Care England - Is It Essential To Focus On Sustainability

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Service provided by: Care England

Is it essential to focus on

Social care providers must take action and gather the evidence to become environmentally sustainable, but what do we mean by sustainability in social care? Jonathan Freeman, Group Sustainability Director at CareTech Ltd and Chair of the Social Care Sustainability Alliance, outlines the key areas to help you on your journey to becoming Environmental, Social and Governance (ESG) compliant.

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Care England

The new Adult Social Care Single Assessment Framework introduces the new ‘Environmental sustainability – sustainable development’ criteria to the CQC inspection regime. This puts environmental sustainability at the heart of what it means to provide a social care service the public can trust. Providers will have to be able to show and evidence that ‘we understand

any negative impact of our activities on the environment, and we strive to make a positive contribution in reducing it and support people to do the same.’

More generally, internal and external stakeholders are becoming more and more focused on the approach taken by providers to achieve net zero carbon and climate resilience.

Increasingly, commissioners are asking providers to demonstrate their sustainability credentials in tender exercises, with more demanding asks of providers and with this element becoming far more important in tender evaluations. We only need to look to the NHS to see what is likely to happen to the social care sector on this issue; the new NHS contractual requirements for healthcare providers now place very clear contractual obligations on providers around carbon reporting.

Sustainability and ESG are not a fad, nor a tick-box exercise. All the evidence points to sustainable businesses being, quite simply, better businesses.

Why and where to start on your sustainability journey?

‘We are on a highway to climate hell with our foot on the accelerator …. [We are in the] fight of our lives and we are losing.’ So said United Nations Secretary-General Antonio Guterres at the COP27 meeting on climate change. In July 2023, leading climate change experts set out in the starkest terms yet their shared concern that action to date to limit global temperature rises to 1.5˚C is falling woefully short of what is required.

Unless decisive and significant action is taken, this is only going to get worse – much worse.

Everyone working in social care is in the same fight. We have as much responsibility as anyone – arguably more so than many – to address the challenges of sustainability.

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Care England

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→ What is sustainability?

Sustainability is about creating the conditions for businesses and organisations to thrive but doing so within the parameters of what the world’s natural resources can support.

Sustainability is about taking action today to protect the long-term future of our planet, our communities and our people. Or, as the United Nations Brundtland Commission better defined it: ‘Meeting the needs of the present without compromising the ability of future generations to meet their own needs.’

What is sustainability in social care?

The challenges of sustainability apply as much to the social care sector as any other sector, as the following three examples show: • Climate change. Mounting pressures driving global warming are increasing the costs to deliver high-quality social care, notably rising energy and fuel costs. The sector is characterised by an ageing property stock and high vehicle dependence. Historic underinvestment and old-fashioned regulators have led to a heavily paper-based system with little investment in technological innovation.

• Population growth. Global population growth is placing an increasing strain on health and social care demand. In the UK this is exacerbated by an ageing population, which is significantly increasing demand for elderly care social care services, particularly for specialist care. The growing number of individuals with increasingly complex care needs is heightening the need for greater and more sophisticated provision.

• Growing inequalities. Increasing demand for social care is outstripping the public sector’s capacity to provide adequate funding through current funding mechanisms, leading to unmet need and individuals having to self-fund more elements for their care with a disproportionate impact on the poorest.

‘Postcode lottery’ inequalities of social care provision and increasingly inappropriate distinctions between the availability of public support for different health conditions are fuelling new inequalities.

As a sector, we face enormous challenges.

The economic situation is further squeezing commissioners’ budgets; inflation is driving up core costs; recruitment and retention continue to be key challenges; regulators’ expectations can be inconsistent; and there are increasing calls to curb private operators’ profits and, indeed, nationalise the sector.

Care England

Some might be tempted, given these pressures, to pull back on investment in sustainability initiatives. However, I believe that this would be a huge mistake – both morally and commercially.

Legislative, regulatory and commissioner pressure It is becoming increasingly clear that the pressure to deliver on sustainability will result in all businesses and organisations having to comply with new requirements. In order for governments to meet international and/or national targets, many climate-related requirements will become mandatory in due course. Those organisations getting ahead of the game and dealing with these incoming requirements in a managed way are most likely to be able to adapt to this new landscape.

Properties The Government estimates that the average residential property contributes six tonnes of carbon every year. There are some 14,500 care homes in England, providing a home to around 425,000 people; 70% of these are residential settings. So, that would suggest that care homes are contributing around 87,000 tonnes of carbon every year. The UK’s first carbon-neutral care home – Luxurycare Group’s Eagles Mount care home in Poole – calculated that its annual carbon impact amounted to 163 tonnes per year! If this figure were replicated for all care homes, we would be looking at an annual total carbon impact of the UK’s residential care homes of more like 2.8 million tonnes.

