ‘X’, had an audience reach of 29.5 million and prompted 3,475 items of media coverage.

• Over 3,500 staff – 33% of all

relevant staff – have already completed the Group’s new online sustainability training course. This supports staff in rolling out the Group’s new service-based CARE4 One Planet Living programme.

• The launch of CareTech’s EnableAll platform – a onestop-shop which enables equality and inclusion for disabled people, economic opportunities for merchants and an ethical alternative for conscious consumers.

WHAT DO THE EXPERTS SAY? Haroon Sheikh, Chief Executive Officer at CareTech, said, ‘Building sustainability targets in to our core business planning and management reporting processes is a significant step forward. This demonstrates powerfully that CareTech embraces the sustainability agenda as “business as usual”.’

Jonathan Freeman MBE, Group Sustainability Director at CareTech, said, ‘The range of activity across all areas of CareTech to place sustainability at the centre of our business model highlights a maturing of our approach as well as a growing understanding of what is required to deliver on our ambitious agenda.

‘I am particularly excited by the roll-out of our new CARE4 One Planet Living programme, which will ensure that every one of our services has a local plan in place by which to deliver change.

As important as corporate initiatives and approaches are, we know that long-term behavioural change across each of our 12,000-plus staff will be required to shift the dial on our sustainability approach.’

CMM May 2024

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NEWS

NEWS

NEWS FROM ACROSS THE GLOBE New partnership to regulate social care professionals The Department of Community Development— Abu Dhabi (DCD) has partnered with the Abu Dhabi Department of Education and Knowledge (ADEK) to oversee the licensing of social care professionals working in private educational institutions in Abu Dhabi.

During the initial phase, some 80 social care professionals to be employed by ADEK will be licensed, and the rest of the professionals working in the educational institutes will be licensed gradually.

Approximately 410 social care professionals will benefit from this collaboration which facilitates ongoing

efforts to create complementary supportive and nurturing environments at home and in school, which ultimately aims to heighten students’ academic performance.

Hamad Ali Al Dhaheri, Undersecretary of the DCD, said, ‘The Department of Community Development is keen to build fruitful and purposeful partnerships that contribute to enhancing the quality of life in society. Its purpose is to regulate social care professionals in educational institutions and to expand the horizons of co-operation between the two departments.

‘The memorandum of understanding will facilitate granting licences to social care

professionals working in the educational sector to ensure the provision of high-quality services through professionals with a high level of competence and qualifications, and within an organised and licensed framework in accordance with established procedures.’

Mubarak Hamad Al Muhairi, Undersecretary at ADEK, said, ‘Recognising the relation between student wellbeing and academic success, our collaboration with the Department of Community Development will ensure the placement of highly competent and qualified professionals at Abu Dhabi private schools to champion student wellbeing.’

Plans announced for investment in social care workforce The Ontario Government is investing more than $100m in two programmes that will train more than 32,000 new personal support workers (PSWs) and nurses in long-term care over the next three years. The investments are part of the Government’s Your Health plan to recruit and retain tens of thousands of long-term care staff over the coming years.

"Positive clinical placement experiences drive recruitment, as students often take jobs in the homes where they complete their placements."

Ontario is investing $94.5 million over three years to extend the Preceptor Resource and Education Program for Long-Term Care (PREP LTC). Since its launch in 2021, the programme has already helped 500 long-term care homes provide clinical placements for over 17,000 nursing and personal support worker students. With the new investment, the programme now aims

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CMM May 2024

to train more than 3,000 new preceptors and support 31,000 new clinical placements by 2027.

Clinical placements are key to providing nursing and personal support worker students with hands-on and on-site experience in long-term care homes under the supervision of preceptors — experienced staff who are trained for this role. Positive clinical placement experiences drive recruitment, as students often take jobs in the homes where they complete their placements. Meanwhile, becoming a preceptor gives existing long-term care staff the opportunity for career development and growth.

Ontario is also investing nearly $11m over three years to expand Living Classrooms, a programme that helps students train to become PSWs on site in local long-term care homes. With this investment, the programme will double the number of living classrooms from 20 to 40, which will support the training of up to 1,300 new PSWs by 2026.

Unlike traditional PSW training programmes, where students start with a classroom education and then move on to clinical placements, Living Classrooms integrate education into a long-term care

home. Students alternate between in-class learning — delivered in the home or nearby — and applying what they learn as they work with residents within the home. The programme is especially beneficial to rural, remote and northern regions, as homes can grow their own staff and students can train without having to leave their communities.

The Ontario Government is fixing long-term care to ensure Ontario’s seniors get the quality of care and quality of life they need and deserve. The plan is built on four pillars: staffing and care; quality and enforcement; building modern, safe and comfortable homes; and connecting seniors with faster, more convenient access to the services they need.

Stan Cho, Ontario Minister of Long-Term Care, said ‘Our Government is fixing long-term care by training, hiring and retaining thousands of healthcare workers to provide high-quality care for residents.

‘We’re investing in programmes that are building a pipeline of talent for the future and giving them more hands-on clinical training, so our long-term care residents get the high-quality care they deserve.’

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PICK PICK AND AND MIXED: MIXED: Making social care sweet for all 18

CMM May 2024

Mike Padgham, Chairman of the Independent Care Group (ICG), evaluates the strength of the mixed market approach to social care delivery and promotes the freedom of choice for individuals.

As we head towards a general election, the age-old debate over who is best placed to deliver social care – ‘for profit’ or ‘not-for-profit’ providers – inevitably surfaces. For some, the belief that social care should only or predominantly be delivered by not-for-profit organisations, rather than the mixed market we

currently have, is irresistible.

It is a little like when George Orwell wrote in Animal Farm, ‘Four legs good, two legs bad.’ In this case, suggesting animal superiority over humans. I hear repeatedly, ‘Not-for-profit good, for-profit bad.’

Let me say at the outset that I fully support not-for-profit providers and see them as a vital component in the delivery of care. But I do view them as part of a mixed market approach to delivering care that includes choice.

There have been repeated calls from the sector for us all to speak up for social care ahead of the polls and make the case for not-for-profit provision. I agree wholeheartedly with this desire to see social care become a key issue at the election. But I believe that we should campaign for all social care provision – we need to support the sector as a whole.

Whilst some call for a predominantly not-for-profit approach, others favour nationalisation. But to switch social care over to a solely

not-for-profit model or to nationalise the sector would cost billions of pounds and take many years to achieve. The country has neither the billions required, nor the time needed. That is arguably why neither is being put forward by any of the main political parties. In these extremely difficult financial times, they may be perceived to be non-starters.

The bigger picture Looking at the wider argument, should there be such a desire to demonise profit in the delivery of care? All providers have to stay in the black or face deregulation by the Care Quality Commission (CQC), whether you call that a profit in the private sector or a surplus in the not-for-profit sector.

Furthermore, if they are to survive against the competition and keep their CQC ratings high, private sector providers must invest a large proportion of their profit into maintaining high standards of service

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PICK AND MIXED: MAKING SOCIAL CARE SWEET FOR ALL

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that respond to the communities they serve. Good-quality care is surely everyone’s aim, whether you make a surplus or a profit.

Most care in this country is provided by small- to medium-sized operators who are embedded in those communities and doing their best to provide a good quality of care, pay their staff as fairly as they can and make a living.

We have seen many examples in recent years where providers have exited the market because they could no longer achieve one or more of those goals. Just because you are a not-for-profit provider does not make you immune from the challenges everyone in the sector currently faces.

The problems are the same: staffing shortages, poor fee levels, debt repayments, huge utility bill increases and so on.

Changing perceptions In any field, including care, there will be instances where large companies grow and pay their senior management in accordance with that size and their responsibility. Yes, there are some highly paid CEOs of care companies but there are some highly paid CEOs of charities too.

Not every penny generated by not-for-profit social care providers goes back into providing care. They have costs and salaries to meet as well.

In the main, private sector social care delivery is carried out by smaller and medium-sized businesses, many of whom are simply trying to make a living and not making millions. That is a message that doesn’t always get across and we need to work harder to make sure it does. That might go some way to alter the perception of independent care providers.

These providers want to pay their staff fairly – just as not-for-profit providers do. But to do so we all need reform of commissioning too, so that those buying care – whoever they buy it from – pay a fair price that enables that provider to deliver the care properly and give their staff the pay and conditions they deserve. At the moment, fees paid by many councils don’t cover paying staff the National Minimum Wage, let alone paying staff better and running the business.

Promoting choice A mixed market of social care provision gives people choice. It would be wrong to deny people the choice of what sort of care they receive or where they spend a very important time of their lives.

Attempts to deliver social care via the public sector have been made before but proved too costly. To suggest renationalising social care would risk returning to that time when the state simply couldn’t cope.

And to make not-for-profit the only player in the game would take a seismic shift that would take many years and cost billions.

We certainly don’t claim to have all the answers and are not welded to the old ways of doing things. A model of social care delivery similar to that currently adopted by GPs in this country might work. After all, GP practices are effectively businesses providing healthcare services to their locale under contract to the NHS and Integrated Care Boards.

That contract arrangement gives them the security they need to invest in their practices. Giving the same contract arrangement to social care providers could encourage them to do the same. An idea I think is worth exploring at least.

Managing solutions Providers have solutions to the sector’s shortfalls which would put social

care back on an even keel, without breaking the bank. In our Five Pillars for Social Care Reform, the Independent Care Group (ICG) suggested ring-fencing a percentage of GDP for care, creating a joined-up National Care Service, setting a minimum carer wage, establishing a task force for reform and creating fair tariffs for services, such as care beds and homecare visits.

There is no getting away from the fact that some extra investment is going to be needed – we have been deprived of money for so long we have to catch up. But it needn’t all be new money. Every penny spent on social care saves money for the NHS by keeping people out of expensive hospital beds and instead, cared for in a place of their choosing such as in their own home, supported living or in a care home. So, a switch of resources from NHS to preventative social care is surely a no-brainer, as it saves the NHS money and puts resources where they are needed, looking after people where they want to be looked after.

The creation of a health and social care levy – where an increase in National Insurance is used to pay for improved health and social care – seemed, whilst not ideal, at least an attempt to help ease the pressures.

I was left feeling very dismayed therefore, when plans to help were shelved yet again.

There is a real fear in politicians over asking the public to pay more – even when it is for our own care. I struggle to believe that the public would resent paying a little more in National Insurance or taxation if they could know that healthcare and social care for themselves and their loved ones was going to be guaranteed and free at the point of need. At the moment, if you need long-term care there is a very good chance you will end up selling your home to pay for it – even if you have dementia, a condition every bit as debilitating as cancer and heart disease, treatment for which is paid for by the NHS.

The message is clear The ICG has been calling for sensible and sustainable reform, including the creation of a joined-up National Care Service, better commissioning practices and improvements to staff pay for three decades.

The Building Capacity and Partnership in Care document set out perfectly what needed to be done by Government, commissioners and independent sector care providers to deliver good, sustainable care with those needing care at the heart of it. However, that document was published in 2001 and never properly followed through. If it had been, the sector may not be facing all the issues it is today.

We must work with what we have. Properly funded, the mixed market provision we have created since the 1990s would work very well in providing good standards of care and choice for recipients and excellent value for money to the public purse.

But the key phrase there is ‘properly funded’ because at the moment, the sector is not and local authorities are failing to commission care at a rate equivalent to the fees needed to deliver that care, with the result that providers of all types are struggling.

Social care needs to campaign, with a unified voice, for change at the coming general election. Side debates over what type of care we should or shouldn’t be providing serve merely to distract and give opponents opportunity to accuse social care of being a divided, splintered sector.

However we provide it, what is important is that we create a sector that delivers the good-quality care that people need and pay the staff properly for doing so. At the moment, we aren’t doing either. That is what we should be fighting for. CMM

Mike Padgham is Chairman of the Independent Care Group (ICG). Email: mikepadgham@independentcaregroup.co.uk X: @Mike_Padgham How else can the social care sector express its unity ahead of the next general election? Visit www.caremanagementmatters.co.uk and leave a comment on this article or join the conversation to share your thoughts.

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Deprivation of liberty in care homes: Fixing a failing Natalie Cresswell, Policy Manager – Equality and Human Rights at Age UK and David Broome, Technical Advice Support Officer – Social Care at Age UK discuss a crucial yet often overlooked issue > impacting people drawing on residential care and support.

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DEPRIVATION OF LIBERTY IN CARE HOMES: FIXING A FAILING SYSTEM

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A hidden crisis

Our new report, A hidden crisis: Older people and deprivation of liberty in care homes, highlights the failure of the Deprivation of Liberty Safeguards (DoLS) to protect the rights of some of the most vulnerable people in our country. The DoLS exist to safeguard the fundamental right to liberty, for those who lack mental capacity to consent to care or treatment.

Under the DoLS, local authorities in England are responsible for authorising deprivations of liberty that occur in care homes and hospitals.

"There is an ever-growing backlog of DoLS cases that is so vast it can now probably never be eradicated."

We show how years of underfunding at the national level has undermined the administration of the DoLS at the local level and the impact this has had on older people, and others who may be subject to a DoLS authorisation. We also show how the effect of long-term underfunding and investment in social care, as well as a workforce crisis, is impacting on those who provide and receive care throughout the system.

We believe that when the DoLS work well, they are a crucial safeguard for older people and others who lack or are perceived to lack mental capacity. It means that this group of people, who by definition often find it difficult or impossible to advocate for themselves, cannot simply have their right to liberty removed without any checks to ensure that this is the best option for them, in their specific case – a humane and civilised response to a difficult set of circumstances.

But the DoLS are not working well in practice.

There is an ever-growing backlog of DoLS cases that is so vast it can now probably never be eradicated.

Since 2015/16 the estimated number of uncompleted DoLS applications has remained at over 100,000, and in 2022/23 126,000 applications went uncompleted by local authorities.

Where applications were completed, it took an average of 156 days to do so for a standard authorisation – much longer than the statutory timeframe of 21 days. This means that many older people will have been unlawfully deprived of their liberty before a DoLS assessment was carried out and a DoLS authorisation issued by their local authority.

While in many cases a deprivation of liberty may have been the right decision for the older person, others will have had their right to liberty

inappropriately denied. Shockingly, in 2022/23, 49,325 people died while waiting for their DoLS authorisation to be completed.

How DoLS delays impact care home providers The current problems with the DoLS and the wider lack of investment in social care also have an impact on the staff who provide care for those who may need to be deprived of their liberty. There are many excellent and hardworking care staff who work diligently to provide good care in often difficult situations, with limited resources. But long delays for DoLS authorisations mean that in practice care providers are often put in a difficult position.

Care home staff often have to wait weeks or months before a decision about a DoLS application is made by the local authority. One care home representative told us that in some cases they had been waiting over a year for authorisation to be given by their local authority. Another said that the wait for authorisation can be ‘four to six weeks, or four to six months’. While care homes can often cover the initial deprivation of liberty under an urgent authorisation for a period of up to seven days, which can then be renewed by the local authority for a further seven, any deprivation of liberty following this is unlawful.

Where there is a long wait for a standard authorisation, care home staff are then faced with difficult choices. If they place restrictions on somebody who may need them, but who does not have a DoLS authorisation in place, they may be at risk of acting unlawfully. However, if they follow the law and do not deprive someone of their liberty until the authorisation is given, they then face the challenge of keeping someone safe who may be at high risk of harm. This also means that in some cases care providers essentially have to make decisions about a deprivation of liberty without anyone external to the care setting checking whether this is the right thing for the person concerned.

The following case study of Helen’s grandad, Peter, illustrates the difficult choices care providers face, as well as the impact DoLS delays can have on the person lacking mental capacity and their family.