Despite recent policy changes, the long-term push to ensure that properties achieve a minimum Energy Performance Certificate (EPC) rating of C in the short term, and B in the longer term, remains. An estimated 60% of residential care homes will need to improve their energy efficiency by at least one EPC level over the next few years. Each EPC grade climb represents around a 30–40% reduction in CO2e emissions per year. So, bringing all residential care homes up to an EPC C rating could deliver as much as a reduction of over 500,000 tonnes of carbon!

According to the National Care Forum, all care homes that are privately rented or bought and sold should have secured an EPC that is rated band E or less before 1st April 2023 and there are plans to significantly reduce this band rating for 2030.

Energy costs 60% of social care providers cite utility bills as a key cost pressure, with some providers reporting 500% increases in energy costs over the last 18 months. We cannot continue to power our estates using fossil fuels, which contribute to global warming and air pollution. The cost-benefit analysis of reducing our energy usage is equally clear, with the recouping of the initial investment for improved energy efficiency and more renewable energy sources such as solar PV panels becoming ever shorter.

The most common energy efficiency improvements you can make require relatively modest investment. Things like low-impact lighting, draught-proofing, improved insulation, replacement windows and better heating controls. Modest improvements could include just adding some draught excluders, turning lights out in empty rooms and other small but

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important changes. More expensive – but often of much greater impact – improvements such as installing solar power and heat pumps are becoming increasingly common. In view of energy costs that have spiralled and are unlikely to be reduced any time soon, the case for these investments has never been greater.

their local communities will attract more local talent. These employers are less likely to trigger concerns about having a care service in the community and will help to promote a more positive view of the social care sector.

Vehicles

Consumer demand

The Homecare Association recently suggested that UK homecare workers travel more than four million miles per day; that equates to 423,000 metric tonnes of carbon emitted each year! You would have to plant almost 2.8 million trees every year to offset the impact on the environment of car miles in social care. Also, that figure doesn’t include the impact of the hundreds of thousands of care professionals commuting to work every day by car.

In December 2022, a third of all new cars sold in the UK were electric vehicles (EVs) – a staggering increase from just three years earlier when the equivalent figure was less than 2%. The upfront costs of EVs are still higher than combustion engine equivalents but when you look at the whole-life costs, however, the latest research shows that EVs are now slightly cheaper to run than their petrol equivalents.

There are some great examples of social care providers already seizing the initiative, such as Northern Ireland’s domiciliary care provider Connected Health, which has introduced a fleet of electric cars and electric bicycles. This introduction is part of its Carbon Neutral Care Initiative.

Taking advantage of new EV salary sacrifice schemes can be a really useful part of your benefits package. At no cost to the organisation (in fact, most will actually save money) providers can offer their staff access to EV-leased cars that, thanks to their tax efficiency, can instantly make EV ownership a reality for many staff. Most of us lease our cars these days, so why not provide your staff with this option to get an EV car, which can help to reduce their fuel bills significantly as well as their carbon impact?

The business case for sustainability often focuses on reducing operating costs, but we should also not overlook the changing expectations and pressures of consumers.

Consumers increasingly demand that the products and services they purchase are ever more sustainable, that they want to select organisations that are ethically driven and that the services they purchase must support their own increasingly sustainable daily routines.

There is absolutely no reason why this should be any different for people choosing their social care providers. Therefore, to remain competitive, social care providers must not only adopt environmentally sustainable practices but also ensure that they communicate this to their potential customers.

The recent launch of Autumna’s Go Green initiative demonstrates the increasing sustainability demands of social care consumers. As Autumna’s press release states, ‘Go Green will give care providers the ability to showcase all of their sustainability and green projects to increasingly environmentally conscious care seekers.’

Staff recruitment and retention Most talk about ESG and sustainability focuses on the environmental elements – the ‘E’ of ESG. As a highly regulated sector, most care providers are also very good at the ‘G’ – Governance – of ESG. The ‘S’ in ESG, however, is often overlooked but is critical to the social care sector. Social care delivers a huge benefit to society but just being a social care provider doesn’t mean that you automatically tick the ‘S’ box.