Case study: Helen’s grandad ‘I was saying “Let’s do it [the DoLS application] today.” But, it took ages. It took six weeks, and he was running around all over the place. They said there was backlog and there were more urgent ones they had to deal with. I was pleading with staff… saying “stop him”, they were saying, “Helen, we can’t – we’re not allowed to.” It was frustrating.’

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CMM May 2024

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DEPRIVATION OF LIBERTY IN CARE HOMES: FIXING A FAILING SYSTEM

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Helen’s grandad, Peter, has had Alzheimer’s for a long time and has been living in care for two years.

He was regularly leaving the care home and being found roaming the streets as he thought he was going to work. As the care home was close to a dual carriageway, Helen and her family felt a constant sense of dread that something serious would happen.

Each time he left the care home, Helen had to come into the care home to speak to the staff.

As her grandad’s Power of Attorney, Helen was approached by the care home about implementing a DoLS. It was framed as a way which would enable staff to prevent him from leaving the home, and she was relieved that there might be a solution. They contacted the local authority, and a Best Interest Assessor (BIA) was assigned who organised a multi-agency meeting with the care home, Peter’s GP, the family and the local authority. This was followed by a BIA assessment.

Following these assessments and meetings, Helen and her family heard almost nothing from the local authority about the application for over six weeks. They were informed there was a backlog, but in this time – as there was no emergency DoLS in place – Peter was regularly leaving the home on his own and the care home staff could do nothing to force him to remain. Helen describes feeling totally helpless during this period and frustrated because she couldn’t understand what was taking so long. When Peter’s DoLS eventually came through it was a relief.

DoLS and the social care workforce crisis

challenging for staff who may end up providing more restrictive care then they would wish because of a lack of resources, and for residents, who may be subject to overly restrictive practices, such as being put to bed early, or being unable to leave their room regularly.

The workforce crisis and high levels of staff turnover also mean that knowledge and experience of DoLS is not always sufficient to provide people with appropriate care. The CQC has noted, for example, that care home staff do not always implement the conditions attached to DoLS orders such as supporting access to places of worship or visits to a relative’s home, due to a limited understanding of the DoLS framework among care providers.

The way forward The problems with the DoLS affect those who lack mental capacity and their families, those who provide social care and local authorities who must manage large numbers of DoLS cases with inadequate funding from central Government. We want the Government to reform and effectively finance the DoLS so that the system works better for older people and everyone involved in the system.

But this alone cannot solve all of the issues.

Social care more widely must be properly funded, and effective solutions found to the workforce crisis, to ensure providers have sufficient resource to provide the best possible care which supports the freedoms of those lacking mental capacity as much as possible. CMM

Providers responsible for the care of people who may need to be deprived of their liberty are also impacted by the wider social care workforce crisis.

Skills for Care figures show that in 2022/23, there were more than 152,000 vacant posts across the care sector. Staff turnover is also high at 30% in the same period. Care providers need sufficient resources to ensure that any deprivation of liberty is the minimum possible and that older people are not subject to any overly restrictive practice.

But this is difficult in the context of staff shortages, where providers are often caring for high numbers of residents with complex needs. Staff told us that they didn’t always have enough time with each resident to deliver proper care, and that ‘there was too much to do in a shift’. This is both Natalie Cresswell is the Policy Manager – Equality and Human Rights at Age UK and David Broome is a Technical Advice Support Officer – Social Care at Age UK. Email: media@ageuk.org.uk X: @ageukcampaigns What is your experience of obtaining a DoLS authorisation? Visit www.caremanagementmatters.co.uk and leave a comment on this article or join the conversation to share your thoughts.

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CMM May 2024

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DĞĚůŝŶĞ ŽŶƐƵůƚĂŶĐLJ >ŝŵŝƚĞĚ zŽƵƌ ĨƌŝĞŶĚůLJ ŶĂƚŝŽŶǁŝĚĞ ƉƌŽǀŝĚĞƌ ŽĨ dƌĂŝŶŝŶŐ ŝŶĐůƵĚŝŶŐ &ŝƌƐƚ ŝĚ͕ ,ĞĂůƚŚ ĂŶĚ ^ĂĨĞƚLJ͕ &ŽŽĚ ,LJŐŝĞŶĞ͕ ,ĞĂůƚŚ ĂŶĚ ^ĂĨĞƚLJ͕ DĂŶĚĂƚŽƌLJ dƌĂŝŶŝŶŐ ĂŶĚ ŽŶƚŝŶƵŝŶŐ WƌŽĨĞƐƐŝŽŶĂů ĞǀĞůŽƉŵĞŶƚ ĐŽƵƌƐĞƐ ĂƐ ǁĞůů ĂƐ Ă ŽŶĞ ƐƚŽƉ ƐŚŽƉ ĨŽƌ Ăůů LJŽƵƌ &ŝƌƐƚ ŝĚ ĂŶĚ DĞĚŝĐĂů ĞƋƵŝƉŵĞŶƚ ŶĞĞĚƐ ƚŽ ƉƌŽǀŝĚĞ LJŽƵ ǁŝƚŚ ĞǀĞƌLJƚŚŝŶŐ LJŽƵ ǁŝůů ŶĞĞĚ ŝŶ ĂŶ ĞŵĞƌŐĞŶĐLJ͘ dŽ ǀŝĞǁ ŽƵƌ ƉƌŽĚƵĐƚƐ ƉůĞĂƐĞ ǀŝƐŝƚ ŽƵƌ YZ ĐŽĚĞ Žƌ ƚŽ ƐƉĞĂŬ ƚŽ ŽŶĞ ŽĨ ŽƵƌ ĨƌŝĞŶĚůLJ ƚĞĂŵ ƉůĞĂƐĞ ĐŽŶƚĂĐƚ͗ dĞůĞƉŚŽŶĞ͗ ϬϯϯϬ ϭϭϴ ϬϰϴϬ KƵƚ ŽĨ ,ŽƵƌƐ͗ Ϭϳϳϲϰ ϰϮϰϮϯϳ ŵĂŝů͗ KĨĨŝĐĞΛŵĞĚůŝŶĞͲĐŽŶƐƵůƚĂŶĐLJ͘ĐŽ͘ƵŬ

CMM May 2024

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INTO PERSPECTIVE How can care providers engage people drawing on care and support with their communities?

In this issue, Into Perspective asks two industry leaders to share the importance of engaging people who draw on care and support with their local communities and to provide tangible takeaways that can be implemented in day-to-day social care operations.

The Care Act 2014 states that the purpose of social care is to promote wellbeing and reduce a person’s need for care and support. It focuses on the core component that the person receiving care should have their views, wishes, feelings and beliefs considered at all times.

According to the World Health Organization 28

CMM May 2024

(WHO), wellbeing is ‘a positive state experienced by individuals and societies, determined by social, economic and environmental conditions’.

Being part of the local community can speak to two of these pieces – social and environmental. A community can offer emotional support to individuals and help them to foster a sense of identity, giving them a sense of belonging and connection.

Guidance from the National Institute for Health and Care Excellence (NICE) endorses community engagement as a strategy for health improvement. The skills and knowledge inherent in the community, and the social networks that are available outside of the care setting, can deliver new perspectives and enrich the lives of those drawing on care and support.

In addition, by fostering a sense of community and inclusivity as a provider of social care, by adopting a person-centred approach and by moving away from being solely service

led – better health can be achieved for the people the service is supporting.

A 2021 report by Think Local Act Personal titled, Towards Resilience: Making community matter in social care, uncovered ‘difficulties with communication, a lack of co-production, a fragmented care market, and… the unequal impact upon groups that are the core concern of adult social care – namely older and disabled people and non-white people and communities’.

The report identifies the important role community has to play, a role that was highlighted by the response to the pandemic, stating, ‘We have seen local people come together and look out for one another, demonstrated by the rapid flourishing of mutual aid groups and an exponential rise in volunteering.

‘We know, therefore, that these “assets” exist and, with timely public investment in nurturing this core economy to become sustainable, we have opportunities to develop the capacity of local people. This will act as an important element of resilience both for those that draw on social care support and wellbeing in general.’

Now is a good time for the sector to focus on fostering community connection and inclusivity, as the week of 24th to 30th June 2024 will play host to Care Home Open Week 2024, where community engagement is a key theme. This annual event is dedicated to showcasing the warmth, care and vibrant communities that care homes provide to residents across the country.

The Care Workers' Charity (CWC) and the National Activity Providers Association (NAPA) have launched a joint fundraising campaign in recognition of the event, harnessing the spirit of unity and compassion they believe defines the care community.

NAPA is dedicated to promoting meaningful and engaging activities to enhance the wellbeing and quality of life of residents in care homes. By partnering with CWC, a charity committed to providing financial support to care workers during times of need, this partnership aims to offer assistance to those who work to bring joy and enrichment to the lives of individuals living and working in care homes.

By creating innovative and meaningful connections with the wider community, outside the walls of the care home, the lives of both residents and care workers can be enriched, and the work of the care sector can be supported and celebrated by the local community in return.

For more information about Care Home Open Week 2024 and to register your care home’s participation in the event, visit the Championing Social Care website.

Partnerships require proactive and inclusive approaches

Care workers are central to supporting engagement

Hilary Woodhead, Executive Director, National Activity Providers Association (NAPA) : @NAPAlivinglife Email: hilary@napa-activities.co.uk

Karolina Gerlich, Chief Executive Officer, the Care Workers’ Charity (CWC) : @CareWorkersFund Email: info@thecwc.org.uk

NAPA’s primary goal is to improve quality of life for individuals receiving care and support services and encouraging their engagement with local communities.

During Care Home Open Week, we urge activity and care teams to arrange open houses, inviting community members to participate in activities like art workshops, gardening sessions or intergenerational storytelling.

These events not only showcase the care setting but also facilitate connections between residents and the wider community.

Maintaining community relationships requires ongoing efforts beyond specific events like Care Home Open Week. By regularly involving community members in activities and events, care settings can encourage a sense of belonging and inclusion.

Here are five tips for success: 1. Build partnerships with nearby schools, businesses and community groups to provide joint activities, events and volunteering opportunities.

2. Organise intergenerational activities such as reading sessions, arts and crafts or music performances to create meaningful connections and bridge generational gaps.

3. Visit local attractions, parks, museums or cultural events, inviting residents to stay connected with their surroundings and engage in shared experiences with community members. These experiences promote social interaction, enhance cognitive stimulation and improve physical activity.

4. Recruit and train community volunteers to assist with activities and events.

Volunteers can contribute time, skills and companionship, enriching residents’ lives.

5. Maintain open communication with the local community through newsletters, social media and events. Share stories, photos and updates about life in the care home, highlighting residents’ achievements, interests and contributions.

This transparency helps dispel misconceptions about care homes and encourages community support.

By implementing NAPA’s tips, activity and care teams can create vibrant and interconnected communities that promote wellbeing and fulfilment for all involved, beyond Care Home Open Week.

Community engagement should be an integral part of care provision throughout the year, but Care Home Open Week is a great time to recognise and support this in new ways. At the CWC, we speak to care workers across the UK and know they are central to supporting this engagement, both as support workers and members of the wider community. There are many ways that care providers can enhance community engagement.

• Utilise local connections: Tap into the knowledge of care workers who live within the community. They likely have connections to local businesses and organisations. Engage them in brainstorming sessions to identify potential partners and activities that align with the community's interests and resources.

• Realistic activities: Ensure that planned activities are realistic and manageable for residents and staff. Activities should be enjoyable and not add unnecessary stress. Consider activities that promote interaction and foster a sense of connection among residents and the community.

• Open-door policy: Embrace this to welcome community members into the care facility.

Hosting open-house events regularly can showcase the positive aspects of social care and provide opportunities for residents to interact with their neighbours.

• Storytelling and advocacy: Encourage care workers to share their experiences and insights with the community.

Personal stories can humanise the caregiving profession and highlight its significance in the lives of individuals drawing on care. Organise events where care workers can speak about their daily activities and the impact they have on residents' happiness and wellbeing.

• Fundraising support: Support initiatives organised by organisations such as the CWC and the NAPA. These fundraisers contribute to sustaining essential support systems for care workers across the UK, ensuring they receive the assistance they need to continue providing quality care.

Incorporating these strategies into daily operations can foster meaningful connections between people drawing on social care, the social care workforce and their North Yorkshire communities, promoting a sense Lancashire of inclusivity and support.

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Social care needs long-term reform:

Now is the time to act

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CMM May 2024

Dan Ryan, Chief Operating Officer at MHA, responds to the outcomes of this year’s Spring Budget and outlines what MHA believes should be the priorities for the next Government.

The Chancellor’s Spring Budget made no mention of social care. For those of us working in the sector, this is indicative of how poorly adult social care has been prioritised over the past few decades.

Instead, the focus of the Spring Budget was on reducing personal taxation, despite consistent polling from Ipsos showing that healthcare is the primary issue that will decide the public’s vote at the next election – ahead of inflation and the wider economic situation.

The Chancellor confirmed a ‘landmark public sector productivity plan’, funded by £3.4bn, which aims to create a more productive NHS and a £2.5bn allocation to the NHS in England for 2024-25.

Whilst widely welcomed by the sector at the time, it was highlighted that the relationship between health and social care was overlooked in the Spring Budget. Leading voices have outlined that investing in social care will allow people to have their needs met in the place they call home and reduce pressure on the NHS. In response to the Spring Budget, Our Chief Executive Officer, Sam Monaghan, commented, ‘As expected, the Chancellor has failed to address the current crisis facing the social care sector during the Spring Budget.

‘Our ask is that, ahead of the next general election, all political parties present a credible, sustainable plan that resolves the current gap between Government funding and the cost of providing care. After decades of successive governments dodging this question, there are now nearly half a million people waiting just for a social care assessment. This cannot continue.’

In the sector, we have faced unprecedented challenges while trying to care for some of the most vulnerable members of our society.

COVID-19, a workforce crisis and cuts in funding for local authorities have all led us to the point we are at today – yet the strategic investment and commitment have just not been there to support us.

As we head towards a general election, now is the time to act. In this feature, we outline MHA’s three key asks of the future governing party, to benefit everyone working in or accessing social care.

Smarter funding At the heart of the sector’s issues is the need for better, long-term funding. The Department of Health and Social Care (DHSC) has allocated specific pots of funding over the past year, which have been welcomed. But this does not constitute sustainable investment and comes nowhere close to acknowledging the need for long-term reform.

Operating costs for care providers have increased significantly in recent years, in line with inflationary pressures and dramatically higher energy bills. In 2021/22, for example, the Government budgeted at least £2.88bn less than the actual cost of delivering care.

Local councils are being forced to make impossible decisions. Recent data published by the Association of Directors of Adult Social Services (ADASS) shows that at least one third of adult social care leaders in England need to find an additional £83.7m of cuts. This is on top of the £806m in savings that directors across England had already committed to make in their budgets.

It’s argued that the true impact on local councils will be even higher, because the cost of providing care to everyone who is going to need it is not included in the projections. As aforementioned, there are currently around half a million people either waiting for their care needs to be assessed or waiting for their care to start.

Once they’ve undergone their assessments, many of these people will be eligible for some level of local council funding, which needs to be factored into future budgets. A recognition that local authorities simply cannot continue to deliver more for less is long overdue.

We are not unrealistic in our expectations

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SOCIAL CARE NEEDS LONG-TERM REFORM: NOW IS THE TIME TO ACT

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here, and we appreciate that Government budgets are not endless. Even if political parties don’t believe they can raise the £8bn per year that the sector needs, having a tangible plan for reform would really help us as providers to understand how we can be more strategic, or what we might be able to achieve in the longer term.

It's also important to recognise the contribution that social care gives back to local authorities, particularly through local workforces. The Women’s Budget Group (WBG) has shown that investing 2% of GDP in the care sector could create up to 1.5 million jobs.