The key elements of the social element of ESG are how organisations look after their people and how they support the local communities. Research makes it very clear that companies that support and empower their people, and are active parts of their local communities, do better. Staff are more loyal, more productive and deliver higher quality. For example, BUPA’s Wellbeing Index 2023 report revealed that 48% of Gen Z workers surveyed agree that they would be willing to consider leaving their jobs if their employer doesn’t demonstrate action on social and environmental issues.

Organisations that are visibly connecting with and supporting

Shifting perspective Delivering on key sustainability issues can address short-term pressures as much as long-term challenges, but it does require a shift in perspective, considering the longer term, whole-life and full costs and benefits. Effective leaders understand that their role is about striking a balance between short-term needs and long-term vision, ensuring their decisions contribute to the long-term sustainable success and growth of their organisations. It’s also about recognising that all of us have a wider set of responsibilities for which we are accountable beyond our own organisations.

Hopefully, this article has encouraged you to accelerate your own sustainability journey.

If you would like to learn more and share your experiences with others in the sector, please get in touch about the Social Care Sustainability Alliance that brings providers from right across social care together to help each other on this vital agenda.

Jonathan Freeman MBE is the Group Sustainability Director at CareTech Ltd and Chair of the Social Care Sustainability Alliance. Email: jonathan.freeman@caretech-uk.com @CareTechFdn 36

Care England

Helping providers to manage and review services Richard Ayres, Social Care Advisor at Care England, tells us more about the SMART offering from Care England and how it aims to help providers navigate the new CQC inspection framework, manage Environmental, Social and Governance (ESG) requirements, source money-saving opportunities and simplify service administration.

With care providers now required to provide information to the CQC to prepare in advance of the inspection, SMART is a Strategic Management Audit Repository Tool that acts as a support for the management and regular review of care services. This is at a time when money, time and resources are stretched to their limits and are designed to be a single-entry point to solve many of the care provider's problems without charge.

CQC inspections

Structured using the CQC’s new Single Assessment Framework (2023), SMART Quality allows providers to store, report and record evidence against the new CQC quality statements. SMART Quality features every key question and quality statement from the CQC’s new assessment framework embedded into the tool, with links to the regulations, ensuring information is all in one place.

Each quality statement contains suggestions for how adherence to the regulation can be evidenced, with the option for providers to add their own custom review element. Providers can also note if any further action is required, with notifications to ensure nothing is missed.

The module also connects to the most recent and historic CQC reports, displaying home ratings under each quality statement since 2016.

SMART Quality allows providers to be ready no matter when the regulator comes calling.

Sustainability

Local authorities and NHS bodies now compare and score care providers on their ESG performance. This means the ability to provide evidence and report on ESG has never been more critical.

An ESG strategy can lead to reduced costs and, whether you are just starting out or progressing your ESG journey, SMART ESG enables providers to report and manage their environmental footprint, social policies and organisational governance, thereby increasing their chances of securing local authority and NHS contracts.

SMART ESG includes over 150 areas to consider when thinking about ESG and provides a repository to collect and record information to evidence the work towards improving your organisation's ESG strategies and requirements.

Care England

Manager and Nominated Individual performance

SMART HR allows recruiters to review the past performance of regulated managers and Nominated Individuals against CQC quality data since 2016, helping to understand how they may have impacted on the quality ratings of services under their control.

Market Intelligence

SMART gives providers access to a subscription-based Market Intelligence Tool (MINT) exhibiting pertinent fee, financial and general data across both the older person, learning disability and supported living providers.

Key data is collated from a wide variety of stakeholders and sources, and is ever-expanding and constantly evolving to ensure a consolidation of all data that providers need in their arsenal to correspond with local authorities and the NHS. MINT data has helped its users to significantly enhance the financial performance of their care services.

Procurement

In a challenging economic environment, SMART Procurement signposts to money-saving deals and innovative solutions that can help reduce the cost of care by up to £60 per resident/service user per week from an average local authority fee of £750 per week, equivalent to an 8% fee uplift.

Surveys

SMART Surveys allows providers to create and disseminate surveys to service users, professionals, friends and family to feed back on service quality and performance in line with the new CQC ‘I’ statements.

Administration

SMART Administration is a simple solution to record key service user information and non-care-related documents in a quick, retrievable system with prompts and reminders, from administration and managing appointments to financial management, legal and contractual paperwork, avoiding the need to maintain paper-based records of non-care-related information.

SMART is a free-to-use tool available to all regulated and non-regulated services nationally. To discuss or access SMART, to review further information and/or to attend a webinar and/or book a demonstration, visit the Care England website.

Richard Ayres is a Social Care Advisor at Care England. Email: rayres@careengland.org.uk @CareEngland 37