A comprehensive workforce strategy More than three quarters (78%) of UK adults say they would feel proud to have a family member working in the social care sector, according to research we carried out with YouGov in 2023. In the survey of more than 2,000 people, 81% of respondents also said they viewed social care as skilled work, with 71% believing they should be paid the same as healthcare assistants in the NHS. But this is not the reality.

Recognising and valuing the professionals who work in social care is key to securing a strong pipeline of talent – paying people fairly, investing in skills and training and enabling more flexible working patterns.

The fact that people currently struggle to see a structured and rewarding career path is preventing them from joining or remaining in the sector. This is particularly true of the younger generation, who are the least likely to consider a career in social care according to our research.

There are approximately 152,000 vacancies across the sector, and we have seen little evidence of a plan to solve this problem to date. The Government’s Care Workforce Pathway had some encouraging elements, but it didn't feel cohesive enough as a framework. Nor was there enough thinking behind how we can attract new people to work in the sector or train, develop and reward those who already do – and that’s what we desperately need.

Yet another avenue of recruitment was closed off to the sector recently, as professional carers from overseas are no longer entitled to bring their dependants with them. In 2023, MHA welcomed 300 talented colleagues from overseas, all of whom play a vital role across our services.

We’re proud of how we’ve been able to help so many people settle into their roles and establish new lives. Our worry is that, with the new legislation, we will see fewer people applying to work in care in the UK. We want to see more thinking from the Government around what a future workforce strategy could look like and how it would be rolled out. One that encourages people from all ages and backgrounds to apply, makes flexible working a

possibility to bring more people back to a career in care, offers fair pay – in line with NHS colleagues – and delivers continuous development and opportunities for progression.

Ultimately, we want to see a clear demonstration that frontline care workers are valued for the role they play in society and that social care is seen as a respected and rewarding career option.

A Social Care Council We believe this vision can be achieved through the establishment of a Social Care Council. This would act as an independent body tackling key issues around recruitment and retention. It would also help to improve the perception of the social care profession, so that it becomes an attractive career choice for more people and is valued and respected by all.

As a sector, we are under no illusion about the scale of the challenges we face, but this is also now being reflected in the general public’s attitudes towards social care. The King’s Fund recently released the results of its British Social Attitudes Survey, in partnership with Nuffield Trust. It reveals that public satisfaction with social care services has fallen, with 57% of respondents citing inadequate pay, working conditions and training for social care professionals as the thing they are most dissatisfied with.

This is exactly what we’d like to see the Government address through a Social Care Council.

As part of the recruitment and retention plan, the body could examine everything from pay scales and shift patterns, to family friendly working policies, upskilling and continuous personal development. We can only secure the future of social care by elevating its status as a profession.

Room for social care?

We appreciate that health and the economy will be big talking points in Westminster this year and beyond. The truth is, social care has a big impact on both of these issues, yet it’s a topic that’s often confined to the back benches.

We know that solving all of the sector’s issues will require significant investment, and that any funding needs to be introduced in an affordable and manageable way. But we also know that this investment reaps rewards for older people, for the NHS and for local economies.

As we approach a general election, we are urging all parties to elevate social care, giving it parity with other major policy decisions. We want to see manifestos that commit to a long-term investment strategy, that address local authority funding, bring some muchneeded financial stability to the sector and help us to find, train and retain a highly qualified and fairly rewarded workforce. CMM

Dan Ryan is Chief Operating Officer at MHA. Email: dan.ryan@mha.org.uk X: @yourMHA Do you agree with MHA’s proposal to create a Social Care Council? Visit www.caremanagementmatters.co.uk and leave a comment on this article or join the conversation to share your thoughts.

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CMM May 2024

Education and training for the social care workforce If you work in adult social care, Macmillan’s Social care community on the Learning Hub is the go-to place for free education and training on cancer care.

There are over 20 on-demand e-learning courses, bitesize resources and virtual classrooms to develop your knowledge and skills in supporting people affected by cancer.

This community is for all staff working in adult social care who want to improve their understanding of cancer and skills in supporting people affected by cancer.

This includes staff working in residential care, nursing homes, home care, sheltered accommodation, assisted living and day centres.

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Are you fit to compete?

Navigating social care procurement

Peter Hamilton, Director at Insequa Ltd, updates on the topic of social care procurement.

In particular, Peter reveals what you can do to make your offer more attractive to procurement teams and set yourself apart from your competitors.

Since I last wrote for CMM, a lot has happened. Yes, there has been a pandemic, and more recently, we have seen the introduction of the Procurement Act 2023, which will come into force by October 2024.

We have seen some changes that have already hit procurement in the social care sector. Local authorities and their procurement teams have now been tasked by the Procurement Act 2023 to engage with service providers before publishing a tender. If they don’t, then they have to publicise why they didn’t engage with the provider network, and most are using market engagement events for this purpose.

This is where the local authority procurement team meets with providers, often over video conference, to understand your likes, dislikes, how service efficiency can be improved and whether there is the capacity and interest to provide services. Some procurement teams use market engagement events to communicate their vision and/or strategy, which is a great place to spark ideas for the added value that your company can offer.

If you know the local authority’s strategy, vision or mission, you can work on innovative ideas to support the procurement team’s outcomes. This gains you those all-important added value points when your bid comes to be evaluated. An answer to a question that covers

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ARE YOU FIT TO COMPETE? NAVIGATING SOCIAL CARE PROCUREMENT

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all the requirements, but provides no added value, might earn only 80% of the available marks. Why not make it 100% and make adding value your key priority?

Social value and net zero Another recent change is the addition of social value. In addition, if you’re tendering for NHS services (whether the NHS is the sole or a joint commissioner), you can add net zero to that list. The need for the NHS and local authorities to work in partnership has crystallised over the pandemic, during which time the NHS was heavily supported by local social care providers. That close relationship looks set to continue, with integrated working and partnership arrangements high on many commissioners’ current list of priorities.

The NHS has set a target of being net zero by 2040 for all direct emissions they control – and being net zero by 2045 for all indirect emissions. Therefore, social care providers need to be aware of what is coming down the road. You need to start thinking about a strategy for carbon reduction. Look both upstream as well as downstream. What do you buy? Where from? When finished with the product, how do you dispose of or recycle it? Are there any alternative local suppliers you could use, reducing carbon emissions incurred in shipping?

Make sure all your suppliers can provide you with a robust disclosure and transition plan to net zero. Check out and understand the lifetime carbon assessment of each of the products you consume – these can range from physical items, such as personal protective equipment, washing machines and chemicals/powders to logistical products, such as staff travel to and from offices, or to and from the homes of people drawing on care and support.

In your bid, create a timeline of events around social value and net zero that demonstrates numbers achieved and forecasts (e.g., CO2 emissions saved). Furthermore, you should explain how you will monitor and report your figures, plus how you will record and analyse the figures to identify potential improvements.

Remaining 'fit to compete' Public sector tendering is a competition, and you must put on your best game face to have a chance of winning. Make sure you have a strong winning strategy and know what will your strategy be if you win? What minimum price can you afford to work for? This is very important for framework tenders, where you’ll have multiple successful competitors, each trying to make their mark with the commissioning authority.

Here are a few key questions you may wish to consider: • Do you have marketing material to help you get new business from the procurement team?

• Can you back this up with feedback from people drawing on care and support, their family, friends and other key stakeholders?

• Can you prove you have capacity to provide cover for winter pressures, pandemics and unusual weather events, such as summer heatwaves?

Get to know the local authority, the community and the wider

stakeholder group which the local community uses. Understand where their needs are and who your competitors are. Develop credible solutions that save time, money, reduce carbon and benefit the local economy. Do you know what the local authority’s main priorities and objectives are? What is their strategy for achieving these and how can you fit into that?

Remember, building rapport has never harmed any sales process.

Writing tenders for someone you have never met is much riskier than being on top of the local strategy and integrated with the community.

If you understand all the above, you will be better placed as a company to align yourself with the local authority’s objectives.

This applies throughout the tender process and afterwards. When communicating with the local authority, you need to make sure all communication has a value. Why should they read your email and what benefit will they derive from reading it?

Here are a few handy hints and tips: 1. Read and fully understand the tender, including the instructions to tenderers. The instructions are your guide to the whole process, including timelines. For example, some local authorities are putting deadlines for TUPE enquiries ahead of the tender deadline – without this vital costing information, you cannot make an informed decision on your costs.

2. Read the specification document carefully, understanding what and how the procuring organisation wants the service to be delivered.

Mirror this in your answers.

3. Break the questions down, as many have several elements. Create a sub-heading for each element and make sure your answer flows. Take the evaluator on a journey: engage them, showing them that you understand and care.

4. Include in your answer both qualitative information, such as case studies, and quantitative data, showing that your examples are one of many. Reassure the procurement team that you have the capacity and capability to scale up.

5. Be mindful of risk. There is plenty in social care provision, so advise the evaluator of the risks and how you will mitigate them, even if the question does not mention them.

6. Look at previous tenders and create a list of subjects that are frequently covered by questions. Engage with your teams, considering how you can add value to each subject matter. If you do this, you may improve your scores by up to 20%.

7. Social value/net zero will soon be given a minimum evaluation score of 10%, so make sure you put credible figures into your tender.

Work with your team on creating strong net zero targets and speak to your local community, developing relevant and measurable social value initiatives that provide strong outcomes.

8. Proofread and have your tender evaluated by someone not connected with your company – someone who has procurement knowledge. Be prepared to re-write elements that need more detail.

If all of this fills you with a feeling of panic, then please reach out and seek Insequa’s advice. It may be the tender you are looking at is not right for you, and you may save yourself a large amount of time and stress by having a conversation with a professional. CMM

Peter Hamilton is Director at Insequa Ltd. Email: peterhamilton@insequa.co.uk X: @insequaltd How has your business demonstrated added value to procurement teams? Visit www.caremanagementmatters.co.uk and leave a comment on this article or join the conversation to share your thoughts.

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CMM May 2024

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Reimagining the international social care workforce:

A GLOBAL CHALLENGE

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CMM May 2024

Professor Vic Rayner OBE, Chief Executive Officer at the National Care Forum (NCF), discusses the critical implications of the recent International Social Care Workforce Summit and newly published report, calling for global unity to overcome shared challenges.

The International Social Care Workforce Summit we co-hosted in Glasgow as part of the Global Ageing Conference saw over 100 attendees, representing 14 different countries, come together to discuss the increasingly urgent challenges affecting the care workforce. Those who presented, and those who came to listen and contribute, left in no doubt at all that these challenges are very much a global issue.

The global picture From Australia to South Africa, throughout Europe, and in India and North America, the same experiences and challenges around care sector recruitment and retention were being felt. As were the pressures that the ‘extraction’ of health and care workers from lower- and middle-income countries, tempted away to work in other parts of the world, were exacting on their home nations.

The Summit could not have taken place at a more salient time, as the World Health Organization says we will see one in six people aged over 60 by 2030 and the world’s population of people aged 60 years and older doubling to 2.1 billion by 2050. Added to that, 2024 will see half the world’s population voting in elections. So, we are entering into a period of potential political change which brings with it the crucial opportunity for us to speak up for care and demonstrate just how important this issue is to the millions of people in receipt of daily care and support, their families and communities.

The Summit heard about initiatives in different countries to both promote and sustain a care workforce, and how rapidly population changes in countries such as India were likely to create an unprecedented demand for health and care staff.

The number of older people in India today stands at 138 million, a figure which is projected to rise to 240 million by 2050.

The movement of labour between countries was highlighted, with a recognition of the positive steps to increase migrant workforce, and to enhance recognition of qualifications across countries, whilst at the same time highlighting how industrial level extraction of workers created gaping holes for some countries in their ability to meet local demand for care.

Closer to home Readers of CMM will be very familiar with the situation facing the care workforce in the UK. We know that adult social care in England faces systemic shortages in frontline workforce, and even with the 70,000 or more international workers joining last year, Skills for Care reported 152,000 vacancies in the sector in October.

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REIMAGINING THE INTERNATIONAL SOCIAL CARE WORKFORCE: A GLOBAL CHALLENGE

> This is unsustainable for any sector, never

mind one upon which millions of people rely for care, each and every day.

Tighter migration regulations brought into legislation in the UK in April may ultimately mean that these international workers, who are so crucial to the system working for people, are no longer able or wish to come to the UK. Without those workers, we are going to have to work at pace to encourage and reward the domestic workforce to fill the current vacancies and to ensure the domestic workers are not themselves tempted to go and work in other countries.

We know that much of the answer to securing a strong future domestic workforce lies in enhancing the pay, terms and conditions of those working within care. However, current Government initiatives such as the care workforce pathway may lay out the route for change but, without an accompanying properly funded pay structure, will do little to attract and retain people to progress through the career structure.

Rising to the challenge The international workforce summit culminated in a fascinating report, produced by the National Care Forum in collaboration with the Global Ageing Network, Scottish Care, LeadingAge and UKRI, pulling together the learning from the event into a call to action for governments and policymakers across the globe. Having heard from people from across the world, there was a shared understanding that in order to tackle this crisis, it was vital for decision makers to rapidly shift their views and recognise that this is not just a challenge for individual countries, but one for the whole world.

The very significant growth in demand for high-quality care and support will affect every country. Addressing this in a way that will enable people to get the care that they want where and when they need it requires us to reorientate our thinking. That being, from viewing care through a domestic lens, to one with a very real international focus, and to see those working within the sector as part of a global care workforce.

So, what are the steps that need to be taken to successfully reimagine the global care workforce to ensure it is robust enough to withstand the pressures of global population change while also improving the perception

of care work and the experiences of the professionals who deliver it?

mean that nowhere in the world can afford to lose care staff to other sectors.

Recognise and respect the global care economy

Challenge ageism and transform the global perception of ageing

We now work in a global care economy, with a global care workforce. Understanding this is critical for policy makers in all parts of the world. Efforts to bolster the workforce in one country cannot continue to be at the detriment of the core health and care workforce infrastructure in another country.

Movement of labour and migration are, of course, a reality in all parts of the globe, but the sort of extraction of skilled labour taking place in lower- and middle-income countries will leave nations with rapidly ageing populations vulnerable. Fairness and responsibility must underpin all employers’ approaches to the care workforce.

Finally, it is important to recognise that we all have a responsibility for the journey that the world is on in relation to ageing. People like Claudia Mahler, United Nations Independent Expert on the Enjoyment of all Human Rights

by Older Persons, who spoke at the Global Ageing Conference, think we should come together as a global community to advocate on the Rights of Older Persons and prioritise their rights and voices.

In addition, campaigners from around the world took part in a global rally last month to call for United Nations member states to begin drafting a convention that will recognise and protect older people's rights. Ageism is one of the gaps in current global human rights thinking and is not a priority for key stakeholders on the ground and on an international level. This has very real ramifications for the global workforce, impacting workers’ status and value. Bringing justice to older people will deliver power and recognition to our workforce, highlighting the Summit’s perspective that providing care that transforms the lives of global ageing citizens is a profession to aspire to.

Shortly after the summit, I was privileged to take on the role of Chair of the Global Ageing Network, a position I will hold for two years alongside my leadership of NCF. Workforce is a key area where working at a global level will strongly support our understanding of how to shape a future for care and support that values people who work in this sector, as well as supporting a shared understanding of what high-quality care and support should look like. I look forward to sharing with providers learnings from our international colleagues and would be delighted to talk to anyone interested in finding out more about the work of the Global Ageing Network.

Working together, using the power and influence we have as a sector, we can hopefully envision a future where we collaborate better as a global community with the lives of people in receipt of care, and the dedicated staff who deliver that care, as our focus.

To read and download the International Social Care Workforce Summit report visit the NCF website. CMM

Drive professionalisation of care workers around the world Professional recognition and development of staff must be the response to the understanding of a global care workforce. The current adherence to territorial qualifications and regulations means that even when workers move, their skills and expertise cannot be fully utilised in the country they move to. This creates a situation where their original country loses their contribution, and the country they move to fails to fully use their experience.

Embrace technology and change to develop the future workforce We need to get smarter about using the research and data available to understand both what is important to the workforce, and what is successful in terms of attracting, training and retaining staff. We can also learn from our international colleagues how, with the correct and responsible adoption of AI and other technology, we can get the balance right and adapt care roles to create efficiencies while fully respecting the people we care for.

Right now, we are too busy ‘throwing spaghetti at the wall to see what sticks’ and we need to get smarter – quickly! The demographic changes which will see a rapid increase in the numbers of people needing care and support will also herald a shrinking workforce in many parts of the world. This will

Professor Vic Rayner OBE is Chief Executive Officer at the National Care Forum. X: @NCFCareForum @VicRayner Email: info@nationalcareforum.org.uk What lessons can we learn as a sector from other nations facing similar workforce challenges? Visit www.caremanagementmatters.co.uk and leave a comment on this article or join the conversation to share your thoughts.

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CMM May 2024

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Markel 3rd Sector Care Awards

CELEBRATING EXCELLENCE

The Markel 3rd Sector Care Awards 2024 saw the national social care charity, Community Integrated Care, awarded the Campaigning for Change Award, recognising the second instalment of its groundbreaking Unfair to Care report.

Just days before winning the award, Community Integrated Care continued its journey in calling for change for social care, launching the third edition of the research in Parliament alongside policymakers, sector leaders and people who work in and draw on the sector.

Who Cares Wins: Unfair to Care 2024 presents a juxtaposing message of both crisis and opportunity. Whilst the challenges of recruitment and retention in social care remain, there is a growing consensus across society, the care sector and from policymakers in the case for change. Teresa Exelby, Chief Corporate Services and People Officer at Community Integrated Care, tells CMM more.

The heart of the problem Recruitment and retention in social care is one of the greatest challenges facing society today.

For too long, we’ve faced an irreversible trend of people who have a unique gift for changing lives, leaving the careers that they love.

With 152,000 vacant roles in social care – hundreds of thousands of people are facing inconsistent or unavailable support due to a lack of capacity. 390,000 people left their 42

CMM May 2024

jobs in 2023, with turnover rates remaining stubbornly high at 28.3%.

At the heart of this is the issue of low and unfair pay. Whilst social care roles are skilled, complex, and accountable, requiring rare vocational qualities, funding for providers has meant that support workers’ pay has been consistently below a living wage for years.

This has resulted in a complicated recruitment and retention problem which, to some degree, has a simple cause – why should people do work that demands a lot of them, for less than they deserve? Unfair to Care seeks to shine a light on this current crisis, outlining how we can correct these injustices, stabilise our workforce and reset our health and social care system to unlock greater economic growth and productivity for years to come.

The research In 2021, we sought to explore and strengthen the case for action by shifting the debate from one of moral subjectivity to objective fact. Partnering with Korn Ferry, the world-leading experts in job evaluation, our first edition of Unfair to Care provided the first-ever independent assessment of the

HEADER frontline support worker role and rates of pay. It proved that, far from being low skilled, the role is clearly technically, emotionally and physically demanding.

This analysis also revealed that the role had parity with the NHS Band 3 position, providing evidence that greater stability could be achieved through introducing objective pay bandings within social care and the development of a national workforce strategy.

As we finalised the third instalment of our research in early 2024, the gap between social care workers and their NHS counterparts remained stark. The average care worker takes home £7,617 less, on average, than they would do in the same role within the NHS – a 35.6% pay gap.

The gap is even more stark when compared to everyday commercial roles, which do not mirror the size, complexity and accountability of care work. If we cannot keep pace with our peers, or readily available roles in other sectors, what hope do we have for stability?

Public and political support Social care is an incredibly vocationally rewarding career. I am privileged to work with thousands of people who live their dream of enabling others to live theirs too. But against the joy is despair – people working tirelessly yet still need the support of food banks, friends or family. People on a tightrope of debt or being one ordinary life shock away from personal disaster.

Through public polling with YouGov, we found that 70% of adults in England believe that social care workers should earn the same as their NHS equivalents and that 87% believe that the shortage of care workers is an important issue for society.

The endemic nature of these problems means that the public is aware, engaged, and motivated for change. More than half of the population – 53% – say that they will have a more favourable view of political parties that address the issues of low pay. From our research, we can see that society recognises the need for change.

2024 is, of course, an electoral year. Our

findings not only present the case for fair pay, but also the reality that it can be a determining issue in how the public approaches the ballot box. There is a potential 2.6 million-strong ‘social care vote’, which could have an impact on key marginal constituencies.

Excitingly, we see scope for political change too. As well as polling the general public, we also carried out the first of its kind polling with YouGov, which revealed that the majority of MPs – 77% of the surveyed audience – recognise that the current rate of pay for social care workers is unfair, with 80% believing that the next government should act to improve pay and terms and conditions for social care workers.

The message is clear: who cares wins, and all political parties must act. Improving social care pay is an investment that will deliver the ‘Social Care Triple Win’: better lives for people who deliver and draw on social care, cost-effective and sustainable care and health services and economic growth and productivity.

Support Community Integrated Care in calling for action. To find out more, visit its website.

finally found my calling.

‘So, when only six months in, my landlord went bankrupt and told me he was selling my flat, I couldn’t believe it. I had used up any savings I had when I was out of work, so I had no deposit for a new flat and no one I could stay with. I felt like my life had been turned upside down and my mental health really took a serious knock.

‘My manager suggested I could apply for a grant from the charity’s Wellbeing Fund.

At the time, this felt like my only hope. I couldn’t believe it when my application had been approved, and not only was I getting the deposit for a new home, I was also getting some money to buy basic furnishings too.

‘It’s now three years later and I love my new home and job so much. I’ve built strong relationships with the people I support, in particular, George, who has learning difficulties and complex needs. We have a strong bond and I get so much happiness from seeing him live the best life he can. Sometimes I look back and can’t believe how much things have changed for me in just a few years – the Wellbeing Fund honestly saved my life.’

Why change is needed – Abbie’s story

Teresa Exelby is Chief Corporate Services and People Officer at Community Integrated Care.

Email: unfairtocare@c-i-c.co.uk X: @ComIntCare

Alongside the research and data, Unfair to Care is supported by rich insights from people who co-ordinate, deliver and draw upon the social care sector.

Support worker, Abbie Bowler, was just 24 when the COVID-19 pandemic struck. Her landlord went bankrupt, and she found herself facing homelessness. With no savings to fall back on, she applied for a grant through Community Integrated Care’s Wellbeing Fund – an additional benefit for colleagues to support them through financial difficulty.

‘When the pandemic hit, I was working in hospitality and almost immediately, I was made redundant. I was worried, but I saw it as an opportunity to find something that I was passionate about. That’s when I came across the support worker role. I applied and got the job – I settled in quickly and felt like I had

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CMM May 2024

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EVENT PREVIEW

GROWING A GREENER FUTURE 30th April 2024

Join Care Management Matters (CMM) and The National Care Forum (NCF) for the latest free CMM Insight webinar. This time, on 30th April 2024, the panel will be discussing the pressing topic of environmental sustainability in social care.

As part of a new, exciting programme of free, lunchtime webinars hosted by CMM and the NCF, and designed to give delegates the information they need to successfully navigate the ever-changing social care sector landscape, you are invited to Growing a Greener Future, a webinar that will look at environmental sustainability through the lens of the care provider.

This webinar will explore the current situation from a provider’s perspective, highlighting the drivers for a greener social care sector, such as reducing direct power consumption through energy efficiency, sustainable use of resources, innovative service models and use of smart digital technologies such as artificial intelligence.

Some additional factors that may be discussed at this webinar include the use of alternative building materials and designs to improve energy efficiency and insulation, reducing water waste and improving the use of recycling facilities. Ways to reduce vehicle emissions may also be touched upon, such as remote monitoring of patients, online consultations, remote meetings and cloud-based reporting.

Also discussed will be the sector’s regulatory environment and ways to effect change, led by people’s needs and experiences, and focusing on what’s important to people when they access services.

The webinar will also draw on what we can learn from NHS and local government approaches; for example, looking at training and involvement, attitudes, infrastructure, benefits, credibility of evidence, adaptability and progress monitoring.

The opportunities that are available for future collaboration and the support needed to make a difference across the sector will be explored, as well as the wider view on the future and what is possible in the context of housing and energy, from installing more energy-efficient doors, windows and heating systems to reducing carbon emissions and making homes warmer.

Making sustainability work in practice Other factors to consider when it comes to ensuring sustainability works in practice include being able to motivate the sector’s workforce, using clear evidence to show that these practices are effective. Then, implementing strategies to ensure that best practice becomes embedded into everyday operations and that all staff members are embodying the new methods.

Being more sustainable in the care sector can be approached from many different angles, from digitising reports to save paper to changing the lightbulbs to energy-saving

models, to considering sustainability when making purchases, to completely revamping buildings and including new technologies.

As well as making less of an impact on the environment and helping to meet sustainability targets, going greener should enable providers to save money, increase efficiency and improve outcomes for their service users and staff.

Join us for Growing a Greener Future The Growing a Greener Future webinar is brought to you by CMM and the NCF, who have had a strong relationship for many years, and have come together to deliver a free webinar series to shed light on the changes taking place in the sector and help delegates to gain clarity moving forwards.

To sign up for this informative, free webinar, visit the CMM website to register and secure your spot. Growing a Greener Future starts at 2.30pm and finishes at 4.00pm on 30th April 2024 and anyone working in the sector is welcome to attend.

You can claim CPD points for attending any of the CMM Insight webinars, including this one. To claim your points, simply sign up and attend the session. Following the session, you will receive a follow-up email from a member of our team to request your details for your CPD certificate.

What steps is your business taking to grow a greener future for the sector? Does your business have any environmental targets that it’s working towards or is it taking part in any green initiatives? Sign up for this webinar and share your progress with the expert panel.

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CMM May 2024

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

National Care Association 2024 Conference 9th May 2024, Manchester https://nationalcareassociation.org.uk/news-events

Event: Date/Location: Contact:

Integrated Care Summit 2024 14th May 2024, London www.kingsfund.org.uk/events/integratedcaresummit

Event:

Creativity in Care: A Day of Inspiration and Imagination with ARC England 14th May 2024, Leeds www.eventbrite.co.uk (search ‘ARC England’)

Date/Location: Contact:

A series of lunchtime webinars FREE to attend

S E C U R E Y O U R P L AC E In association with

www.caremanagementmatters.co.uk @CMM_Magazine #CMMInsight

Event: Date/Location: Contact:

An Introduction to Age-friendly Communities 15th May 2024, Online https://ageing-better.org.uk/events/anintroduction-to-age-friendly-communities

Event: Date/Location: Contact:

The Mental Health & Wellbeing Show 17th May 2024, Cardiff https://mhwshow.co.uk

Event: Date/Location: Contact:

ACP 2024: Advancing Continence Priorities 20th-21st May 2024, Liverpool https://acpcontinence.co.uk/conference

Event: Date/Location: Contact:

LaingBuisson Social Care Summit 2024 11th June 2024, London www.laingbuissonevents.com/social-caresummit-2024

CMM EVENTS Event: Date/Location: Contact:

CMM Insight webinar – Growing a Greener Future 30th April 2024, Online 12:00noon - 13:30pm Lisa Werthmann, Director, 01223 207770 lisa.werthmann@carechoices.co.uk www.caremanagementmatters.co.uk/webinar

Please mention CMM when booking your place.

Sign up online to receive discounts to CMM events and for more information on our upcoming events in 2024. www.caremanagementmatters.co.uk @CMM_Magazine #CMMInsight

CMM May 2024

45

STRAIGHT TALK Jo Guy, Founder and Chief Executive Officer at social care recruitment specialists, AJ Recruitment, discusses proven strategies to generate candidates in challenging markets.

The sector faces several recruitment challenges.

From experience, we know that combining active and passive recruitment methods can be effective. By leveraging both methods, organisations can cast a wider net to attract a diverse pool of candidates.

Active methods Social media is a powerful tool for increasing brand awareness and reaching out to a large audience. Organisations should have an active social media presence and use it to showcase vacancies, company culture and employee success stories.

Targeted advertising on LinkedIn, Facebook and Twitter can help you reach specific demographics relevant to your recruitment needs. You can tailor campaigns to attract candidates with the skills and experience you're seeking, even if they're not actively job seeking.

Social media also allows you to reach out to candidates directly through private messaging.

Messages that express genuine interest in the candidate's background and skills can help start a conversation and establish a rapport that may lead to further discussions.

Posting adverts on industry-specific job boards and websites can help attract candidates who are actively seeking employment. By leveraging online job boards effectively, you can reach a wide pool of candidates.

Your adverts must be clear, detailed, engaging and accurately describe the role, responsibilities and requirements. To attract suitable candidates, adverts should highlight the unique aspects of your organisation, such as its mission, values and workplace culture.

Keep your adverts fresh and relevant by regularly reviewing and updating them.

Monitor their performance, track applicant response rates and make adjustments as needed to maximise your recruitment efforts.

A lot of online job boards offer paid advertising. This allows your advert to receive priority placement in search results and job alerts, increasing their visibility. This ensures that your adverts are seen by a larger pool of candidates, including those who may not actively search for jobs.

Attending industry-specific networking events, conferences or seminars can be a great way to generate and connect with candidates.

These events allow you to engage with people who are already active in the field. Participating in career fairs hosted by universities, colleges or community organisations is also a great way to meet candidates.

Encouraging current employees to refer candidates can be an effective way to attract talent. Organisations can incentivise employees to refer their friends and fill vacancies. Referrals are extremely cost effective and allow you to action recommendations from your employees.

The employee referral app, Care Friends, in partnership with Skills for Care, has revealed that staff who have been referred by current employees stay for longer, and referrals see a 50% less year one attrition than the sector average. Industry norms show that employees typically refer 5% of job applicants when schemes are not promoted, yet this can rise to over 40% when this is really driven hard in organisations.

Passive methods Online CV databases such as Indeed, Glassdoor and ZipRecruiter allow you to connect with potential candidates who are not actively job seeking but may be open to new opportunities if presented with the right offer. You can search for, and filter candidates based on specific criteria, such as skills, experience and location.

Sending personalised emails to individuals who have been identified as potential

candidates involves crafting compelling messages that highlight your organisation's mission, values and the specific reasons why the recipient would be a good fit for the role.

Reach out to passive candidates in your database who may not be actively looking for job opportunities but have expressed interest in your organisation in the past. Personalise your outreach messages to rekindle their interest and encourage them to consider new opportunities within your organisation.

Having a strong company brand can also reduce staff turnover by up to 28%.

This is because candidates have a better understanding of what they’re getting into, what’s expected of them and what their life at that company will be like. Modern job seekers are looking for brands with a positive social impact and purpose.

This is why reviews are so important for your employer brand. These can be reposted onto your social media, to ensure anyone who searches your organisation can start to build trust with you.

Company reviews help jobseekers make informed decisions about whether to apply for a job at a particular company. Reviews are instrumental in educating jobseekers who are looking to start a new career or catch a glimpse into the day-to-day experience working for a given employer.

Establishing your organisation as a thought leader can attract candidates who may not even be actively looking. Passive candidates may be drawn to organisations that demonstrate expertise and innovation in the field. This can be achieved by sharing valuable content, such as blog posts, whitepapers and case studies, that address industry challenges and trends.

By utilising these methods, we are confident that the sector can address its recruitment challenges and attract candidates to fill vacancies.

Jo Guy is Founder and Chief Executive Officer at social care recruitment specialists, AJ Recruitment. Email: joguy@ajrecruitment.com X: @AJ_Recruitment 46

CMM May 2024

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